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Sample records for pedicle axis view

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. Broadband quantitative phase microscopy with extended field of view using off-axis interferometric multiplexing.

    PubMed

    Girshovitz, Pinhas; Frenklach, Irena; Shaked, Natan T

    2015-11-01

    We propose a new portable imaging configuration that can double the field of view (FOV) of existing off-axis interferometric imaging setups, including broadband off-axis interferometers. This configuration is attached at the output port of the off-axis interferometer and optically creates a multiplexed interferogram on the digital camera, which is composed of two off-axis interferograms with straight fringes at orthogonal directions. Each of these interferograms contains a different FOV of the imaged sample. Due to the separation of these two FOVs in the spatial-frequency domain, they can be fully reconstructed separately, while obtaining two complex wavefronts from the sample at once. Since the optically multiplexed off-axis interferogram is recorded by the camera in a single exposure, fast dynamics can be recorded with a doubled imaging area. We used this technique for quantitative phase microscopy of biological samples with extended FOV. We demonstrate attaching the proposed module to a diffractive phase microscopy interferometer, illuminated by a broadband light source. The biological samples used for the experimental demonstrations include microscopic diatom shells, cancer cells, and flowing blood cells. PMID:26440914

  8. Off-axis photopolymer holographic elements for large-field-of-view visor-projected displays

    NASA Astrophysics Data System (ADS)

    Sergeant, Shirley A.; Hurst, Andrew E.

    1995-03-01

    A number of helmet mounted displays have been designed in recent years. The majority of these designs have been dismissed on the grounds of safety when considering the optical configuration. The principle of the design discussed in this paper is that of a display projected using the visor, where it acts not only as the display visor but also provides windblast, laser, and nuclear flash, protection. The display is projected by means of a holographic combining element on the visor. This paper addresses the design and manufacture of the holographic components employed, discussing the use of DuPont photopolymer material for this application. Off-axis holograms configured around the geometry of the head/helmet, give a wide field of view, with good eye relief. Well defined reflective and transmissive properties of the hologram are required to give full system compatibility. The resultant system does not compromise the safety of the user, whilst maintaining a fully integrated man/machine interface, i.e. low mass, and manageable center of gravity.

  9. Ancient views on the hypothalamic-pituitary-thyroid axis: an historical and epistemological perspective.

    PubMed

    Toni, R

    2000-10-01

    The modern views on the anatomical and physiological interactions between the hypothalamus, pituitary and thyroid gland have emerged only in the last fifty years, although their historical roots may be found in a number of ancient and still not widely known ideas and observations. The regulation of energy body stores and temperature by the hypothalamic-pituitary-thyroid axis, for example, is a classical case of "fixitè du mileu interieur" in the sense originally suggested by Claude Bernard in the late 1800s, i.e. a homeostatic mechanism, but already 2100 year previously Aristotle had stated that the brain was necessary for the maintenance of body integrity by regulating food intake and behavior in relation to body temperature, the latter primarily determined by the heat of the blood. Five hundred years later Galen of Pergamon reported fundamental discoveries in the anatomy of the third ventricle region, including the location of the pituitary gland inside the sella turcica embodied in a vascular network, the rete mirabilis, and observed nerves adjoining the "soft flesh" in the neck, i.e. the thyroid gland. He first proposed that the energy of the body (the vital spirit) was carried through the arteries at the level of the rete mirabilis, where it was transformed into nerve impulse (the animal spirit), eventually transferred by the nerves to the periphery of the body, "glands" included, raising implicitly the possibility for a nervous influence over the thyroid activity. The Galenic model remained virtually unaltered up to the beginning of the 14th century, when the mediaeval anatomist Mondino de' Liuzzi put forth the idea that the thyroid gland interacted with the heat of the blood present in the internal carotid arteries due to their anatomical relation with the thyroid. This interaction enriched the vital spirit, i.e. the energy of the body, prior to its transformation into animal spirit, i.e. to nerve impulse directed to the periphery of the body. In addition

  10. Cervical pedicle morphometry in a Latin American population

    PubMed Central

    Herrero, Carlos Fernando; Luis do Nascimento, Anderson; Maranho, Daniel Augusto Carvalho; Ferreira-Filho, Narcélio Mendes; Nogueira, Carolina Pinto; Nogueira-Barbosa, Marcello Henrique; Defino, Helton Luis Aparecido

    2016-01-01

    Abstract The goal of this study was to conduct a detailed computed tomography (CT) assessment in the Brazilian population of the screw starting point, trajectory, and dimensions of pedicle in the cervical spine. Two hundred consecutive patients were retrospectively evaluated using cervical spine CT, with imaging reconstruction of each cervical vertebrae in the axial plane with 2 mm, and in sagittal reconstructions with 3 mm. Parameters in axial plane included the pedicle width (PW), pedicle axis length (PAL), pedicle transverse angle (PTA), and the distance from the entry point to the point between the lamina and spinous process (DEP). Measurements in the sagittal plane involved the pedicle height (PH) and the pedicle sagittal angle (PSA). The mean PW and PH were smaller in females than in males in all cervical vertebrae, but there were no significant differences of PTA among genders. PSA ranged from 15.2° to 23.7°. Mean values of PAL and DEP had a tendency to decrease from the proximal to distal cervical vertebrae. PW was <4 mm in 7.5% of men (C3) and 25% of women (C3), and <4.5 mm in 20% (C3 male) and 66% (C3 female). The intra- and inter-observer reliability were very good for the tomographic measurement of PW, and good for PH. For PAL, the intraobserver reliability was good, but the interobserver reliability varied from moderate to good. Considering PTA and PSA, the intraobserver reliability was good, but the interobserver reliability moderate for PTA and poor or fair for PSA. DEP measurements showed poor intraobserver reliability, and poor or moderate interobserver reliability. Our results presented similar trend of previous studies, but the frequency of patients with PW <4.5 mm in our population is higher, suggesting an increased risk during the attempting of transpedicular screw technique. PMID:27336889

  11. 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.

  12. Ancient views on the hypothalamic-pituitary-thyroid axis: an historical and epistemological perspective.

    PubMed

    Toni, R

    2000-10-01

    The modern views on the anatomical and physiological interactions between the hypothalamus, pituitary and thyroid gland have emerged only in the last fifty years, although their historical roots may be found in a number of ancient and still not widely known ideas and observations. The regulation of energy body stores and temperature by the hypothalamic-pituitary-thyroid axis, for example, is a classical case of "fixitè du mileu interieur" in the sense originally suggested by Claude Bernard in the late 1800s, i.e. a homeostatic mechanism, but already 2100 year previously Aristotle had stated that the brain was necessary for the maintenance of body integrity by regulating food intake and behavior in relation to body temperature, the latter primarily determined by the heat of the blood. Five hundred years later Galen of Pergamon reported fundamental discoveries in the anatomy of the third ventricle region, including the location of the pituitary gland inside the sella turcica embodied in a vascular network, the rete mirabilis, and observed nerves adjoining the "soft flesh" in the neck, i.e. the thyroid gland. He first proposed that the energy of the body (the vital spirit) was carried through the arteries at the level of the rete mirabilis, where it was transformed into nerve impulse (the animal spirit), eventually transferred by the nerves to the periphery of the body, "glands" included, raising implicitly the possibility for a nervous influence over the thyroid activity. The Galenic model remained virtually unaltered up to the beginning of the 14th century, when the mediaeval anatomist Mondino de' Liuzzi put forth the idea that the thyroid gland interacted with the heat of the blood present in the internal carotid arteries due to their anatomical relation with the thyroid. This interaction enriched the vital spirit, i.e. the energy of the body, prior to its transformation into animal spirit, i.e. to nerve impulse directed to the periphery of the body. In addition

  13. 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.

  14. Pedicle streaking: A novel and simple aid in pedicle positioning in free tissue transfer

    PubMed Central

    Aggarwal, Aditya; Singh, Hardeep; Mahendru, Sanjay; Brajesh, Vimalendu; Singh, Sukhdeep; Khare, Ashish; Kothari, Umang; Khazanchi, Rakesh Kumar

    2015-01-01

    Introduction: The pedicle positioning in free tissue transfer is critical to its success. Long thin pedicles are especially prone to this complication where even a slight twist in the perforator can result in flap loss. Pedicles passing through the long tunnels are similarly at risk. Streaking the pedicle with methylene blue is a simple and safe method which increases the safety of free tissue transfer. Materials and Methods: Once the flap is islanded on the pedicle and the vascularity of the flap is confirmed, the pedicle is streaked with methylene blue dye at a distance of 6-7 mm. The streaking starts from the origin of the vessels and continued distally on to the under surface of flap to mark the complete course of the pedicle in alignment. The presence of streaking in some parts and not in rest indicates twist in the pedicle. Observation and Results: Four hundred and sixty five free flaps have been done at our centre in the last 5 years. The overall success rate of free flaps is 95.3% (22 free flap failures). There has not been a single case of pedicle twist leading to flap congestion and failure. Conclusion: This simple and novel method is very reliable for pedicle positioning avoiding any twist necessary for successful free tissue transfer. PMID:26933280

  15. Pedicle screw-based posterior dynamic stabilizers for degenerative spine: in vitro biomechanical testing and clinical outcomes.

    PubMed

    Chamoli, Uphar; Diwan, Ashish D; Tsafnat, Naomi

    2014-09-01

    Dynamic stabilization in a degenerate symptomatic spine may be advantageous compared with conventional fusion procedures, as it helps preserve motion and minimizes redistribution of loads at instrumented and adjacent segments. This article presents a systematic review of biomechanical and clinical evidence available on some of the pedicle screw based posterior dynamic stabilization (PDS) devices. Using Medline, Embase, and Scopus online databases, we identified four pedicle-screw-PDS devices for which both, biomechanical testing and clinical follow-up data are available: Graf artificial ligaments, Isobar TTL, Polyetheretherketone rods, and Dynesys. The current state-of-the-art of pedicle-screw-PDS devices is far from achieving its desired biomechanical efficacy, which has resulted in a weak support for the posited clinical benefits. Although pedicle-screw-PDS devices are useful in salvaging a moderately degenerate functionally suboptimal disc, for severe disc degeneration cases fusion is still the preferred choice. We conclude that a pedicle-screw-PDS device should aim at restoring load sharing amongst spinal elements while preserving the qualitative and quantitative nature of spinal motion, especially minimize posterior shift of the helical axis of motion. More precise and objective assessment techniques need to be standardized for in vivo evaluation of intervertebral motion and load sharing amongst spinal elements across different pedicle-screw-PDS devices.

  16. 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. PMID:26922675

  17. Pedicle screw placement with O-arm and stealth navigation.

    PubMed

    Patil, Suresh; Lindley, Emily M; Burger, Evalina L; Yoshihara, Hiroyuki; Patel, Vikas V

    2012-01-16

    Various navigation systems are available to aid pedicle screw placement. The O-arm replaces the need for fluoroscopy and generates a 3-dimensional volumetric dataset that can be viewed as transverse, coronal, and sagittal images of the spine, similar to computed tomography (CT) scanning. The dataset can be downloaded to the Stealth system (Medtronic Navigation, Louisville, Colorado) for real-time intraoperative navigation.The main objectives of the current study were to assess (1) accuracy of pedicle screw placement using the O-arm/Stealth system, and (2) time for draping, positioning of the O-arm, and screw placement. Of 188 screws (25 patients), 116 had adequate images for analysis. The average time for O-arm draping was 3.5 minutes. Initial O-arm positioning was 6.1 minutes, and final positioning was 4.9 minutes. Mean time for screw placement, including O-arm draping and positioning and array attachment, was 8.1 minutes per screw. Mean time for screw placement alone was 5.9 minutes per screw. Screw placements on final O-arm images were on average 3.14 mm deeper than on the snapshot navigation images. Three screws (2.6%) breached the medial cortex, and 3 screws (2.6%) were misaligned and did not follow the pilot hole trajectory.The use of the O-arm/Stealth system was associated with a low rate of pedicle screw misalignment. The time to place screws was less than previously reported with CT navigation, but longer than conventional techniques. It is important to be aware of the potential discrepancy between snapshot navigation images and actual screw placement on final O-arm images. Our findings suggest that final screw positions may be deeper than awl positions appear on navigation images.

  18. Pedicle Screw Fixation Study in Immature Porcine Spines to Improve Pullout Resistance during Animal Testing.

    PubMed

    Le Cann, Sophie; Cachon, Thibaut; Viguier, Eric; Miladi, Lotfi; Odent, Thierry; Rossi, Jean-Marie; Chabrand, Patrick

    2015-01-01

    The porcine model is frequently used during development and validation of new spinal devices, because of its likeness to the human spine. These spinal devices are frequently composed of pedicle screws with a reputation for stable fixation but which can suffer pullouts during preclinical implantation on young animals, leading to high morbidity. With a view to identifying the best choices to optimize pedicle screw fixation in the porcine model, this study evaluates ex vivo the impact of weight (age) of the animal, the level of the vertebrae (lumbar or thoracic) and the type of screw anchorage (mono- or bi-cortical) on pedicle screw pullouts. Among the 80 pig vertebrae (90- and 140-day-old) tested in this study, the average screw pullout forces ranged between 419.9N and 1341.2N. In addition, statistical differences were found between test groups, pointing out the influence of the three parameters stated above. We found that the the more caudally the screws are positioned (lumbar level), the greater their pullout resistance is, moreover, screw stability increases with the age, and finally, the screws implanted with a mono-cortical anchorage sustained lower pullout forces than those implanted with a bi-cortical anchorage. We conclude that the best anchorage can be obtained with older animals, using a lumbar fixation and long screws traversing the vertebra and inducing bi-cortical anchorage. In very young animals, pedicle screw fixations need to be bi-cortical and more numerous to prevent pullout.

  19. 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.

  20. 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. PMID:15919986

  1. Pedicle screw piercer with warning device - A technique to increase accuracy of pedicle screw placement

    PubMed Central

    Bin, Lin; Yong, He; Yang, Xu; Bi, Zhang; Mo, Sha; Zhi-Min, Guo

    2014-01-01

    Background: Pedicle screw fixation has achieved significant popularity amongst spinal surgeons for both single and multilevel spinal fusion. Suboptimal placements of pedicle screws may lead to neurological and vascular complications. There have been many advances in techniques available for navigating through the pedicle; however, these techniques are not without drawbacks. The purpose of this study was to investigate the efficacy and feasibility of the pedicle piercer with warning device. Materials and Methods: Eight normal adult thoracolumbar specimens from cadavers consisting of 80 vertebras (T8–L5) were selected and randomly allocated into four groups. Each group contained 20 vertebra. Group 1 was tested for maximum pressure of the piercer within the vertebrae (F1). Group 2 was tested for maximum pressure of the warning piercer penetrating front cortex of the vertebral body (F2). Group 3 was tested for the maximum pressure of piercer penetrating vertebral body endplate (F3) and pedicle notch (F41, F42). Group 4 was tested for maximum pressure of the piercer penetrating the vertebral lateral cortex (F6), the medial and lateral cortex of pedicle (F51, F52). In the second experiment of this study, 4 normal adult specimens consisting of 40 vertebra and 80 pedicles were used for testing the alarm effects of pedicle piercer. The following indicators were adopted for the tests including true positive/negative, false positive/negative, sensitivity, specificity, availability, Youden index, and diagnostic efficiency. SPSS 16.0 was used for statistical analysis. Results: There were statistically significant differences between F1, and F2, F3, F41, F42, F51, F52 respectively (P < 0.05). F1 = 8.970 ± 0.2698, F3 = 13.055 ± 0.6718. We found that the threshold value of piercer warning was from 9.6 to 12.3 Kgf. Sensitivity was 92.31%, specificity was 95.12%, usability was 87.45%, Youden index was 87.43% and diagnostic efficiency was 92.5% respectively. Conclusion: Warning

  2. The mechanisms of medial pedicle wall violation: insertion method is as important as correct cannulation of the pedicle.

    PubMed

    Isik, Cengiz; Kose, Kamil Cagri; Inanmaz, Mustafa Erkan; Tagil, Suleyman Murat; Sarman, Hakan

    2014-01-01

    A cadaver study aims to determine the mechanisms of medial pedicle wall violation after a correct cannulation of the pedicle. The study presents finding out the effect of insertion angle and insertion force on medial wall violation. We used 100 lumbar pedicles of cadavers. Special wooden blocks were produced to simulate a fixed angle fault after a correct pedicle cannulation. Pedicles were divided into 4 groups: 10-degree free drive (group 10), 15-degree free drive (group 15), 10-degree push drive (group 10P), and 15-degree push drive (group 15P). After insertion of pedicle screws, laminectomies were done and the pedicles were evaluated from the inside. Pedicle complications were more in group 10P than group 10 (P = 0.009). Medial wall fracture (P = 0.002) and canal penetration were more in group 15P than group 15 (P = 0.001). Groups 10P and 15P were similar regarding medial wall fractures but canal penetration was significantly higher in group 15P (P = 0.001). Medial wall breaches can happen after correct cannulation of pedicles. Change in insertion angle is one factor but the most important factor is the use of a pushing force while inserting a screw. The pedicle seems to be extremely tolerant to insertion angulation mistakes up to 10 degrees and tends to lead the screw into the correct path spontaneously. PMID:25400951

  3. The Mechanisms of Medial Pedicle Wall Violation: Insertion Method Is as Important as Correct Cannulation of the Pedicle

    PubMed Central

    Isik, Cengiz; Kose, Kamil Cagri; Inanmaz, Mustafa Erkan; Tagil, Suleyman Murat; Sarman, Hakan

    2014-01-01

    A cadaver study aims to determine the mechanisms of medial pedicle wall violation after a correct cannulation of the pedicle. The study presents finding out the effect of insertion angle and insertion force on medial wall violation. We used 100 lumbar pedicles of cadavers. Special wooden blocks were produced to simulate a fixed angle fault after a correct pedicle cannulation. Pedicles were divided into 4 groups: 10-degree free drive (group 10), 15-degree free drive (group 15), 10-degree push drive (group 10P), and 15-degree push drive (group 15P). After insertion of pedicle screws, laminectomies were done and the pedicles were evaluated from the inside. Pedicle complications were more in group 10P than group 10 (P = 0.009). Medial wall fracture (P = 0.002) and canal penetration were more in group 15P than group 15 (P = 0.001). Groups 10P and 15P were similar regarding medial wall fractures but canal penetration was significantly higher in group 15P (P = 0.001). Medial wall breaches can happen after correct cannulation of pedicles. Change in insertion angle is one factor but the most important factor is the use of a pushing force while inserting a screw. The pedicle seems to be extremely tolerant to insertion angulation mistakes up to 10 degrees and tends to lead the screw into the correct path spontaneously. PMID:25400951

  4. Cement leakage in pedicle screw augmentation: a prospective analysis of 98 patients and 474 augmented pedicle screws.

    PubMed

    Mueller, Jan U; Baldauf, Joerg; Marx, Sascha; Kirsch, Michael; Schroeder, Henry W S; Pillich, Dirk T

    2016-07-01

    OBJECTIVE Loosening and pullout of pedicle screws are well-known problems in pedicle screw fixation surgery. Augmentation of pedicle screws with bone cement, first described as early as 1975, increases the pedicle-screw interface and pullout force in osteoporotic vertebrae. The aim of the present study was to identify cement leakage and pulmonary embolism rates in a large prospective single-center series of pedicle screw augmentations. METHODS All patients who underwent cement-augmented pedicle screw placement between May 2006 and October 2010 at the authors' institution were included in this prospective cohort study. Perivertebral cement leakage and pulmonary cement embolism were evaluated with a CT scan of the area of operation and with a radiograph of the chest, respectively. RESULTS A total of 98 patients underwent placement of cement-augmented pedicle screws; 474 augmented screws were inserted in 237 vertebrae. No symptomatic perivertebral cement leakage or symptomatic pulmonary cement embolism was observed, but asymptomatic perivertebral cement leakage was seen in 88 patients (93.6%) and in 165 augmented vertebrae (73.3%). Cement leakage most often occurred in the perivertebral venous system. Clinically asymptomatic pulmonary cement embolism was found in 4 patients (4.1%). CONCLUSIONS Perivertebral cement leakage often occurs in pedicle screw augmentation, but in most cases, it is clinically asymptomatic. Cement augmentation should be performed under continuous fluoroscopy to avoid high-volume leakage. Alternative strategies, such as use of expandable screws, should be examined in more detail for patients at high risk of screw loosening.

  5. [Identification of gallbladder pedicle anatomy during laparoscopic cholecystectomy].

    PubMed

    Tebala, Giovanni D; Innocenti, Paolo; Ciani, Renzo; Zumbo, Antonella; Fonsi, Giovanni B; Bellini, Pierpaolo; De Chiara, Fabio; Fittipaldi, Domenico; Hadjiamiri, Hossein; Lamaro, Stefano; Marinoni, Riccardo

    2004-01-01

    Laparoscopic cholecystectomy is widely accepted nowadays as the gold standard in the treatment of cholelithiasis. This new technique was initially associated with a significant increase in morbidity, and in particular in iatrogenic biliary injuries and arterial haemorrhages, perhaps due to a lack of knowledge of the "laparoscopic anatomy" of the gallbladder pedicle. In this technique the anatomical structures are viewed on a two-dimensional video monitor, and the dissection is performed with long instruments without manual sensitivity. Therefore, the laparoscopic surgeon has to deal with new anatomical views and must be aware of the possible arterial and biliary variants. In this review we describe our technique of laparoscopic cholecystectomy, with particular reference to manoeuvres useful for identifying the various anatomical structures at the gallbladder hilum. In our opinion, it is mandatory to avoid cutting any duct if its identity has yet to be established. For this reason, we pay great attention to the anatomical dissection of Calot's triangle, in order to accurately identify the cystic duct and the cystic artery and any other vascular or biliary structures. Routine intraoperative cholangiography may be useful for identifying the biliary anatomy. When in doubt, the surgeon should not hesitate to convert the procedure to open surgery.

  6. A Robot-Assisted Surgical System Using a Force-Image Control Method for Pedicle Screw Insertion

    PubMed Central

    Tian, Wei; Han, Xiaoguang; Liu, Bo; Liu, Yajun; Hu, Ying; Han, Xiao; Xu, Yunfeng; Fan, Mingxing; Jin, Haiyang

    2014-01-01

    Objective To introduce a robot-assisted surgical system for spinal posterior fixation that can automatically recognize the drilling state and stop potential cortical penetration with force and image information and to further evaluate the accuracy and safety of the robot for sheep vertebra pedicle screw placement. Methods The Robotic Spinal Surgery System (RSSS) was composed of an optical tracking system, a navigation and planning system, and a surgical robot equipped with a 6-DOF force/torque sensor. The robot used the image message and force signals to sense the different operation states and to prevent potential cortical penetration in the pedicle screw insertion operation. To evaluate the accuracy and safety of the RSSS, 32 screw insertions were conducted. Furthermore, six trajectories were deliberately planned incorrectly to explore whether the robot could recognize the different drilling states and immediately prevent cortical penetration. Results All 32 pedicle screws were placed in the pedicle without any broken pedicle walls. Compared with the preoperative planning, the average deviations of the entry points in the axial and sagittal views were 0.50±0.33 and 0.65±0.40 mm, and the average deviations of the angles in the axial and sagittal views were 1.9±0.82° and 1.48±1.2°. The robot successfully recognized the different drilling states and prevented potential cortical penetration. In the deliberately incorrectly planned trajectory experiments, the robot successfully prevented the cortical penetration. Conclusion These results verified the RSSS’s accuracy and safety, which supported its potential use for the spinal surgery. PMID:24466043

  7. Survivorship analysis of pedicle spinal instrumentation.

    PubMed

    McAfee, P C; Weiland, D J; Carlow, J J

    1991-08-01

    Between 1985 and 1989, the senior author performed 120 consecutive pedicle instrumentation cases--78 Steffee (VSP) procedures and 42 procedures using Cotrel-Dubousset instrumentation. Posterolateral or posterior fusions using autogenous iliac bone graft were performed across the instrumented vertebrae in all cases. Survivorship analysis was used to calculate a predicted cumulative rate of success for this series of patients over 10 years postoperative follow-up. The criteria of failure of pedicular instrumentation or "death" of an implant were defined as 1) screw bending, 2) screw breakage, 3) infection, 4) loosening of implants, 5) any rod or plate hardware problems, or 6) removal of hardware due to a neurologic complication. Out of 526 pedicle screws (175 Cotrel-Dubousset screws, 351 VSP screws) there were 22 problem screws (22/526 = 4.18%). Six screws had bent, none were infected, 16 screws had broken, and none were loose. The 22 problem screw events occurred in 12 patients. In seven patients, the instrumentation failure was an incidental radiographic finding, in that patients had a solid posterolateral fusion. The remaining five patients had screw breakage in association with a pseudarthrosis. Life table calculations predicted the survivorship of instrumentation without complications would be 80% at 10 years postoperative follow-up. Actuarial analysis predicted the survivorship of solid posterolateral fusion at 90% at 10 years follow-up. This survivorship rate is similar to those predicted at 10 years follow-up for other more widely used orthopedic surgical implants such as total hip arthroplasty components.

  8. Mucocele formation under pedicled nasoseptal flap.

    PubMed

    Vaezeafshar, Reza; Hwang, Peter H; Harsh, Griffith; Turner, Justin H

    2012-01-01

    The pedicled nasoseptal flap has become an indispensible tool for the reconstruction of skull base defects. This flap is easily harvested, provides a large surface area of vascularized tissue, and has few reported complications. We describe the case of a 60-year-old man who underwent endoscopic, endonasal transsphenoidal surgery with septal flap reconstruction who developed a sphenoid sinus mucocele postoperatively. We also have reviewed the literature for similar findings and discuss this complication in the setting of pituitary surgery and endoscopic skull base repair. Although likely a rare occurrence, mucocele formation after septal flap reconstruction should be recognized and monitored with postoperative nasal endoscopy and radiologic imaging. Reoperation or mucocele drainage may be necessary if symptomatic or in cases of rapid enlargement.

  9. C2 Pedicle Screw Placement: A Novel Teaching Aid

    PubMed Central

    Moisi, Marc; Chapman, Jens; Oskouian, Rod J; Tubbs, R. Shane

    2016-01-01

    The C2 pedicle screw is more biomechanically stable and provides patients with increased postoperative range of motion in comparison to other methods of C2 fixation. However, as a result of the proximity of the C2 pedicle to the transverse foramen, there is a considerable risk of intraoperative morbidity due to vertebral artery injury laterally or vertebral canal breach medially. Other than the use of cadavers for the demonstration and practice of C2 pedicle screw placement, there are currently few other readily available teaching aids for the training of residents and fellows. Herein, we describe a simple and cost effective modality for the demonstration, evaluation, and practice of C2 pedicle screw placement in a laboratory setting. PMID:27433409

  10. [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. PMID:27514827

  11. Bilateral Pedicle and Crossed Translaminar Screws in C2.

    PubMed

    Mendelsohn, Daniel; Dea, Nicolas; Lee, Robert; Boyd, Michael C

    2015-10-01

    Multiple techniques exist for the fixation of C2, including axial pedicle screws and bilateral translaminar screws. We describe a novel method of incorporating both the translaminar and pedicle screws within C2 to improve fixation to the subaxial spine in patients requiring posterior cervical instrumentation for deformity correction or instability. We report three cases of patients with cervical spinal instability, who underwent cervical spine instrumentation for stabilization and/or deformity correction. Bilateral C2 pedicle screws were inserted, followed by bilateral crossed laminar screws. The instrumentation method successfully achieved fixation in all three patients. There were no immediate postoperative complications, and hardware positioning was satisfactory. Instrumenting C2 with translaminar and pedicle screws is technically feasible, and it may improve fixation to the subaxial spine in patients with poor bone quality or severe subaxial deformity, which require a stronger instrumentation construct.

  12. Posterior spinal fusion using pedicle screws.

    PubMed

    Athanasakopoulos, Michael; Mavrogenis, Andreas F; Triantafyllopoulos, George; Koufos, Spiros; Pneumaticos, Spiros G

    2013-07-01

    Few clinical studies have reported polyetheretherketone (PEEK) rod pedicle screw spinal instrumentation systems (CD-Horizon Legacy PEEK rods; Medtronic, Minneapolis, Minnesota). This article describes a clinical series of 52 patients who underwent posterior spinal fusion using the PEEK Rod System between 2007 and 2010. Of the 52 patients, 25 had degenerative disk disease, 10 had lateral recess stenosis, 6 had degenerative spondylolisthesis, 6 had lumbar spine vertebral fracture, 4 had combined lateral recess stenosis and degenerative spondylolisthesis, and 1 had an L5 giant cell tumor. Ten patients had 1-segment fusion, 29 had 2-segment fusion, and 13 had 3-segment fusion. Mean follow-up was 3 years (range, 1.5-4 years); no patient was lost to follow-up. Clinical evaluation was performed using the Oswestry Disability Index and a low back and leg visual analog pain scale. Imaging evaluation of fusion was performed with standard and dynamic radiographs. Complications were recorded. Mean Oswestry Disability Index scores improved from 76% preoperatively (range, 52%-90%) to 48% at 6 weeks postoperatively, and to 34%, 28%, and 30% at 3, 6, and 12 months postoperatively, respectively. Mean low back and leg pain improved from 8 and 9 points preoperatively, respectively, to 6 and 5 points immediately postoperatively, respectively, and to 2 points each thereafter. Imaging union of the arthrodesis was observed in 50 (96%) patients by 1-year follow-up. Two patients sustained screw breakage: 1 had painful loss of sagittal alignment of the lumbar spine and underwent revision spinal surgery with pedicle screws and titanium rods and the other had superficial wound infection and was treated with wound dressing changes and antibiotics for 6 weeks. No adjacent segment degeneration was observed in any patient until the time of this writing. PMID:23823055

  13. Cement leakage in pedicle screw augmentation: a prospective analysis of 98 patients and 474 augmented pedicle screws.

    PubMed

    Mueller, Jan U; Baldauf, Joerg; Marx, Sascha; Kirsch, Michael; Schroeder, Henry W S; Pillich, Dirk T

    2016-07-01

    OBJECTIVE Loosening and pullout of pedicle screws are well-known problems in pedicle screw fixation surgery. Augmentation of pedicle screws with bone cement, first described as early as 1975, increases the pedicle-screw interface and pullout force in osteoporotic vertebrae. The aim of the present study was to identify cement leakage and pulmonary embolism rates in a large prospective single-center series of pedicle screw augmentations. METHODS All patients who underwent cement-augmented pedicle screw placement between May 2006 and October 2010 at the authors' institution were included in this prospective cohort study. Perivertebral cement leakage and pulmonary cement embolism were evaluated with a CT scan of the area of operation and with a radiograph of the chest, respectively. RESULTS A total of 98 patients underwent placement of cement-augmented pedicle screws; 474 augmented screws were inserted in 237 vertebrae. No symptomatic perivertebral cement leakage or symptomatic pulmonary cement embolism was observed, but asymptomatic perivertebral cement leakage was seen in 88 patients (93.6%) and in 165 augmented vertebrae (73.3%). Cement leakage most often occurred in the perivertebral venous system. Clinically asymptomatic pulmonary cement embolism was found in 4 patients (4.1%). CONCLUSIONS Perivertebral cement leakage often occurs in pedicle screw augmentation, but in most cases, it is clinically asymptomatic. Cement augmentation should be performed under continuous fluoroscopy to avoid high-volume leakage. Alternative strategies, such as use of expandable screws, should be examined in more detail for patients at high risk of screw loosening. PMID:26943258

  14. The Superiority of Intraoperative O-arm Navigation-assisted Surgery in Instrumenting Extremely Small Thoracic Pedicles of Adolescent Idiopathic Scoliosis

    PubMed Central

    Liu, Zhen; Jin, Mengran; Qiu, Yong; Yan, Huang; Han, Xiao; Zhu, Zezhang

    2016-01-01

    Abstract To investigate the accuracy of O-arm navigation-assisted screw insertion in extremely small thoracic pedicles and to compare it with free-hand pedicle screw insertion in adolescent idiopathic scoliosis (AIS). A total of 344 pedicle screws were inserted in apical region (defined as 2 vertebrae above and below the apex each) of 46 AIS patients (age range 13–18 years) with O-arm navigation and 712 screws were inserted in 92 AIS patients (age range 11–17 years) with free-hand technique. According to the narrowest diameter orthogonal to the long axis of the pedicle on a trajectory entering the vertebral body on preoperative computed tomography, the pedicles were classified into large (>3 mm) and small (≤3 mm) subgroups. Furthermore, a subset of extremely small pedicles (≤2 mm in the narrowest diameter) was specifically discussed. Screw accuracy was categorized as grade 0: no perforation, grade 1: perforation by less than 2 mm, grade 2: perforation by 2 to 4 mm, grade 3: perforation over 4 mm. In the O-arm group, the mean thoracic pedicle diameters were 2.23 mm (range 0.7–2.9 mm) and 3.48 mm (3.1–7.1 mm) for small and large pedicles, respectively. In the free-hand group, the small and large thoracic pedicle diameters were 2.42 mm (range 0.6–2.9 mm) and 3.75 mm (3.1–6.9 mm), respectively. The overall accuracies of screw insertion in large and small thoracic pedicles (grade 0, 1) were significantly higher in O-arm group (large: 93.8%, 210/224, small: 91.7%, 110/120) than those of free-hand group (large: 84.9%, 353/416, small: 78.4%, 232/296) (P < 0.05). Importantly, the overall accuracy of screw placement in extremely small pedicles was significantly higher in the O-arm group (84.3%, 48/57) compared with 62.7% (79/126) in free-hand group (P < 0.05), and the incidence of medial perforation was significantly lower in O-arm group (11.1%, 1/9) compared with 17.0% (8/47) in free-hand group (P < 0.05). The O

  15. Posterior osteosynthesis of a spontaneous bilateral pedicle fracture of the lumbar spine.

    PubMed

    Han, Sang-Hyun; Hyun, Seung-Jae; Jahng, Tae-Ahn; Kim, Ki-Jeong

    2016-03-01

    Spontaneous bilateral pedicle fractures of the lumbar spine are rare, and an optimal surgical treatment has not been suggested. The authors report the case of a 50-year-old woman who presented with low-back pain and right leg radiating pain of 1 year's duration. Radiological studies revealed a spontaneous bilateral pedicle fracture of L-5. All efforts at conservative treatment failed, and the patient underwent surgery for osteosynthesis of the fractured pedicle using bilateral pedicle screws connected with a bent rod. Her low-back and right leg pain were relieved postoperatively. A CT scan performed 3 months postoperatively revealed the disappearance of the pedicle fracture gap and presence of newly formed bony trabeculation. In rare cases of spontaneous bilateral pedicle fracture of the lumbar spine, osteosynthesis of the fractured pedicle using bilateral pedicle screws and a bent rod is a motion-preserving technique that may be an effective option when conservative management has failed.

  16. Hydroxyapatite composite resin cement augmentation of pedicle screw fixation.

    PubMed

    Turner, Alexander W L; Gillies, R Mark; Svehla, Martin J; Saito, Masanobu; Walsh, William R

    2003-01-01

    Pedicle screw stability is poor in osteopenic vertebrae attributable, in part, to low screw-bone interface strength. The current authors examined cement augmentation using a low curing temperature hydroxyapatite and bis-phenol-A glycidol methacrylate-based composite resin. This cement may stiffen the screw-bone interface and reduce the harmful effects associated with polymethylmethacrylate regarding temperature and toxic monomer. Thirty-five lumbar vertebrae from human cadavers were instrumented with pedicle screws, with one pedicle previously injected with cement and the other as the control. Caudocephalad toggling of +/- 1 mm for 1600 cycles was applied to the pedicle screws, and the resulting forces supported by the implant-bone interface were captured by a load cell. A curve was constructed from the peak caudal load for each cycle and three mechanical measures parameterized this curve: (1) initial load; (2) rate of load decay during the first 400 cycles; and (3) final load. The initial load increased by 16% as a result of cement augmentation, the final load increased by 65%, and the rate of load decay decreased by 59%. Cement augmentation of pedicle screws increased the stiffness and stability of the screw-bone interface. PMID:12579026

  17. Delayed perforation of the aorta by a thoracic pedicle screw.

    PubMed

    Wegener, Bernd; Birkenmaier, Christof; Fottner, Andreas; Jansson, Volkmar; Dürr, Hans Roland

    2008-09-01

    Pedicle screw instrumentation has become increasingly popular during the past 20 years and a vast selection of products is available on the market. With rising implantation rates, reports about specific complications also have increased. The main reason for these complications is the fact that the course of the pedicle and in turn the positioning of the pedicle screw cannot be adequately controlled visually. Based on the anatomy of the surrounding structures, complications caused by malpositioning can be divided into three main groups: mechanical, neurological and vascular. Beyond mechanical limitations of spinal motion, nerve injury can lead to neurological problems while injuries to vascular structures usually cause hemorrhage. These typical problems in general become apparent intraoperatively or in the immediate postoperative course. We report on a rare delayed complication and analyze the factors that led to it. In addition, we outline our treatment strategy. The goal has to be to avoid such problems in the future by using suitable navigational aids. PMID:18622634

  18. Multiple axis reticle

    NASA Astrophysics Data System (ADS)

    Barns, Chris E.; Gunter, William D.

    1990-09-01

    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.

  19. 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.

  20. Biomechanical Evaluation of Pedicle Screw-Based Dynamic Stabilization Devices for the Lumbar Spine: A Systematic Review

    PubMed Central

    Ponnappan, Ravi K.; Song, Jason; Vaccaro, Alexander R.

    2008-01-01

    Study Design This study is a systematic review of published biomechanical studies involving pedicle screw-based posterior dynamic stabilization devices (PDS) with a special focus on kinematics and load transmission through the functional spine unit (FSU). Methods A literature search was performed via the PubMed online database from 1990 to 2008 using the following key words: “biomechanics,” “lumbar dynamic stabilization,” “Graf system,” “Dynesys,” and “posterior dynamic implant.” Citations were limited to papers describing biomechanics of pedicle screw-based PDS devices currently available for clinical use. Studies describing clinical experience, radiology, and in vivo testing were excluded from the review. Parameters measured included kinematics of the FSU (range of motion (ROM), neutral zone (NZ), and location of the center of rotation) and load transmission through the disk, facets, and instrumentation. Results A total of 27 publications were found that concerned the biomechanical evaluation of lumbar pedicle screw-based dynamic stabilization instrumentation. Nine in vitro experimental studies and 4 finite element analyses satisfied the inclusion criteria. The Dynesys implant was the most investigated pedicle screw-based PDS system. In vitro cadaveric studies mainly focused on kinematics comparing ROM of intact versus instrumented spines whereas finite element analyses allowed analysis of load transmission at the instrumented and adjacent levels. Conclusion Biomechanical studies demonstrate that pedicle screw-based PDS devices limit intervertebral motion while unloading the intervertebral disk. The implant design and the surgical technique have a significant impact on the biomechanical behavior of the instrumented spinal segment. The posterior placement of such devices results in non-physiologic intervertebral kinematics with a posterior shift of the axis of rotation. Biomechanical studies suggest that the difference at the adjacent level

  1. Assessment of Left Ventricular Ejection Fraction Calculation on Long-axis Views From Cardiac Magnetic Resonance Imaging in Patients With Acute Myocardial Infarction

    PubMed Central

    Huttin, Olivier; Petit, Marie-Anaïs; Bozec, Erwan; Eschalier, Romain; Juillière, Yves; Moulin, Frédéric; Lemoine, Simon; Selton-Suty, Christine; Sadoul, Nicolas; Mandry, Damien; Beaumont, Marine; Felblinger, Jacques; Girerd, Nicolas; Marie, Pierre-Yves

    2015-01-01

    Abstract To assess left ventricular ejection fraction (LVEF) accurately, cardiac magnetic resonance (CMR) can be indicated and lays on the evaluation of multiple slices of the left ventricle in short axis (CMRSAX). The objective of this study was to assess another method consisting of the evaluation of 2 long-axis slices (CMRLAX) for LVEF determination in acute myocardial infarction. One hundred patients underwent CMR 2 to 4 days after acute myocardial infarction. LVEF was computed by the area-length method on horizontal and vertical CMRLAX images. Those results were compared to reference values obtained on contiguous CMRSAX images in one hand, and to values obtained from transthoracic echocardiography (TTE) in the other hand. For CMRSAX and TTE, LVEF was computed with Simpson method. Reproducibility of LVEF measurements was additionally determined. The accuracy of volume measurements was assessed against reference aortic stroke volumes obtained by phase-contrast MR imaging. LVEF from CMRLAX had a mean value of 47 ± 8% and were on average 5% higher than reference LVEF from CMRSAX (42 ± 8%), closer to routine values from TTELAX (49 ± 8%), much better correlated with the reference LVEF from CMRSAX (R = 0.88) than that from TTE (R = 0.58), obtained with a higher reproducibility than with the 2 other techniques (% of interobserver variability: CMRLAX 5%, CMRSAX 11%, and TTE 13%), and obtained with 4-fold lower recording and calculation times than for CMRSAX. Apart from this, CMRLAX stroke volume was well correlated with phase-contrast values (R = 0.81). In patients with predominantly regional contractility abnormalities, the determination of LVEF by CMRLAX is twice more reproducible than the reference CMRSAX method, even though the LVEF is consistently overestimated compared with CMRSAX. However, the CMRLAX LVEF determination provides values closer to TTE measurements, the most available and commonly used method in clinical practice, clinical

  2. 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.

  3. 21 CFR 888.3070 - Pedicle screw spinal system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the...; spinal tumor; and failed previous fusion (pseudarthrosis). These pedicle screw spinal systems must comply... stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion in...

  4. 21 CFR 888.3070 - Pedicle screw spinal system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the...; spinal tumor; and failed previous fusion (pseudarthrosis). These pedicle screw spinal systems must comply... stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion in...

  5. 21 CFR 888.3070 - Pedicle screw spinal system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the...; spinal tumor; and failed previous fusion (pseudarthrosis). These pedicle screw spinal systems must comply... stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion in...

  6. 21 CFR 888.3070 - Pedicle screw spinal system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the...; spinal tumor; and failed previous fusion (pseudarthrosis). These pedicle screw spinal systems must comply... stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion in...

  7. 21 CFR 888.3070 - Pedicle screw spinal system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the...; spinal tumor; and failed previous fusion (pseudarthrosis). These pedicle screw spinal systems must comply... stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion in...

  8. Endovascular aortic injury repair after thoracic pedicle screw placement.

    PubMed

    Pesenti, S; Bartoli, M A; Blondel, B; Peltier, E; Adetchessi, T; Fuentes, S

    2014-09-01

    Our objective was to describe the management and prevention of thoracic aortic injuries caused by a malposition of pedicle screws in corrective surgery of major spine deformities. Positioning pedicle screws in thoracic vertebras by posterior approach exposes to the risk of injury of the elements placed ahead of the thoracic spine, as the descending thoracic aorta. This complication can result in a cataclysmic bleeding, needing urgent vascular care, but it can also be totally asymptomatic, resulting in the long run in a pseudoaneurysm, justifying the systematic removal of the hardware. We report the case of a 76-year-old woman who underwent spinal correction surgery for thoraco-lumbar degenerative kypho-scoliosis. Immediately after the surgery, a thoracic aortic injury caused by the left T7 pedicle screw was diagnosed. The patient underwent a two-step surgery. The first step was realized by vascular surgeons and aimed to secure the aortic wall by short endovascular aortic grafting. During the second step, spine surgeons removed the responsible screw by posterior approach. The patient was discharged in a rehabilitation center 7 days after the second surgery. When such a complication occurs, a co-management by vascular and spine surgeons is necessary to avoid major complications. Endovascular management of this kind of vascular injuries permits to avoid an open surgery that have a great rate of morbi-mortality in frail patients. Nowadays, technologies exist to prevent this kind of event and may improve the security when positioning pedicle screws. PMID:25023930

  9. Breast reduction utilizing the maximally vascularized central breast pedicle.

    PubMed

    Hester, T R; Bostwick, J; Miller, L; Cunningham, S J

    1985-12-01

    Experience using a maximally vascularized central breast pedicle to nourish the nipple-areola is presented. The pedicle is designed to incorporate vascular contributions from the lateral thoracic artery, intercostal perforators, internal mammary perforators, and thoracoacromial artery by means of the pectoralis major muscle. The basic technique is as follows: First, the areola is incised and 2-cm-thick skin and subcutaneous flaps are dissected medially, laterally, and superiorly, freeing the entire central breast mound. Second, the breast is reduced in a "Christmas tree" manner, being careful not to narrow the base of the pedicle. Third, excess skin and subcutaneous tissue is excised inferomedially and laterally and the nipple is inset into proper locations. The advantages of this technique are (1) large and small reductions can be done, (2) pedicle length does not appear to be a problem, and (3) the central mound gives the forward projection needed for good contour and good aesthetic results. Sixty-five patients with follow-up to 4 years are presented.

  10. 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

  11. 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.

  12. Spinal pedicle subtraction osteotomy for fixed sagittal imbalance patients.

    PubMed

    Hyun, Seung-Jae; Kim, Yongjung J; Rhim, Seung-Chul

    2013-11-16

    In addressing spinal sagittal imbalance through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. Posterior column osteotomies such as the facetectomy or Ponte or Smith-Petersen osteotomy provide the least correction, but can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies; however, they carry increased technical demands, longer operative time, and greater blood loss and associated significant morbidity, including neurological injury. The literature focusing on pedicle subtraction osteotomy for fixed sagittal imbalance patients is reviewed. The long-term overall outcomes, surgical tips to reduce the complications and suggestions for their proper application are also provided.

  13. Innovative techniques in preventing and salvaging neurovascular pedicle flaps in reconstructive foot and ankle surgery.

    PubMed

    Zgonis, Thomas; Stapleton, John J

    2008-04-01

    Pedicle flaps to cover soft tissue defects of the foot, ankle, and lower extremity are invaluable. However, venous congestion and flap necrosis, a common complication, poses greater morbidity to the patient as few remaining options for attempted limb salvage remain. The authors discuss how to prevent flap failure by allowing close observation and strict offloading of the pedicle flap through current external fixation designs. This article also discusses the role of medicinal leeches in reestablishing blood flow through the pedicle flap to prevent tissue necrosis. In addition, the use of hydrosurgery as an innovative technique offers the surgeon another option if faced with pedicle flap necrosis. PMID:19825700

  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. Vertical axis wind turbine

    SciTech Connect

    Kato, Y.; Seki, K.; Shimizu, Y.

    1981-01-27

    Wind turbines are largely divided into vertical axis wind turbines and propeller (Horizontal axis) wind turbines. The present invention discloses a vertical axis high speed wind turbine provided with a starting and braking control system. This vertical axis wind turbine is formed by having blades of a proper airfoil fitted to respective supporting arms provided radially from a vertical rotary axis by keeping the blade span-wise direction in parallel with the axis and being provided with a low speed control windmill in which the radial position of each operating piece varies with a centrifugal force produced by the rotation of the vertical rotary axis.

  16. 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.

  17. [Pedicled versus free TRAM flap for breast reconstruction].

    PubMed

    Galla, T J; Lukas, B; Feller, A M

    1999-03-01

    In breast reconstruction, the free TRAM-flap offers many advantages over the pedicled TRAM-flap. Due to its superior perfusion, the free flap rarely develops necrosis. Shaping of the flap is easier due to the lack of the thick muscle pedicle. Because the rectus muscle is spared, there is minimal donor site morbidity. However, the necessary microvascular anastomoses reduced the acceptance of the free TRAM-flap. During a 13-months period, 51 breast reconstructions were performed in 41 patients, 31 unilateral and ten bilateral. 45 flaps served for delayed reconstruction and six flaps for immediate reconstruction. The operations were performed by two teams working simultaneously. The average operating time was 3.9 hours for unilateral and 6.9 hours for bilateral delayed reconstruction. For immediate reconstruction, 6.2 and 6.3 hours were required for uni- and bilateral procedures, respectively. In 38 flaps, the thoracodorsal vessels served as recipient vessels; 13 flaps were anastomosed to the internal mammary artery and vein. Postoperative complications were observed in 13 patients. Three vessel anastomoses had to be revised. In one flap, a partial necrosis occurred; in two flaps hematoma evacuation was necessary. Two patients suffered from fat necroses at the abdomen and one umbilicus was lost. Skin irritations and seromas at the abdomen occurred in five patients. Pulmonary embolism was diagnosed in one patient three weeks postoperatively. Abdominal hernias or bulging in the epigastric area were not observed up to 15 months after reconstruction. These results reveal a low complication rate for breast reconstruction with the free TRAM-flap. The advantages of this technique as compared to the pedicled technique are discussed.

  18. 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.

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

    PubMed

    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

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

    PubMed

    Qu, Linda T; Kelpin, John P; Eichhorn, Mitchell G; Komorowska-Timek, Ewa

    2016-08-01

    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

  1. 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

  2. Pedicle Screw-Based Posterior Dynamic Stabilization: Literature Review

    PubMed Central

    Sengupta, Dilip K.; Herkowitz, Harry N.

    2012-01-01

    Posterior dynamic stabilization (PDS) indicates motion preservation devices that are aimed for surgical treatment of activity related mechanical low back pain. A large number of such devices have been introduced during the last 2 decades, without biomechanical design rationale, or clinical evidence of efficacy to address back pain. Implant failure is the commonest complication, which has resulted in withdrawal of some of the PDS devices from the market. In this paper the authors presented the current understanding of clinical instability of lumbar motions segment, proposed a classification, and described the clinical experience of the pedicle screw-based posterior dynamic stabilization devices. PMID:23227349

  3. Vertical axis windmill

    SciTech Connect

    Zheug, Y.K.

    1984-03-06

    A vertical axis windmill has a blade pivotally connected to a rotatable support structure on an axis passing through its center of gravity which is arranged to lie forward of its aerodynamic center whereby the blade automatically swings outwardly and inwardly when moving on the windward and leeward sides respectively of the axis of rotation of said support means.

  4. Benefits of using omental pedicle flap over muscle flap for closure of open window thoracotomy

    PubMed Central

    Chikaishi, Yasuhiro; Kuwata, Taiji; Takenaka, Masaru; Oka, Soichi; Hirai, Ayako; Imanishi, Naoko; Kuroda, Koji; Tanaka, Fumihiro

    2016-01-01

    Background Open window thoracotomy (OWT) as well as its closure are challenging. Transposition of omental pedicle and muscle flaps is often performed for OWT closure; however, the better technique among the two is unknown. The purpose of this series was to evaluate the outcomes of using both omental pedicle and muscle flaps for the aforementioned closure. Methods This was an observational retrospective cohort study on 27 consecutive patients who underwent OWT closure at a single institution between January 2005 and December 2014. The operation was performed using either omental pedicle or muscle flap with thoracoplasty. We compared both techniques in terms of the patient background [sex, age, body mass index (BMI) and C-reactive protein (CRP) before OWT and serum albumin levels before OWT closure], presence of methicillin-resistant Staphylococcus aureus (MRSA) infection, rate of bronchopleural fistula (BPF), duration of OWT, recurrence of local infection, morbidity, duration of indwelling drainage after operation, success, mortality and postoperative hospital stay. Results There were 9 (33.3%) omental pedicle flap procedures and 18 (66.7%) muscle flap procedures. The rate of local recurrence after closure of OWT was significantly higher with muscle flap than with omental pedicle flap (0% vs. 50.0%, P=0.012). The median duration of postoperative hospital stay was significantly shorter with omental pedicle flap than that with muscle flap (16.0 vs. 41.5 days, P=0.037). Mortality was observed in 2 patients (11.2%) in the muscle flap group and no patient in the omental pedicle flap group. Success rate was similar between the two groups (100% for omental pedicle flap vs. 83.3% for muscle flap). Conclusions Omental pedicle flap was superior to muscle flap in terms of reducing local recurrence and shortening postoperative hospital stay. However, mortality, morbidity and success rates were not affected by the choice of flap. PMID:27499959

  5. 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

  6. Monoaxial pedicle screws are superior to polyaxial pedicle screws and the two pin external fixator for subcutaneous anterior pelvic fixation in a biomechanical analysis.

    PubMed

    Vaidya, Rahul; Onwudiwe, Ndidi; Roth, Matthew; Sethi, Anil

    2013-01-01

    Purpose. Comparison of monoaxial and polyaxial screws with the use of subcutaneous anterior pelvic fixation. Methods. Four different groups each having 5 constructs were tested in distraction within the elastic range. Once that was completed, 3 components were tested in torsion within the elastic range, 2 to torsional failure and 3 in distraction until failure. Results. The pedicle screw systems showed higher stiffness (4.008 ± 0.113 Nmm monoaxial, 3.638 ± 0.108 Nmm Click-x; 3.634 ± 0.147 Nmm Pangea) than the exfix system (2.882 ± 0.054 Nmm) in distraction. In failure testing, monoaxial pedicle screw system was stronger (360 N) than exfixes (160 N) and polyaxial devices which failed if distracted greater than 4 cm (157 N Click-x or 138 N Pangea). The exfix had higher peak torque and torsional stiffness than all pedicle systems. In torsion, the yield strengths were the same for all constructs. Conclusion. The infix device constructed with polyaxial or monoaxial pedicle screws is stiffer than the 2 pin external fixator in distraction testing. In extreme cases, the use of reinforcement or monoaxial systems which do not fail even at 360 N is a better option. In torsional testing, the 2 pin external fixator is stiffer than the pedicle screw systems.

  7. Iso-C3D navigation assisted pedicle screw placement in deformities of the cervical and thoracic spine

    PubMed Central

    Rajan, Vinod V; Kamath, Vijay; Shetty, Ajoy Prasad; Rajasekaran, S

    2010-01-01

    Background: Pedicle screw instrumentation of the deformed cervical and thoracic spine is challenging to even the most experienced surgeon and associated with increased incidence of screw misplacement. Iso-C3D based navigation has been reported to improve the accuracy of pedicle screw placement, however, there are very few studies assessing its efficacy in the presence of deformity. We conducted a study to evaluate the accuracy of Iso-C3D based navigation in pedicle screw fixation in the deformed cervical and thoracic spine. Materials and Methods: We inserted 98 cervical pedicle screws (18 patients) and 242 thoracic pedicle screws (17 patients) using Iso-C3D based navigation for deformities of spine due to scoliosis, ankylosing spondylitis, post traumatic and degenerative disorders. Two independent observers determined and graded the accuracy of screw placement from postoperative computed tomography (CT) scans. Results: Postoperative CT scans of the cervical spine showed 90.8% perfectly placed screws with 7 (7%) grade I pedicle breaches, 2 (2%) grade II pedicle breaches and one anterior cortex penetration (< 2mm). Five lateral pedicle breaches violated the vertebral artery foramen and three medial pedicle breaches penetrated the spinal canal; however, no patient had any neurovascular complications. In the thoracic spine there were 92.2% perfectly placed screws with only six (2%) grade II pedicle breaches, eight (3%) grade I pedicle breaches and five screws (2%) penetrating the anterior or lateral cortex. No neuro-vascular complications were encountered. Conclusion: Iso-C3D based navigation improves the accuracy of pedicle screw placement in deformities of the cervical and thoracic spine. The low incidence of pedicle breach implies increased safety for the patient. PMID:20419003

  8. Fetal and Neonatal HPA Axis.

    PubMed

    Wood, Charles E; Walker, Claire-Dominique

    2015-01-01

    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.

  9. Vaginal reconstruction using perineal-thigh flaps with subcutaneous pedicle.

    PubMed

    Chen, Z; Chen, C; Chen, M; Zhang, J; Wu, N; Wang, J

    1991-03-01

    A technique of vaginal reconstruction using bilateral, perineal-thigh flaps with subcutaneous pedicle is described. In this procedure, the flaps were raised bilaterally and introduced into an artificial space between the urinary bladder and rectum. The blood supply for the flaps flows from the perineal artery through anastomotic branches to the external pudendal artery. The authors used the technique on four patients, and all the flaps survived entirely. There was no complication. According to a more than two-year follow-up survey, the reconstructed vaginas are expansible and contract little. No stent is needed. There is good sensitivity in the wall of the artificial vagina because sensory nerves run through the flaps.

  10. 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. PMID:25810603

  11. "United Pedicle Flap" for management of multiple gingival recessions.

    PubMed

    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

  12. Vertical Axis Wind Turbine

    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.

  13. Complete DIEP flap survival following pedicle resection, 4 years after its transfer. Clinical evidence of autonomization

    PubMed Central

    Longo, Benedetto; Laporta, Rosaria; Sorotos, Michail; Atzeni, Matteo; Santanelli di Pompeo, Fabio

    2016-01-01

    Abstract We report a case of complete DIEP flap survival, following venous congestion due to the excision of a local recurrence with main pedicle, 4 years after its transfer for breast reconstruction. PMID:27713917

  14. The use of the pedicled supraclavicular flap in noma reconstructive surgery.

    PubMed

    Hartman, Ed H M; Van Damme, Philip A; Sauter, Hartwig; Suominen, Sinikka H H

    2006-01-01

    Three noma patients with large unilateral facial defects were reconstructed using the pedicled supraclavicular flap technique in the Noma Children Hospital in Sokoto, Nigeria. The results are-although not completely perfect-encouraging enough to report and to repeat the technique in future reconstructive noma surgery after moderate modifications. It is advised not to tunnel the pedicle in the neck, but instead to open the neck. Then, the flap can be inset in a Z-plasty fashion to close the neck without the chance of compression of the pedicle of the flap. In this way flap necrosis can be prevented, without the risk of a scar contracture of the neck. Another technique, which can prevent partial flap necrosis and loss of tissue, with the need for secondary stage interventions, is a delay procedure of the flap. Incorporation of the fascia in the pedicled supraclavicular flap can be another option to fulfil the abovementioned requirements.

  15. Comparison of Expansive Pedicle Screw and Polymethylmethacrylate-Augmented Pedicle Screw in Osteoporotic Sheep Lumbar Vertebrae: Biomechanical and Interfacial Evaluations

    PubMed Central

    Zhang, Bo; Xie, Qing-yun; Wang, Cai-ru; Liu, Jin-biao; Liao, Dong-fa; Jiang, Kai; Lei, Wei; Pan, Xian-ming

    2013-01-01

    Background It was reported that expansive pedicle screw (EPS) and polymethylmethacrylate-augmented pedicle screw (PMMA-PS) could be used to increase screw stability in osteoporosis. However, there are no studies comparing the two kinds of screws in vivo. Thus, we aimed to compare biomechanical and interfacial performances of EPS and PMMA-PS in osteoporotic sheep spine. Methodology/Principal Findings After successful induction of osteoporotic sheep, lumbar vertebrae in each sheep were randomly divided into three groups. The conventional pedicle screw (CPS) was inserted directly into vertebrae in CPS group; PMMA was injected prior to insertion of CPS in PMMA-PS group; and the EPS was inserted in EPS group. Sheep were killed and biomechanical tests, micro-CT analysis and histological observation were performed at both 6 and 12 weeks post-operation. At 6-week and 12-week, screw stabilities in EPS and PMMA-PS groups were significantly higher than that in CPS group, but there were no significant differences between EPS and PMMA-PS groups at two study periods. The screw stability in EPS group at 12-week was significantly higher than that at 6-week. The bone trabeculae around the expanding anterior part of EPS were more and denser than that in CPS group at 6-week and 12-week. PMMA was found without any degradation and absorption forming non-biological “screw-PMMA-bone” interface in PMMA-PS group, however, more and more bone trabeculae surrounded anterior part of EPS improving local bone quality and formed biological “screw-bone” interface. Conclusions/Significance EPS can markedly enhance screw stability with a similar effect to the traditional method of screw augmentation with PMMA in initial surgery in osteoporosis. EPS can form better biological interface between screw and bone than PMMA-PS. In addition, EPS have no risk of thermal injury, leakage and compression caused by PMMA. We propose EPS has a great application potential in augmentation of screw stability

  16. 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.

  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. 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.

  19. 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

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

    PubMed

    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 AND 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. 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

  2. Exaggerated supine oblique view of the cervical spine

    SciTech Connect

    Abel, M.S.

    1982-06-01

    The technique of the 60 degree supine oblique view is described together with anatomic skeletal studies of this projection. The view is convenient for emergency room radiography and useful in other clinical radiography. The view separates widely the anterior and posterior portions of the vertebrae in a side to side projection. This makes for an elongated but detailed view of the articular processes, pedicles, and intervertebral foramina. In the cadavar specimen and clinically the view is shown to be useful in delineating fracture deformities of the articular process and visualizing constriction of the intervertebral foramen superiorly. Encroachment of the foramen superiorly is likely to compromise the emerging nerve root in this area.

  3. 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.

  4. Quantitative Anatomy of C7 Vertebra in Southern Chinese for Insertion of Lateral Mass Screws and Pedicle Screws

    PubMed Central

    Chan, Chi Hin; Wong, Kam Kwong; Wong, Wing Cheung

    2016-01-01

    Study Design Retrospective study. Purpose To analyze the quantitative anatomy of C7 vertebra for insertion of lateral mass screws and pedicle screws in Southern Chinese patients. Overview of Literature C7 lateral mass is smaller when compared to other subaxial cervical levels, which limits the length of lateral mass screws that can be used. Some studies have suggested pedicle screws for better fixation. But, this option is limited by the narrow pedicle width. Methods We have obtained computed tomography (CT) cervical spine data in 0.625 mm slices from our radiology department. The patients were adults. CTs were from May to August, 2015. The lateral mass screw length was measured using Margerl's technique and pedicle width and pedicle screw trajectory were determined in three-dimensional reformated images. Results CT scans of cervical spines of 94 patients were obtained and 188 lateral masses and pedicles of C7 vertebrae were measured. The mean lateral mass screw length was 13.2 mm (standard deviation [SD] 1.6 mm), mean outer pedicle width was 5.9 mm (SD 1.0 mm) and mean pedicle screw trajectory was 29.4 degrees (SD 3.6 degrees). Most (91.0%) of the pedicles had an outer diameter ≥4.5 mm. Conclusions The mean lateral mass screw length was longer when compared with other similar studies, while the mean outer pedicle width was narrower. Nearly 10% of the pedicles were unable to accommodate 3.5 mm screws. These findings favor the use of lateral mass screws to provide a safe and stable fixation for C7 vertebrae in Southern Chinese patients, while the final choice of fixation method should only be confirmed after careful preoperative planning with CT scan. PMID:27559451

  5. [Experimental investigation of neovascularisation in large prefabricated flaps after arteriovenous pedicle implantation].

    PubMed

    Nguyen, The H; Klöppel, M; Staudenmaier, R; Biemer, E

    2004-08-01

    The principle of prefabricated flaps is based on the transformation of a formerly random-pattern vascularized flap, through implantation of a vascular pedicle, into a newly neovascularized axial flap, which can be transferred after a period of neovascularisation from the prepared donor site to the recipient site by using microvascular techniques. In 30 Chinchilla Bastard rabbits weighing from 3700 to 4200 g, a skeletonized arteriovenous pedicle with distal ligation harvested from the femoral and saphena magna artery and vein was implanted beneath an 8 x 15 cm abdominal skin flap to investigate the neovascularisation process in the flap over the course of time. In order to prevent neovascularisation occurring from the underlying vascular bed into the flap, a silicon sheet measuring 8 x 15 cm x 0.25 mm was placed and fixed on the abdominal wall. Flap vitality and neovascularisation process in prefabricated flaps were evaluated by macroscopic observation, blood analysis, selective microangiography, histology and scintigraphy at the various time intervals of 4, 8, 12, 16 and 20 days. The study results showed that newly formed vessels sprouting from the implanted pedicle were seen four days after pedicle implantation. With the retention time of pedicle in the flaps, they continued to grow, became meander and more dense. Respective connections between newly formed vessels and the originally available vasculature of the abdominal flap were markedly observed in the 12- and 16-day groups. Twenty days after prefabrication, the abdominal flap was completely perfused by the blood flow supplied from the newly implanted arteriovenous pedicle through newly formed vessels arising from the implanted pedicle and their rich vascular communications. The neovascularisation in the prefabricated flap consisted of the implanted pedicle, newly formed vessels, the originally available vasculature and their vascular connections. In comparison to the control group (the quantification was

  6. Vessel sealing versus suture ligation for canine ovarian pedicle haemostasis: a randomised clinical trial.

    PubMed

    Schwarzkopf, I; Van Goethem, B; Vandekerckhove, P M; de Rooster, H

    2015-01-31

    Vessel sealing (VS) is well established in laparoscopic ovariectomy (OVE) in dogs. The objectives of this study were to evaluate the efficacy of ovarian pedicle haemostasis by VS using a commercially available VS tool in open OVE and compare it with suture ligation (SL). A prospective, randomised clinical trial including 20 female dogs was designed. Open OVE was performed via a standard mid-line celiotomy by a single surgeon using a standardised protocol. At random, the right ovarian pedicle was sealed (VS) or ligated (SL) whereas the left pedicle was treated by the alternative technique. Surgical times for procedural stages and intra-operative complications were recorded and statistically evaluated. Total surgical time was 29.28±11.13 minutes (range 12.50-62.13 minutes) and time from identification to removal of the ovary was significantly less when sealing (VS 2.22±0.58 minutes) than when ligating (SL 4.10±1.13 minutes P=0.0001). Intra-operative complications were rare for both techniques (failure of the electrode of the VS device (n=3); ovarian pedicle haemorrhage due to ligature slippage (n=1)). The results of the current study indicate that ovarian pedicle haemostasis achieved by VS is significantly faster than by placement of ligatures without appearing to compromise safety.

  7. 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.

  8. Influence of a pedicle flap design on acute postoperative sequelae after lower third molar removal.

    PubMed

    Goldsmith, Sam M; De Silva, Rohana Kumara; Tong, Darryl C; Love, Robert M

    2012-03-01

    Pain, swelling, trismus, and alveolar osteitis often occur after removal of impacted third molar teeth. To minimize these complications a number of mucoperiosteal flap designs have been advocated, but, to date, a pedicle flap design has not been evaluated. In a randomized prospective split mouth study, 52 participants had bilateral symmetrically impacted mandibular third molars removed over two sessions. A buccal envelope or pedicle flap was randomly assigned to the left or right third molar site. Pre-and postoperative pain and swelling were recorded using a standardized visual analogue scale, trismus was measured as the maximum inter-incisal opening distance in millimetres and dry socket was assessed clinically. Greater continuous pain, pain on maximum opening, and oro-facial swelling were recorded with the pedicle flap design. Continuous pain resolved significantly faster with this flap design (p<0.05). Trismus was similar for both flap designs (p>0.05). Five cases of alveolar osteitis occurred with the envelope flap whilst no cases developed with the pedicle flap, but the incidence was too small for statistical analysis. The pedicle flap improved some aspects of postoperative pain experience and reduced the incidence of alveolar osteitis, but further investigation with a larger sample size is required to evaluate its significance.

  9. 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

  10. Comparison of the bending performance of solid and cannulated spinal pedicle screws using finite element analyses and biomechanical tests.

    PubMed

    Shih, Kao-Shang; Hsu, Ching-Chi; Hou, Sheng-Mou; Yu, Shan-Chuen; Liaw, Chen-Kun

    2015-09-01

    Spinal pedicle screw fixations have been used extensively to treat fracture, tumor, infection, or degeneration of the spine. Cannulated spinal pedicle screws with bone cement augmentation might be a useful method to ameliorate screw loosening. However, cannulated spinal pedicle screws might also increase the risk of screw breakage. Thus, the purpose of this study was to investigate the bending performance of different spinal pedicle screws with either solid design or cannulated design. Three-dimensional finite element models, which consisted of the spinal pedicle screw and the screw's hosting material, were first constructed. Next, monotonic and cyclic cantilever bending tests were both applied to validate the results of the finite element analyses. Finally, both the numerical and experimental approaches were evaluated and compared. The results indicated that the cylindrical spinal pedicle screws with a cannulated design had significantly poorer bending performance. In addition, conical spinal pedicle screws maintained the original bending performance, whether they were solid or of cannulated design. This study may provide useful recommendations to orthopedic surgeons before surgery, and it may also provide design rationales to biomechanical engineers during the development of spinal pedicle screws. PMID:26208430

  11. The immature HPO axis.

    PubMed

    Buttram, V C

    1975-01-01

    One cause or anovulation may be an immature hypothalamic-pituitary-ovarian axis. The fact that initial menstrual cycles are usually irregular and often anovulatory implies that a maturation process is taking place in the HPO axis and that cyclic ovulatory menstruation begins only when adequate maturation occurs. Moreover, the external appearance of the ovary of a severely oligomenorrheic or amenorrheic female frequently is similar to that of a prepubertal female--this is, the ovary appears normal in size of slightly smaller, has a smooth, glistening surface without convolutions, and its capsule-like outer surface reveals few, if any, underlying follicles. A reasonable assumption is that there is inadequate gonadotropin stimulation of these ovaries possibly as a result of an immature HPO axis. The studies by radioimmunoassay of FSH and LH levels in prepubertal and pubertal females offer no statistical data by which to measure the maturity of the HPO axis, although consistently low FSH and LH levels may prove meaningful. Studies of FSH and LH in patients exhibiting gonadal dysgenesis neither support or disprove the immature HPO axis theory, but studies of idiopathic sexual precocity tend to support it. Studies using LH-RF in prepubertal and pubertal females indicate a pattern of response which may give useful information in the area.

  12. Innervation and anesthesia of the antler pedicle in wapiti and fallow deer.

    PubMed Central

    Woodbury, M R; Haigh, J C

    1996-01-01

    The heads from 6 mature male wapiti and 8 mature male fallow deer were dissected to provide a description of the nerves supplying the antler pedicles. Innervation in both species was found to resemble that of the red deer, with major contributions coming from the infratrochlear and zygomaticotemporal nerves. All heads displayed a dorsal branch from the auriculopalpebral nerve, but in only 2 wapiti and 3 fallow deer heads was this branch observed travelling to the pedicle. The dorsal branches of the 2nd cervical nerve were isolated in each head but could not be traced to the pedicles. Failure to induce anesthesia of the antler employing specific nerve blocks on the infratrochlear and zygomaticotemporal nerves can occur if the dorsal branch of the auriculopalpebral nerve is not blocked. PMID:8853883

  13. A Novel Blasted and Grooved Low Profile Pedicle Screw Able to Resist High Compression Bending Loads

    PubMed Central

    Kim, Young-Sung; Choi, Hong-June; Kim, Kyung-Hyun; Park, Jeong-Yoon; Jeong, Hyun-Yong; Chin, Dong-Kyu; Kim, Keun-Su; Yoon, Young-Sul; Lee, Yoon-Chul; Cho, Yong-Eun

    2012-01-01

    Objective Polyaxial pedicle screws are a safe, useful adjunct to transpedicular fixation. However, the large screw head size can cause soft tissue irritation, high rod positioning, and facet joint injury. However, the mechanical resistance provided by small and low profile pedicle screws is very limited. We therefore developed a novel, low profile pedicle screw using grooving and blasting treatment that is able to resist a high compression bending load. Methods We evaluated the compression bending force to displacement and yield loads for seven different screw head types that differed with regard to their groove intervals and whether or not they had been blasted. Results The rank order of screw types that had the greatest compression bending force to displacement was as follows: (1) universal polyaxial, (2) low polyaxial with 0.1mm grooves and blasting, (3) low polyaxial with blasting, (4) low polyaxial with 0.15mm grooves and blasting, (5) low polyaxial with 0.05mm grooves and blasting, (6) low polyaxial with 0.05mm grooves, (7) and low polyaxial. Low polyaxial screws with 0.1mm grooves and blasting had the maximum yield load and highest compression bending force to displacement of all seven polyaxial screw head systems evaluated. Conclusion Blasting and grooving treatment of pedicle screw heads resulted in screw heads with a high yield load and compression bending force relative to displacement because of increased friction. Low polyaxial pedicle screws with 0.1 mm grooves treated by blasting have mechanical characteristics similar to those of universal polyaxial pedicle screws. PMID:25983790

  14. Trans-Endplate Pedicle Pillar System in Unstable Spinal Burst Fractures: Design, Technique, and Mechanical Evaluation

    PubMed Central

    Zhao, Chunfeng; Hongo, Michio; Ilharreborde, Brice; Zhao, Kristin D.; Currier, Bradford L.; An, Kai-Nan

    2015-01-01

    Background Short-segment pedicle screw instrumentation (SSPI) is used for unstable burst fractures to correct deformity and stabilize the spine for fusion. However, pedicle screw loosening, pullout, or breakage often occurs due to the large moment applied during spine motion, leading to poor outcomes. The purpose of this study was to test the ability of a newly designed device, the Trans-Endplate Pedicle Pillar System (TEPPS), to enhance SSPI rigidity and decrease the screw bending moment with a simple posterior approach. Methods Six human cadaveric spines (T11-L3) were harvested. A burst fracture was created at L1, and the SSPI (Moss Miami System) was used for SSPI fixation. Strain gauge sensors were mounted on upper pedicle screws to measure screw load bearing. Segmental motion (T12-L2) was measured under pure moment of 7.5 Nm. The spine was tested sequentially under 4 conditions: intact; first SSPI alone (SSPI-1); SSPI+TEPPS; and second SSPI alone (SSPI-2). Results SSPI+TEPPS increased fixation rigidity by 41% in flexion/extension, 28% in lateral bending, and 37% in axial rotation compared with SSPI-1 (P<0.001), and it performed even better compared to SSPI-2 (P<0.001 for all). Importantly, the bending moment on the pedicle screws for SSPI+TEPPS was significantly decreased 63% during spine flexion and 47% in lateral bending (p<0.001). Conclusion TEPPS provided strong anterior support, enhanced SSPI fixation rigidity, and dramatically decreased the load on the pedicle screws. Its biomechanical benefits could potentially improve fusion rates and decrease SSPI instrumentation failure. PMID:26502352

  15. 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

  16. [Resurfacing of a trochanteric pressure sore by a pedicled fasciocutaneous anterolateral thigh flap: a case report].

    PubMed

    Zeitoun, J; Faghahati, S; Burin Des Roziers, B; Daoud, G; Cartier, S

    2013-06-01

    The anterolateral thigh flap is usually used as a free flap for various kinds of reconstruction and resurfacing of distant areas. Cover of a deep trochanteric pressure sore is commonly made by muscular or musculocutaneous flaps such as tensor of fascia lata or vastus lateralis. We report the case of a trochanteric pressure sore covered by a fasciocutaneous pedicled anterolateral thigh flap after negative pressure therapy in a 58-year-old paraplegic patient. After 6 months, a good quality of coverage was obtained with minimal morbidity of donor site. The pedicled fasciocutaneous anterolateral flap appears as a reliable option for the treatment of trochanteric pressure sore.

  17. 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.

  18. Balancing Rigidity and Safety of Pedicle Screw Fixation via a Novel Expansion Mechanism in a Severely Osteoporotic Model

    PubMed Central

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

    2015-01-01

    Many successful attempts to increase pullout strength of pedicle screws in osteoporotic bone have been accompanied with an increased risk of catastrophic damage to the patient. To avoid this, a single-armed expansive pedicle screw was designed to increase fixation strength while controlling postfailure damage away from the nerves surrounding the pedicle. The screw was then subsequently tested in two severely osteoporotic models: one representing trabecular bone (with and without the presence of polymethylmethacrylate) and the other representing a combination of trabecular and cortical bone. Maximum pullout strength, stiffness, energy to failure, energy to removal, and size of the resulting block damage were statistically compared among conditions. While expandable pedicle screws produced maximum pullout forces less than or comparable to standard screws, they required a higher amount of energy to be fully removed from both models. Furthermore, damage to the cortical layer in the composite test blocks was smaller in all measured directions for tests involving expandable pedicle screws than those involving standard pedicle screws. This indicates that while initial fixation may not differ in the presence of cortical bone, the expandable pedicle screw offers an increased level of postfailure stability and safety to patients awaiting revision surgery. PMID:25705655

  19. Minimally Invasive Mini Open Split-Muscular Percutaneous Pedicle Screw Fixation of the Thoracolumbar Spine

    PubMed Central

    Ulutaş, Murat; Seçer, Mehmet; Çelik, Suat Erol

    2015-01-01

    We prospectively assessed the feasibility and safety of a new percutaneous pedicle screw (PPS) fixation technique for instrumentation of the thoracic and lumbar spine in this study. All patients were operated in the prone position under general anesthesia. A 6 to 8 cm midline skin incision was made and wide subcutaneous dissection was performed. The paravertebral muscles were first dissected subperiosteally into the midline incision of the fascia for lumbar microdiscectomy with transforaminal lumbar interbody fusion cage implantation. After the secondary paramedian incisions on the fascia, the PPSs were inserted via cleavage of the multifidus muscles directly into the pedicles under fluoroscopy visualization. A total of 35 patients underwent surgery with this new surgical technique. The control group for operative time, blood loss and analgesic usage consisted of 35 randomly selected cases from our department. The control group underwent surgery via conventional pedicle screw instrumentation with paramedian fusion. All patients in the minimal invasive surgery series were ambulatory with minimal pain on the first postoperative day. The operation time and blood loss and the postoperative analgesic consumption were significantly less with this new technique. In conclusion, the minimal invasive mini open split-muscular percutaneous pedicle screw fixation technique is safe and feasible. It can be performed via a short midline skin incision and can also be combined with interbody fusion, causing minimal pain without severe muscle damage. PMID:25874062

  20. Treatment of bronchopleural fistula after pneumonectomy by using an omental pedicle.

    PubMed

    Martini, G; Widmann, J; Perkmann, R; Steger, K

    1994-03-01

    Dehiscence of the bronchial stump, particularly following pneumonectomy, is one of the most serious complications in lung surgery. Various approaches to this problem have been tried. Two patients with postpneumonectomy bronchopleural fistula were treated successfully by using a pedicle of the greater omentum.

  1. 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

  2. Minimally invasive mini open split-muscular percutaneous pedicle screw fixation of the thoracolumbar spine.

    PubMed

    Ulutaş, Murat; Seçer, Mehmet; Çelik, Suat Erol

    2015-03-01

    We prospectively assessed the feasibility and safety of a new percutaneous pedicle screw (PPS) fixation technique for instrumentation of the thoracic and lumbar spine in this study. All patients were operated in the prone position under general anesthesia. A 6 to 8 cm midline skin incision was made and wide subcutaneous dissection was performed. The paravertebral muscles were first dissected subperiosteally into the midline incision of the fascia for lumbar microdiscectomy with transforaminal lumbar interbody fusion cage implantation. After the secondary paramedian incisions on the fascia, the PPSs were inserted via cleavage of the multifidus muscles directly into the pedicles under fluoroscopy visualization. A total of 35 patients underwent surgery with this new surgical technique. The control group for operative time, blood loss and analgesic usage consisted of 35 randomly selected cases from our department. The control group underwent surgery via conventional pedicle screw instrumentation with paramedian fusion. All patients in the minimal invasive surgery series were ambulatory with minimal pain on the first postoperative day. The operation time and blood loss and the postoperative analgesic consumption were significantly less with this new technique. In conclusion, the minimal invasive mini open split-muscular percutaneous pedicle screw fixation technique is safe and feasible. It can be performed via a short midline skin incision and can also be combined with interbody fusion, causing minimal pain without severe muscle damage. PMID:25874062

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

    PubMed Central

    Modi, Hitesh N.; Fernandez, Harry; Yang, Jae Hyuk; Song, Hae-Ryong

    2008-01-01

    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°) and 69% in group 2 (curve >90°) 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. PMID:18830636

  5. 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

  6. 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.

  7. Pedicle-Screw-Based Dynamic Systems and Degenerative Lumbar Diseases: Biomechanical and Clinical Experiences of Dynamic Fusion with Isobar TTL

    PubMed Central

    Barrey, Cédric; Perrin, Gilles; Champain, Sabina

    2013-01-01

    Dynamic systems in the lumbar spine are believed to reduce main fusion drawbacks such as pseudarthrosis, bone rarefaction, and mechanical failure. Compared to fusion achieved with rigid constructs, biomechanical studies underlined some advantages of dynamic instrumentation including increased load sharing between the instrumentation and interbody bone graft and stresses reduction at bone-to-screw interface. These advantages may result in increased fusion rates, limitation of bone rarefaction, and reduction of mechanical complications with the ultimate objective to reduce reoperations rates. However published clinical evidence for dynamic systems remains limited. In addition to providing biomechanical evaluation of a pedicle-screw-based dynamic system, the present study offers a long-term (average 10.2 years) insight view of the clinical outcomes of 18 patients treated by fusion with dynamic systems for degenerative lumbar spine diseases. The findings outline significant and stable symptoms relief, absence of implant-related complications, no revision surgery, and few adjacent segment degenerative changes. In spite of sample limitations, this is the first long-term report of outcomes of dynamic fusion that opens an interesting perspective for clinical outcomes of dynamic systems that need to be explored at larger scale. PMID:25031874

  8. Vertical axis wind turbines

    DOEpatents

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

    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.

  9. Semimajor Axis Estimation Strategies

    NASA Technical Reports Server (NTRS)

    How, Jonathan P.; Alfriend, Kyle T.; Breger, Louis; Mitchell, Megan

    2004-01-01

    This paper extends previous analysis on the impact of sensing noise for the navigation and control aspects of formation flying spacecraft. We analyze the use of Carrier-phase Differential GPS (CDGPS) in relative navigation filters, with a particular focus on the filter correlation coefficient. This work was motivated by previous publications which suggested that a "good" navigation filter would have a strong correlation (i.e., coefficient near -1) to reduce the semimajor axis (SMA) error, and therefore, the overall fuel use. However, practical experience with CDGPS-based filters has shown this strong correlation seldom occurs (typical correlations approx. -0.1), even when the estimation accuracies are very good. We derive an analytic estimate of the filter correlation coefficient and demonstrate that, for the process and sensor noises levels expected with CDGPS, the expected value will be very low. It is also demonstrated that this correlation can be improved by increasing the time step of the discrete Kalman filter, but since the balance condition is not satisfied, the SMA error also increases. These observations are verified with several linear simulations. The combination of these simulations and analysis provide new insights on the crucial role of the process noise in determining the semimajor axis knowledge.

  10. 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.

  11. Doppler-assisted vascular pedicle flaps in eyelid and periorbital reconstruction.

    PubMed

    Yeatts, R P; Newsom, R W; Matthews, B L

    1996-09-01

    The use of a transcutaneous ultrasonic Doppler flow detector to identify the supratrochlear and superficial temporal arteries permits the design of narrow-based, thin-tipped forehead flaps for use in medial canthal and eyelid reconstruction. In the 13 cases described, the axial, vascular supply of a proposed myocutaneous forehead flap was determined with a transcutaneous ultrasonic Doppler flow detector permitting narrow-based pedicle widths of 0.8 to 1.2 cm. The design of the distal portion of the flap was determined by the primary defect. The width of the flap varied from 1.5 to 4.0 cm, with the flap's axial length limited only by the hairline. This use of the ultrasonic Doppler flow detector, permitting narrow-based, thin-tipped vascular pedicle flaps, has assisted in refining the concept of forehead flaps and has made these flaps an acceptable primary reconstructive technique in the periorbital region. PMID:8790111

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

    PubMed

    Abduljabbar, Fahad H; Rossel, Felipe; Nooh, Anas; Jarzem, Peter

    2015-09-28

    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

  13. Pedicled buccal fat pad graft for root coverage in severe gingival recession defect

    PubMed Central

    Panda, Saurav; Del Fabbro, Massimo; Satpathy, Anurag; Das, Abhaya Chandra

    2016-01-01

    Gingival recession (GR) is a condition resulting in root exposure which leads to root sensitivity, pain, root caries, plaque retention, poor esthetics, and tooth loss. Sites exhibiting Miller Class III and IV GR are not suitable for treatment with surgical root coverage techniques, and their prognosis are very poor with current techniques. In this case report, pedicled buccal fat pad (PBFP) was employed as subepithelial graft technique for root coverage of maxillary tooth with Class III GR defect along with furcation involvement and the absence of keratinized gingiva. PBFP as the subepithelial graft is likely to increase the predictability and outcome of root coverage procedures in the treatment of cases with poor prognosis, owing to its pedicled vascularity. PBFP may be considered as a reliable modality for root coverage of such severe maxillary posterior GR defects, as reported, that could not be repaired by other conventional procedures. PMID:27143839

  14. Pedicled buccal fat pad graft for root coverage in severe gingival recession defect.

    PubMed

    Panda, Saurav; Del Fabbro, Massimo; Satpathy, Anurag; Das, Abhaya Chandra

    2016-01-01

    Gingival recession (GR) is a condition resulting in root exposure which leads to root sensitivity, pain, root caries, plaque retention, poor esthetics, and tooth loss. Sites exhibiting Miller Class III and IV GR are not suitable for treatment with surgical root coverage techniques, and their prognosis are very poor with current techniques. In this case report, pedicled buccal fat pad (PBFP) was employed as subepithelial graft technique for root coverage of maxillary tooth with Class III GR defect along with furcation involvement and the absence of keratinized gingiva. PBFP as the subepithelial graft is likely to increase the predictability and outcome of root coverage procedures in the treatment of cases with poor prognosis, owing to its pedicled vascularity. PBFP may be considered as a reliable modality for root coverage of such severe maxillary posterior GR defects, as reported, that could not be repaired by other conventional procedures. PMID:27143839

  15. 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.

  16. Clinical Use of 3D Printing Guide Plate in Posterior Lumbar Pedicle Screw Fixation.

    PubMed

    Chen, Hongliang; Wu, Dongying; Yang, Huilin; Guo, Kaijin

    2015-01-01

    BACKGROUND This study aimed to evaluate the clinical efficacy of use of a 3D printing guide plate in posterior lumbar pedicle screw fixation. MATERIAL AND METHODS We enrolled 43 patients receiving posterior lumbar pedicle screw fixation. The experimental group underwent 3D printing guide plate-assisted posterior lumbar pedicle screw fixation, while the control group underwent traditional x-ray-assisted posterior lumbar pedicle screw fixation. After surgery, CT scanning was done to evaluate the accuracy of screw placement according to the Richter standard. RESULTS All patients were followed up for 1 month. The mean time of placement for each screw and the amount of hemorrhage was 4.9±2.1 min and 8.0±11.1 mL in the experimental group while 6.5±2.2 min and 59.9±13.0 mL in the control group, respectively, with significant differences (p<0.05). The fluoroscopy times of each screw placement was 0.5±0.4 in the experimental group, which was significantly lower than that in the control group 1.2±0.7 (p<0.05). The excellent and good screw placement rate was 100% in the experimental group and 98.4% in the control group, without any statistical difference (P>0.05). No obvious complications were reported in either group. CONCLUSIONS Compared with the traditional treatment methods, the intra-operative application of 3D printing guide plate can shorten the operation time and reduce the amount of hemorrhage. It can also reduce the fluoroscopy times compared with the traditional fluoroscopy, which cannot improve the accuracy rate of screw placement. PMID:26681388

  17. Immediate use of medicinal leeches to salvage venous congested reverse pedicled neurocutaneous flaps.

    PubMed

    Gideroglu, Kaan; Yildirim, Serkan; Akan, Mithat; Akoz, Tayfun

    2003-01-01

    Reverse pedicled neurocutaneous flaps have recently become popular for reconstructing soft tissue defects of the lower extremity. Venous congestion is a relatively common problem in these flaps in diabetic patients and those with electric burns, and this may cause partial or complete loss if capillary perfusion is not re-established urgently. We describe our experience of 13 neurocutaneous flaps, of which five developed venous congestion and were treated successfully with leeches placed immediately.

  18. Repair of Fingertip Defect Using an Anterograde Pedicle Flap Based on the Dorsal Perforator

    PubMed Central

    Wei, Peng; Chen, Weiwei; Mei, Jin; Ding, Maochao; Yu, Yaling; Xi, Shanshan; Zhou, Renpeng

    2016-01-01

    Background: The purposes of this article are to introduce and assess the results of a long-term follow-up of using anterograde pedicle flap based on the dorsal branches of proper digital neurovascular bundles from the dorsum of the middle phalanx for the fingertip defect. Methods: Between February 2011 and December 2012, 31 patients underwent reconstruction of fingertip defects using a homodigital flap based on the dorsal perforator in the middle phalanx. The defect size ranged from 1.3 cm × 1.5 cm to 2.4 cm × 3.0 cm. During surgery, the flap was designed on the dorsal middle phalangeal region. The pedicle was a neurovascular bundle consisting of an artery, vein, and sensory nerve; the rotation of pedicle was <90 degrees. Results: The clinical results were satisfactory after 3 to 9 months of follow-up. The flaps were considered cosmetically acceptable by both patients and doctors. The sensory recovery was excellent, 2-point discrimination was 4.96 ± 1.47 mm, and the recovery of range of motion of the interphalangeal joints was very good. Conclusions: The anterograde island flap based on the dorsal branches of proper digital neurovascular bundles is an ideal aesthetic reconstruction method for fingertip defect. A 90-degree rotated island pedicle flap was very versatile, easy to design, and had good survival. This technique is simple with less damage to the donor site, without sacrificing the branch of the digital artery and nerve. The reliable source of blood supply and satisfactory recovery of sensation can be achieved without affecting the interphalangeal joint activity. PMID:27482478

  19. Clinical Use of 3D Printing Guide Plate in Posterior Lumbar Pedicle Screw Fixation

    PubMed Central

    Chen, Hongliang; Wu, Dongying; Yang, Huilin; Guo, Kaijin

    2015-01-01

    Background This study aimed to evaluate the clinical efficacy of use of a 3D printing guide plate in posterior lumbar pedicle screw fixation. Material/Methods We enrolled 43 patients receiving posterior lumbar pedicle screw fixation. The experimental group underwent 3D printing guide plate-assisted posterior lumbar pedicle screw fixation, while the control group underwent traditional x-ray-assisted posterior lumbar pedicle screw fixation. After surgery, CT scanning was done to evaluate the accuracy of screw placement according to the Richter standard. Results All patients were followed up for 1 month. The mean time of placement for each screw and the amount of hemorrhage was 4.9±2.1 min and 8.0±11.1 mL in the experimental group while 6.5±2.2 min and 59.9±13.0 mL in the control group, respectively, with significant differences (p<0.05). The fluoroscopy times of each screw placement was 0.5±0.4 in the experimental group, which was significantly lower than that in the control group 1.2±0.7 (p<0.05). The excellent and good screw placement rate was 100% in the experimental group and 98.4% in the control group, without any statistical difference (P>0.05). No obvious complications were reported in either group. Conclusions Compared with the traditional treatment methods, the intra-operative application of 3D printing guide plate can shorten the operation time and reduce the amount of hemorrhage. It can also reduce the fluoroscopy times compared with the traditional fluoroscopy, which cannot improve the accuracy rate of screw placement. PMID:26681388

  20. Measurement of the volume of the pedicled TRAM flap in immediate breast reconstruction.

    PubMed

    Chang, K P; Lin, S D; Hou, M F; Lee, S S; Tsai, C C

    2001-12-01

    The transverse rectus abdominis musculocutaneous (TRAM) flap is now accepted as the standard for breast reconstruction, but achieving symmetrical breast reconstruction is still a challenge. A precise estimate of the volume of the flap is necessary to reconstruct a symmetrical and aesthetically pleasing breast. Many methods have been developed to overcome this problem, but they have not been suitable for the pedicled TRAM flap. By using a self-made device based on the Archimedes' principle, the authors can calculate accurately the volume of the pedicled TRAM flap and predict reliably the breast volume intraoperatively. The "procedure" is based on a self-made box into which the pedicled TRAM flap is placed. Warm saline is added to the box and the flap is then removed. Flap volume is calculated easily by determining the difference between the preestimated volume of the box and the volume of the residual water. From February to May 2000, this method was used on 28 patients to predict breast volume for breast reconstruction. This study revealed that the difference of the maximal chest circumferences (the index of the breast volume) demonstrates a positive correlation with the difference of the volumes and weights between the mastectomy specimen and the net TRAM flap. However, a more closely positive correlation exists between the differences of maximal chest circumference volume (r = 0.677) than maximal chest circumference weight (r = 0.618). These data reveal that the reconstructed breast's volume has a closer relationship with the volume of the net pedicled TRAM flap, rather than with its weight. PMID:11756827

  1. Clinical Use of 3D Printing Guide Plate in Posterior Lumbar Pedicle Screw Fixation.

    PubMed

    Chen, Hongliang; Wu, Dongying; Yang, Huilin; Guo, Kaijin

    2015-12-18

    BACKGROUND This study aimed to evaluate the clinical efficacy of use of a 3D printing guide plate in posterior lumbar pedicle screw fixation. MATERIAL AND METHODS We enrolled 43 patients receiving posterior lumbar pedicle screw fixation. The experimental group underwent 3D printing guide plate-assisted posterior lumbar pedicle screw fixation, while the control group underwent traditional x-ray-assisted posterior lumbar pedicle screw fixation. After surgery, CT scanning was done to evaluate the accuracy of screw placement according to the Richter standard. RESULTS All patients were followed up for 1 month. The mean time of placement for each screw and the amount of hemorrhage was 4.9±2.1 min and 8.0±11.1 mL in the experimental group while 6.5±2.2 min and 59.9±13.0 mL in the control group, respectively, with significant differences (p<0.05). The fluoroscopy times of each screw placement was 0.5±0.4 in the experimental group, which was significantly lower than that in the control group 1.2±0.7 (p<0.05). The excellent and good screw placement rate was 100% in the experimental group and 98.4% in the control group, without any statistical difference (P>0.05). No obvious complications were reported in either group. CONCLUSIONS Compared with the traditional treatment methods, the intra-operative application of 3D printing guide plate can shorten the operation time and reduce the amount of hemorrhage. It can also reduce the fluoroscopy times compared with the traditional fluoroscopy, which cannot improve the accuracy rate of screw placement.

  2. To Pringle or not to pringle: is Pedicle clamping a necessity in liver resection?

    PubMed

    Obiekwe, S R; Quintaine, L; Khannaz, A; Laurent, C; Saric, J

    2014-01-01

    A single center prospective study was done to evaluate the role of hepatic portal pedicle clamping (PC) during right hepatectomy (RH) in patients with primary and secondary liver tumors. Cirrhotics were excluded. Two groups were compared for preoperative demographics including diagnosis, tumor size, portal vein embolization and liver enzymes, pre and postoperative hemoglobin levels, percentage of residual liver mass, morbidity and mortality, pedicle clamp time, intensive care unit stay, length of hospital stay and blood loss. We observed no significant difference in the analysis of the post-operative hemoglobin, liver enzymes, residual liver size, size of tumor resected, need for postoperative monitoring in ICU stay, length of hospital stay and blood loss. Mortality and morbidity were the same. None of the patients were transfused during surgery. Our findings show that pedicle clamping was beneficial 15% of the time when uncontrolled intra-operative bleeding was encountered or in a subset of patients with peliosis, steatohepatitis, Jehovah Witness patient, and post-chemotherapy patients. However, its advantage has to be weighed against the disadvantages. PMID:25436318

  3. To Pringle or not to pringle: is Pedicle clamping a necessity in liver resection?

    PubMed

    Obiekwe, S R; Quintaine, L; Khannaz, A; Laurent, C; Saric, J

    2014-01-01

    A single center prospective study was done to evaluate the role of hepatic portal pedicle clamping (PC) during right hepatectomy (RH) in patients with primary and secondary liver tumors. Cirrhotics were excluded. Two groups were compared for preoperative demographics including diagnosis, tumor size, portal vein embolization and liver enzymes, pre and postoperative hemoglobin levels, percentage of residual liver mass, morbidity and mortality, pedicle clamp time, intensive care unit stay, length of hospital stay and blood loss. We observed no significant difference in the analysis of the post-operative hemoglobin, liver enzymes, residual liver size, size of tumor resected, need for postoperative monitoring in ICU stay, length of hospital stay and blood loss. Mortality and morbidity were the same. None of the patients were transfused during surgery. Our findings show that pedicle clamping was beneficial 15% of the time when uncontrolled intra-operative bleeding was encountered or in a subset of patients with peliosis, steatohepatitis, Jehovah Witness patient, and post-chemotherapy patients. However, its advantage has to be weighed against the disadvantages. PMID:25513103

  4. 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. PMID:26709786

  5. Basic Study for Ultrasound-Based Navigation for Pedicle Screw Insertion Using Transmission and Backscattered Methods

    PubMed Central

    Chen, Ziqiang; Wu, Bing; Zhai, Xiao; Bai, Yushu; Zhu, Xiaodong; Luo, Beier; Chen, Xiao; Li, Chao; Yang, Mingyuan; Xu, Kailiang; Liu, Chengcheng; Wang, Chuanfeng; Zhao, Yingchuan; Wei, Xianzhao; Chen, Kai; Yang, Wu; Ta, Dean; Li, Ming

    2015-01-01

    The purpose of this study was to understand the acoustic properties of human vertebral cancellous bone and to study the feasibility of ultrasound-based navigation for posterior pedicle screw fixation in spinal fusion surgery. Fourteen human vertebral specimens were disarticulated from seven un-embalmed cadavers (four males, three females, 73.14 ± 9.87 years, two specimens from each cadaver). Seven specimens were used to measure the transmission, including tests of attenuation and phase velocity, while the other seven specimens were used for backscattered measurements to inspect the depth of penetration and A-Mode signals. Five pairs of unfocused broadband ultrasonic transducers were used for the detection, with center frequencies of 0.5 MHz, 1 MHz, 1.5 MHz, 2.25 MHz, and 3.5 MHz. As a result, good and stable results were documented. With increased frequency, the attenuation increased (P<0.05), stability of the speed of sound improved (P<0.05), and penetration distance decreased (P>0.05). At about 0.6 cm away from the cortical bone, warning signals were easily observed from the backscattered measurements. In conclusion, the ultrasonic system proved to be an effective, moveable, and real-time imaging navigation system. However, how ultrasonic navigation will benefit pedicle screw insertion in spinal surgery needs to be determined. Therefore, ultrasound-guided pedicle screw implantation is theoretically effective and promising. PMID:25861053

  6. Effect of different radial hole designs on pullout and structural strength of cannulated pedicle screws.

    PubMed

    Chen, Hsin-Chang; Lai, Yu-Shu; Chen, Wen-Chuan; Chen, Jou-Wen; Chang, Chia-Ming; Chen, Yi-Long; Wang, Shih-Tien; Cheng, Cheng-Kung

    2015-08-01

    Cannulated pedicle screws are designed for bone cement injection to enhance fixation strength in severely osteoporotic spines. However, the screws commonly fracture during insertion. This study aims to evaluate how different positions/designs of radial holes may affect the pullout and structural strength of cannulated pedicle screws using finite element analysis. Three different screw hole designs were evaluated under torsion and bending conditions. The pullout strength for each screw was determined by axial pullout failure testing. The results showed that when the Von Mises stress reached the yield stress of titanium alloy the screw with four radial holes required a greater torque or bending moment than the nine and twelve hole screws. In the pullout test, the strength and stiffness of each screw with cement augmentation showed no significant differences, but the screw with four radial holes had a greater average pullout strength, which probably resulted from the significantly greater mean maximum lengths of cement augmentation. Superior biomechanical responses, with lower stress around the radial holes and greater pullout strength, represented by cannulated pedicle screw with four radial holes may worth recommending for clinical application. PMID:26054806

  7. 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

  8. 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

  9. 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

  10. The combination of inferior pedicle method and dermal suspension sling technique: one new efficient method for breast reduction

    PubMed Central

    Ding, Hao; Wang, Benzhong; Gu, Yufang; Zhao, Yu

    2015-01-01

    Objective: To explore a method of breast reduction which ensures well nipple and areola lactation function, adequate blood supply and good medial fullness and projection. At the same time, this study could evaluate the advantages of the combination of inferior pedicle method and dermal suspension sling technique for breast reduction. Methods: From 2011.11 to 2013.8, 13 women have undergone breast reduction using utilizing inferior pedicle combined with the dermal suspension sling technique. The inferior pedicle was designed with medial and lateral triangular flaps in the areas where normally be excised. These triangular flaps were deepithelialized and defatted. The flaps were attached to the chest wall above the inferior pedicle to create a dermal “cage”. Results: After operation, Sensation of nipple and areola complex, breast projection and shape were sustained during follow-up, of which the median interval was 12 months. No patient had poor projection and bottoming out. Conclusion: Dermal suspension and horizontal dermal placation provides a structural foundation to the inferior pedicle. It is an effective method of treatment for breast reduction, in that the sensation and lactation function of nipple and areola complex get further guaranteed, have nice breast projection and shape, and can be applied to all cases of breast reduction. PMID:26131293

  11. Cortical and Standard Trajectory Pedicle Screw Fixation Techniques in Stabilizing Multisegment Lumbar Spine with Low Grade Spondylolisthesis

    PubMed Central

    İnceoğlu, Serkan

    2015-01-01

    Background Cortical screw (CS) fixation has been recently proposed as an alternative to the standard pedicle screw (PS) fixation technique. Biomechanical studies involving individual screw pullout and single level motion segment stabilization showed comparable performance of both techniques. However, whether this new fixation technique can be applied to the stabilization of multilevel lumbar segments with significant destabilization has been unclear. Purpose To compare stability of CS fixation to the traditional PS fixation in an unstable 3 level spondylolisthesis model. Study Design This is a biomechanical study comparing cortical trajectory pedicle screw fixation to traditional trajectory pedicle screw fixation in an unstable cadaveric model using nondestructive flexibility test. Methods Eight fresh frozen cadaveric lumbar spines (T12- S1) were obtained. After intact baseline testing, a 3-level lowgrade spondylolisthesis was simulated at the L1-4. Each specimen was instrumented with the PS and CS fixation systems. Standard nondestructive flexibility test was performed. Range of motion at each level was compared between the constructs during flexion-extension, lateral bending, and axial rotation. Results The destabilization model significantly increased the ROM in all planes (P<0.05). Both fixation techniques provided significant reduction in the ROM (P<0.05). There was no significant difference in ROM between the PS and CS groups in any of planes (P>0.05). Conclusions Cortical trajectory pedicle screw fixation provided stabilization to multilevel lumbar segment with low-grade spondylolisthesis comparable to the standard trajectory pedicle screw construct. PMID:26484009

  12. 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

  13. Molecular regulation of hypothalamus-pituitary-gonads axis in males.

    PubMed

    Jin, Jia-Min; Yang, Wan-Xi

    2014-11-01

    The hypothalamic-pituitary-gonadal axis (HPG) plays vital roles in reproduction and steroid hormone production in both sexes. The focus of this review is upon gene structures, receptor structures and the signaling pathways of gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH). The hormones' functions in reproduction as well as consequences resulting from mutations are also summarized. Specific characteristics of hormones such as the pulsatile secretions of GnRH are also covered. The different regulators of the HPG axis are introduced including kisspeptin, activin, inhibin, follistatin, androgens and estrogen. This review includes not only their basic information, but also their unique function in the HPG axis. Here we view the HPG axis as a whole, so relations between ligands and receptors are well described crossing different levels of the HPG axis. Hormone interactions and transformations are also considered. The major information of this article is depicted in three figures summarizing the current discoveries on the HPG axis. This article systematically introduces the basic knowledge of the HPG axis and provides information of the current advances relating to reproductive hormones.

  14. 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.

  15. Axis I and Axis II diagnostic parameters of homicide.

    PubMed

    Yarvis, R M

    1990-01-01

    A series of 100 murderers was examined to discern overall patterns of psychopathology. In addition, demographic and other discriminating factors were used to test the hypothesis that murderers do not constitute a homogenous population and that subgroups will differ diagnostically. DSM-III diagnostic criteria were used to make each diagnosis. The sample was found to be representative of the universe from which it was drawn at least as could be determined by available comparative criteria. Four Axis I (psychoses, substance abuse, dysthymia, no Axis I) and three Axis II (antisocial, borderline, no Axis II) diagnostic categories accounted for more than 80 percent of the study population. The murderers were found to be a heterogenous population, and subgroups based on a combination of assailant's crime pattern, sex, prior criminal history, and relationship to victim manifested different prevailing diagnostic patterns.

  16. Pedicle screw placement in the lumbar spine: effect of trajectory and screw design on acute biomechanical purchase.

    PubMed

    Wray, Steven; Mimran, Ronnie; Vadapalli, Sasidhar; Shetye, Snehal S; McGilvray, Kirk C; Puttlitz, Christian M

    2015-05-01

    OBJECT Low bone mineral density in patients undergoing lumbar spinal surgery with screws is an especially difficult challenge because poor bone quality can severely compromise the maximum achievable purchase of the screws. A relatively new technique, the cortical bone screw trajectory, utilizes a medialized trajectory in the caudocephalad direction to engage a greater amount of cortical bone within the pars interarticularis and pedicle. The objectives of this cadaveric biomechanical study were to 1) evaluate a cortical screw system and compare its mechanical performance to the traditional pedicle screw system; 2) determine differences in bone quality associated with the cortical screw trajectory versus the normal pedicle screw insertion technique; 3) determine the cortical wall breach rate with both the cortical and traditional screw trajectories; and 4) determine the performance of the traditional screw in the cortical screw trajectory. METHODS Fourteen fresh frozen human lumbar spine sections (L1-5) were used in this study (mean age 57 ± 19 years). The experimental plan involved drilling and tapping screw holes for 2 trajectories under navigation (a traditional pedicle screw and a cortical screw) in both high-and low-quality vertebrae, measuring the bone quality associated with these trajectories, placing screws in the trajectories, and evaluating the competence of the screw purchase via 2 mechanical tests (pullout and toggle). The 3 experimental variants were 1) traditional pedicle screws placed in the traditional pedicle screw trajectory, 2) traditional pedicle screws placed in the cortical screw trajectory, and 3) cortical screws placed in the cortical screw trajectory. RESULTS A statistically significant increase in bone quality was observed for the cortical trajectories with a cortical screw (42%; p < 0.001) and traditional pedicle screw (48%; p < 0.001) when compared to the traditional trajectory with a traditional pedicle screw within the high

  17. Improvement of the Rotation Arch of the Posterior Interosseous Pedicle Flap Preserving Both Reverse Posterior and Anterior Interosseous Vascular Sources

    PubMed Central

    Tiengo, Cesare; Lombardi, Matteo; Bassetto, Franco

    2016-01-01

    Purpose: The reverse posterior interosseous artery flap has several advantages, not sacrificing any major blood vessel, but its relatively short pedicle limits the use to cover defects up to the metacarpophalangeal joint. Our purpose is to demonstrate that the ligature of the anterior interosseous artery (AIA), proximal to the communicating branch with the posterior interosseous artery, leads to an improved flap rotation arch, preserving both vascular sources. Methods: Sixteen fresh cadavers with latex perfusion were analyzed before and after our technique of elongation, and the so-obtained measures were standardized in “percentage of elongation of the pedicle.” Eight patient with the loss of substance at the dorsal aspect of the hand have been treated with this technique, and results were evaluated in terms of flap survival and complication rates. Results: The medium length of the pedicle in the normal flap was 10.8 cm, and after the section of the AIA, the medium length of the pedicle was 13.6 cm with a medium increase of 2.8 cm. It means a medium increase of 24% of the length of the pedicle. In all patients treated, full coverage of the defect was obtained, and we did not experience major complications. Conclusions: This anatomical study supported by our clinical experience demonstrates that the use of the variant described above permits to reach more distal part of the hand without being afraid to stretch the pedicle because of the connection with the anastomotic arcades of the AIA at the wrist reducing the risk of ischemia of the flap. PMID:27536473

  18. Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience

    PubMed Central

    Akbar, Saleem; Dhar, Shabir A.

    2008-01-01

    To assess the efficacy and feasibility of vertebroplasty and posterior short-segment pedicle screw fixation for the treatment of traumatic lumbar burst fractures. Short-segment pedicle screw instrumentation is a well described technique to reduce and stabilize thoracic and lumbar spine fractures. It is relatively a easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support. Patients with traumatic lumbar burst fractures without neurologic deficits were included. After a short segment posterior reduction and fixation, bilateral transpedicular reduction of the endplate was performed using a balloon, and polymethyl methacrylate cement was injected. Pre-operative and post-operative central and anterior heights were assessed with radiographs and MRI. Sixteen patients underwent this procedure, and a substantial reduction of the endplates could be achieved with the technique. All patients recovered uneventfully, and the neurologic examination revealed no deficits. The post-operative radiographs and magnetic resonance images demonstrated a good fracture reduction and filling of the bone defect without unwarranted bone displacement. The central and anterior height of the vertebral body could be restored to 72 and 82% of the estimated intact height, respectively. Complications were cement leakage in three cases without clinical implications and one superficial wound infection. Posterior short-segment pedicle fixation in conjunction with balloon vertebroplasty seems to be a feasible option in the management of lumbar burst fractures, thereby addressing all the three columns through a single approach. Although cement leakage occurred but had no clinical consequences or neurological deficit. PMID:18193300

  19. A novel endoscopic-assisted harvesting of pedicled freestyle fasciocutaneous flaps.

    PubMed

    Huang, Jen-Wu; Lin, Yi-Ying; Wu, Nai-Yuan; Yen, David Hung-Tsang

    2015-02-01

    The endoscopy-assisted technique has been demonstrated in harvesting muscle flaps; however, for pedicled freestyle fasciocutaneous flaps, few studies have applied this technique. We present a surgical procedure utilizing endoscopic-assisted method to identify the perforators of pedicled freestyle fasciocutaneous flaps for the reconstruction of soft tissue defects. From August to December 2012, 9 consecutive patients underwent endoscopic-assisted harvesting of fasciocutaneous flaps for the reconstruction of soft tissue defects. All of the defects were caused by trauma with tendon or bone exposure. Postoperatively, all patients were requested to return for outpatient follow-up visits for at least 3 months. The age of the 9 patients (8 men and 1 woman) ranged from 20 to 79 years (median 59 years). The defects ranged in size from 2 × 2 to 6 × 8 cm2. Two patients received anterolateral thigh transmuscular perforator flaps, 5 patients received fibular septocutaneous perforator flaps, and 2 patients received medial gastrocnemius transmuscular perforator flaps. The median incision length was 10 cm, and the median operative time was 120 minutes. None of the patients had intraoperative complications, and intraoperative bleeding was minimal (<50 mL). At the end of the 3-month follow-up period, none of the patients had any complications on either recipient or donor site, including total or partial necrosis of the flaps, flap dehiscence, hematomas, seromas, wound infections, or any conditions that indicated additional unplanned operative procedures. All of the patients had surviving flaps. Our results demonstrated that the endoscopic-assisted method could be a valuable and reliable alternative in harvesting pedicled freestyle fasciocutaneous flaps. PMID:25715266

  20. 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

  1. 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. PMID:25665108

  2. Indications, Outcomes, and Complications of Pedicled Propeller Perforator Flaps for Upper Body Defects: A Systematic Review

    PubMed Central

    Lazzeri, Davide; Huemer, Georg M.; Nicoli, Fabio; Larcher, Lorenz; Dashti, Talal; Grassetti, Luca; Li, Qingfeng; Spinelli, Giuseppe; Agostini, Tommaso

    2013-01-01

    Background The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. Methods A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis. Results From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed. Conclusions Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body. PMID:23362479

  3. Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience.

    PubMed

    Afzal, Suhail; Akbar, Saleem; Dhar, Shabir A

    2008-03-01

    To assess the efficacy and feasibility of vertebroplasty and posterior short-segment pedicle screw fixation for the treatment of traumatic lumbar burst fractures. Short-segment pedicle screw instrumentation is a well described technique to reduce and stabilize thoracic and lumbar spine fractures. It is relatively a easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support. Patients with traumatic lumbar burst fractures without neurologic deficits were included. After a short segment posterior reduction and fixation, bilateral transpedicular reduction of the endplate was performed using a balloon, and polymethyl methacrylate cement was injected. Pre-operative and post-operative central and anterior heights were assessed with radiographs and MRI. Sixteen patients underwent this procedure, and a substantial reduction of the endplates could be achieved with the technique. All patients recovered uneventfully, and the neurologic examination revealed no deficits. The post-operative radiographs and magnetic resonance images demonstrated a good fracture reduction and filling of the bone defect without unwarranted bone displacement. The central and anterior height of the vertebral body could be restored to 72 and 82% of the estimated intact height, respectively. Complications were cement leakage in three cases without clinical implications and one superficial wound infection. Posterior short-segment pedicle fixation in conjunction with balloon vertebroplasty seems to be a feasible option in the management of lumbar burst fractures, thereby addressing all the three columns through a single approach. Although cement leakage occurred but had no clinical consequences or neurological deficit. PMID:18193300

  4. [Use of pedicled cutaneous groin flaps in distal reconstruction of the upper extremity].

    PubMed

    Molski, M; Potocki, K; Stańczyk, J; Komorowska, A; Murawski, M

    2000-01-01

    In the years 1981-1997 at the Department of Plastic Surgery Medical Centre for Postsgraduate Education in Warsaw 116 patients were treated surgically using groin flaps and 97 patients using a pedicled cutaneous groin flap. This paper reports the results of the later technique. Reconstructions were performed in 10 female patients aged 18-58 (mean age 37.5 years) and 87 male patients aged 15-67 (mean age 33.8 years). The tissue defects or acquired deformations were caused by: crush injuries (26 cases), scalping injuries (23 cases), rugged injuries (18 cases), avulsion trauma (15 cases), explosion injuries (8 cases) and electric burns (7 cases). Flap size depended upon extent of the tissue defect and the from flaps were 7-26 cm long and 4-12 cm wide. Flap area ranged from 35 to 260 square centimetres. Emergency procedures were performed in 59 patients (61%). Secondary reconstructions were carried out in 38 cases (39%). Operative technique was based on the rules described by McGregor and Jackson. The donor site was sutured primarily tubulizing its basis--as in tube flap. The flap pedicle was cut off during a one stage procedure in 41 patients 21-30 days (mean 23 days) after surgery or during a two-stage procedure in 56 cases. The two-stage procedure consisted of an incision of part of the pedicle after 15-45 days post-op (mean 21 days) followed by a complete dissection after a few days (mean 4 days). In 44 cases the flap required modelling i.e. excision of excessives kin and/or thinning of subcutaneous tissue. The flap healed in 96 patients (99%). Complications at different stages of the treatment were observed in 40 patients (41%). In 3 cases wound ischemia was observed because of too tight suturing. Removal of skin sutures lead to normalization of blood supply. In 7 patients cyanotic skin of the distal part with no significant consequences was observed. In 27 patients (28%) necrosis of the marginal tissues surrounding the operation wound after cutting of the pedicle

  5. Attempted reinnervation of the equine larynx using a muscle pedicle graft.

    PubMed

    Harrison, I W; Speirs, V C; Braund, K G; Steiss, J E

    1992-01-01

    Laryngeal hemiplegia was induced in 4 ponies via a left recurrent laryngeal neurectomy. Reinnervation of the denervated left cricoarytenoideus dorsalis muscle was then attempted using a muscle pedicle graft from the right cricoarytenoideus dorsalis muscle. In 3 ponies there was no return of abductor function and failure of graft survival. In the fourth pony there was return of abductor function along with survival of the muscle bridge, however, there was evidence of reinnervation across the neurectomy site. Muscle-to-muscle neurotization of the paralyzed equine larynx, utilizing the cricoarytenoideus dorsalis muscle, does not appear to be a clinically useful technique.

  6. Interpolated subcutaneous fat pedicle melolabial flap for large nasal lining defects

    PubMed Central

    Griffin, Garrett R.; Chepeha, Douglas C.; Moyer, Jeffrey S.

    2016-01-01

    Full-thickness nasal deformities are a reconstructive challenge. Restoration of a reliable internal lining is critical for a successful reconstruction. Septal hinge flaps are the workhorse for internal lining defects. However, these and other intranasal mucosal flaps are sometimes unavailable due to prior harvest or previous oncologic resection. We present the two-stage interpolated subcutaneous fat pedicle melolabial flap for lining large defects when traditional intranasal flaps are unavailable. This approach is particularly useful when one forehead flap has already been expended, preserving the patient's remaining forehead tissue for external cover. PMID:22965480

  7. 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

  8. Minimally invasive transforaminal lumbar interbody fusion with percutaneous navigated guidewireless lumbosacral pedicle screw fixation.

    PubMed

    Chen, Kevin S; Park, Paul

    2016-07-01

    This video details the minimally invasive approach for treatment of a symptomatic Grade II lytic spondylolisthesis with high-grade foraminal stenosis. In this procedure, the use of a navigated, guidewireless technique for percutaneous pedicle screw placement at the lumbosacral junction is highlighted following initial decompression and transforaminal interbody fusion. Key steps of the procedure are delineated that include positioning, exposure, technique for interbody fusion, intraoperative image acquisition, and use of a concise 2-step process for navigated screw placement without using guidewires. The video can be found here: https://youtu.be/2u6H4Pc_8To . PMID:27364422

  9. 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.

  10. 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

  11. 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.

  12. Earth View, Art View

    ERIC Educational Resources Information Center

    Dambekalns, Lydia

    2005-01-01

    Educational practice today encourages interdisciplinary teaching as teachers address important basic themes from a variety of angles. In this article, the author talks about one of her successful projects that focuses on "sense of place" as one such theme, with the more specific charge of viewing Earth from both scientific and artistic…

  13. 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

  14. 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.

  15. 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

  16. Enhancement of pedicle screw stability using calcium phosphate cement in osteoporotic vertebrae: in vivo biomechanical study.

    PubMed

    Taniwaki, Yoshimichi; Takemasa, Ryuichi; Tani, Toshikazu; Mizobuchi, Hiroo; Yamamoto, Hiroshi

    2003-01-01

    We conducted an experimental study using female beagles with and without ovariectomy-induced osteoporosis to determine the effect of calcium phosphate cement (CPC) on the mechanical stability of inserted pedicle screws. A drill hole was created from the base of the transverse process to the vertebral body; CPC was injected into the hole, and then a screw was inserted into the same hole. In the presence of osteoporosis evidenced by dual X-ray absorptiometry, the stability of the inserted screw augmented by CPC against pull-out and cephalocaudal forces were significantly greater by 28% and 54% at 1 week after operation, 48% and 71% at 2 weeks, and 56% and 68% at 4 weeks compared with those without CPC. The pull-out strength increased progressively with time after surgery, probably reflecting new-bone growth from the surrounding cancellous bone, which was in direct contact with the CPC, as shown in the histologic study. At each time point the cephalocaudal rigidity was similar and the pull-out strength greater than that for the screws inserted without CPC in nonporotic dogs. These findings suggest that CPC augments the stability of the inserted pedicle screws and increases the stiffness of fixed osteoporotic motion segments using instrumentation. PMID:12768486

  17. Nasolabial pedicled compared with island flaps for intraoral reconstruction of oncological defects: complications, recovery of sensitivity, and assessment of quality of life.

    PubMed

    Maria, Lazaridou; Konstantinos, Vaxtsevanos; Ioannis, Dimitrakopoulos; Nikolaos, Lazaridis; Konstantinos, Antoniades

    2016-09-01

    Our aim was to compare pedicled and island nasolabial flaps used for reconstruction of oral defects in terms of postoperative complications, recovery of sensitivity, and quality of life. We organised a retrospective cohort study of 49 patients who had had intraoral reconstruction with nasolabial pedicled (n-=13) and island (n=36) flaps. Twenty- two patients filled in a validated quality-of-life (QoL) questionnaire and we did sensitivity tests (sharp discrimination with the aid of a Semmes-Weinstein™ aesthesiometer). Descriptive and bivariate statistics were computed and probabilities of 0.05 were accepted as significant. There were 11 flap-related complications (22%), and the flap was totally necrotic in three patients (6%), all of whom had island flaps. There was a significant association between flap-related complications and the use of reconstruction plate p=0.001, 95% CI 2.36 to 11.37) and advanced stage (T3 and T4 p=0.01, 95% CI 1.45 to 5.26). Skin sensitivity recovered in both island and pedicled flaps. Patients treated with island flaps had significantly more problems with prosthetic rehabilitation than those treated with pedicled flaps. The relatively low morbidity and adequate functional and aesthetic results make the pedicled nasolabial flap a viable technique. De-epithelialisation of the pedicle in island flaps permits coverage of defects with unilateral flaps in a one-stage reconstruction. However, the pedicle may be excessively stretched, leading to ischaemic complications. PMID:27182010

  18. 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

  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.

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

    PubMed

    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

  2. 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.

  3. Changing optical axis due to reactor operation

    NASA Astrophysics Data System (ADS)

    Hussey, D. S.; Jacobson, D. L.; Baltic, E.

    2011-09-01

    During reactor operation, the neutron flux distribution is modified by the reactor control mechanisms and in the case of the reactor at the National Institute of Standards and Technology, this is determined by the angular position of the Cd shim arms and the vertical position of an Al regulating rod. The changing flux distribution results in a change in the optical axis of neutron beams, whose view is a fixed position within the reactor core. The changing optical axis results in two noticeable image artifacts: poor registration between images of a static object taken at different times and a change in the shape of the flat field intensity. These two effects were measured during the first four days of reactor operation. Both measurements show correlation with the reactor control mechanisms, with combined correlation coefficients during the first two days after reactor startup approaching 1. The change in the edge position is well below the image spatial resolution, and has more uncertainty associated with it. However, the change in the flat-field shape demonstrates a clear correlation with both shim arm angle and regulating rod position.

  4. Optimal localization by pointing off axis.

    PubMed

    Yovel, Yossi; Falk, Ben; Moss, Cynthia F; Ulanovsky, Nachum

    2010-02-01

    Is centering a stimulus in the field of view an optimal strategy to localize and track it? We demonstrated, through experimental and computational studies, that the answer is no. We trained echolocating Egyptian fruit bats to localize a target in complete darkness, and we measured the directional aim of their sonar clicks. The bats did not center the sonar beam on the target, but instead pointed it off axis, accurately directing the maximum slope ("edge") of the beam onto the target. Information-theoretic calculations showed that using the maximum slope is optimal for localizing the target, at the cost of detection. We propose that the tradeoff between detection (optimized at stimulus peak) and localization (optimized at maximum slope) is fundamental to spatial localization and tracking accomplished through hearing, olfaction, and vision.

  5. 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

  6. In vitro biomechanical study of pedicle screw pull-out strength based on different screw path preparation techniques

    PubMed Central

    Moldavsky, Mark; Salloum, Kanaan; Bucklen, Brandon; Khalil, Saif; Mehta, Jwalant S

    2016-01-01

    Background: Poor screw-to-bone fixation is a clinical problem that can lead to screw loosening. Under-tapping (UT) the pedicle screw has been evaluated biomechanically in the past. The objective of the study was to determine if pedicle preparation with a sequential tapping technique will alter the screw-to-bone fixation strength using a stress relaxation testing loading protocol. Materials and Methods: Three thoracolumbar calf spines were instrumented with pedicle screws that were either probed, UT, standard-tapped (ST), or sequential tapped to prepare the pedicle screw track and a stress relaxation protocol was used to determine pull-out strength. The maximum torque required for pedicle screw insertion and pull-out strength was reported. A one-way ANOVA and Tukeys post-hoc test were used to determine statistical significance. Results: The pedicle screw insertion torques for the probed, UT, ST and sequentially tapped (SQT) techniques were 5.09 (±1.08) Nm, 5.39 (±1.61) Nm, 2.93 (±0.43) Nm, and 3.54 (±0.67) Nm, respectively. There is a significant difference between probed compared to ST (P ≤ 0.05), as well as UT compared to both ST and SQT (P ≤ 0.05). The pull-out strength for pedicle screws for the probed, UT, ST and SQT techniques was 2443 (±782) N, 2353(±918) N, 2474 (±521) N, and 2146 (±582) N, respectively, with no significant difference (P ≥ 0.05) between techniques. Conclusions: The ST technique resulted in the highest pull-out strength while the SQT technique resulted in the lowest. However, there was no significant difference in the pull-out strength for the various preparation techniques and there was no correlation between insertion torque and pull-out strength. This suggests that other factors such as bone density may have a greater influence on pull-out strength. PMID:27053808

  7. Finite Element Analysis of a New Pedicle Screw-Plate System for Minimally Invasive Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Zhou, Yue; Li, Changqing; Liu, Huan

    2015-01-01

    Purpose Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is increasingly popular for the surgical treatment of degenerative lumbar disc diseases. The constructs intended for segmental stability are varied in MI-TLIF. We adopted finite element (FE) analysis to compare the stability after different construct fixations using interbody cage with posterior pedicle screw-rod or pedicle screw-plate instrumentation system. Methods A L3–S1 FE model was modified to simulate decompression and fusion at L4–L5 segment. Fixation modes included unilateral plate (UP), unilateral rod (UR), bilateral plate (BP), bilateral rod (BR) and UP+UR fixation. The inferior surface of the S1 vertebra remained immobilized throughout the load simulation, and a bending moment of 7.5 Nm with 400N pre-load was applied on the L3 vertebra to recreate flexion, extension, lateral bending, and axial rotation. Range of motion (ROM) and Von Mises stress were evaluated for intact and instrumentation models in all loading planes. Results All reconstructive conditions displayed decreased motion at L4–L5. The pedicle screw-plate system offered equal ROM to pedicle screw-rod system in unilateral or bilateral fixation modes respectively. Pedicle screw stresses for plate system were 2.2 times greater than those for rod system in left lateral bending under unilateral fixation. Stresses for plate were 3.1 times greater than those for rod in right axial rotation under bilateral fixation. Stresses on intervertebral graft for plate system were similar to rod system in unilateral and bilateral fixation modes respectively. Increased ROM and posterior instrumentation stresses were observed in all loading modes with unilateral fixation compared with bilateral fixation in both systems. Conclusions Transforaminal lumbar interbody fusion augmentation with pedicle screw-plate system fixation increases fusion construct stability equally to the pedicle screw-rod system. Increased posterior

  8. 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.

  9. 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.

  10. 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

  11. Chronic Lyme disease and the 'Axis of Evil'.

    PubMed

    Stricker, Raphael B; Johnson, Lorraine

    2008-12-01

    Lyme disease is a controversial illness, and the existence of chronic Lyme disease induced by persistent infection with the Lyme spirochete, Borrelia burgdorferi, is the subject of continued debate. A recent publication defined the 'Axis of Evil' in this controversy as physicians who treat patients with needlessly prolonged courses of antibiotics, 'specialty laboratories' that perform 'inaccurate' Lyme testing and the internet, which promotes 'Lyme hysteria'. We examine the 'Axis of Evil' components in the context of diagnostic and therapeutic challenges for Lyme disease patients and their physicians, and we present an evidence-based refutation to this misguided view. Despite its virulent nature, the 'Axis of Evil' perspective is a useful starting point to resolve the controversy over Lyme disease.

  12. 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.

  13. 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.

  14. Early detection of pedicle screw-related spinal cord injury by continuous intraoperative neurophysiological monitoring (IONM).

    PubMed

    Jahangiri, Faisal R; Sheryar, Muhammad; Al Behairy, Yaser

    2014-12-01

    Pedicle screw placement has a high risk of damaging the motor and sensory pathways due to the close proximity to the spinal cord and nerve roots. Early detection and prevention of injury can be achieved by utilizing Somatosensory Evoked Potentials (SSEP) and Transcranial electrical Motor Evoked Potentials (TCeMEP) during a scoliosis surgery. A 19-year-old female presented for correction of scoliosis. After intubation, electrodes were placed for upper and lower SSEPs, EMGs and TCeMEPs. Total intravenous anesthesia was used. Baseline SSEP and TCeMEP responses were present in all limbs. Eight pedicle screws were placed. After placing the last screw, TCeMEP signals were lost bilaterally in lower extremities. Surgery was paused. After removing all the screws TCeMEP responses returned to baseline in left lower limb but remained absent in right lower limb. A wake-up test was performed which was positive in her right leg. Blood pressure was increased and bolus of steroids was given. There was no improvement in right lower limb TCeMEP responses. Surgeon was advised to stop the surgery and proceed for MRI and follow-up. SSEP signals remained stable in all four-extremities. The surgical correction was cancelled. MRI revealed intramedullary spinal cord ischemic changes at T11. After extubation, patient was unable to move her right lower extremity with flaccid paralysis. She also complained about severe burning in her left lower extremity. The patient was taken for rehabilitation exercises. One week post-op, she was moving hip flexors and two weeks later had afull motor function, bilaterally. Real-time IONM was useful in early identification of spinal cord injury. Significant changes were seen in TCeMEP, without any change in SSEP. We highly recommend utilizing continuous TCeMEP and SSEP monitoring during pedicle screw placement for prevention of injury to the spinal cord. In this case, the patient would have been paralyzed post-operatively without the use of IONM. PMID

  15. 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.

  16. 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

  17. Simultaneous Use of Both Bilateral Intralaminar and Pedicle Screws for C2 Stabilization.

    PubMed

    Tarukado, Kiyoshi; Tono, Osamu; Doi, Toshio

    2015-10-01

    Four patients underwent stabilization surgery using both bilateral C2 pedicle screw (PS) and intralaminar screw (LS). Neural and vascular injury resulting from incorrect screw placement was assessed using computed tomography (CT). The evaluation of bone union was assessed by lateral flexion-extension X-ray films and CT. The symptoms were improved in all patients. There were no intraoperative complications. Furthermore, there were no cases of neurological worsening or vascular injury from incorrect screw placement. Failure of instrumentation or screw loosening during the follow-up period did not occur in any of the patients. All cases had accomplished bone union at the final follow-up. Theoretically, the stabilization technique using both bilateral C2 PS and LS at the same time can provide more stability than any other single technique. Simultaneous use of both bilateral C2 PS and LS is potentially a good choice for surgical repair. PMID:26435800

  18. [Circulatory disturbance of middle lobe by bending of lobar pedicle after right upper lobectomy].

    PubMed

    Yurugi, Yohei; Maeta, Hiroyuki; Ohno, Takashi; Hosoya, Keiko; Matsumura, Azumi; Nishimura, Kengo; Miyasaka, Shigeto; Morimoto, Keisuke

    2013-11-01

    A 66-year-old man was diagnosed as lung cancer. We performed right upper lobectomy and lymphnode dissection. On the 1st postoperative day, a chest radiograph showed an opacification in the right upper lung field. Computed tomography (CT) showed a stenosis of the middle lobe bronchus and infiltrative shadow of the middle lobe on the 3rd postoperative day. Fiber optic bronchoscopic examination also revealed a bend and stenosis of the middle lobe bronchus, but tortion was not demonstrated. On the 6th postoperative day, chest radiographic findings was worsened. Torsion of the middle lobe was suspected, and rethoracotomy was performed on the 7th postoperative day. The right middle lobe was not rotated, but the lobar pedicle bend toward cranial. The middle lobe was highly congested necessitating lobectomy. PMID:24322317

  19. Percutaneous Transpedicular Interbody Fusion Technique in Percutaneous Pedicle Screw Stabilization for Pseudoarthrosis Following Pyogenic Spondylitis.

    PubMed

    Ikuta, Ko; Masuda, Keigo; Yonekura, Yutaka; Kitamura, Takahiro; Senba, Hideyuki; Shidahara, Satoshi

    2016-04-01

    This report introduces a percutaneous transpedicular interbody fusion (PTPIF) technique in posterior stabilization using percutaneous pedicle screws (PPSs). An 81-year-old man presented with pseudoarthrosis following pyogenic spondylitis 15 months before. Although no relapse of infection was found, he complained of obstinate low back pain and mild neurological symptoms. Radiological evaluations showed a pseudoarthrosis following pyogenic spondylitis at T11-12. Posterior stabilization using PPSs from Th9 to L2 and concomitant PTPIF using autologous iliac bone graft at T11-12 were performed. Low back pain and neurological symptoms were immediately improved after surgery. A solid interbody fusion at T11-12 was completed 9 months after surgery. The patient had no restriction of daily activity and could play golf at one year after surgery. PTPIF might be a useful option for perform segmental fusion in posterior stabilization using PPSs. PMID:27114777

  20. “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

  1. Attempts to restore abduction of the paralyzed equine arytenoid cartilage. I. Nerve-muscle pedicle transplants.

    PubMed Central

    Ducharme, N G; Horney, F D; Partlow, G D; Hulland, T J

    1989-01-01

    The purpose of this project was to adapt a surgical technique from humans and dogs to horses in which a portion of an accessory muscle of respiration and its nerve supply is transplanted to a denervated dorsal cricoarytenoid muscle. Anatomical dissections in seven horses revealed two possible donor nerve-pedicle grafts: the omohyoid and the sternothyrohyoid, both innervated by a branch of the first and second cervical nerves. Histochemical evaluations in two ponies of the dorsal cricoarytenoid, omohyoid and sternothyrohyoid muscles revealed similar proportions of fiber types 1 and 2 in all three muscles. Electromyographic studies in these two ponies revealed that the omohyoid and sternothyrohyoid muscles contract synchronously with respirations during forced inspiration under general anesthesia. Based on surgical ease of access, a 1 cm2 portion of the omohyoid muscle at the point of penetration of the second cervical nerve was used as a nerve-muscle pedicle graft in an attempt to reinnervate the left dorsal cricoarytenoid muscle in four ponies. These four ponies (as well as three others which served as controls) had previously undergone left recurrent laryngeal nerve transection. All seven ponies endoscopically showed signs of complete left laryngeal hemiplegia immediately postoperatively. Animals were monitored endoscopically for 30 weeks after surgery. The three control ponies showed no abduction of the arytenoid cartilage. In addition, in these three ponies, histological and histochemical expected changes of muscle fiber atrophy and fibrosis were present in the dorsal cricoarytenoid muscle.(ABSTRACT TRUNCATED AT 250 WORDS) Images Fig. 1. Fig. 4. Fig. 5. Fig. 6. Fig. 7. Fig. 8. PMID:2713785

  2. 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

  3. 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. PMID:27583161

  4. 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.

  5. Stress and the reproductive axis.

    PubMed

    Toufexis, D; Rivarola, M A; Lara, H; Viau, V

    2014-09-01

    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 example, both testosterone and oestrogen modulate the response of the HPA axis, whereas 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, as well as 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 such as oestrogen receptor (ER)α that govern sexual behaviour, and may be particularly important in determining the sexual strategies utilised 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 into the ovary, which produces a noncyclic 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 increases 5-HT1A receptor expression at postsynaptic sites. These mechanisms could explain the 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 behavioural phenotype that is largely unaffected by oestrogen, a hyporesponsive HPA axis that is hypersensitive to the modulating effects

  6. 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

  7. 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

  8. Double-pedicle abdominal perforator free flaps for unilateral breast reconstruction: new horizons in microsurgical tissue transfer to the breast.

    PubMed

    Hamdi, Moustapha; Khuthaila, Dana K; Van Landuyt, Koenraad; Roche, Nathalie; Monstrey, Stan

    2007-01-01

    The DIEAP (deep inferior epigastric artery perforator) flap is a suitable option for breast reconstruction resulting in excellent aesthetic outcome, and minimal donor site morbidity. Contraindications for use of the DIEAP flap may include previous abdominal liposuction and/or surgery, or lack of abdominal tissue. The purpose of this paper is to describe options of using abdominal perforator flaps, based on double-pedicle techniques, despite these contraindications. A retrospective evaluation was carried out on a series of 16 patients who required abdominal double-pedicle free perforator flaps for unilateral breast reconstruction since June 2002. The indications were multiple abdominal scars, previous abdominal liposuction and thin patients in five, three and eight cases, respectively. Preoperative mapping of the vascular network was done using Duplex and/or multi-detector CT scan imaging. Clinical evaluation of medical charts was done regarding patients' characteristics, surgical techniques, ischaemia/total operative time and complications. A clinical evaluation was done on all patients with average follow up of 15 months. Fat necrosis was investigated clinically and by mammogram examination. Different microsurgical techniques were performed to provide enough blood supply to the requested flaps: Perforator (P) to contralateral Deep Inferior Epigastric (DIE) anastomosis (P/DIEAP), in two patients; bilateral DIE vessels (DIEAP/DIEAP) in seven patients; and DIE with SIE (superficial inferior epigastric) vessels in seven patients (DIEAP/SIEA). One pedicle was always anastomosed to the internal mammary vessels. The second pedicle was anastomosed end-to-end to a side branch of the DIE or end-to-side with the DIE pedicle in 13 cases. The thoracodorsal vessels were used as recipient vessels for the second pedicle in three cases. Average operative time was 6h 30min (range 5h 30min-8h). All 16 flaps survived and fat necrosis occurred in one case. The harvesting of perforator

  9. 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.

  10. Hypothalamus-Pituitary-Thyroid Axis.

    PubMed

    Ortiga-Carvalho, Tania M; Chiamolera, Maria I; Pazos-Moura, Carmen C; Wondisford, Fredic E

    2016-01-01

    The hypothalamus-pituitary-thyroid (HPT) axis determines the set point of thyroid hormone (TH) production. Hypothalamic thyrotropin-releasing hormone (TRH) stimulates the synthesis and secretion of pituitary thyrotropin (thyroid-stimulating hormone, TSH), which acts at the thyroid to stimulate all steps of TH biosynthesis and secretion. The THs thyroxine (T4) and triiodothyronine (T3) control the secretion of TRH and TSH by negative feedback to maintain physiological levels of the main hormones of the HPT axis. Reduction of circulating TH levels due to primary thyroid failure results in increased TRH and TSH production, whereas the opposite occurs when circulating THs are in excess. Other neural, humoral, and local factors modulate the HPT axis and, in specific situations, determine alterations in the physiological function of the axis. The roles of THs are vital to nervous system development, linear growth, energetic metabolism, and thermogenesis. THs also regulate the hepatic metabolism of nutrients, fluid balance and the cardiovascular system. In cells, TH actions are mediated mainly by nuclear TH receptors (210), which modify gene expression. T3 is the preferred ligand of THR, whereas T4, the serum concentration of which is 100-fold higher than that of T3, undergoes extra-thyroidal conversion to T3. This conversion is catalyzed by 5'-deiodinases (D1 and D2), which are TH-activating enzymes. T4 can also be inactivated by conversion to reverse T3, which has very low affinity for THR, by 5-deiodinase (D3). The regulation of deiodinases, particularly D2, and TH transporters at the cell membrane control T3 availability, which is fundamental for TH action. © 2016 American Physiological Society. Compr Physiol 6:1387-1428, 2016. PMID:27347897

  11. 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.

  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. Technique for Minimizing Donor-site Morbidity after Pedicled TRAM-Flap Breast Reconstruction: Outcomes by a Single Surgeon’s Experience

    PubMed Central

    Rietjens, Mario; De Lorenzi, Francesca; Andrea, Manconi; Petit, Jean-Yves; Hamza, Alaa; Martella, Stefano; Barbieri, Benedetta; Gottardi, Alessandra; Giuseppe, Lomeo

    2015-01-01

    Background: Breast reconstruction with pedicled transverse rectus abdominis myocutaneous (TRAM) flap can result in significant abdominal wall donor-site morbidity. We present our technique of transversely dividing the anterior fascia and rectus abdominis combined with reinforcement above the arcuate line for closure of the anterior abdominal wall defect to prevent contour deformities performed by a single senior surgeon and compare these results with those of our prior series. Methods: We described our new technique of closure of the abdominal wall defect and retrospectively performed the comparison between the results of pedicled TRAM flaps using the new closure technique and those of 420 pedicled TRAM flaps from our 2003 publication in terms of abdominal bulging and hernia. Results: Sixty-seven pedicled TRAM flaps in 65 patients were compared with 420 pedicled TRAM flaps of the 2003 series. The new technique was associated with 5 partial TRAM flap necroses (8%). There was no total flap loss with the new technique. The median follow-up period was 13 months (range, 4–36 months). There were no instances of abdominal hernia and bulge during follow-up in the new series. Compared with the previous 2003 series, the new technique was superior in terms of occurrence of abdominal wall hernia or bulging. Conclusions: We are still performing pedicled TRAM flap for autologous breast reconstruction. Using the technique of transversely dividing the anterior fascia and rectus abdominis combined with reinforcement above the arcuate line can reduce the occurrence of abdominal bulging and hernia. PMID:26495189

  14. Computer-Aided Surgery Does Not Increase the Accuracy of Dorsal Pedicle Screw Placement in the Thoracic and Lumbar Spine: A Retrospective Analysis of 2,003 Pedicle Screws in a Level I Trauma Center

    PubMed Central

    Kraus, Michael; Weiskopf, Julia; Dreyhaupt, Jens; Krischak, Gert; Gebhard, Florian

    2014-01-01

    Study Design A retrospective analysis of a prospective database. Objective Meta-analyses suggest that computer-assisted systems can increase the accuracy of pedicle screw placement for dorsal spinal fusion procedures. The results of further meta-analyses report that in the thoracic spine, both the methods have comparable placement accuracy. These studies are limited due to an abundance of screw classification systems. The aim of this study was to assess the placement accuracy and potentially influencing factors of three-dimensionally navigated versus conventionally inserted pedicle screws. Methods This was a retrospective analysis of a prospective database at a level I trauma center of pedicle screw placement (computer-navigated versus traditionally placed) for dorsal spinal stabilizations. The cases spanned a 5.5-year study period (January 1, 2005, to June 30, 2010). The perforations of the pedicle were differentiated in three grades based on the postoperative computed tomography. Results The overall placement accuracy was 86% in the conventional group versus 79% in the computer-navigated group (grade 0). The computer-navigated procedures were superior in the lumbar spine and the conventional procedures were superior in the thoracic spine, but both failed to be of statistical significance. The level of experience of the performing surgeon and the patient's body mass index did not influence the placement accuracy. The only significant influence was the spinal segment: the higher the spinal level where the fusion was performed, the more likely the screw was displaced. Conclusions The computer-navigated and conventional methods are both safe procedures to place transpedicular screws at the traumatized thoracic and lumbar spine. At the moment, three-dimensionally based navigation does not significantly increase the placement accuracy. PMID:25844281

  15. Comparison of open and percutaneous lumbar pedicle screw revision rate using 3-D image guidance and intraoperative CT.

    PubMed

    Santos, Edward Rainier G; Sembrano, Jonathan N; Yson, Sharon C; Polly, David W

    2015-02-01

    Complications arising from a malpositioned screw can be both devastating and costly. The incidence of neurologic injury secondary to a malpositioned screw is reported to be as high as 7% to 12%. The advancement of image-guided technology has allowed surgeons to place screws more accurately and confirm correct placement prior to leaving the operating room. Only a small number of studies have examined image-guided pedicle screw accuracy in terms of intraoperative revision and reoperation rates. The purpose of this study was to determine the intraoperative revision and return to surgery rates for navigated lumbar pedicle screws and to compare navigated open and percutaneous techniques. The authors reviewed 199 cases of 3-dimensional image-guided lumbar pedicle screw instrumentation from November 2006 to December 2011. Screw or K-wire removal, repositioning, or eventual abandonment of insertion were noted. Chi-square test was used to determine statistical significance in rates between the 2 groups (alpha=0.05). The authors also noted return to surgery secondary to complications from a malpositioned screw. The overall intraoperative revision rate of navigated lumbar pedicle screws was 4.6%. There were significantly more revisions in the percutaneously inserted screws (7.5%) than with the open technique (2.7%) (P=.0004). If K-wire revisions are excluded, there was no statistically significant difference in intraoperative revision rates between the percutaneous and open groups (2.1% vs 2.7%, respectively) (P=.0004). No patients underwent reoperation for a malpositioned screw. This technology has virtually eliminated the need for reoperation for screw malposition. It may suggest a more cost-effective way of preventing neurovascular injuries and revision surgeries.

  16. 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

  17. Biomechanical and finite element analyses of bone cement-Injectable cannulated pedicle screw fixation in osteoporotic bone.

    PubMed

    Liu, Yaoyao; Xu, Jianzhong; Sun, Dong; Luo, Fei; Zhang, Zehua; Dai, Fei

    2016-07-01

    The objectives of this study were to investigate the safety and biomechanical stability of a polymethylmethacrylate (PMMA)-augmented bone cement-injectable cannulated pedicle screw (CICPS) in cancellous bone model, and to analyze the stress distribution at the screw-cement-bone interface. The OMEGA cannulated pedicle screw (OPS) and conventional pedicle screw (CPS) were used as control groups. Safety of the CICPS was evaluated by the static bending and bending fatigue tests. Biomechanical stability was analyzed by the maximum axial pullout strength and maximum torque tests. Stress distribution at the screw-cement-bone interface was analyzed by the finite element (FE) method. The CICPS and CPS produced statistically similar values for bending stiffness, bending structural stiffness, and bending yield moment. The maximum pullout force was 53.47 ± 8.65 N in CPS group, compared to 130.82 ± 7.32 N and 175.45 ± 43.01 N in the PMMA-augmented OPS and CICPS groups, respectively (p < 0.05). The CICPS had a significantly greater torque than the OPS and CPS. The FE model did not reveal excessive stress at the screw-cement-bone interface in the CICPS group. In conclusion, PMMA-augmentation with CICPS may be a potentially useful method to increase the stability of pedicle screws in patients with osteoporosis. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 960-967, 2016. PMID:25976272

  18. 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

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

    PubMed

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

    2016-03-01

    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 higher than

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

    PubMed

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

    2016-03-01

    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 higher than

  1. 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.

  2. 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

  3. Computer Simulation and Analysis on Flow Characteristics and Distribution Patterns of Polymethylmethacrylate in Lumbar Vertebral Body and Vertebral Pedicle

    PubMed Central

    Liu, Da; Liu, Xu-li; Zhang, Bo; Liao, Dong-fa; Li, Zhi-qiang; Zhou, Jiang-jun; Kang, Xia; Zheng, Wei; Lei, Wei

    2015-01-01

    This study was designed to analyze the flow and distribution of polymethylmethacrylate (PMMA) in vertebral body through computer simulation. Cadaveric lumbar vertebrae were scanned through electron beam tomography (EBT). The data was imported into Mimics software to build computational model. Vertebral body center and junction of pedicle and vertebral body were chosen as injection points. Silicone oil with viscosity of 100,000 cSt matching with PMMA bone cement was chosen for injection. The flow and distribution of silicone oil were analyzed using Fluent software. In vertebral body, silicone oil formed a circle-like shape centered by injection point on transverse and longitudinal sections, finally forming a sphere-like shape as a whole. Silicone oil diffused along lateral and posterior walls forming a circle-like shape on transverse section centered by injection point in pedicle, eventually forming a sphere-like shape as a whole. This study demonstrated that silicone oil flowed and diffused into a circle-like shape centered by injection point and finally formed a sphere-like shape as a whole in both vertebral body and pedicle. The flow and distribution of silicon oil in computational model could simulate PMMA distribution in vertebral body. It may provide theoretical evidence to reduce PMMA leakage risk during percutaneous vertebroplasty. PMID:26770969

  4. “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

  5. Radiographic determinants of the elbow rotation axis: experimental identification and quantitative validation.

    PubMed

    Bottlang, M; O'Rourke, M R; Madey, S M; Steyers, C M; Marsh, J L; Brown, T D

    2000-09-01

    This study identifies new radiographic indices to approximate the location of the elbow rotational axis. With use of electromagnetic motion tracking source data, the average rotational axis of the ulnohumeral articulation was calculated in seven cadaveric specimens. Quasi-lateral radiographs of the elbow specimens were then analyzed to identify radiographic landmarks of the elbow axis in the lateral view. The spatial relationships of these landmarks with the elbow aligned on-axis were contrasted with their relationships in eight distinct off-axis alignments. Elbow axis orientation in the transverse plane (internal/external rotation) was identified by the location of a dense intramedullary cortical line, appearing in the projection of the distal humerus in relation to the periosteal surface of the posterior cortex of the humerus. This intramedullary line corresponds to the posteromedial cortex of the distal humerus. Correct alignment occurred when this line laid 27.1+/-3.7% of the anteroposterior humeral diameter anterior from the periosteal surface of the posterior cortex. Axis orientation in the coronal plane (abduction/adduction) was identified by the concentric appearance of radiographic arcs formed by the capitellum, trochlear sulcus, and medial trochlear flange. Using these radiographic indices, three orthopaedic surgeons were able to fluoroscopically align the elbow along the axis of rotation with an accuracy of 3.7+/-1.8 degrees. These results are immediately applicable to fluoroscopic identification of the elbow axis. This technique can be used to increase the accuracy of hinge placement during application of hinged external fixation or distraction arthroplasty.

  6. ScaphoLunate Axis Method.

    PubMed

    Yao, Jeffrey; Zlotolow, Dan A; Lee, Steve K

    2016-03-01

    Background Treating chronic scapholunate ligament injuries without the presence of arthritis remains an unsolved clinical problem facing wrist surgeons. This article highlights a technique for reconstructing the scapholunate ligament using novel fixation, the ScaphoLunate Axis Method (SLAM). Materials and Methods In a preliminary review of the early experience of this technique, 13 patients were evaluated following scapholunate ligament reconstruction utilizing the SLAM technique. Description of Techinque The scapholunate interval is reconstructed utilizing a palmaris longus autograft passed between the scaphoid and lunate along the axis of rotation in the sagittal plane. It is secured in the lunate using a graft anchor and in the scaphoid utilizing an interference screw. The remaining graft is passed dorsally to reconstruct the dorsal scapholunate ligament. Results At an average follow-up of 11 months, the mean postoperative scapholunate gap was 2.1 mm. The mean postoperative scapholunate angle was 59 degrees. The mean postoperative wrist flexion and extension was 45 and 56 degrees, respectively. The mean grip strength was 24.9 kg, or 62% of the contralateral side. The mean pain score (VAS) was 1.7. There was 1 failure with recurrence of the pathologic scapholunate gap and the onset of pain. Conclusion While chronic scapholunate ligament instability remains an unsolved problem facing wrist surgeons, newer techniques are directed toward restoring the normal relationships of the scaphoid and lunate in both the coronal and sagittal planes. The SLAM technique has demonstrated promise in preliminary clinical studies. PMID:26855838

  7. Centration axis in refractive surgery.

    PubMed

    Arba Mosquera, Samuel; Verma, Shwetabh; McAlinden, Colm

    2015-01-01

    The human eye is an asymmetric optical system and the real cornea is not a rotationally symmetrical volume. Each optical element in the eye has its own optical and neural axes. Defining the optimum center for laser ablation is difficult with many available approaches. We explain the various centration approaches (based on these reference axes) in refractive surgery and review their clinical outcomes. The line-of-sight (LOS) (the line joining the entrance pupil center with the fixation point) is often the recommended reference axis for representing wavefront aberrations of the whole eye (derived from the definition of chief ray in geometrical optics); however pupil centration can be unstable and change with the pupil size. The corneal vertex (CV) represents a stable preferable morphologic reference which is the best approximate for alignment to the visual axis. However, the corneal light reflex can be considered as non-constant, but dependent on the direction of gaze of the eye with respect to the light source. A compromise between the pupil and CV centered ablations is seen in the form of an asymmetric offset where the manifest refraction is referenced to the CV while the higher order aberrations are referenced to the pupil center. There is a need for a flexible choice of centration in excimer laser systems to design customized and non-customized treatments optimally. PMID:26605360

  8. 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.

  9. 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

  10. 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.

  11. Posterior interosseous artery flap, fasciosubcutaneous pedicle technique: a study of 25 cases.

    PubMed

    Puri, Vinita; Mahendru, Sanjay; Rana, Roshani

    2007-01-01

    This study was undertaken in an attempt to improve the versatility of the posterior interosseous artery flap (PIA flap) and to decrease flap complication rate. The PIA flap was used for resurfacing 25 cases of the hand and distal forearm over a 2-year period. Observations were made on the anatomy of the PIA flap and its distal reach. Doppler analysis was made a mandatory part of the preoperative planning. Flaps were also raised from the zone of injury if Doppler confirmed the presence of good perforators. No attempt was made to identify the anastomosis between the anterior interosseous artery (AIA) and the PIA prior to flap raising since its presence was ascertained preoperatively with a Doppler and flap raising could begin straightway, saving precious tourniquet time. The surgical technique was further modified to include a large amount of fascia and subcutaneous tissue with the flap. This could perhaps be the reason for survival of larger flaps, absence of venous congestion and the low complication rate seen in our series. These flaps were used to resurface defects involving the dorsum of the hand, palm, distal forearm, wrist and fingers (both dorsal and volar surfaces). The distal reach of the flap was improved by exteriorising the pedicle and bowstringing it across the wrist which was kept in extension. The flap could thus easily reach the distal interphalangeal joint. This exteriorised pedicle was covered with a split thickness skin graft and was divided 3 weeks later under local anaesthesia making it a two-stage procedure. Adipofascial and osteocutaneous PIA flaps were also used depending on the requirement. Out of 25 flaps, 23 were of the adipofascial variety and one each of the fascial and osteocutaneous type. The majority of the patients were between 21 and 30 years old. Trauma was the leading cause of tissue deficit in our series (19/25). Within the trauma group occupational mishap (entrapment of hand in roller machine, presser machine, etc.) was the

  12. [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

  13. Minimally Invasive Lumbar Pedicle Screw Fixation Using Cortical Bone Trajectory – A Prospective Cohort Study on Postoperative Pain Outcomes

    PubMed Central

    Deb, Sayantan; Pham, Lan; Singh, Harminder

    2016-01-01

    Objective: Our study aims to evaluate the clinical outcomes of cortical screws in regards to postoperative pain. Background: Pedicle screw fixation is the current mainstay technique for posterior spinal fusion. Over the past decade, a new technique called cortical screw fixation has been developed, which allows for medialized screw placement through stronger cortical bone. There have been several studies that showed either biomechanical equivalence or superiority of cortical screws. However, there is currently only a single study in the literature looking at clinical outcomes of cortical screw fixation in patients who have had no prior spine surgery. Methods: We prospectively looked at the senior author’s patients who underwent cortical versus pedicle lumbar screw fixation surgeries between 2013 and 2015 for lumbar degenerative disease. Eighteen patients underwent cortical screw fixation, and 15 patients underwent traditional pedicle screw fixation. We looked at immediate postoperative pain, changes in short-term pain (six to 12 weeks post-surgery), and changes in long-term pain (six to eight months). All pain outcomes were measured using a visual analog scale ranging from 1 to 10. Mann-Whitney or Kruskal-Wallis tests were used to measure continuous data, and the Fisher Exact test was used to measure categorical data as appropriate. Results: Our results showed that the cortical screw cohort showed a trend towards having less peak postoperative pain (p = 0.09). The average postoperative pain was similar between the two cohorts (p = 0.93). There was also no difference in pain six to 12 weeks after surgery (p = 0.8). However, at six to eight months, the cortical screw cohort had worse pain compared to the pedicle screw cohort (p = 0.02). Conclusions: The cortical screw patients showed a trend towards less peak pain in the short-term (one to three days post-surgery) and more pain in the long-term (six to eight months post-surgery) compared to pedicle screw patients

  14. 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

  15. Minimally Invasive Lumbar Pedicle Screw Fixation Using Cortical Bone Trajectory – A Prospective Cohort Study on Postoperative Pain Outcomes

    PubMed Central

    Deb, Sayantan; Pham, Lan; Singh, Harminder

    2016-01-01

    Objective: Our study aims to evaluate the clinical outcomes of cortical screws in regards to postoperative pain. Background: Pedicle screw fixation is the current mainstay technique for posterior spinal fusion. Over the past decade, a new technique called cortical screw fixation has been developed, which allows for medialized screw placement through stronger cortical bone. There have been several studies that showed either biomechanical equivalence or superiority of cortical screws. However, there is currently only a single study in the literature looking at clinical outcomes of cortical screw fixation in patients who have had no prior spine surgery. Methods: We prospectively looked at the senior author’s patients who underwent cortical versus pedicle lumbar screw fixation surgeries between 2013 and 2015 for lumbar degenerative disease. Eighteen patients underwent cortical screw fixation, and 15 patients underwent traditional pedicle screw fixation. We looked at immediate postoperative pain, changes in short-term pain (six to 12 weeks post-surgery), and changes in long-term pain (six to eight months). All pain outcomes were measured using a visual analog scale ranging from 1 to 10. Mann-Whitney or Kruskal-Wallis tests were used to measure continuous data, and the Fisher Exact test was used to measure categorical data as appropriate. Results: Our results showed that the cortical screw cohort showed a trend towards having less peak postoperative pain (p = 0.09). The average postoperative pain was similar between the two cohorts (p = 0.93). There was also no difference in pain six to 12 weeks after surgery (p = 0.8). However, at six to eight months, the cortical screw cohort had worse pain compared to the pedicle screw cohort (p = 0.02). Conclusions: The cortical screw patients showed a trend towards less peak pain in the short-term (one to three days post-surgery) and more pain in the long-term (six to eight months post-surgery) compared to pedicle screw patients

  16. 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.

  17. 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.

  18. 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.

  19. Biomechanical study of the sacroiliac fracture fixation with titanium rods and pedicle screws

    PubMed Central

    Ueno, Fabrício Hidetoshi; Pisani, Marina Justi; Machado, André Nunes; Rodrigues, Fábio Lucas; Fujiki, Edison Noburo; Rodrigues, Luciano Miller Reis

    2015-01-01

    OBJECTIVES: To assess biomechanically different fixations means of the sacroiliac joint with pedicle screws and to compare the traditional head height with reduced ones. METHODS: We used a polyethylene model representing the pelvic ring and simulated a unilateral sacroiliac dislocation. We set up three different constructions: 1) two screws attached to a rod; 2) two rods connected to two small head screws each; and 3) two rods connected to two average headed screws each. We conducted tests in a biomechanical testing and a mechanized processing laboratory. RESULTS: Group 1 supported an average maximum load of 99.70 N. Group 2 supported an average maximum load of 362.46 N. Group 3 endured an average maximum load of 404.15 N. In the assembly with one rod, the resistance decreased as compared with the one with two bars: 72.5 % compared to small-headed screws and 75.3 % to the traditional screw. CONCLUSION: The assembly with a single bar presented inferior results when compared to the double bar assembly. There was no statistical difference in the results between the screws used. Experimental Study. PMID:26207094

  20. Treatment of left laryngeal hemiplegia in standardbreds, using a nerve muscle pedicle graft.

    PubMed

    Fulton, I C; Derksen, F J; Stick, J A; Robinson, N E; Walshaw, R

    1991-09-01

    The efficacy of a nerve muscle pedicle (NMP) graft in restoring upper airway function was evaluated in exercising horses with induced left laryngeal hemiplegia. The NMP graft was created from the first cervical nerve and the omohyoideus muscle and transplanted into the left cricoarytenoideus dorsalis muscle. Seven adult Standardbreds were trained to exercise on a treadmill inclined at 6.38 degrees. With the horses at rest and exercising at 4.2 and 7.0 m/s, the following variables were recorded: peak inspiratory and expiratory transupper airway pressures (defined as the pressure difference between a lateral tracheal catheter and a mask catheter), peak inspiratory and expiratory air flow, inspiratory and expiratory impedance, tidal volume, minute ventilation, heart rate, and respiratory frequency. Measurements were made before left recurrent laryngeal neurectomy (LRLN), 28 days after LRLN, and 12, 24, and 52 weeks after the NMP graft (n = 5) or sham operation (n = 2). Before LRLN, exercise increased inspiratory and expiratory air flow and transupper airway pressure, whereas the impedance was unchanged. After LRLN, transupper airway inspiratory pressure and impedance were significantly greater and inspiratory air flow was significantly less than baseline values at 7.0 m/s. The sham operation did not improve airway function. Twelve weeks after insertion of the NMP graft, inspiratory impedance and inspiratory air flow were significantly different (improved) from LRLN values. Twenty-four weeks after insertion of the NMP graft, inspiratory impedance was not significantly different from LRLN values.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. 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. PMID:25769251

  2. 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

  3. 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.

  4. Off-axis multiple scattering of a laser beam in turbid media Comparison of theory and experiment

    NASA Astrophysics Data System (ADS)

    Gerstl, Siegfried A. W.; Zardecki, Andrew; Unruh, Wesley P.; Stupin, David M.; Stokes, Grant H.

    1987-03-01

    The off-axis forward-scattered radiation from a low energy He-Ne laser, scattered by high density hydrosols, is studied experimentally and theoretically. The validity range of theoretical calculations is determined using four measurements with two optical depths and two detector fields of view. For narrow field of view detectors, experimental and theoretical agreement is good close to the beam axis and decreases with transverse distance; agreement is good at greater distances from the beam axis using an open detector. The small-angle approximation adequately describes multiple scattering close to the beam; calculations are significantly improved by combining the small-angle approximation with diffusion theory.

  5. Off-axis multiple scattering of a laser beam in turbid media: comparison of theory and experiment.

    PubMed

    Gersti, S A; Zardecki, A; Unruh, W P; Stupin, D M; Stokes, G H; Elliott, N E

    1987-03-01

    The off-axis forward-scattered radiation from a low energy He-Ne laser, scattered by high density hydrosols, is studied experimentally and theoretically. The validity range of theoretical calculations is determined using four measurements with two optical depths and two detector fields of view. For narrow field of view detectors, experimental and theoretical agreement is good close to the beam axis and decreases with transverse distance; agreement is good at greater distances from the beam axis using an open detector. The small-angle approximation adequately describes multiple scattering close to the beam; calculations are significantly improved by combining the small-angle approximation with diffusion theory.

  6. A numerical method of tracing a vortical axis along local topological axis line

    NASA Astrophysics Data System (ADS)

    Nakayama, Katsuyuki; Hasegawa, Hideki

    2016-06-01

    A new numerical method is presented to trace or identify a vortical axis in flow, which is based on Galilean invariant flow topology. We focus on the local flow topology specified by the eigenvalues and eigenvectors of the velocity gradient tensor, and extract the axis component from its flow trajectory. Eigen-vortical-axis line is defined from the eigenvector of the real eigenvalue of the velocity gradient tensor where the tensor has the conjugate complex eigenvalues. This numerical method integrates the eigen-vortical-axis line and traces a vortical axis in terms of the invariant flow topology, which enables to investigate the feature of the topology-based vortical axis.

  7. 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.

  8. 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

  9. Principles of the prolactin/vasoinhibin axis.

    PubMed

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

    2015-11-15

    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.

  10. 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

  11. Clinical Efficacy of a Modified Nagata Method That Retains the Fascia Pedicle of the Mastoid Skin Flap in Auricular Reconstruction of Chinese Microtia Patients.

    PubMed

    Wang, Wang-Shu; Yan, Dong-Mei; Chen, Jun-Yang; Zhang, Duo; Shao, Ying; Peng, Wei-Hai

    2016-03-01

    The purpose of this study was to search for an enhanced blood supply in the distal edge of the skin at the mastoid area in total auricular reconstruction. The authors modified the Nagata method by reserving a subcutaneous fascia pedicle (diameter, 3 to 5 mm) at the intersection of the point 11 to 13 mm from the residual ear tragus (or tragus projection) and 8 to 10 mm from the lowest point of the residual ear lobe. Compared with the traditional Nagata method group, the modified Nagata method group that retained the fascia pedicle of the mastoid skin flap had higher rates of excellent and good flaps (p < 0.05). Auricular reconstruction with the modified Nagata method, retaining the fascia pedicle of the mastoid skin flap, had a reduced incidence of skin flap necrosis.

  12. Clinical Efficacy of a Modified Nagata Method That Retains the Fascia Pedicle of the Mastoid Skin Flap in Auricular Reconstruction of Chinese Microtia Patients.

    PubMed

    Wang, Wang-Shu; Yan, Dong-Mei; Chen, Jun-Yang; Zhang, Duo; Shao, Ying; Peng, Wei-Hai

    2016-03-01

    The purpose of this study was to search for an enhanced blood supply in the distal edge of the skin at the mastoid area in total auricular reconstruction. The authors modified the Nagata method by reserving a subcutaneous fascia pedicle (diameter, 3 to 5 mm) at the intersection of the point 11 to 13 mm from the residual ear tragus (or tragus projection) and 8 to 10 mm from the lowest point of the residual ear lobe. Compared with the traditional Nagata method group, the modified Nagata method group that retained the fascia pedicle of the mastoid skin flap had higher rates of excellent and good flaps (p < 0.05). Auricular reconstruction with the modified Nagata method, retaining the fascia pedicle of the mastoid skin flap, had a reduced incidence of skin flap necrosis. PMID:26910682

  13. Versatility of Pedicled Tensor Fascia Lata Flap: A Useful and Reliable Technique for Reconstruction of Different Anatomical Districts

    PubMed Central

    Akhtar, Md. Sohaib; Khurram, Mohd Fahud; Khan, Arshad Hafeez

    2014-01-01

    Aims and Objectives. The aim of this study was to evaluate the versatility of pedicled tensor fascia lata flap for reconstruction of various anatomical regions. Materials and Methods. In this retrospective study a total of 34 patients with defects over various anatomical regions were included. The defects were located over the trochanter (n = 12), groin (n = 8), perineum (n = 6), lower anterior abdomen (n = 6), gluteal region (n = 1), and ischial region (n = 1). The etiology of defects included trauma (n = 12), infection (n = 8), pressure sores (n = 8), and malignancy (n = 6). Reconstruction was performed using pedicled tensor fascia lata flaps. Patients were evaluated in terms of viability of the flap and donor site morbidity. The technical details of the operative procedure have also been outlined. Results. All the flaps survived well except 5 patients in which minor complications were noted and 1 who experienced complete flap loss. Of those with minor complications, 1 patient developed distal marginal necrosis and 1 developed infection which subsided within three days by dressings and antibiotics and in 2 patients partial loss of the skin graft occurred at the donor site out of which 1 required regrafting and another one healed completely with dressing and antibiotics. All the patients were followed up for an average period of 6 months, ranging from 1 to 12 months. Donor site morbidity was minimal. Conclusion. It was concluded that the pedicled tensor fascia lata flap is a versatile, reliable, easy, and less time consuming procedure for the coverage of defects around trochanter, groin, lower anterior abdomen, perineum, and ischial region. PMID:25485149

  14. 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.

  15. Biomechanical analysis of different types of pedicle screw augmentation: a cadaveric and synthetic bone sample study of instrumented vertebral specimens.

    PubMed

    Chao, Kuo-Hua; Lai, Yu-Shu; Chen, Wen-Chuan; Chang, Chia-Ming; McClean, Colin J; Fan, Chang-Yuan; Chang, Chia-Hao; Lin, Leou-Chyr; Cheng, Cheng-Kung

    2013-10-01

    This study aims to determine the pull-out strength, stiffness and failure pull-out energy of cement-augmented, cannulated-fenestrated pedicle screws in an osteoporotic cadaveric thoracolumbar model, and to determine, using synthetic bone samples, the extraction torques of screws pre-filled with cement and those with cement injected through perforations. Radiographs and bone mineral density measurements from 32 fresh thoracolumbar vertebrae were used to define specimen quality. Axial pull-out strength of screws was determined through mechanical testing. Mechanical pull-out strength, stiffness and energy-to-failure ratio were recorded for cement-augmented and non-cement-augmented screws. Synthetic bone simulating a human spinal bone with severe osteoporosis was used to measure the maximum extraction torque. The pull-out strength and stiffness-to-failure ratio of cement pre-filled and cement-injected screws were significantly higher than the non-cement-augmented control group. However, the cement pre-filled and cement-injected groups did not differ significantly across these values (p=0.07). The cement pre-filled group had the highest failure pull-out energy, approximately 2.8 times greater than that of the cement-injected (p<0.001), and approximately 11.5 times greater than that of the control groups (p<0.001). In the axial pull-out test, the cement-injected group had a greater maximum extraction torque than the cement pre-filled group, but was statistically insignificant (p=0.17). The initial fixation strength of cannulated screws pre-filled with cement is similar to that of cannulated screws injected with cement through perforations. This comparable strength, along with the heightened pull-out energy and reduced extraction torque, indicates that pedicle screws pre-filled with cement are superior for bone fixation over pedicle screws injected with cement. PMID:23669371

  16. 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

  17. 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

  18. Aesthetic mental and cervical reconstruction after severe acne inversa by using a bilateral pedicled expanded forehead flap.

    PubMed

    Fu, Siqi; Fan, Jincai; Liu, Liqiang; Gan, Cheng; Tian, Jia; Jiao, Hu; Chen, Wenlin; Yang, Zengjie; Yin, Zhuming

    2012-11-01

    Acne inverse (AI), also known as hidradenitis suppurativa, is characterized by inflammatory nodules, fistulating sinus tracts, and painful skin abscesses. The severe AI often produces disfiguring scars influenced in both the appearance and function, especially in the facial and cervical regions. There might be difficulties in the situation for surgical treatment. This report described a 26-year-old man with severe scarring contractures in the neck and mandible regions after a long-term AI treated successfully with a bilateral pedicled expanded forehead flap. With the achievement of mental cervical angle, the patient has been reconstructed well both aesthetically and functionally during the long-term follow-ups. PMID:23172497

  19. Aesthetic mental and cervical reconstruction after severe acne inversa by using a bilateral pedicled expanded forehead flap.

    PubMed

    Fu, Siqi; Fan, Jincai; Liu, Liqiang; Gan, Cheng; Tian, Jia; Jiao, Hu; Chen, Wenlin; Yang, Zengjie; Yin, Zhuming

    2012-11-01

    Acne inverse (AI), also known as hidradenitis suppurativa, is characterized by inflammatory nodules, fistulating sinus tracts, and painful skin abscesses. The severe AI often produces disfiguring scars influenced in both the appearance and function, especially in the facial and cervical regions. There might be difficulties in the situation for surgical treatment. This report described a 26-year-old man with severe scarring contractures in the neck and mandible regions after a long-term AI treated successfully with a bilateral pedicled expanded forehead flap. With the achievement of mental cervical angle, the patient has been reconstructed well both aesthetically and functionally during the long-term follow-ups.

  20. 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

  1. 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

  2. Dual-view angle backlight module design.

    PubMed

    Chen, Bo-Tsuen; Pan, Jui-Wen

    2015-10-01

    We propose a bilayer light guide plate (BLGP) with specially designed microstructures and two light source modules to achieve an adjustable viewing angle backlight for ecofriendly displays. The dual viewing angle backlight module has a thin, simple structure and a high optical efficiency. Comparison with the conventional edge-lit backlight module shows an improvement in the on-axis luminance of the narrow viewing angle mode of 4.3 times and a decrease in the half-luminance angle of 7° in the horizontal direction. When using the wide viewing angle mode, there is an improvement in the on-axis luminance of 1.8 times and an improvement in the half-luminance angle of 54° in the horizontal direction. The uniformity of illuminance can reach 80% in each mode. The backlight optical sheet number is reduced from 5 to 1. PMID:26479670

  3. Concentrating solar cookers with eccentric axis

    SciTech Connect

    Wang Xiping; Sha Yong Ling; Hou Shugin; Liu Zude

    1992-12-31

    This paper describes the design, development and use of a concentrating solar cooker with eccentric axis in China. For the same power, the older circular parabolic cookers are large in volume and less convenient to operate than the cooker with eccentric axis. Calculations are presented for the design of the cooker and for obtaining an accurate test of its efficiency.

  4. 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.

  5. 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.

  6. A novel technique for cheek mucosa defect reconstruction using a pedicled buccal fat pad and buccinator myomucosal island flap.

    PubMed

    Ferrari, Silvano; Ferri, Andrea; Bianchi, Bernardo; Copelli, Chiara; Magri, Alice Sara; Sesenna, Enrico

    2009-01-01

    Reconstruction of cheek mucosa defects following tumor resections can be approached with several techniques, depending on size of the defect. Fasciocutaneous and perforators free flaps are widely employed today for such reconstructions. However, small defects or general health of the patient may limit their indications. Furthermore, approaching moderate size defects, some techniques, like temporalis muscle or fascia pedicled flaps, lead to contracture with limitation of mouth opening or trisma, and others, like intraoral local flaps, do not provide enough tissue for the reconstructions. In this work the authors propose, for reconstructing these kind of defects, the use of a buccinator myomucosal island flap and a buccal fat pad pedicled flap association. A case is reported and the surgical technique is explained. This new reconstructive technique can easily be used for reconstructing moderate-sized cheek defects, achieving optimal results: the internal mucosal lining is restored in few weeks without any retraction, contracture, of scars on the face limiting the aesthetic outcome and mouth opening. PMID:18620893

  7. The Retrospective Analysis of Posterior Short-Segment Pedicle Instrumentation without Fusion for Thoracolumbar Burst Fracture with Neurological Deficit

    PubMed Central

    Zou, Hui; Ping, Ansong; Wang, Yongzhi; Ai, Qiyong

    2014-01-01

    This study aims to investigate the efficacy of posterior short-segment pedicle instrumentation without fusion in curing thoracolumbar burst fracture. All of the 53 patients were treated with short-segment pedicle instrumentation and laminectomy without fusion, and the restoration of retropulsed bone fragments was conducted by a novel custom-designed repositor (RRBF). The mean operation time and blood loss during surgery were analyzed; the radiological index and neurological status were compared before and after the operation. The mean operation time was 93 min (range: 62–110 min) and the mean intraoperative blood loss was 452 mL in all cases. The average canal encroachment was 50.04% and 10.92% prior to the surgery and at last followup, respectively (P < 0.01). The preoperative kyphotic angle was 17.2 degree (±6.87 degrees), whereas it decreased to 8.42 degree (±4.99 degrees) at last followup (P < 0.01). Besides, the mean vertebral body height increased from 40.15% (±9.40%) before surgery to 72.34% (±12.32%) at last followup (P < 0.01). 45 patients showed 1-2 grades improvement in Frankel's scale at last followup. This technique allows for satisfactory canal clearance and restoration of vertebral body height and kyphotic angle, and it may promote the recovery of neurological function. However, further research is still necessary to confirm the efficacy of this treatment. PMID:24723809

  8. Minimally Invasive Transforaminal Lumbar Interbody Fusion with Unilateral Pedicle Screw Fixation: Comparison between Primary and Revision Surgery

    PubMed Central

    Kang, Moo Sung; 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. PMID:24949483

  9. Pedicled sensate composite calcaneal flap to achieve full weight-bearing surface in midshaft leg amputations: case report.

    PubMed

    Livani, Bruno; de Castro, Gabriel F; Filho, Jose R Tonelli; Belangero, William D; Ramos, Tamara M; Mongon, Mauricio

    2011-01-01

    Of the possible levels of amputation, transtibial amputations result in functionally excellent outcomes. However, in contrast to hind foot amputations, such as Syme and especially Boyd amputation, acute or late complications related to the amputated stump are frequent with the various described techniques. The aim of this study was to describe a hind foot (including the calcaneum and fat pad) pedicled sensate flap with a surface that allowed full terminal weight-bearing in transtibial amputations in adults. One male patient, 66 years old with schizophrenia and chronic distal tibial osteomyelitis, underwent a leg amputation with sensate composite calcaneal flap construction. The stump was painless and able to bear total terminal weight at 12 weeks. Calcaneum tibial fusion was observed at 12-week postoperative follow-up. A below-knee prosthesis was adapted in 12 weeks, and at the 1-year follow-up, the patient was completely satisfied with the functional performance of his stump. The flap described provides proprioceptive feedback with the best bone and skin to support weight bearing. Another advantage is the possibility to use the same prosthesis commonly used in Boyd or Syme amputation due a longer arm leverage, which also allows full terminal weight-bearing. In the current study, a transtibial amputation covered with a pedicled sensate plantar flap preserving the calcaneum was proposed. In theory, the anatomic structures spared in this technique provide a strong full weight-bearing terminal surface of the stump that will last a lifetime. PMID:20945284

  10. Multiobjective Optimization Design of Spinal Pedicle Screws Using Neural Networks and Genetic Algorithm: Mathematical Models and Mechanical Validation

    PubMed Central

    Amaritsakul, Yongyut; Chao, Ching-Kong

    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. PMID:23983810

  11. The Utility of a Digital Virtual Template for Junior Surgeons in Pedicle Screw Placement in the Lumbar Spine

    PubMed Central

    Zhao, Xin; Zhao, Jie; Xie, Youzhuan; Mi, Jie

    2016-01-01

    This study assessed the utility of three-dimensional preoperative image reconstruction as digital virtual templating for junior surgeons in placing a pedicle screw (PS) in the lumbar spine. Twenty-three patients of lumbar disease were operated on with bilateral PS fixation in our hospital. The two sides of lumbar pedicles were randomly divided into “hand-free group” (HFG) and “digital virtual template group” (DVTG) in each patient. Two junior surgeons preoperatively randomly divided into these two groups finished the placement of PSs. The accuracy of PS and the procedure time of PS insertion were recorded. The accuracy of PS in DVTG was 91.8% and that in HFG was 87.7%. The PS insertion procedure time of DVTG was 74.5 ± 8.1 s and that of HFG was 90.9 ± 9.9 s. Although no significant difference was reported in the accurate rate of PS between the two groups, the PS insertion procedure time was significantly shorter in DVTG than in HFG (P < 0.05). Digital virtual template is simple and can reduce the procedure time of PS placement. PMID:27314013

  12. 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

  13. 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

  14. Ultra precision machining technique of off-axis optics for coastal water remote sensing

    NASA Astrophysics Data System (ADS)

    Jeon, Min-Woo; Hyun, Sang-Won; Han, Jeong-Yeol; Kim, Geon-Hee

    2015-10-01

    An off-axis optical system can effectively avoid some problems, such as aberrations, shielded area created by the secondary mirror and a narrow field of view (FOV), while an on-axis optical system has the problems. Inspired by the consideration, the off-axis optical system is generally used for hyperspectral sensors and telescopes. However, there are several obstacles limiting the productivity of the off-axis optics in fabrication and measurement processes. In this study, to overcome this weakness, we suggests a new fabrication technique using a customized jig, not separated from the work-piece. A convex aspheric mirror and the off-axis mirror are fabricated by Single Point Diamond Turning Machine (SPDTM) for comparison analysis of surface state. The mirrors are made from aluminum (Al6061-T6) and used for the reflectors of a coastal water remote sensing system. We show fast machining and simple measurement in comparison with traditional off-axis single machining and measurement, provide performance results, such as form accuracy and surface roughness measured by both contact 3D profilometer (UA3P) and non-contact 3D profiler (CCI-Optics). The customized ultra-precision machining process can be effectively used for complex off-axis mirror fabricating.

  15. 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. PMID:27557003

  16. 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.

  17. An Innovative Method of Assessing the Mechanical Axis Deviation in the Lower Limb in Standing Position

    PubMed Central

    Kamath, Jagannath; Jayasheelan, Nikil; Singh, Rohit

    2016-01-01

    Introduction Various methods of measuring mechanical axis deviation of lower limb have been described including radiographic and CT scanogram, intraoperative fluoroscopy with the use of an electrocautery cord. These methods determine the mechanical axis in a supine, non-weight bearing position. Although long cassette standing radiographic view is used for the purpose but is not available at most centres. A dynamic method of determining the mechanical axis in a weight bearing position was devised in this study. Aim The aim of the study was to describe a simpler and newer method in quantifying the mechanical axis deviation in places where full length cassettes for standing X rays are not available. Materials and Methods A pilot study was conducted on 15 patients. The deviation from the mechanical axis was measured using a manually operated, hydraulic mechanism based, elevating scissor lift table. Patient was asked to stand erect over the elevating lift table with both patellae facing forward and C-arm image intensifier was positioned horizontally. Radiological markers were tied to a radio-opaque thread and placed at the centre of head of the femur and another at the centre of the tibio-talar joint. C-arm views of the hip, ankle and knee joint were taken to confirm the correct position of the marker by varying the height of the lift table. Results The mechanical axis deviation values were recorded by measuring distance between the centre of the knee and radio-opaque thread in cm. This was measured in each case both clinically and from the image on the monitor. The two values were found to be statistically same. Pain was measured on VAS. Mechanical axis deviation values and VAS score were found to be positively significantly correlated. Conclusion This technique is dynamic, unique and accurate as compared to other methods for assessing mechanical axis deviation in a weight bearing position. PMID:27504362

  18. Off-axis reflective optical apparatus

    NASA Technical Reports Server (NTRS)

    Ames, Lawrence L. (Inventor); Leary, David F. (Inventor); Mammini, Paul V. (Inventor)

    2005-01-01

    Embodiments of the present invention are directed to a simple apparatus and a convenient and accurate method of mounting the components to form an off-axis reflective optical apparatus such as a collimator. In one embodiment, an off-axis reflective optical apparatus comprises a mounting block having a ferrule holder support surface and an off-axis reflector support surface which is generally perpendicular to the ferrule holder support surface. An optical reflector is mounted on the off-axis reflector support surface and has a reflected beam centerline. The optical reflector has a conic reflective surface and a conic center. A ferrule holder is mounted on the ferrule holder support surface. The ferrule holder provides a ferrule for coupling to an optical fiber and orienting a fiber tip of the optical fiber along a fiber axis toward the optical reflector. The fiber axis is nonparallel to the reflected beam centerline. Prior to mounting the optical reflector to the off-axis reflector support surface and prior to mounting the ferrule holder to the ferrule holder support surface, the optical reflector is movable on the off-axis reflector surface and the ferrule holder is movable on the ferrule holder support surface to align the conic center of the optical reflector with respect to the fiber tip of the optical fiber, and the apparatus has at least one of the following features: (1) the optical reflector is movable on the off-axis reflector support surface to adjust a focus of the fiber tip with respect to the optical reflector, and (2) the ferrule holder is movable on the ferrule holder support surface to adjust the focus of the fiber tip with respect to the optical reflector.

  19. 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

  20. Comparison between percutaneous fluoroscopic-guided and conventional open pedicle screw placement techniques for the thoracic spine: a safety evaluation in human cadavers.

    PubMed

    Kwan, M K; Chiu, C K; Lee, C K; Chan, C Y W

    2015-11-01

    Percutaneous placement of pedicle screws is a well-established technique, however, no studies have compared percutaneous and open placement of screws in the thoracic spine. The aim of this cadaveric study was to compare the accuracy and safety of these techniques at the thoracic spinal level. A total of 288 screws were inserted in 16 (eight cadavers, 144 screws in percutaneous and eight cadavers, 144 screws in open). Pedicle perforations and fractures were documented subsequent to wide laminectomy followed by skeletalisation of the vertebrae. The perforations were classified as grade 0: no perforation, grade 1: < 2 mm perforation, grade 2: 2 mm to 4 mm perforation and grade 3: > 4 mm perforation. In the percutaneous group, the perforation rate was 11.1% with 15 (10.4%) grade 1 and one (0.7%) grade 2 perforations. In the open group, the perforation rate was 8.3% (12 screws) and all were grade 1. This difference was not significant (p = 0.45). There were 19 (13.2%) pedicle fractures in the percutaneous group and 21 (14.6%) in the open group (p = 0.73). In summary, the safety of percutaneous fluoroscopy-guided pedicle screw placement in the thoracic spine between T4 and T12 is similar to that of the conventional open technique.

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

    PubMed

    Avila, Mauricio J; 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

  2. Use of a pedicled fillet foot flap for knee preservation in severe lower extremity trauma: A case report and literature review

    PubMed Central

    Jensson, David; Audolfsson, Thorir; Mani, Maria; Rodriguez-Lorenzo, Andres

    2015-01-01

    We report the sequential use of a pedicled fillet foot flap in a clinical case of complex bilateral lower extremity trauma to achieve stable wound closure, maximizing length preservation and gait rehabilitation. In addition, we perform a literature review of the use of fillet foot flaps in lower extremity trauma. PMID:27252976

  3. Creation of false pedicles and a neo-pelvis for lumbopelvic reconstruction following en bloc resection of an iliosacral chondrosarcoma with lumbar spine extension: technical note.

    PubMed

    Mendel, Ehud; Nathoo, Narendra; Scharschmidt, Thomas; Schmidt, Carl; Boehmler, James; Mayerson, Joel L

    2014-03-01

    En bloc resection with negative tumor margins remains the principal treatment option for control or cure of primary pelvic chondrosarcomas, as current adjuvant therapies remain ineffective. Iliosacral chondrosarcomas with involvement of the sciatic notch are sufficiently challenging tumors. However, when there is concomitant lumbar extension requiring resection of the pedicles to maintain negative surgical margins, transpedicular screw fixation is not possible, making reconstruction of the lumbopelvic junction extremely challenging. A patient with an iliosacral chondrosarcoma with lumbar spine extension is presented in this report to illustrate a novel lumbopelvic spinal construct. Following combined external pelvectomy and hemisacrectomy with contralateral L3-5 hemilaminectomy and ipsilateral pediculotomy, bicortical transvertebral body screws were substituted for the missing pedicles, resulting in the creation of "false pedicles," which were further supplemented with an autologous vascularized fibular strut graft from the amputated lower limb and applied to the lateral aspect of the vertebral bodies. The creation of false pedicles allowed for a robust reconstruction of the lumbopelvic junction, including maintaining pelvic ring integrity with a "neo-pelvis", creating a functional load-bearing construct adequate for early mobilization and ambulation. The biomechanical dynamics of this unique construct are also discussed.

  4. 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.

  5. 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.

  6. Pedicle shifting or migration as one of the causes of curve progression after posterior fusion: an interesting case report and review of literature.

    PubMed

    Jain, Sudeep; Modi, Hitesh N; Suh, Seung-Woo; Yang, Jae-Hyuk; Hong, Jae-Young

    2009-11-01

    The aim of this retrospective study was to explain a previously undescribed mechanism of 'pedicle migration or shift' with longitudinal growth of the spine owing to biological remodeling of plastic posterior fusion mass as well as pedicles which may explain at least a few cases of deformity recurrence after posterior fusion in scoliosis surgery. Progressive loss of deformity correction after scoliosis surgery in growing children has been variously described. The various mechanisms described have been 'crankshaft effect', pseudoarthrosis, implant failure (loosening/breakage), biological plasticity, choosing wrong levels, excessive apical translation causing decompensation by unfused segments, progressive etiology, inadequate anchorage provided by some older instrumentation systems, etc. Though there have been claims that segmental pedicle instrumentation might prevent crankshaft phenomenon by providing a more rigid fixation, numerous studies have shown progressive loss of correction even after segmental pedicle instrumentation. A 10.6-year-old girl was fused posteriorly before her prepubertal growth spurt using segmental screw rod instrumentation. The index case in our study showed progressive loss of operative correction during subsequent follow-up at 2 years. This probably occurred because of longitudinal growth of the spine and posterior fusion mass because of its biological plasticity during the period of rapid growth spurt. In conclusion, despite the recent trend towards the use of segmental pedicle instrumented correction and fusion and claims that by providing rigid, tri-column fixation, it enhances fusion and controls growth of the vertebral body anteriorly; caution must be taken in children with high remaining growth and high growth velocity. PMID:19734809

  7. Computational studies of horizontal axis wind turbines

    NASA Astrophysics Data System (ADS)

    Xu, Guanpeng

    A numerical technique has been developed for efficiently simulating fully three-dimensional viscous fluid flow around horizontal axis wind turbines (HAWT) using a zonal approach. The flow field is viewed as a combination of viscous regions, inviscid regions and vortices. The method solves the costly unsteady Reynolds averaged Navier-Stokes (RANS) equations only in the viscous region around the turbine blades. It solves the full potential equation in the inviscid region where flow is irrotational and isentropic. The tip vortices are simulated using a Lagrangean approach, thus removing the need to accurately resolve them on a fine grid. The hybrid method is shown to provide good results with modest CPU resources. A full Navier-Stokes based methodology has also been developed for modeling wind turbines at high wind conditions where extensive stall may occur. An overset grid based version that can model rotor-tower interactions has been developed. Finally, a blade element theory based methodology has been developed for the purpose of developing improved tip loss models and stall delay models. The effects of turbulence are simulated using a zero equation eddy viscosity model, or a one equation Spalart-Allmaras model. Two transition models, one based on the Eppler's criterion, and the other based on Michel's criterion, have been developed and tested. The hybrid method has been extensively validated for axial wind conditions for three rotors---NREL Phase II, Phase III, and Phase VI configurations. A limited set of calculations has been done for rotors operating under yaw conditions. Preliminary simulations have also been carried out to assess the effects of the tower wake on the rotor. In most of these cases, satisfactory agreement has been obtained with measurements. Using the numerical results from present methodologies as a guide, Prandtl's tip loss model and Corrigan's stall delay model were correlated with present calculations. An improved tip loss model has been

  8. 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.

  9. Remote viewing.

    PubMed

    Scott, C

    1988-04-15

    Remote viewing is the supposed faculty which enables a percipient, sited in a closed room, to describe the perceptions of a remote agent visiting an unknown target site. To provide convincing demonstration of such a faculty poses a range of experimental and practical problems, especially if feedback to the percipient is allowed after each trial. The precautions needed are elaborate and troublesome; many potential loopholes have to be plugged and there will be strong temptations to relax standards, requiring exceptional discipline and dedication by the experimenters. Most reports of remote viewing experiments are rather superficial and do not permit assessment of the experimental procedures with confidence; in many cases there is clear evidence of particular loopholes left unclosed. Any serious appraisal of the evidence would have to go beyond the reports. Meanwhile the published evidence is far from compelling, and certainly insufficient to justify overthrow of well-established scientific principles.

  10. 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.

  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. 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.

  13. Bronchopleural fistula after pneumonectomy: interdisciplinary surgical closure by an ipsilateral pedicled latissimus dorsi flap supported by video-assisted thoracoscopy.

    PubMed

    Wolter, A; Scholz, T; Diedrichson, J; Arens-Landwehr, A; Schroeder-Finckh, R; Liebau, J

    2013-11-01

    Post-pneumonectomy bronchopleural fistula (BPF) remains a rare but often life-threatening complication and therapeutic challenge. Traditional surgical procedures include chronic open drainage, attempts at direct stump closure, thoracoplasty with or without chest wall muscle transposition and trans-sternal bronchial closure. We describe a case with successful closure of a chronic BPF after pneumonectomy by intrathoracic transposition of a pedicled latissimus dorsi muscle flap circumferentially fixed on the surrounding pleural tissue under continuous video-assisted thoracoscopic overview. The postoperative course was without complications; no tumour, empyema or fistula re-occurred. In this article we want to present the potential advantages of video-assisted thoracoscopic support and interdisciplinary teamwork to improve the outcome of patients with BPFs after pneumonectomy.

  14. 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. PMID:26617340

  15. Comparison of Surgical Outcomes Between Short-Segment Open and Percutaneous Pedicle Screw Fixation Techniques for Thoracolumbar Fractures.

    PubMed

    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 AND 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

  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. 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.

  18. 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

  19. 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.

  20. Use of preferential inspection to define the viewing sphere and characteristic views of an arbitrary machined tool part.

    PubMed

    Perrett, D I; Harries, M H; Looker, S

    1992-01-01

    Measurements were made of the way human subjects visually inspected an idealized machined tool part (a 'widget') while learning the three-dimensional shape of the object. Subjects were free to rotate the object about any axis. Inspection was not evenly distributed across all views. Subjects focused on views where the faces of the object were orthogonal to the line of sight and the edges of the object were aligned parallel or at right angles to the gravitational axis. These 'face' or 'plan' views were also the easiest for subjects to bring to mind in a mental imagery task. By contrast, when subjects were instructed to imagine the views displaying the most structural information they visualized views lying midway between face views.

  1. Modular off-axis solar concentrator

    SciTech Connect

    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.

  2. Enclosed, off-axis solar concentrator

    DOEpatents

    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.

  3. 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)

  4. The hypothalamic-pituitary-gonadal axis is target of cadmium toxicity. An update of recent studies and potential therapeutic approaches.

    PubMed

    Lafuente, Anunciación

    2013-09-01

    This review presents an overview of neuroendocrine disruption induced by cadmium on the hypothalamic-pituitary-gonadal (HHG) axis. This review focuses on a number of hypotheses: (1) the HHG axis is a physiological target on cadmium toxicity; (2) cadmium could induce chronotoxicity on this neuroendocrine axis by disrupting the daily pattern of the HHG axis activity; (3) cadmium exposure throughout life could contribute to the oxidative stress and the circadian rhythms disruption induced by aging on the HHG; and (4) cadmium induces oxidative stress in the HHG axis so antioxidants could prevent or reduce cadmium toxicity in this system. Cadmium disrupts the regulatory mechanisms of this physiological axis, by altering neurotransmitters involved in this regulation at the hypothalamic level, altering gonadotropin hormone secretion, and by affecting testicular or ovarian structure and activity. These effects are age-dependent and they could be related to the circadian rhythms of this physiological axis. Several antioxidant agents could have a protective action against the neuroendocrine toxicity of cadmium on the reproductive system. A comprehensive view of the physiological axis may provide a better understanding about the neuroendocrine toxicity of cadmium on the reproductive system, so this perspective is recommended for undertaking further studies.

  5. The hypothalamic-pituitary-gonadal axis is target of cadmium toxicity. An update of recent studies and potential therapeutic approaches.

    PubMed

    Lafuente, Anunciación

    2013-09-01

    This review presents an overview of neuroendocrine disruption induced by cadmium on the hypothalamic-pituitary-gonadal (HHG) axis. This review focuses on a number of hypotheses: (1) the HHG axis is a physiological target on cadmium toxicity; (2) cadmium could induce chronotoxicity on this neuroendocrine axis by disrupting the daily pattern of the HHG axis activity; (3) cadmium exposure throughout life could contribute to the oxidative stress and the circadian rhythms disruption induced by aging on the HHG; and (4) cadmium induces oxidative stress in the HHG axis so antioxidants could prevent or reduce cadmium toxicity in this system. Cadmium disrupts the regulatory mechanisms of this physiological axis, by altering neurotransmitters involved in this regulation at the hypothalamic level, altering gonadotropin hormone secretion, and by affecting testicular or ovarian structure and activity. These effects are age-dependent and they could be related to the circadian rhythms of this physiological axis. Several antioxidant agents could have a protective action against the neuroendocrine toxicity of cadmium on the reproductive system. A comprehensive view of the physiological axis may provide a better understanding about the neuroendocrine toxicity of cadmium on the reproductive system, so this perspective is recommended for undertaking further studies. PMID:23811532

  6. 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

  7. Unusual length of pedicle: pedunculated squamous papilloma of uvula causing unusual Dysphagia of long duration in a child of 10 years.

    PubMed

    Devi, Ramisetty Sabitha; Rajsekhar, B; Srinivas, G Vijay; Moon, Ninad J

    2014-01-01

    Benign oropharyngeal tumors are far less common compared to malignant tumors. Oropharyngeal papilloma is present in adults. Squamous papillomas are exophytic masses of oral cavity. When they occur on the palate they are most often asymptomatic and benign. Pedunculated squamous papillomas usually arise from the soft palate, tonsil, or the epiglottis. These lesions can sometimes prove to be fatal. A case of pedunculated squamous papilloma, arising from the laryngopharynx, the clinical presentation, the site of origin, and the size of the lesion were quite unusual. The narrow base of the pedicle made the intraoral excision possible. But here, we present a case of a 10-year-old boy who had history of dysphagia of 3-year duration for solid food and he was comfortable only in squatting position the reason being squamous papilloma of uvula (unusual site) atypically because of astonishing length of pedicle (2.3 inches).

  8. The subepithelial connective tissue pedicle graft combined with the coronally advanced flap for restoring missing papilla: a report of two cases.

    PubMed

    De Castro Pinto, Rodrigo Carlos Nahas; Colombini, Bella Luna; Ishikiriama, Sérgio Kiyoshi; Chambrone, Leandro; Pustiglioni, Francisco Emílio; Romito, Giuseppe Alexandre

    2010-03-01

    This case report describes the clinical application of the coronally advanced flap procedure associated with the subepithelial connective tissue pedicle graft in the reconstruction of interdental papilla. This procedure was used in two distinct situations: to reconstruct missing papilla and cover two Miller Class IV gingival recessions between the maxillary right lateral incisor and canine (case 1) and to improve esthetics and restore missing papilla between the maxillary left central and lateral incisors (case 2). In case 1, there was a clinical attachment level gain, complete root coverage (canine), and an increase in papillary height. Case 2 showed similar improvements for the interdental papilla, ie, significant reduction of the black triangle. Subepithelial connective tissue pedicle graft associated with a coronally advanced flap yielded satisfactory esthetics and may be considered a viable approach for the treatment of missing papilla associated or not with recession-type defects. However, further investigation is required.

  9. Dual-axis energy recovery linac.

    SciTech Connect

    Wang, C.-x.; Noonan, J.; Lewellen, J.

    2007-01-01

    In this paper we propose a new type of energy-recovery linac (ERL) for ERL applications. The envisioned dualaxis energy-recovery linac allows energy recovery of parallel beams, accelerating/decelerating along different axes, via the same dual-axis superconducting cavity. This new scheme offers many advantages over conventional ERLs in various applications. Preliminary feasibility considerations are presented.

  10. Multi-axis control of telemanipulators

    NASA Technical Reports Server (NTRS)

    Mckinnon, G. M.; Kruk, Ron

    1989-01-01

    The development of multi-axis hand controllers for use in telemanipulator systems is described. Experience in the control of the SRMS (shuttle remote manipulator system) arm is reviewed together with subsequent tests involving a number of simulators and configurations, including use as a side-arm flight control for helicopters. The factors affecting operator acceptability are reviewed.

  11. 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…

  12. Tennis Rackets and the Parallel Axis Theorem

    NASA Astrophysics Data System (ADS)

    Christie, Derek

    2014-04-01

    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.

  13. 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.

  14. Enhancement of venous drainage with vein stripper for reversed pedicled neurocutaneous flaps.

    PubMed

    Sonmez, Erhan; Silistireli, Özlem Karataş; Karaaslan, Önder; Kamburoğlu, Haldun Onuralp; Safak, Tunc

    2013-05-01

    The flaps based on the vascular axis of superficial sensitive cutaneous nerves had gained increased popularity in reconstructive surgery because of such major advantages as preservation of major extremity arteries and avoidance of microsurgical procedures. However, postoperative venous congestion resulting in partial or total necrosis is still a common problem for these flaps. The aim of the current study is to introduce a new method for reducing the postoperative venous congestion of neural island flap with the results of reconstruction of the soft tissue defects of foot and ankle. This method was used to treat 19 patients with various chronic soft tissue defects of the foot and ankle between 2011 and 2012. We observed that the novel method presented in this report enables effective venous drainage, solving the postoperative venous congestion problem of these flaps.

  15. Comparative Analysis of Effect of Density, Insertion Angle and Reinsertion on Pull-Out Strength of Single and Two Pedicle Screw Constructs Using Synthetic Bone Model

    PubMed Central

    Varghese, Vicky; Kumar, Gurunathan Saravana

    2016-01-01

    Study Design Biomechanical study. Purpose To determine the effect of density, insertion angle and reinsertion on pull-out strength of pedicle screw in single and two screw-rod configurations. Overview of Literature Pedicle screw pull-out studies have involved single screw construct, whereas two screws and rod constructs are always used in spine fusions. Extrapolation of results using the single screw construct may lead to using expensive implants or increasing the fusion levels specifically in osteoporotic bones. Methods Single screw and two screw pull-out strength tests were carried out according to American Society for Testing and Materials F 543-07 on foam models to test the effect of density, insertion angle and reinsertion using poly axial pedicle screws. Results Bone density was the most significant factor deciding the pull-out strength in both single and two screw constructs. The difference in pull-out strength between single screw and two screw configurations in extremely osteoporotic bone model (80 kg/m3) was 78%, whereas in the normal bone model it was 48%. Axial pull-out value was highest for the single screw configuration; in the two screw configuration the highest pull-out strength was at 10°–15°. There was an 18% reduction in pull-out strength due to reinsertion in single screw configuration. The reinsertion effect was insignificant in the two screw configuration. Conclusions A significant difference in response of various factors on holding power of pedicle screw between single and two-screw configurations is evident. The percentage increase in pull-out strength between single and two screw constructs is higher for osteoporotic bone when compared to normal bone. Reinsertion has no significant effect on pull-out strength in the two screw rod configuration. PMID:27340518

  16. Results of triple muscle (sartorius, tensor fascia latae and part of gluteus medius) pedicle bone grafting in neglected femoral neck fracture in physiologically active patients

    PubMed Central

    Mishra, Pankaj Kumar; Gupta, Anuj; Gaur, Suresh Chandra

    2014-01-01

    Background: Femoral neck fractures are notorious for complications like avascular necrosis and nonunion. In developing countries, various factors such as illiteracy, low socioeconomic status, ignorance are responsible for the delay in surgery. Neglected fracture neck femur always poses a formidable challenge. The purpose of this study was to evaluate the results of triple muscle pedicle bone grafting using sartorius, tensor fasciae latae and part of gluteus medius in neglected femoral neck fracture. Materials and Methods: This is a retrospective study with medical record of 50 patients, who were operated by open reduction, internal fixation along with muscle pedicle bone grafting by the anterior approach. After open reduction, two to three cancellous screws (6.5 mm) were used for internal fixation in all cases. A bony chunk of the whole anterior superior iliac spine of 1 cm thickness, 1 cm width and 4.5 cm length, taken from the iliac crest comprised of muscle pedicle of sartorius, tensor fascia latae and part of gluteus medius. Then the graft with all three muscles mobilized and put in the trough made over the anterior or anterosuperior aspect of the femoral head. The graft was fixed with one or two 4.5 mm self-tapping cortical screw in anterior to posterior direction. Results: 14 patients were lost to followup. The results were based on 36 patients. We observed that in our series, there was union in 34, out of 36 (94.4%) patients. All patients were within the age group of 15-51 years (average 38 years) with displaced neglected femoral neck fracture of ≥30 days. Mean time taken for full clinicoradiological union was 14 weeks (range-10-24 weeks). Conclusion: Triple muscle pedicle bone grafting gives satisfactory results for neglected femoral neck fracture in physiologically active patients. PMID:25298553

  17. Transplantation of iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels in the treatment of osteonecrosis of the femoral head

    PubMed Central

    CUI, GUOFENG; WEI, RONG; HOU, CHUNYING; BI, ZHENGGANG

    2016-01-01

    The aim of this study was to evaluate the efficacy and clinical application of iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels for the treatment of Association for Research on Osseous Circulation (ARCO) stage II–III osteonecrosis of the femoral head (ONFH) in young adults. In total, 35 patients with ONFH at ARCO stage II–III were treated with iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels. Patients were classified according to etiological factors and ARCO stages. Postoperative clinical assessment was accomplished with Harris hip scores (HHSs), and ARCO stage change was evaluated with imaging. All 35 patients completed the follow-up. The HHS results indicated that hip function was improved significantly from the preoperative status of 56.53±7.66 points to the postoperative status of 87.49±5.89 points (P<0.0001). Postoperative imaging displayed apparent osteogenesis and satisfactory structural remodeling in 32 patients, presenting no staging progress. Three patients exhibited mild collapse (<2 mm) compared with preoperative collapse. No patients developed osteoarthritis or required total hip arthroplasty. The clinical success rate was 91.43%. Iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels is a feasible means for treating ARCO stage II–III ONFH in young adults, who have abundant blood circulation, good osteogenesis and function of the hip. It is also an effective means for retaining the femoral head. PMID:27284301

  18. Three-dimensional C-arm computed tomography combined with fluoroscopic guided pediculoplasty for treatment of vertebral body metastasis with lytic pedicle.

    PubMed

    Sun, Gang; Jin, Peng; Li, Min; Lui, Xunwei; Li, Fandong; Xie, Zhiyong; Ding, Juan; Peng, Zhaohui

    2012-04-01

    The aim of this retrospective study was to evaluate a percutaneous pediculoplasty (PP) technique, using 3-dimensional C-arm CT reformation combined with fluoroscopic guidance for patients presented vertebral body metastasis with lytic pedicle. Thirteen patients (average age 57.8 years) were treated through lytic pedicle approach in our study. Subjective good and partial pain relief was reported with Visual Analogue Scale reduction ≥ 4 in 11/13 patients at 1 month after procedure, two patients with insufficient pain relief died from clinical complications unrelated with PP at 3 month follow-up. Pain relief was maintained in 10 patients at 6 month post-procedural follow-up. One patient died from underlying disease unrelated with the procedure at 5 month follow-up. PP through the lytic pedicle approach under 3-dimensional C-arm CT reformation combined with fluoroscopic guidance was a feasible, safe, and minimally invasive procedure that could provide both the precise control of needle placement and cement injection with one imaging system.

  19. Surgical treatment of the osteoporotic spine with bone cement-injectable cannulated pedicle screw fixation: technical description and preliminary application in 43 patients

    PubMed Central

    Dai, Fei; Liu, Yaoyao; Zhang, Fei; Sun, Dong; Luo, Fei; Zhang, Zehua; Xu, Jianzhong

    2015-01-01

    OBJECTIVES: To describe a new approach for the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws. METHODS: Between June 2010 and February 2013, 43 patients with degenerative spinal disease and osteoporosis (T-score <-2.5) underwent lumbar fusion using cement-injectable cannulated pedicle screws. Clinical outcomes were evaluated using a Visual Analog Scale and the Oswestry Disability Index. Patients were given radiographic follow-up examinations after 3, 6, and 12 months and once per year thereafter. RESULTS: All patients were followed for a mean of 15.7±5.6 months (range, 6 to 35 months). The Visual Analog Scale and Oswestry Disability Index scores showed a significant reduction in back pain (p = 0.018) and an improvement in lower extremity function (p = 0.025) in patients who underwent lumbar fusion using the novel screw. Intraoperative cement leakage occurred in four patients, but no neurological complications were observed. Radiological observation indicated no loosening or pulling out of the novel screw, and bone fusion was excellent. CONCLUSIONS: The described polymethylmethacrylate augmentation technique using bone cement-injectable cannulated pedicle screws can reduce pain and improve spinal dysfunction in osteoporotic patients undergoing osteoporotic spine surgery. PMID:25789520

  20. Evaluation of the Effect of Fixation Angle between Polyaxial Pedicle Screw Head and Rod on the Failure of Screw-Rod Connection.

    PubMed

    Çetin, Engin; Özkaya, Mustafa; Güler, Ümit Özgür; Acaroğlu, Emre; Demir, Teyfik

    2015-01-01

    Introduction. Polyaxial screws had been only tested according to the ASTM standards (when they were perpendicularly positioned to the rod). In this study, effects of the pedicle screws angled fixation to the rod on the mechanical properties of fixation were investigated. Materials and Method. 30 vertically fixed screws and 30 screws fixed with angle were used in the study. Screws were used in three different diameters which were 6.5 mm, 7.0 mm, and 7.5 mm, in equal numbers. Axial pull-out and flexion moment tests were performed. Test results compared with each other using appropriate statistical methods. Results. In pull-out test, vertically fixed screws, in 6.5 mm and 7.0 mm diameter, had significantly higher maximum load values than angled fixed screws with the same diameters (P < 0.01). Additionally, vertically fixed screws, in all diameters, had significantly greater stiffness according to corresponding size fixed with angle (P < 0.005). Conclusion. Fixing the pedicle screw to the rod with angle significantly decreased the pull-out stiffness in all diameters. Similarly, pedicle screw instrumentation fixed with angle decreased the minimum sagittal angle between the rod and the screw in all diameters for flexion moment test but the differences were not significant.

  1. Evaluation of the Effect of Fixation Angle between Polyaxial Pedicle Screw Head and Rod on the Failure of Screw-Rod Connection

    PubMed Central

    Çetin, Engin; Özkaya, Mustafa; Güler, Ümit Özgür; Acaroğlu, Emre

    2015-01-01

    Introduction. Polyaxial screws had been only tested according to the ASTM standards (when they were perpendicularly positioned to the rod). In this study, effects of the pedicle screws angled fixation to the rod on the mechanical properties of fixation were investigated. Materials and Method. 30 vertically fixed screws and 30 screws fixed with angle were used in the study. Screws were used in three different diameters which were 6.5 mm, 7.0 mm, and 7.5 mm, in equal numbers. Axial pull-out and flexion moment tests were performed. Test results compared with each other using appropriate statistical methods. Results. In pull-out test, vertically fixed screws, in 6.5 mm and 7.0 mm diameter, had significantly higher maximum load values than angled fixed screws with the same diameters (P < 0.01). Additionally, vertically fixed screws, in all diameters, had significantly greater stiffness according to corresponding size fixed with angle (P < 0.005). Conclusion. Fixing the pedicle screw to the rod with angle significantly decreased the pull-out stiffness in all diameters. Similarly, pedicle screw instrumentation fixed with angle decreased the minimum sagittal angle between the rod and the screw in all diameters for flexion moment test but the differences were not significant. PMID:27019578

  2. Defining the Indications of Pedicled Groin and Abdominal Flaps in Hand Reconstruction in the Current Microsurgery Era.

    PubMed

    Al-Qattan, Mohammad M; Al-Qattan, Ahmed M

    2016-09-01

    Three decades ago, pedicled flaps from the groin and abdomen were the workhorses in hand and forearm reconstruction. These pedicled flaps have several disadvantages including patient discomfort, stiffness, the need for flap division, and the inability to elevate the hand after acute trauma. Hence it is not surprising that free flap reconstruction has become the method of choice in coverage of complex hand and forearm defects. Despite this, pedicled flaps may still be indicated in the current era of microsurgery. Based on a review of the literature and the author's experience, the current review defines these indications as follows: complex defects in children aged less than 2 years; coverage of digital stump defects in preparation for toe-to-hand transfer; high-voltage electric burns with the hand surviving on collateral blood supply; salvage of the thumb ray in high-voltage electric burns with concurrent thrombosis of the radial artery; mutilating hand injuries; length preservation of multiple digital amputations in manual workers; and multiple defects within the digits, hand, or forearm. These indications are discussed along with clinical examples. PMID:27450894

  3. 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.

  4. A dual-axis approach to understanding neuroendocrine development.

    PubMed

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

    2015-09-01

    This introduction sets out to present 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 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 these axes work together.

  5. A dual-axis approach to understanding neuroendocrine development.

    PubMed

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

    2015-09-01

    This introduction sets out to present 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 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 these axes work together. PMID:26220016

  6. 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. PMID:25430200

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. Kinesin follows the microtubule's protofilament axis

    PubMed Central

    1993-01-01

    We tested the hypothesis that kinesin moves parallel to the microtubule's protofilament axis. We polymerized microtubules with protofilaments that ran either parallel to the microtubule's long axis or that ran along shallow helical paths around the cylindrical surface of the microtubule. When gliding across a kinesin-coated surface, the former microtubules did not rotate. The latter microtubules, those with supertwisted protofilaments, did rotate; the pitch and handedness of the rotation accorded with the supertwist measured by electron cryo- microscopy. The results show that kinesin follows a path parallel to the protofilaments with high fidelity. This implies that the distance between consecutive kinesin-binding sites along the microtubule must be an integral multiple of 4.1 nm, the tubulin monomer spacing along the protofilament, or a multiple of 8.2 nm, the dimer spacing. PMID:8099076

  13. 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.

  14. 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.

  15. Interplay between tilted and principal axis rotation

    SciTech Connect

    Datta, Pradip

    2014-08-14

    At IUAC-INGA, our group has studied four neutron rich nuclei of mass-110 region, namely {sup 109,110}Ag and {sup 108,110}Cd. These nuclei provide the unique platform to study the interplay between Tilted and Principal axis rotation since these are moderately deformed and at the same time, shears structures are present at higher spins. The salient features of the high spin behaviors of these nuclei will be discussed which are the signatures of this interplay.

  16. The IL-23 axis in Salmonella gastroenteritis.

    PubMed

    Godinez, Ivan; Keestra, A Marijke; Spees, Alanna; Bäumler, Andreas J

    2011-11-01

    Non-typhoidal Salmonella (NTS) serotypes cause a localized gastroenteritis in immunocompetent individuals. In contrast, primary immunodeficiencies that impair interleukin-23 (IL-23)-dependent pathways are associated in humans with disseminated NTS bloodstream infections (bacteraemia). The recent use of animal models has helped to define the role the IL-23 axis plays during NTS gastroenteritis, but additional work is needed to elucidate how this host defence pathway prevents NTS bacteraemia. PMID:21740501

  17. 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.

  18. 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.

  19. Structure and mineralisation density of antler and pedicle bone in red deer (Cervus elaphus L.) exposed to different levels of environmental fluoride: a quantitative backscattered electron imaging study

    PubMed Central

    KIERDORF, UWE; KIERDORF, HORST; BOYDE, ALAN

    2000-01-01

    The structure and relative degree of mineralisation of antler and pedicle bone of yearling red deer stags exposed either to low or high levels of environmental fluoride were determined by digital quantitative backscattered electron (BSE) imaging. Bone fluoride content (BFC) in antlers (845±86 mg F−/kg ash, arithmetic mean± S.E.M.) and pedicles (1448±154 mg F−/kg ash) of deer from a highly fluoride polluted area in North Bohemia (Czech Republic) were significantly higher (P < 0.001) than those of controls from uncontaminated regions in West Germany (antlers: 206±41, pedicles: 322±52 mg F−/kg ash). Mean (56.5±4.5%) and maximum (84.9±2.1%) mineralised bone area of the control antlers significantly (P < 0.05 and P < 0.001, respectively) exceeded the corresponding values for the N. Bohemian deer (43.3±1.3 and 73.3±1.9%, respectively), while the pedicles from the 2 groups did not differ significantly. In the pooled antler samples (n = 18), negative correlations existed between BFC and mean (rs = −0.62, P < 0.01) as well as maximum (rs = −0.69, P < 0.01) mineralised bone area. Morphological imaging revealed a decreased width and an increased porosity of the antler cortex in the N. Bohemian specimens. Mean (148.5±1.7) and maximum (154.2±1.7) BSE-signal intensities (= grey levels; range between a monobrominated (grey level 0) and a monoiodinated (grey level 255) dimethacrylate resin standard) of the antlers from the controls were significantly higher than those of the N. Bohemian deer (140.7±2.1 and 145.7±2.2, respectively; P < 0.05 for both comparisons). In the pooled antler samples, negative correlations between BFC and mean (rs = −0.51, P < 0.05) as well as maximum (rs = −0.52, P < 0.05) BSE-signal intensities were observed. No significant differences in mineralisation density parameters were found for the 2 pedicle samples, and BFC and mineralisation density of the pooled pedicles were uncorrelated. Morphological imaging revealed bone mottling

  20. 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.

  1. Percutaneous Pedicle Screw Fixation with Polymethylmethacrylate Augmentation for the Treatment of Thoracolumbar Intravertebral Pseudoarthrosis Associated with Kummell's Osteonecrosis.

    PubMed

    Kim, Hyeun-Sung; Heo, Dong-Hwa

    2016-01-01

    Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA) augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis. Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS) score for back pain, and the Oswestry Disability Index (ODI) were analyzed. In addition, radiologic and clinical parameters of PPF group were compared with percutaneous vertebroplasty (PVP) group. Results. Vertebral height and kyphotic angle of the compressed vertebral bodies were significantly corrected after the operation (P < 0.05). Further, restored vertebral height was maintained during the 2 or more years of postoperative follow-up. Compared to the PVP group the postoperative compression ratio and kyphotic angle were significantly lower in the PPF group (P < 0.05). The postoperative ODI and VAS of the PVP group were significantly higher than the PPF (P < 0.05). Conclusions. According to our results, short-segment PPF with PMMA augmentation may be an effective minimally invasive treatment for osteoporosis in cases of osteoporotic vertebral compression fractures with Kummell's osteonecrosis. PMID:27595101

  2. 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

  3. Percutaneous Pedicle Screw Fixation with Polymethylmethacrylate Augmentation for the Treatment of Thoracolumbar Intravertebral Pseudoarthrosis Associated with Kummell's Osteonecrosis

    PubMed Central

    2016-01-01

    Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA) augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis. Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS) score for back pain, and the Oswestry Disability Index (ODI) were analyzed. In addition, radiologic and clinical parameters of PPF group were compared with percutaneous vertebroplasty (PVP) group. Results. Vertebral height and kyphotic angle of the compressed vertebral bodies were significantly corrected after the operation (P < 0.05). Further, restored vertebral height was maintained during the 2 or more years of postoperative follow-up. Compared to the PVP group the postoperative compression ratio and kyphotic angle were significantly lower in the PPF group (P < 0.05). The postoperative ODI and VAS of the PVP group were significantly higher than the PPF (P < 0.05). Conclusions. According to our results, short-segment PPF with PMMA augmentation may be an effective minimally invasive treatment for osteoporosis in cases of osteoporotic vertebral compression fractures with Kummell's osteonecrosis.

  4. Histologic evaluation of nerve muscle pedicle graft used as a treatment for left laryngeal hemiplegia in standardbreds.

    PubMed

    Fulton, I C; Derksen, F J; Stick, J A; Robinson, N E; Duncan, I D

    1992-04-01

    A nerve muscle pedicle (NMP) graft was placed in the cricoarytenoideus dorsalis (CAD) muscle of 6 horses with induced left laryngeal hemiplegia. The NMP graft was created by use of the first cervical nerve and omohyoideus muscle. In 1 horse (control), the first cervical nerve was transected after placement of the NMP graft. One year after the surgical procedure, horses were examined endoscopically and then anesthetized. While the larynx was observed endoscopically, the first cervical nerve was stimulated. Horses were subsequently euthanatized, and the larynx was harvested. Prior to anesthesia, the endoscopic appearance of the larynx of all horses was typical of laryngeal hemiplegia. During anesthesia, stimulation of the first cervical nerve produced vigorous abduction of the left arytenoid in principal horses but not in the control horse. The right cricoarytenoideus lateralis and CAD muscles were grossly and histologically normal. Also, the left cricoarytenoideus lateralis was atrophic in all horses as was the left CAD muscle of the control horse. In contrast, the left CAD muscle harvested from principal horses had evidence of reinnervation with type 1 or type 2 fiber grouping. One year after the NMP graft procedure, horses with left laryngeal hemiplegia had reinnervation of the left CAD muscle. In another study, reinnervation was sufficient to allow normal laryngeal function during exercise. Combined, these data suggest that the NMP graft procedure is a viable technique for the treatment of left laryngeal hemiplegia in horses.

  5. Percutaneous Pedicle Screw Fixation with Polymethylmethacrylate Augmentation for the Treatment of Thoracolumbar Intravertebral Pseudoarthrosis Associated with Kummell's Osteonecrosis

    PubMed Central

    2016-01-01

    Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA) augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis. Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS) score for back pain, and the Oswestry Disability Index (ODI) were analyzed. In addition, radiologic and clinical parameters of PPF group were compared with percutaneous vertebroplasty (PVP) group. Results. Vertebral height and kyphotic angle of the compressed vertebral bodies were significantly corrected after the operation (P < 0.05). Further, restored vertebral height was maintained during the 2 or more years of postoperative follow-up. Compared to the PVP group the postoperative compression ratio and kyphotic angle were significantly lower in the PPF group (P < 0.05). The postoperative ODI and VAS of the PVP group were significantly higher than the PPF (P < 0.05). Conclusions. According to our results, short-segment PPF with PMMA augmentation may be an effective minimally invasive treatment for osteoporosis in cases of osteoporotic vertebral compression fractures with Kummell's osteonecrosis. PMID:27595101

  6. Reconstruction of transhumeral amputation stumps with ipsilateral pedicled latissimus dorsi myocutaneous flap in high voltage electrical burns.

    PubMed

    Kesiktas, Erol; Eser, Cengiz; Gencel, Eyuphan; Aslaner, Emrah Efe; Yavuz, Metin

    2015-03-01

    Injury due to high-voltage (>1000V) electricity is one of the most challenging problems in emergency medicine and plastic surgery. Extremity amputation because of electrical injury yields a stump that leaves vital structures, such as bone, muscle, blood vessels, and nerves, exposed; these structures should be covered with appropriate tissue. We designed a retrospective study that included twelve patients with a high-voltage electrical injury followed by trans-humeral amputation who were evaluated between 2004 and 2013. The ages of the patients ranged between 8 and 35 years (mean, 16.9 years). Following amputation, the defects were covered with an ipsilateral pedicled latissimus dorsi (LD) myocutaneous flap for stump protection and functional transfer. We concluded that the use of an ipsilateral LD myocutaneous flap is an adequate surgical operation in upper extremity amputations resulting from high-voltage electrical burn injuries and that this procedure permits stump length maintenance, contributes to arm functioning, avoids extended operation times, and prepares patients for prosthesis usage.

  7. 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

  8. C7 intralaminar screw placement, an alternative to lateral mass or pedicle fixation for treatment of cervical spondylytic myelopathy, kyphotic deformity, and trauma: A case report and technical note

    PubMed Central

    Koltz, Michael T.; Maulucci, Christopher M.; Sansur, Charles A.; Hamilton, D. Kojo

    2014-01-01

    Background: The authors present a case to illustrate the necessity and technical feasibility of C7 laminar screw placement for treatment of sub-axial cervical spondylitic myelopathy. The indications for C7 lateral mass screw placement was required internal fixation, with small lateral masses (8 mm) and pedicles (4 mm). Case Description: A 67-year-old female with compressive myelopathy after a fall from standing is presented. Magnetic resonance (MR) imaging of the cervical spine showed severe C3-6 spondylosis with canal and foraminal compromise. Computed tomography of the cervical spine confirmed the MR imaging findings as well as showed suboptimal lateral mass and pedicles for screw placement. The patient underwent a C3-6 laminectomy, C3-6 lateral mass, and C7 laminar screw placement. Postoperatively, the patient recovered without complication. Conclusion: Internal fixation of the cervical spine after iatrogenic destabilization by decompression of neural elements secondary to advanced spondylosis can be technically challenging. Anatomical landmarks needed for safe placement of lateral mass or pedicle instrumentation are often distorted by the patients’ advanced pathology or Inherent biology. The C7 screw is a key structural element to a long construct and therefore necessitates large lateral masses or pedicles to safely place a functional screw. C7 laminar screws may be placed safely without fluoroscopic guidance when sufficient C7 lateral mass or pedicle screws are not possible or with undue risk. PMID:24575319

  9. Micromachined dual input axis rate gyroscope

    NASA Astrophysics Data System (ADS)

    Juneau, Thor Nelson

    The need for inexpensive yet reliable angular rate sensors in fields ranging from automotive to consumer electronics has motivated prolific micromachined rate gyroscope research. The vast majority of research has focused on single input axis rate gyroscopes based upon either translational resonance, such as tuning forks, or structural mode resonance, such as vibrating rings. However, this work presents a novel, contrasting approach based on angular resonance of a rotating rigid rotor suspended by torsional springs. The inherent symmetry of the circular design allows angular rate measurement about two axes simultaneously, hence the name micromachined dual-axis rate gyroscope. The underlying theory of operation, mechanical structure design optimization, electrical interface circuitry, and signal processing are described in detail. Several operational versions were fabricated using two different fully integrated surface micromachining processes as proof of concept. The heart of the dual-axis rate gyroscope is a ˜2 mum thick polysilicon disk or rotor suspended above the substrate by a four beam suspension. When this rotor in driven into angular oscillation about the axis perpendicular to the substrate, a rotation rate about the two axes parallel to the substrate invokes an out of plane rotor tilting motion due to Coriolis acceleration. This tilting motion is capacitively measured and on board integrated signal processing provides two output voltages proportional to angular rate input about the two axes parallel to the substrate. The design process begins with the derivation of gyroscopic dynamics. The equations suggest that tuning sense mode frequencies to the drive oscillation frequency can vastly increase mechanical sensitivity. Hence the supporting four beam suspension is designed such that electrostatic tuning can match modes despite process variations. The electrostatic tuning range is limited only by rotor collapse to the substrate when tuning-voltage induced

  10. The Windsor-Quebec City Axis: Basic Characteristics.

    ERIC Educational Resources Information Center

    Yeates, Maurice

    1984-01-01

    The Windsor-Quebec City axis is Canada's most important economic entity. The axis comprises four distinct physiographic units, with considerable climatic variation across the area. Containing two distinct linguistic groups (English and French), the axis has a rich agricultural system and is the manufacturing heartland of Canada. (RM)

  11. The Axis Feature: Illusionary Effects on Children's Judgments of Length.

    ERIC Educational Resources Information Center

    Scher, Anat

    1982-01-01

    Forty five-year-olds compared two arms of an L-shaped figure on-axis or perpendicular to axis inside circles of different diameters. In making perceptual judgments about the relative length, the children tended to describe the on-axis line as longer. The context model of visual anomalies was supported. (Author/CM)

  12. 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.

  13. Off-axis low coherence interferometry contouring

    NASA Astrophysics Data System (ADS)

    Delacrétaz, Yves; Pavillon, Nicolas; Lang, Florian; Depeursinge, Christian

    2009-12-01

    In this article we present a method to achieve tri-dimensional contouring of macroscopic objects. A modified reference wave speckle interferometer is used in conjunction with a source of reduced coherence. The depth signal is given by the envelope of the interference signal, directly determined by the coherence length of the source. Fringes are detected in the interferogram obtained by a single shot and are detected by means of adequate filtering. With the approach based on off-axis configuration, a contour line can be extracted from a single acquisition, thus allowing to use the system in harsh environment.

  14. 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.

  15. Pulsed 3-Axis Vector SERF Magnetometer

    NASA Astrophysics Data System (ADS)

    Hedges, Morgan; Romalis, Michael

    2016-05-01

    We demonstrate a 3-axis atomic vector magnetometer operating in the SERF regime, using a single beam path, and capable of operating in Earth's field using field feedback. It has similar sensitivity along all 3 axes that is fundamentally limited by photon and atom shot noise. The scheme uses a high intensity pump pulse to polarize Rb atoms in ~ 1 μs and a sequence of magnetic field pulses applied while the atoms are monitored during free precession. The sequence used provides minimal sensitivity to pulse errors, while also allowing unambiguous discrimination between external magnetic fields and misalignment between laser and magnetic coil axes.

  16. Equilibrium calculations for helical axis stellarators

    SciTech Connect

    Hender, T.C.; Carreras, B.A.

    1984-04-01

    An average method based on a vacuum flux coordinate system is presented. This average method permits the study of helical axis stellarators with toroidally dominated shifts. An ordering is introduced, and to lowest order the toroidally averaged equilibrium equations are reduced to a Grad-Shafranov equation. Also, to lowest order, a Poisson-type equation is obtained for the toroidally varying corrections to the equilibium. By including these corrections, systems that are toroidally dominated, but with significant helical distortion to the equilibrium, may be studied. Numerical solutions of the average method equations are shown to agree well with three-dimensional calculations.

  17. Pituitary-ovarian-splenic axis in ovulation

    PubMed Central

    Oakley, Oliver R.; Frazer, Michele L.; Ko, CheMyong

    2011-01-01

    Leukocytes are rapidly recruited to the preovulatory ovary and play a crucial role as facilitators of ovulation and luteal formation. In this article, recent findings on leukocyte trafficking to the ovary, as well as the physiological role of leukocytes in the ovary, will be summarized and discussed. We then explore the novel hypothesis that the hypothalamus-pituitary-ovarian (HPO) axis might include the spleen as a reservoir of leukocytes by summarizing recent reports on this topic, both in the fields of immunology and reproductive biology. PMID:21600783

  18. Double pedicled perforator flap to close flank defects: an alternative for closure of a large lumbar defect after basalioma excision--a case report and review of the literature.

    PubMed

    Arco, Gunther; Horch, Raymund E; Arkudas, Andreas; Dragu, Adrian; Bach, Alexander D; Kneser, Ulrich

    2009-10-01

    Large defects following resection of skin cancers are sometimes a challenge for the reconstructive surgeon. Although skin grafts are considered as the first choice for reconstruction of large skin defects at the trunk region, pedicled or free flaps provide sometimes a superior functional and aesthetic outcome. Perforator flaps represent a valuable option for these patients. The progress in understanding the perforator vessel system of the body facilitated the development of a plethora of novel pedicled flaps which could be transferred over long distances with minimal donor site morbidity. We present a patient suffering from a large exulcerated basalioma at the lumbar region. The skin defect after excision was reconstructed using a novel concept based on 2 independent pedicled perforator flaps, a lumbar artery perforator, and a lateral intercostal artery perforator.

  19. Computer Assisted Mechanical Axis and Kinematic TKA

    PubMed Central

    McEwen, Peter; Mahoharan, Varaguna

    2016-01-01

    Introduction: Total knee arthroplasty (TKA) has traditionally been and largely continues to be aligned mechanically, that being with a neutral coronal plane mechanical tibiofemoral axis and a joint line orientated at 900 to this axis. Femoral component rotation is set by gap balancing or by externally rotating 30 from any of a number femoral reference lines. This produces a rectangular flexion gap and relaxes patellar tracking. Kinematic alignment (KA) is an alternative technique that aims to restore premorbid alignment, joint orientation and ligament tension. The basic premise for this technique is based on evidence that the medial and lateral femoral condyles consistently equate to cylinders of equal or near equal size and that therefore with a fixed radius, cruciate retaining implant, matched distal femoral, posterior femoral and proximal tibial resections, accounting for bone and cartilage already lost will reproduce the premorbid joint line and restore native premorbid kinematics. Femoral rotation is therefore referenced off the prearthritic posterior condylar axis (PCA) that is on average internally rotated to the AP axis. Kinematic alignment therefore has the potential to challenge patellar tracking, increase patellar load and potentially increase patellar complications. Method: Case control study – level of evidence III-2. Between November 2012 and June 2013 the senior author completed 104 consecutive computer assisted (CAS) kinematically aligned total knee arthroplasties (TKA) with a cruciate retaining, fixed bearing, single radius implant. The results of these surgeries were compared with the results of 91 consecutive CAS mechanically aligned TKA done between November 2011 and October 2012 using the same navigation system and implant Implant sizing and positioning as well as gap measurement and ligament balance was done with computer assistance in all cases. Data was collected prospectively and analysed retrospectively. Results: The Oxford Knee Score

  20. A PDMS-Based 2-Axis Waterproof Scanner for Photoacoustic Microscopy

    PubMed Central

    Kim, Jin Young; Lee, Changho; Park, Kyungjin; Lim, Geunbae; Kim, Chulhong

    2015-01-01

    Optical-resolution photoacoustic microscopy (OR-PAM) is an imaging tool to provide in vivo optically sensitive images in biomedical research. To achieve a small size, fast imaging speed, wide scan range, and high signal-to-noise ratios (SNRs) in a water environment, we introduce a polydimethylsiloxane (PDMS)-based 2-axis scanner for a flexible and waterproof structure. The design, theoretical background, fabrication process and performance of the scanner are explained in details. The designed and fabricated scanner has dimensions of 15 × 15 × 15 mm along the X, Y and Z axes, respectively. The characteristics of the scanner are tested under DC and AC conditions. By pairing with electromagnetic forces, the maximum scanning angles in air and water are 18° and 13° along the X and Y axes, respectively. The measured resonance frequencies in air and water are 60 and 45 Hz along the X axis and 45 and 30 Hz along the Y axis, respectively. Finally, OR-PAM with high SNRs is demonstrated using the fabricated scanner, and the PA images of micro-patterned samples and microvasculatures of a mouse ear are successfully obtained with high-resolution and wide-field of view. OR-PAM equipped with the 2-axis PDMS based waterproof scanner has lateral and axial resolutions of 3.6 μm and 26 μm, respectively. This compact OR-PAM system could potentially and widely be used in preclinical and clinical applications. PMID:25923931

  1. A computerized method for mathematical description of three-dimensional root canal axis.

    PubMed

    Dobó-Nagy, C; Keszthelyi, G; Szabó, J; Sulyok, P; Ledeczky, G; Szabó, J

    2000-11-01

    Knowledge of the three-dimensional (3D) morphology of root canals is important for successful endodontic treatment. The objective of the present study was to determine the 3D root canal axis mathematically. Two views (mesiodistal and buccolingual) of digitized images were taken from extracted natural human teeth. Geometric reconstruction to standardize projection geometry was conducted on images. Because 90-degree turn-around image pairs are Monge images of a given root canal, these Monge images were positioned using photogrammetric methods. Each well-ordered axis pair of a given root canal was put into a common coordinate system resulting in 3D polynomial function of the actual root canal. On the basis of the results gained using 10 samples evaluated with the Friedman statistical test, this description seems to be reproducible. The 3D representation of the root canal may help the clinicians in choosing the optimal instruments and shaping techniques. The root canal axis that is described by the 3D function forms a basis for determination of curvature values and torsion values in each of the axis points. Evaluating these values may also yield a new type of classification. PMID:11469291

  2. A PDMS-Based 2-Axis Waterproof Scanner for Photoacoustic Microscopy.

    PubMed

    Kim, Jin Young; Lee, Changho; Park, Kyungjin; Lim, Geunbae; Kim, Chulhong

    2015-01-01

    Optical-resolution photoacoustic microscopy (OR-PAM) is an imaging tool to provide in vivo optically sensitive images in biomedical research. To achieve a small size, fast imaging speed, wide scan range, and high signal-to-noise ratios (SNRs) in a water environment, we introduce a polydimethylsiloxane (PDMS)-based 2-axis scanner for a flexible and waterproof structure. The design, theoretical background, fabrication process and performance of the scanner are explained in details. The designed and fabricated scanner has dimensions of 15 × 15 × 15 mm along the X, Y and Z axes, respectively. The characteristics of the scanner are tested under DC and AC conditions. By pairing with electromagnetic forces, the maximum scanning angles in air and water are 18° and 13° along the X and Y axes, respectively. The measured resonance frequencies in air and water are 60 and 45 Hz along the X axis and 45 and 30 Hz along the Y axis, respectively. Finally, OR-PAM with high SNRs is demonstrated using the fabricated scanner, and the PA images of micro-patterned samples and microvasculatures of a mouse ear are successfully obtained with high-resolution and wide-field of view. OR-PAM equipped with the 2-axis PDMS based waterproof scanner has lateral and axial resolutions of 3.6 μm and 26 μm, respectively. This compact OR-PAM system could potentially and widely be used in preclinical and clinical applications. PMID:25923931

  3. Exact ray-trace beam for an off-axis paraboloid surface.

    PubMed

    Arguijo, Pedro; Scholl, Marija Strojnik

    2003-06-01

    When an off-axis paraboloidal mirror focuses a parallel beam, the image is formed on one side of the optical axis. For a tilted beam focused by an off-axis paraboloidal mirror, the focus is no longer pointlike (not considering the diffraction effect); rather, it is a distorted spot. This is due to the inherent aberrations of the surface. In addition, there is a change in the focus position. We calculate by exact ray-trace equations the modified wave-front aberration and express it in power series. Our formulation uses the optical path variation along a defined principal ray that we relate to the parameter that describe the surface and the beam angle of incidence. We designate this ray as that reflected by the center of the entrance pupil and field of view. We employ the direction cosines of the principal ray to compute the wave-front aberration function of a beam reflected by an off-axis paraboloid.

  4. Extremely Soft X-Ray Flash as the Indicator of Off-axis Orphan GRB Afterglow

    NASA Astrophysics Data System (ADS)

    Urata, Yuji; Huang, Kuiyun; Yamazaki, Ryo; Sakamoto, Takanori

    2015-06-01

    We verified the off-axis jet model of X-ray flashes (XRFs) and examined a discovery of off-axis orphan gamma-ray burst (GRB) afterglows. The XRF sample was selected on the basis of the following three factors: (1) a constraint on the lower peak energy of the prompt spectrum {E}{obs}{src}, (2) redshift measurements, and (3) multicolor observations of an earlier (or brightening) phase. XRF 020903 was the only sample selected on the basis of these criteria. A complete optical multicolor afterglow light curve of XRF 020903 obtained from archived data and photometric results in the literature showed an achromatic brightening around 0.7 days. An off-axis jet model with a large observing angle (0.21 rad, which is twice the jet opening half-angle, {θ }{jet}) can naturally describe the achromatic brightening and the prompt X-ray spectral properties. This result indicates the existence of off-axis orphan GRB afterglow light curves. Events with a larger viewing angle (\\gt ∼ 2{θ }{jet}) could be discovered using an 8 m class telescope with wide-field imagers such as the Subaru Hyper-Suprime-Cam and the Large Synoptic Survey Telescope.

  5. An investigation of the application of laser-assisted indocyanine green fluorescent dye angiography in pedicle transverse rectus abdominus myocutaneous breast reconstruction

    PubMed Central

    Newman, Martin I; Samson, Michel C; Tamburrino, Joseph F; Swartz, Kimberly A; Brunworth, Louis

    2011-01-01

    BACKGROUND: Pedicle transverse rectus abdominus myocutaneous (pTRAM) flaps remain the most common method of autologous tissue breast reconstruction. Using pTRAM flaps, complications often arise postoperatively, secondary to inadequate circulation. Tissues from distant angiosomes are associated with poorer perfusion, but this differs among patients. Many modalities have been used to reduce the risk of complications, but none have achieved widespread application. The authors believe that laser-assisted indocyanine green fluorescent dye angiography (LA-ICGA) can potentially reduce the risk of complications. METHODS: In two routine, single-pedicle, ipsilateral pTRAM flaps, LA-ICGA imaging was performed following the division of the distal rectus muscle and deep inferior epigastric pedicle. The resulting images were used to guide design of the flap and debridement. RESULTS: In case 1, good perfusion was observed in zone 1 and part of zone 2. In case 2, good perfusion was observed in zone 1 and 50% of zone 3, with little perfusion in zone 2. In both cases, tissues with poor perfusion were debrided before transfer and inset. In both patients, there were no issues with wound healing, tissue necrosis or fat necrosis. CONCLUSIONS: The variability of perfusion of the pTRAM flap among individuals is well appreciated. LA-ICGA helped to determine the limits of good perfusion and, therefore, the limits of tissue to be preserved for transfer and inset. This helped to avoid harvesting poorly perfused tissue that would have almost certainly experienced necrosis and, ultimately, would have reduced the risk of postoperative complications. PMID:22379372

  6. An aerial composite imaging method with multiple upright cameras based on axis-shift theory

    NASA Astrophysics Data System (ADS)

    Fang, Junyong; Liu, Xue; Xue, Yongqi; Tong, Qingxi

    2010-11-01

    Several composite camera systems were made for wide coverage by using 3 or 4 oblique cameras. A virtual projecting center and image was used for geometrical correction and mosaic with different projecting angles and different spatial resolutions caused by oblique cameras. An imaging method based axis-shift theory is proposed to acquire wide coverage images by several upright cameras. Four upright camera lenses have the same wide angle of view. The optic axis of lens is not on the center of CCD, and each CCD in each camera covers only one part of the whole focus plane. Oblique deformation caused by oblique camera would be avoided by this axis-shift imaging method. The principle and parameters are given and discussed. A prototype camera system is constructed by common DLSR (digital single lens reflex) cameras. The angle of view could exceed 80 degrees along the flight direction when the focal length is 24mm, and the ratio of base line to height could exceed 0.7 when longitudinal overlap is 60%. Some original and mosaic images captured by this prototype system in some ground and airborne experiments are given at last. Experimental results of image test show that the upright imaging method can effectively avoid the oblique deformation and meet the geometrical precision of image mosaic.

  7. Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting

    PubMed Central

    Baksi, D D; Pal, A K; Baksi, D P

    2016-01-01

    Background: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8–30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN) of femoral head. Moreover, in presence of AVN of femoral head neither free fibular graft nor cancellous bone graft is satisfactory. The vascularied bone grafting by deep circumflex iliac artery based on iliac crest bone grafting, free vascularied fibular grafting and muscle pedicle periosteal grafting showed high incidence of success rate. Osteosynthesis is the preferred treatment of choice in ununited femoral neck fracture in younger individuals. Materials and Methods: Of the 293 patients operated during the period from June 1977 to June 2009, 42 were lost to followup. Seven patients with gluteus medius muscle pedicle bone grafting (MPBG) were excluded. Thus, out of 244 patients, 208 (85.3%) untreated nonunion and 36 (14.7%) following failure of primary internal fixation were available for studies. Time interval between the date of injury and operation in untreated nonunion cases was mean 6.5 months and in failed internal fixation cases was mean 11.2 months. Ages of the patients varied from 16 to 55 years. Seventy patients had partial and 174 had subtotal absorption of the femoral neck. Evidence of avascular necrosis (AVN) femoral head was found histologically in 135 (54.3%) and radiologically in 48 (19.7%) patients. The patients were operated by open reduction of fracture, cannulated hip

  8. Horizontal-axis clothes washer market poised for expansion

    SciTech Connect

    George, K.L.

    1994-12-31

    The availability of energy- and water-efficient horizontal-axis washing machines in the North American market is growing, as US and European manufacturers position for an expected long-term market shift toward horizontal-axis (H-axis) technology. Four of the five major producers of washing machines in the US are developing or considering new H-axis models. New entrants, including US-based Staber Industries and several European manufacturers, are also expected to compete in this market. The intensified interest in H-axis technology is partly driven by speculation that new US energy efficiency standards, to be proposed in 1996 and implemented in 1999, will effectively mandate H-axis machines. H-axis washers typically use one-third to two-thirds less energy, water, and detergent than vertical-axis machines. Some models also reduce the energy needed to dry the laundry, since their higher spin speeds extract more water than is typical with vertical-axis designs. H-axis washing machines are the focus of two broadly-based efforts to support coordinated research and incentive programs by electric, gas, and water utilities: The High-Efficiency Laundry Metering/Marketing Analysis (THELMA), and the Consortium for Energy Efficiency (CEE) High-Efficiency Clothes Washer Initiative. These efforts may help to pave the way for new types of marketing partnerships among utilities and other parties that could help to speed adoption of H-axis washers.

  9. 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

  10. Axial viewing of an ICP with a graphite torch injector

    SciTech Connect

    Houk, R.L.; Winge, R.K.; Praphairaksit, N.

    1996-09-01

    A hollow graphite torch injector constricts the analyte emission zone and prevents the production of off-axis emission from the upstream reaches of the axial channel. These properties should both improve signal, reduce background and alleviate matrix effects during axial viewing of the ICP through a metal sampling orifice thrust into the plasma. Recent results along these lines will be presented.

  11. 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

  12. 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

  13. Changes in cardiac function after pedicle subtraction osteotomy in patients with a kyphosis due to ankylosing spondylitis.

    PubMed

    Fu, J; Song, K; Zhang, Y G; Zheng, G Q; Zhang, G Y; Liu, C; Wang, Y

    2015-10-01

    Cardiac disease in patients with ankylosing spondylitis (AS) has previously been studied but not in patients with a kyphosis or in those who have undergone an operation to correct it. The aim of this study was to measure the post-operative changes in cardiac function of patients with an AS kyphosis after pedicle subtraction osteotomy (PSO). The original cohort consisted of 39 patients (33 men, six women). Of these, four patients (two men, two women) were lost to follow-up leaving 35 patients (31 men, four women) to study. The mean age of the remaining patients was 37.4 years (22.3 to 47.8) and their mean duration of AS was 17.0 years (4.6 to 26.4). Echocardiographic measurements, resting heart rate (RHR), physical function score (PFS), and full-length standing spinal radiographs were obtained before surgery and at the two-year follow-up. The mean pre-operative RHR was 80.2 bpm (60.6 to 112.3) which dropped to a mean of 73.7 bpm (60.7 to 90.6) at the two-year follow-up (p = 0.0000). Of 15 patients with normal ventricular function pre-operatively, two developed mild left ventricular diastolic dysfunction (LVDD) at the two-year follow-up. Of 20 patients with mild LVDD pre-operatively only five had this post-operatively. Overall, 15 patients had normal LV diastolic function before their operation and 28 patients had normal LV function at the two-year follow-up. The clinical improvement was 15 out of 20 (75.0%): cardiac function in patients with AS whose kyphosis was treated by PSO was significantly improved.

  14. 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.

  15. Biomechanical evaluation of lumbar pedicle screws in spondylolytic vertebrae: comparison of fixation strength between the traditional trajectory and a cortical bone trajectory.

    PubMed

    Matsukawa, Keitaro; Yato, Yoshiyuki; Imabayashi, Hideaki; Hosogane, Naobumi; Asazuma, Takashi; Chiba, Kazuhiro

    2016-06-01

    OBJECTIVE In the management of isthmic spondylolisthesis, the pedicle screw system is widely accepted surgical strategy; however, there are few reports on the biomechanical behavior of pedicle screws in spondylolytic vertebrae. The purpose of the present study was to compare fixation strength between pedicle screws inserted through the traditional trajectory (TT) and those inserted through a cortical bone trajectory (CBT) in spondylolytic vertebrae by computational simulation. METHODS Finite element models of spondylolytic and normal vertebrae were created from CT scans of 17 patients with adult isthmic spondylolisthesis (mean age 54.6 years, 10 men and 7 women). Each vertebral model was implanted with pedicle screws using TT and CBT techniques and compared between two groups. First, fixation strength of a single screw was evaluated by measuring axial pullout strength. Next, vertebral fixation strength of a paired-screw construct was examined by applying forces simulating flexion, extension, lateral bending, and axial rotation to vertebrae. RESULTS Fixation strengths of TT screws showed a nonsignificant difference between the spondylolytic and the normal vertebrae (p = 0.31-0.81). Fixation strength of CBT screws in the spondylolytic vertebrae demonstrated a statistically significant decrease in pullout strength (21.4%, p < 0.01), flexion (44.1%, p < 0.01), extension (40.9%, p < 0.01), lateral bending (38.3%, p < 0.01), and axial rotation (28.1%, p < 0.05) compared with those in the normal vertebrae. In the spondylolytic vertebrae, no statistically significant difference was observed for pullout strength between TT and CBT (p = 0.90); however, the CBT construct showed lower vertebral fixation strength in flexion (39.0%, p < 0.01), extension (35.6%, p < 0.01), lateral bending (50.7%, p < 0.01), and axial rotation (59.3%, p < 0.01) compared with the TT construct. CONCLUSIONS CBT screws are less optimal for stabilizing the spondylolytic vertebra due to their lower

  16. Revision characteristics of cement-augmented, cannulated-fenestrated pedicle screws in the osteoporotic vertebral body: a biomechanical in vitro investigation. Technical note.

    PubMed

    Blattert, Thomas R; Glasmacher, Stefan; Riesner, Hans-Joachim; Josten, Christoph

    2009-07-01

    In generalized osteoporosis, instrumentation with cement-augmented pedicle screws is an amplification of the therapeutic spectrum. Early clinical results are promising for both solid and cannulated screws; however, there are concerns regarding the revision characteristics of these screws, especially for the cannulated-fenestrated type with its continuous cement interconnection from the core of the screw to surrounding bone tissue. In a human cadaver model, bone mineral density (BMD) was assessed radiographically. Spinal levels T9-L4 were instrumented left unilaterally, transpedicularly by using cannulated-fenestrated pedicle screws with the dimensions 6.5 x 45 mm. Polymethylmethacrylate cement (1.5 ml) was injected through the screws into each vertebra. After polymerization of the cement, the extraction torque was recorded. For both implantation and explantation of the screws, a fluoroscope was used to guarantee correct screw and cement positioning and to observe possible co-movements-that is, any movement of the cement mass within the vertebral body upon removal of the screw. For comparison, the extraction torque of same-dimension pedicle screws was recorded in a nonosteoporotic, non-cement-augmented instrumentation. The BMD was 0.60 g/cm2, a level that corresponds to a severe grade of osteoporosis. For removal of the screws, the median and mean extraction torques were 34 and 49 +/- 44 Ncm, respectively. No co-movements of the cement mass occurred within the vertebral body. In the nonosteoporotic control, BMD was 1.38 g/cm2. The median and mean extraction torques were 123 and 124 +/- 12 Ncm, respectively. Thus, the revision characteristics of cement-augmented, cannulated-fenestrated pedicle screws are not problematic, even in cases of severe osteoporosis. The winglike cement interconnection between the screw core and surrounding bone tissue is fragile enough to break off in the event of an extraction torque and to release the screw. There is no proof to support

  17. Off-axis digital holographic camera for quantitative phase microscopy.

    PubMed

    Monemhaghdoust, Zahra; Montfort, Frédéric; Emery, Yves; Depeursinge, Christian; Moser, Christophe

    2014-06-01

    We propose and experimentally demonstrate a digital holographic camera which can be attached to the camera port of a conventional microscope for obtaining digital holograms in a self-reference configuration, under short coherence illumination and in a single shot. A thick holographic grating filters the beam containing the sample information in two dimensions through diffraction. The filtered beam creates the reference arm of the interferometer. The spatial filtering method, based on the high angular selectivity of the thick grating, reduces the alignment sensitivity to angular displacements compared with pinhole based Fourier filtering. The addition of a thin holographic grating alters the coherence plane tilt introduced by the thick grating so as to create high-visibility interference over the entire field of view. The acquired full-field off-axis holograms are processed to retrieve the amplitude and phase information of the sample. The system produces phase images of cheek cells qualitatively similar to phase images extracted with a standard commercial DHM.

  18. 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…

  19. Assessment of aortic stenosis from the right parasternal view: when the answer is just on the opposite side.

    PubMed

    Corsi, Davide; Imperatori, Andrea; Fontana, Antonella; Russo, Pierluigi; Trocino, Giuseppe

    2013-01-01

    We present the case of a man with severe aortic stenosis in whom diagnosis was established by evaluating the transvalvular gradient from the right parasternal view, since classical measurements from the apical five-chamber view were discordant with the indexed aortic valve area obtained in the short-axis view.

  20. Melatonin and hypothalamic-pituitary-gonadal axis.

    PubMed

    Shi, L; Li, N; Bo, L; Xu, Z

    2013-01-01

    Melatonin (N-acetyl-5-methoxy-tryptamine), a principal product of the pineal gland, is produced mainly during the dark phase of the circadian cycle. This hormone plays a crucial role in the regulation of circadian and seasonal changes in various aspects of physiology and neuroendocrine functions. In mammals, melatonin can influence sexual maturation and reproductive functions via activation of its receptors and binding sites in the hypothalamic-pituitary-gonadal (HPG) axis. This review summarizes current knowledge of melatonin on the hypothalamus, pituitary gland, and gonads. We also review recent progress in clinical applications of melatonin or potentials of using melatonin, as a reducer of oxidative stress, to improve reproductive functions for the diseases such as women infertility.

  1. Gonadotropic axis and Trypanosoma brucei gambiense infection.

    PubMed

    Boersma, A; Noireau, F; Hublart, M; Boutignon, F; Lemesre, J L; Racadot, A; Degand, P

    1989-06-01

    A gonad endocrine survey on 46 Congolese patients (15 women and 31 men) with parasitologically confirmed trypanosomiasis found amenorrhoea in 60% of the women and impotence in 70% of the men. The basic gonad endocrine examination showed a decrease in oestradiol levels in about 65% of the women. Both amenorrhoea and low oestrogen levels were observed in the second phase (P2) of the disease, but low oestrogen levels were sometimes noted in the first phase of the disease (P1). In the men, about 50% of the cases (P2) showed a decrease in testosterone. However, as in the women, the variation of testosterone was also observed in the first phase (P1). A static and dynamic examination of the hypothalamic-pituitary-gonadal axis was undertaken in order to investigate the origin of these hypogonadisms. A supra - or extra-hypophyseal origin is discussed.

  2. 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.

  3. Vertical-Axis Wind Turbine Mesh Generator

    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 facilitatesmore » 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.« less

  4. 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.

  5. Off-axis coherently pumped laser

    NASA Technical Reports Server (NTRS)

    Koepf, G. A. (Inventor)

    1984-01-01

    A coherently optically pumped laser system is described. A pump laser beam propagates through a laser medium contained in a degenerate cavity resonator in a controlled multiple round trip fashion in such a way that the unused pump beam emerges from an injection aperture at a different angle from which it enters the resonator. The pump beam is angularly injected off of the central axis of the resonator body whereupon the pump beam alternately undergoes spreading and focusing while pumping the laser medium by a process of resonant absorption. The emergent pump beam can also be used as a second pump beam source by being reinjected back into the cavity or it can be used for pumping another laser.

  6. Thumb-actuated two-axis controller

    NASA Technical Reports Server (NTRS)

    Hollow, R. H. (Inventor)

    1986-01-01

    A two axis joystick controller is described. It produces at least one output signal in relation to pivotal displacement of a member with respect to an intersection of the two axes. The member is pivotally movable on a support with respect to the two axes. The support has a centrally disposed aperture. A light source is mounted on the pivotally movable member above the aperture to direct light through the aperture. A light sensor is mounted below the aperture in the support at the intersection of the two axes to receive the light from the light source directed through the aperture. The light sensor produces at least one output signal related to a location on the sensor at which the light from the light source strikes the sensor.

  7. Force-balanced dual-axis microgyroscope

    NASA Astrophysics Data System (ADS)

    An, Seungdo; Oh, Yong-Soo; Lee, Byeungleul; Park, Kyu-Yeon; Go, Youn-il; Kim, Jeong-gon; Song, Ci M.; Lee, Seungseob

    1997-11-01

    The surface micromachining process realized the dual-axis microgyroscope. The 7.5 micrometers -thick polysilicon layer deposited by LPCVD is used for the vibrating structure. In this research, we present a new structure with high angular inertia momentum and compact size. In particular, this structure can utilize a simple force-balancing torsional torque which does not need another top electrode layer to reduce the intrinsic non-linearity of a capacitive-type sensor. The gyroscope is tested in a high vacuum chamber for a high Q-factor. The sensing mode is separated 2 percent from the driving mode by applying the inter-plate DC tuning bias. The experiment resulted in a nose equivalent signal of 0.1 deg/sec.

  8. 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.

  9. 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.

  10. 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.

  11. Otic axis locator: closing the accuracy gap in cephalometrics and cast mounting.

    PubMed

    Thurow, R C

    2000-03-01

    An overview is presented of a new technique to improve the accuracy and reproducibility of earpost-dependent orientation in procedures such as cephalometric radiography and cast mounting, using a custom-molded ear canal insert to provide a stable fitted socket for more exact earpost fit. This is especially valuable in follow-up treatment and serial studies because the insert can be filed for future use on the same patient to provide identical positioning in successive registrations. Cephalometric radiography is further enhanced by the addition of a radiopaque x-ray marker deep in the canal, otherwise inaccessible, close to the bony ear canal (anatomical porion) and the mandibular condyle. This marker is also visible in all 3 cephalometric views-lateral, frontal (posteroanterior) and coronal (submental-vertex)-providing an exact common horizontal axis (Otic axis) for a three-dimensional Cartesian coordinate system of measurement.

  12. 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

  13. Surgical epicondylar axis vs anatomical epicondylar axis for rotational alignment of the femoral component in total knee arthroplasty.

    PubMed

    Tanavalee, A; Yuktanandana, P; Ngarmukos, C

    2001-06-01

    The anatomical epicondylar (AEpi) axis and the surgical epicondylar (SEpi) axis have been widely used as the epicondylar axis, one of the most commonly used axes for rotational alignment of the femoral component in total knee arthroplasty. The purpose of this study was to evaluate the differences and reliability between these two axes. Computerized tomography scan of the distal femur was done in 55 osteoarthritic knees. Thirty-two knees were varus and 23 knees were neutral in alignment. Axes for rotational alignment of the femoral component were lined including posterior condylar (PC), anteroposterior (AP), AEpi, and SEpi axes. Angles between each pair of axes were measured including PC-AEpi, PC-SEpi, AP-AEpi, AP-SEpi and AP-PC. The average PC-AEpi angle was 5.7 degrees +/- 1.7 degrees. The average PC-SEpi angle was 1.5 degrees +/- 2.1 degrees. The average AP-AEpi angle was 90.2 degrees +/- 1.0 degrees. The average AP-SEpi angle was 94.5 degrees +/- 1.3 degrees and the average AP-PC angle was 95.9 degrees +/- 2.0 degrees. Twenty-nine per cent of knees had prominent medial epicondyle (a landmark for AEpi axis) and 5 per cent had prominent medial sulcus (a landmark for SEpi axis). The lateral epicondyle was prominent in all knees. There were no significant differences of all angles of referencing axes between men and women (p>0.05). There were no significant differences between varus and neutral knees in terms of PC-AEpi angle and PC-SEpi angle (p>0.05). The AEpi axis was more perpendicular to the AP axis and more external rotated to the PC axis than the SEpi axis. Because the perpendicular line to the AEpi axis was closer to the AP axis than that of the SEpi axis and the AEpi axis provided appropriate external rotated to the PC axis, the AEpi axis was more reliable for rotational alignment of the femoral component than the SEpi axis. On the other hand, SEpi axis, providing less external rotated to the PC axis, may be difficult to define and could cause

  14. A Simple Numerical Approach To Avalanche Forecasting: Chowkibal-tangdhar Axis, Kashmir, India

    NASA Astrophysics Data System (ADS)

    Singh, Amreek; Joshi, J. C.; Ganju, Ashwagosha

    Chowkibal-Tangdhar axis of Kashmir region in India is a stretch of about 36 kms with 26 major avalanche sites. It falls in Pir Panjal range and crosses Nastachun pass cutting across Shamsabari Mountains, at an altitude of 3120m. Snow-meteorological data of 10 years recorded at two different altitude zones in the axis were statistically analyzed in the backdrop of the avalanche occurrences observed during the same period on the axis. The results show primary significance towards avalanching for certain variables e.g. fresh snow depth, snowfall rate, standing snow, water equivalent of fresh precipitation, recorded at either observatory. But for others, especially wind parameters, trend of significance is different for the two observatories. The results have also been compared with one similar study conducted for the data from Kooteny pass, British Columbia, Canada. The comparison shows a similar significance trend for most of the variables for the two areas. The attempt has also been made to identify the ranges of variables responsible for the formation of loose snow, slab, dry or wet avalanches with their avalanche size. The overall study provides an objective criterion to assess the significance of individual snow-met variables from avalanching point of view. The significance criterion thus evolved has been further implemented in the development of a simple numerical model to assess the probability, type and size of avalanching in the axis. For a particular day, the significance level of individual parameters is first determined according to the developed criterion. The average level of significance then indicates the probability of avalanching in the axis on that day. A critical limit of probability based on the data of past occurrences, helps to put that particular day in the class of avalanche or non-avalanche day. The values of the individual variables, then predict the likely nature of avalanche in terms of type and size based on the pre-identified ranges.

  15. DC 12m telescope. Preliminary calculations. Investigation of elevation axis position.

    SciTech Connect

    Guarino, V. J.; High Energy Physics

    2009-12-18

    This paper examines some simple calculations of a 2D model of a telescope in order to understand how different design parameters affect the design. For the design of a telescope it is assumed that they need a design that minimizes deflections of the dish and also minimizes the size of the motors and torques needed to rotate in elevation. A common belief is that a lighter dish and minimum counterweight is desirable. However, these calculations show this is not necessarily true. The torque needed for rotation depends on the moment of inertia and if the telescope is balanced about the elevation axis. A light dish with no CW requires that the elevation axis be several meters in front of the dish (8-9m) in order to be balanced. This is not practical from a structural point of view. If the elevation axis is only 2m in front of the dish and there is no counterweight then the telescope will be unbalanced and the toruqes required will be very high - much higher than the torques needed only to overcome inertia. A heavy dish though can act as its own counterweight and the elevation axis only has to be 2-3m in front of the dish in order to achieve a balanced telescope. Also the struts that support the camera from the dish place a load on the dish which will put a bending moment on the dish. This bending moment will deform the dish and require it to be stiffer. A counterweight structure performs two functions. First, it allows the telescope to be balanced about the elevation axis. Second, it applies a force on the dish that opposes the forces from the camera struts, thereby reducing the bending moment and deformations of the dish.

  16. Pediatric Arm Reconstruction after Shot-gun Injury Using Peroneal Free-flap and Pedicled Latissimus Dorsi Muscle Flap: Late Follow-up.

    PubMed

    Olvera-Caballero, Carlos; Ortiz-Dominguez, Abel

    2016-08-01

    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

  17. 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

  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.

  19. Clinical outcome of posterior C1-C2 pedicle screw fixation and fusion for atlantoaxial instability: A retrospective study of 86 patients.

    PubMed

    Zheng, Yonghong; Hao, Dingjun; Wang, Biao; He, Baorong; Hu, Huimin; Zhang, Haiping

    2016-10-01

    We retrospectively studied the clinical results of posterior C1-C2 pedicle screw fixation and fusion for 86 patients diagnosed with atlantoaxial instability from January 2002 to January 2013. The study population included 48 men and 38 women, with an average age of 42.6 (range, 16-69years old). The causes of atlantoaxial instability could be divided into traumatic fracture (44 patients), congenital malformation (17 patients), rheumatoid arthritis (15 patients), and other causes (nine patients). The mean follow-up duration was 33.9months (range, 13-72months). The average operative time was 133.0min (range, 90-290min), and the mean blood loss during the operation was 185.7ml (range, 110-750ml). No patient experienced neurological function worsening related to the surgical procedure. In addition, 63% of the patients who presented with neurological symptoms reported improvement after surgery. Screw placement and reduction was achieved satisfactorily in all the patients and their neck pain was greatly relieved. Plain radiography and CT scans indicated solid fusion after 12months in all the patients. We suggest that C1-C2 pedicle screw internal fixation is a reliable method for treating atlantoaxial instability. PMID:27544229

  20. 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

  1. Area-Based Medial Axis of Planar Curves

    PubMed Central

    Niethammer, Marc; Betelu, Santiago; Sapiro, Guillermo; Tannenbaum, Allen; Giblin, Peter J.

    2013-01-01

    A new definition of affine invariant medial axis of planar closed curves is introduced. A point belongs to the affine medial axis if and only if it is equidistant from at least two points of the curve, with the distance being a minimum and given by the areas between the curve and its corresponding chords. The medial axis is robust, eliminating the need for curve denoising. In a dynamical interpretation of this affine medial axis, the medial axis points are the affine shock positions of the affine erosion of the curve. We propose a simple method to compute the medial axis and give examples. We also demonstrate how to use this method to detect affine skew symmetry in real images. PMID:23710110

  2. ThreatView

    2007-09-25

    The ThreatView project is based on our prior work with the existing ParaView open-source scientific visualization application. Where ParaView provides a grapical client optimized scientific visualization over the VTK parallel client server architecture, ThreatView provides a client optimized for more generic visual analytics over the same architecture. Because ThreatView is based on the VTK parallel client-server architecture, data sources can reside on remote hosts, and processing and rendering can be performed in parallel. As seenmore » in Fig. 1, ThreatView provides four main methods for visualizing data: Landscape View, which displays a graph using a landscape metaphor where clusters of graph nodes produce "hills" in the landscape; Graph View, which displays a graph using a traditional "ball-and-stick" style; Table View, which displays tabular data in a standard spreadsheet; and Attribute View, which displays a tabular "histogram" of input data - for a selected table column, the Attribute View displays each unique value within the column, and the number of times that value appears in the data. There are two supplemental view types: Text View, which displays tabular data one-record-at-a-time; and the Statistics View, which displays input metadata, such as the number of vertices and edges in a graph, the number of rows in a table, etc.« less

  3. ThreatView

    SciTech Connect

    Shead, Timothy M.; Wylie, Brian

    2007-09-25

    The ThreatView project is based on our prior work with the existing ParaView open-source scientific visualization application. Where ParaView provides a grapical client optimized scientific visualization over the VTK parallel client server architecture, ThreatView provides a client optimized for more generic visual analytics over the same architecture. Because ThreatView is based on the VTK parallel client-server architecture, data sources can reside on remote hosts, and processing and rendering can be performed in parallel. As seen in Fig. 1, ThreatView provides four main methods for visualizing data: Landscape View, which displays a graph using a landscape metaphor where clusters of graph nodes produce "hills" in the landscape; Graph View, which displays a graph using a traditional "ball-and-stick" style; Table View, which displays tabular data in a standard spreadsheet; and Attribute View, which displays a tabular "histogram" of input data - for a selected table column, the Attribute View displays each unique value within the column, and the number of times that value appears in the data. There are two supplemental view types: Text View, which displays tabular data one-record-at-a-time; and the Statistics View, which displays input metadata, such as the number of vertices and edges in a graph, the number of rows in a table, etc.

  4. 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.

  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. PMID:27348437

  6. ICPP: Results from Helical Axis Stellarators

    NASA Astrophysics Data System (ADS)

    Blackwell, B. D.

    2000-10-01

    Helical axis stellarators produce magnetic surfaces of high rotational transform and moderate shear solely by means of external currents, with the promise of high β. Several machines with quite different toroidal, helical, and ``bumpy'' Fourier components of magnetic field are now operating. The H-1 Heliac (1m, 1Tesla: Canberra, Australia), an M=3, low aspect ratio flexible heliac has been operated up to 0.5 Tesla with RF heating up to Ti ~ 100eV. Confinement transitions observed in this plasma exhibit many features of improved confinement regimes in tokamaks obtained at much larger power. ECH at 28GHz is being commissioned, and results from a suite of scattering, scalar and vector tomographic and multipoint probe and optical measurements will be presented. The M=4 Flexible Heliac ``TJ-II'' (1.5m, 1.2T: CIEMAT, Madrid) has accumulated a database of ECH plasma (1T) for a variety of configurations, (iota ~ 1.3--2.24) and a comprehensive set of diagnostics. Temperatures up to 2keV were measured by Thomson scattering/ECE. Observations include stored energy dependence, evidence of internal transport barriers, ELM-like bursts of magnetic activity and E×B sheared flows near rational surfaces in the plasma boundary. A new advanced configuration, the helical-axis heliotron, ``Heliotron J'' (1.2m, 1.5T: IAE, Kyoto University), the successor to Heliotron E, uses a ``bumpy'' magnetic component to improve high-energy particle confinement and reduce neoclassical transport. A combination of toroidal and helical coils produces a range of configurations. First plasma was successfully produced on December 1999, by ECH at 53GHz(2ω_ce). Following field mapping and final installation of diagnostics, the full experiment will start July 2000. The Helically Symmetric Experiment, ``HSX'' (Univ. Wisconsin, Madison) employs computer optimized non-planar coils to exploit a quasi-symmetry that minimizes toroidal magnetic field harmonics, confirmed by recent mapping of the drift orbits

  7. The multi-axis vibration environment and man.

    PubMed

    Lovesey, E J

    1970-12-01

    Many investigations into the effects of vibration on man have been performed since Mallock's first study of London Underground vibrations in 1902. The vibration research has tended to be confined to the vertical (heave) axis, yet recent experiments have indicated that low frequency vibration along the lateral (sway) axis has a greater adverse effect upon comfort and performance. Measurements of the vibration environments in current forms of transport including motor vehicles, hovercraft and aircraft etc have shown that appreciable quantities of vibration along all three axes exist. Further vibration research should consider the effects of multi-axis vibrations upon man rather than limit tests to single axis vibration. PMID:15676336

  8. Shot H3837: Darht's first dual-axis explosive experiment

    NASA Astrophysics Data System (ADS)

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

    2012-03-01

    Test H3837 was the first explosive shot performed in front of both flash x-ray axes at the Los Alamos Dual Axis Radiographic Hydrodynamic Test (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.

  9. Constraints on Spin Axis and Thermal Properties of Asteroids in the WISE Catalog

    NASA Astrophysics Data System (ADS)

    MacLennan, Eric M.; Emery, J. P.

    2013-10-01

    It has widely been accepted that dynamical state of asteroids can strongly be influenced by radiation forces (e.g., Yarkovsky and YORP). Determination of an object’s thermal properties and spin state are a critical step towards understanding the effects of these forces. In this respect, observations of thermal flux emitted from the surfaces of asteroids are a powerful tool. The emission of flux is determined by the temperature distribution which is controlled by the thermal inertia, rotation rate, and spin axis orientation. By gathering data at multiple viewing geometries, the temperature distribution can be modeled accurately enough to separate the effects attributed to (some of) these parameters. Over the length of its mission, the Wide-Field Infrared Survey Explorer (WISE) observed many asteroids in two epochs (i.e., on either side of opposition) such that data for both morning and afternoon times were gathered. We have begun a project that employs a Thermophysical Model (TPM) in order to analyze these multi-epoch thermal observations with the goal of deriving the thermal properties and spin axis of a large number of asteroids. Here, we first investigate the validity and limits of our method on objects with a previously determined spin axis. Asteroid (413) Edburga has a published spin axis of λ = 202o, β = - 45o (ecliptic longitude and latitude, respectively) using the lightcurve inversion method. With our technique, we estimate a solution consistent with the previous estimate. Applying our TPM to WISE multi-epoch thermal observations of (155) Scylla (no known spin axis estimate), we also place estimates for the ecliptic longitude and latitude of its spin axis. Analysis of multi-epoch thermal data enables determination of spin axis orientation without knowing the rotation period, in contrast to the lightcurve inversion method. This is due to the coupling of thermal inertia and rotation rate in determining the longitudinal distribution of temperature. Their

  10. Control system for a vertical axis windmill

    SciTech Connect

    Brulle, R.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/sup 0/ and 270/sup 0/ 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. Control system for a vertical axis windmill

    SciTech Connect

    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.

  12. Gut/brain axis and the microbiota.

    PubMed

    Mayer, Emeran A; Tillisch, Kirsten; Gupta, Arpana

    2015-03-01

    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

  13. 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.

  14. The Proline Regulatory Axis and Cancer

    PubMed Central

    Phang, James Ming; Liu, Wei; Hancock, Chad; Christian, Kyle J.

    2012-01-01

    Studies in metabolism and cancer have characterized changes in core pathways involving glucose and glutamine, emphasizing the provision of substrates for building cell mass. But recent findings suggest that pathways previously considered peripheral may play a critical role providing mechanisms for cell regulation. Several of these mechanisms involve the metabolism of non-essential amino acids, for example, the channeling of glycolytic intermediates into the serine pathway for one-carbon transfers. Historically, we proposed that the proline biosynthetic pathway participated in a metabolic interlock with glucose metabolism. The discovery that proline degradation is activated by p53 directed our attention to the initiation of apoptosis by proline oxidase/dehydrogenase. Now, however, we find that the biosynthetic mechanisms and the metabolic interlock may depend on the pathway from glutamine to proline, and it is markedly activated by the oncogene MYC. These findings add a new dimension to the proline regulatory axis in cancer and present attractive potential targets for cancer treatment. PMID:22737668

  15. Hypothalamic-pituitary-adrenocortical axis: neuropsychiatric aspects.

    PubMed

    Jacobson, Lauren

    2014-04-01

    Evidence of aberrant hypothalamic-pituitary-adrenocortical (HPA) activity in many psychiatric disorders, although not universal, has sparked long-standing interest in HPA hormones as biomarkers of disease or treatment response. HPA activity may be chronically elevated in melancholic depression, panic disorder, obsessive-compulsive disorder, and schizophrenia. The HPA axis may be more reactive to stress in social anxiety disorder and autism spectrum disorders. In contrast, HPA activity is more likely to be low in PTSD and atypical depression. Antidepressants are widely considered to inhibit HPA activity, although inhibition is not unanimously reported in the literature. There is evidence, also uneven, that the mood stabilizers lithium and carbamazepine have the potential to augment HPA measures, while benzodiazepines, atypical antipsychotics, and to some extent, typical antipsychotics have the potential to inhibit HPA activity. Currently, the most reliable use of HPA measures in most disorders is to predict the likelihood of relapse, although changes in HPA activity have also been proposed to play a role in the clinical benefits of psychiatric treatments. Greater attention to patient heterogeneity and more consistent approaches to assessing treatment effects on HPA function may solidify the value of HPA measures in predicting treatment response or developing novel strategies to manage psychiatric disease.

  16. 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.

  17. Principal axis-based correspondence between multiple cameras for people tracking.

    PubMed

    Hu, Weiming; Hu, Min; Zhou, Xue; Tan, Tieniu; Lou, Jianguang; Maybank, Steve

    2006-04-01

    Visual surveillance using multiple cameras has attracted increasing interest in recent years. Correspondence between multiple cameras is one of the most important and basic problems which visual surveillance using multiple cameras brings. In this paper, we propose a simple and robust method, based on principal axes of people, to match people across multiple cameras. The correspondence likelihood reflecting the similarity of pairs of principal axes of people is constructed according to the relationship between "ground-points" of people detected in each camera view and the intersections of principal axes detected in different camera views and transformed to the same view. Our method has the following desirable properties: 1) Camera calibration is not needed. 2) Accurate motion detection and segmentation are less critical due to the robustness of the principal axis-based feature to noise. 3) Based on the fused data derived from correspondence results, positions of people in each camera view can be accurately located even when the people are partially occluded in all views. The experimental results on several real video sequences from outdoor environments have demonstrated the effectiveness, efficiency, and robustness of our method. PMID:16566515

  18. 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.

  19. 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

  20. Flux pinning by a-axis grains in c-axis-oriented Y-Ba-Cu-O films

    NASA Astrophysics Data System (ADS)

    Fuke, H.; Yoshino, H.; Yamazaki, M.; Thanh, T. D.; Nakamura, S.; Ando, K.; Kobayashi, Y.

    1992-05-01

    The relationship between the microstructures and pinning forces is investigated by measuring the magnetic-field dependence and angular dependence of Jc in several kinds of YBCO thin films having different microstructures. A high-Jc value was kept even when the magnetic field was applied perpendicular to the film plane in the case of a c-axis-oriented film which was studded with a-axis-oriented grains. The boundaries between the a-axis-oriented grain and the c-axis-oriented grain are considered to be effective as pinning centers.

  1. Short-term Results of Muscle-Pedicle Bone Grafting with Tensor Fascia Lata for Delayed Femoral Neck Fractures; Case Series and Literature Review

    PubMed Central

    Salgotra, Kuldip; Kohli, Sarabjeet; Vishwakarma, Nilesh

    2016-01-01

    Neglected, untreated and delayed femur neck fractures are commonly encountered and the treatment dilemma arises especially when the patient is physiologically young and osteosynthesis is the preferred option. Controversy exists in the current literature as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularized fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata and Quadratus femoris graft) and vascularized bone grafting do not have clear lines of indications. The current study is a case series of 7 patients with femur neck fractures with delayed presentation beyond the vascular emergency period who were treated with osteosynthesis with muscle pedicle bone graft (MPBG) using tensor fascia lata muscle pedicle graft. Patients were followed clinical and radiologically at 6 weeks, 3 and 6 months, 1 year and 3 years and patients were regularly followed. The mean age of the patients was 47 ± 1.1 ranging from 38 to 55 years. There were 6 (85.7%) men and 1 (14.3%) women among the patients. Overall 5 (71.5%) patients had transcervical and 2 (28.5%) had subcapital fractures. At the end of 6 months, 6 (85.7%) patients were pain free and on plain radiographs fracture union was noted. One (14.3%) patient developed collapse and persistent nonunion. Younger group less than 50 years presenting with neglected fracture neck femur should always be give an option of head salvage surgery in selected cases. Muscle pedicle bone grafting has been proven although inconsistently as a valid option for fracture neck femur. We encourage osteosynthesis with the use of tensor fascia lata muscle pedicle grafting along with cancellous cannulated screws as a first option in selected cases of neglected femur neck fractures. PMID:27331067

  2. Spin axis behavior of the LAGEOS satellites

    NASA Astrophysics Data System (ADS)

    AndréS, J. I.; Noomen, R.; Bianco, G.; Currie, D. G.; Otsubo, T.

    2004-06-01

    The satellites LAGEOS-I and LAGEOS-II are essential for the scientific study of various (geo)physical phenomena, such as geocenter motion and absolute scale. The high quality of such science products strongly depends on the absolute quality of the SLR observations and that of the orbit description. Therefore all accelerations experienced by the spacecraft need to be modeled as accurately as possible, the thermal radiation forces being one of them. Traditionally, this is done by estimating so-called empirical accelerations. However, the rotational dynamics of LAGEOS-I in particular no longer allows such a simple approach: a full modeling of the spin behavior, the temperature distribution over the spacecraft surface and the resulting net force prove necessary to achieve the best results. As a first step, a new model, Lageos Spin Axis Model (LOSSAM) has been developed. It is unique in its combination of analytical theory and empirical observations. Its mathematics is taken after previous investigators, although flaws have been corrected. LOSSAM describes the full spin behavior of LOSSAM based on the following phenomena: (1) the geomagnetic field, (2) the Earth's gravity field, (3) the satellite center of pressure offset, and (4) the effective difference in reflectivity between the satellite hemispheres. Its accuracy has been demonstrated by an improvement of about a 50% in the RMS residual of the Yarkovsky-Schach effect signal (as shown by [2004]). Such a high-quality model for rotational behavior is indispensable for a proper force modeling, and hence also for the quality of typical LAGEOS science products.

  3. Characterization of off-axis fishbones

    NASA Astrophysics Data System (ADS)

    Heidbrink, W. W.; Austin, M. E.; Fisher, R. K.; García-Muñoz, M.; Matsunaga, G.; McKee, G. R.; Moyer, R. A.; Muscatello, C. M.; Okabayashi, M.; Pace, D. C.; Shinohara, K.; Solomon, W. M.; Strait, E. J.; Van Zeeland, M. A.; Zhu, Y. B.

    2011-08-01

    Repetitive bursting instabilities with strong frequency chirping occur in high-beta, beam-heated plasmas with safety factor q > 1 in the DIII-D tokamak. Although the mode structures differ, in many ways, the off-axis fishbones are similar to the q = 1 fishbones first observed on the Poloidal Divertor Experiment (PDX). The modes are driven by energetic trapped ions at the fast-ion precession frequency. During a burst, the frequency changes most rapidly as the mode reaches its maximum amplitude. Larger amplitude bursts have larger growth rates and frequency chirps. Unlike PDX fishbones, the decay phase is highly variable and is usually shorter than the growth phase. Also, the waveform is highly distorted by higher harmonics during the latter portion of a burst. The radial mode structure alters its shape during the burst. Like PDX fishbones, the modes expel trapped ions in a 'beacon' with a definite phase relationship relative to the mode. Seven types of loss detectors measure the beacon. The losses scale linearly with mode amplitude. The neutron rate changes most rapidly at maximum mode amplitude but, depending on the loss diagnostic, the losses often peak a few cycles later. The non-ambipolar fast-ion losses cause a sudden change in toroidal rotation frequency across the entire plasma. In addition to an overall drop, the neutron signal oscillates in response to the wave. Unlike the beacon of lost particles, which maintains a fixed phase relative to the mode, the phase of the neutron oscillations steadily increases throughout the burst, with the greatest phase slippage occurring in the highly nonlinear phase near maximum mode amplitude.

  4. 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.

  5. 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.

  6. Vertical-axis windmill of the Chinese type

    SciTech Connect

    Campbell, J.

    1982-12-21

    A vertical-axis windmill comprising a central pole having a longitudinal axis about which a plurality of sales may revolve as would the main sails of three sailing boats restricted to follow a horizontal circular course and including means for lowering the windmill for protection or service without the sails engaging the ground.

  7. Distortion definition and correction in off-axis systems

    NASA Astrophysics Data System (ADS)

    Da Deppo, Vania; Simioni, Emanuele; Naletto, Giampiero; Cremonese, Gabriele

    2015-09-01

    Off-axis optical configurations are becoming more and more used in a variety of applications, in particular they are the most preferred solution for cameras devoted to Solar System planets and small bodies (i.e. asteroids and comets) study. Off-axis designs, being devoid of central obstruction, are able to guarantee better PSF and MTF performance, and thus higher contrast imaging capabilities with respect to classical on-axis designs. In particular they are suitable for observing extended targets with intrinsic low contrast features, or scenes where a high dynamical signal range is present. Classical distortion theory is able to well describe the performance of the on-axis systems, but it has to be adapted for the off-axis case. A proper way to deal with off-axis distortion definition is thus needed together with dedicated techniques to accurately measure and hence remove the distortion effects present in the acquired images. In this paper, a review of the distortion definition for off-axis systems will be given. In particular the method adopted by the authors to deal with the distortion related issues (definition, measure, removal) in some off-axis instruments will be described in detail.

  8. Implementation of a Two-Axis Servo-Hydraulic System for Full-Scale Fatigue Testing of Wind Turbine Blades

    SciTech Connect

    Hughes, S. D.; Musial, W. D.; Stensland, T.

    1999-09-09

    Recently, the blade fatigue testing capabilities at NREL were upgraded from single-axis to two-axis loading. To implement this, several practical challenges were addressed, as hardware complexity increased dramatically with two actuators applying the loads at right angles to each other. A custom bellcrank was designed and implemented to minimize the load angle errors and to prevent actuator side loading. The control system was upgraded to accept load and displacement feedback from two actuators. The inherent long strokes uniquely associated with wind turbine blade-tests required substantial real-time corrections for both the control and data systems. A custom data acquisition and control system was developed using a National Instruments LabVIEW platform that interfaces with proprietary servo-hydraulic software developed by MTS Corporation. Before testing, the program is run under quasi-static (slow speed) conditions and iterates to determine the correct operational control parameters for the controller, taking into consideration geometry, test speed, and phase angle errors between the two actuators. Comparisons are made between single-axis and two-axis test loads using actual test load data and load uncertainties are qualitatively described. To date, two fatigue tests have been completed and another is currently ongoing using NREL's two-axis capability.

  9. Limitations and difficulties of echocardiographic short-axis assessment of paravalvular leakage after corevalve transcatheter aortic valve implantation.

    PubMed

    Geleijnse, Marcel L; Di Martino, Luigi F M; Vletter, Wim B; Ren, Ben; Galema, Tjebbe W; Van Mieghem, Nicolas M; de Jaegere, Peter P T; Soliman, Osama I I

    2016-01-01

    To make assessment of paravalvular aortic leakage (PVL) after transcatheter aortic valve implantation (TAVI) more uniform the second Valve Academic Research Consortium (VARC) recently updated the echocardiographic criteria for mild, moderate and severe PVL. In the VARC recommendation the assessment of the circumferential extent of PVL in the short-axis view is considered critical. In this paper we will discuss our observational data on the limitations and difficulties of this particular view, that may potentially result in overestimation or underestimation of PVL severity. PMID:27600600

  10. 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.

  11. 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.

  12. Exercise and the Hypothalamo-Pituitary-Adrenal Axis.

    PubMed

    Duclos, Martine; Tabarin, Antoine

    2016-01-01

    Exercise represents a potent physiological stimulus upon the hypothalamo-pituitary adrenal (HPA) axis. Two major factors modulate the HPA axis response to exercise: intensity and duration. Endurance training per se does not induce permanent hypercortisolism as endurance-trained subjects have similar biological markers of HPA axis activity in resting condition as healthy untrained men. However, during a challenge of the HPA axis, endurance-trained subjects demonstrate an adaptation of the HPA axis activity to repeated exercise resulting from decreased tissular sensitivity to glucocorticoids. A great diversity of other mechanisms is involved in this adaptation, acting potentially at all levels in the cascade and leading to the biological effects of cortisol. PMID:27348531

  13. Fracture modes in off-axis fiber composites

    NASA Technical Reports Server (NTRS)

    Sinclair, J. H.; Chamis, C. C.

    1978-01-01

    Criteria were developed for identifying, characterizing, and quantifying fracture modes in high-modulus graphite-fiber/resin unidirectional composites subjected to off-axis tensile loading. Procedures are described which use sensitivity analyses and off-axis data to determine the uniaxial strength of fiber composites. It was found that off-axis composites fail by three fracture modes which produce unique fracture surface characteristics. The stress that dominates each fracture mode and the load angle range of its dominance can be identified. Linear composite mechanics is adequate to describe quantitatively the mechanical behavior of off-axis composites. The uniaxial strengths predicted from off-axis data are comparable to these measured in uniaxial tests.

  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. Posterior Thigh Flap Pedicled on the Cutaneous Vessels Arising From the Popliteo-posterior Intermediate Artery: A Report of 5 Cases.

    PubMed

    Sun, Xi-Guang; Gong, Xu; Song, Liang-Song; Cui, Jian-Li; Yu, Xin; Liu, Bin; Lu, Lai-Jin

    2016-08-01

    Surgical repair of soft tissue defects of the knee and leg remains challenging. Using a case study approach, the anatomy of the popliteo-posterior intermediate cutaneous artery was examined, and a reverse island flap method was developed and implemented. After obtaining informed consent, 5 patients (1 woman, 4 men, age range 31 to 57 years) underwent the experimental use of a reverse island flap with a posterior thigh flap pedicled on the cutaneous vessels arising from the popliteo-posterior intermediate artery to repair soft-tissue defects of the knee and leg. The defects were caused by burned skin below the knee (n = 1), progressive skin necrosis in the knee after fracture surgery (n = 2), and skin infections associated with diabetes mellitus (n = 2). Skin defect sizes ranged from 15 cm x 5 cm to 30 cm x 12 cm. These large defects did not heal spontaneously; wound duration ranged from 1 week to 1 year, and all patients had refused defect repair with free flaps. Patients received posterior thigh flaps pedicled on the popliteo-posterior intermediate artery with areas ranging from 17 cm x 6 cm to 25 cm x 12 cm. All patients were treated with antibiotics and local dressings (iodoform and alcohol) changed daily post surgery, and blood supply was monitored by assessing the texture and color of the flap and venous regurgitation (ie, vein drainage disturbance). Four (4) of the five flaps survived completely. In 1 patient, partial survival of the flap, which had a good blood supply despite a venous circulation disorder, occurred: in this case, complete survival was achieved after treatment with a retrograde fascial flap and skin grafting. The appearance and texture of all flaps were satisfactory (ie, patients underwent only 1 operation, healing time was approximately 2 weeks, flap quality was close to normal skin, the donor site closed directly, and the shape and function of the knee and leg recovered well). No donor site abnormality was observed, and no postsurgical

  16. Transforaminal lumbar interbody fusion using one diagonal fusion cage with unilateral pedicle screw fixation for treatment of massive lumbar disc herniation

    PubMed Central

    Zhao, Chang-Qing; Ding, Wei; Zhang, Kai; Zhao, Jie

    2016-01-01

    Background: Large lumbar or lumbosacral (LS) disc herniations usually expand from the paramedian space to the neuroforamen and compress both the transversing (lower) and the exiting (upper) nerve roots, thus leading to bi-radicular symptoms. Bi-radicular involvement is a statistically significant risk factor for poor outcome in patients presenting with far lateral or foraminal disc herniation after facet preserving microdecompression. There is evidence showing that patients suffering from large lumbar disc herniations treated with interbody fusion have significant superior results in comparison with those who received a simple discectomy. We report our experiences on managing large LS disc herniation with bi-radicular symptoms by transforaminal lumbar interbody fusion (TLIF) using one diagonal fusion cage with unilateral pedicle screw/rod fixation. Materials and Methods: Twenty-three patients who suffered from single level lumbar or LS disc herniation with bi-radicular symptoms treated with unilateral decompression and TLIF using one diagonal fusion cage with ipsilateral pedicle screw/rod fixation operated between January 2005 and December 2009, were included in this study. Operation time and blood loss were recorded. The pain and disability status were pre- and postoperatively evaluated by the visual analog score (VAS) and Oswestry Disability Index (ODI). Interbody bony fusion was detected by routine radiographs and computed tomography scan. Adjacent segment degeneration was detected by routine radiographs and magnetic resonance imaging examination. Overall outcomes were categorized according to modified Macnab classification. Results: The patients were followed up for an average of 44.7 months. Pain relief in the VAS and improvement of the ODI were significant after surgery and at final followup. No severe complications occurred during hospital stay. Interbody bony fusion was achieved in every case. No cage retropulsion was observed, while 3 cases experienced

  17. Theoretical performance of cross-wind axis turbines with results for a catenary vertical axis configuration

    NASA Technical Reports Server (NTRS)

    Muraca, R. J.; Stephens, M. V.; Dagenhart, J. R.

    1975-01-01

    A general analysis capable of predicting performance characteristics of cross-wind axis turbines was developed, including the effects of airfoil geometry, support struts, blade aspect ratio, windmill solidity, blade interference and curved flow. The results were compared with available wind tunnel results for a catenary blade shape. A theoretical performance curve for an aerodynamically efficient straight blade configuration was also presented. In addition, a linearized analytical solution applicable for straight configurations was developed. A listing of the computer program developed for numerical solutions of the general performance equations is included in the appendix.

  18. Influence of the short-axis cine acquisition protocol on the cardiac function evaluation: A reproducibility study

    PubMed Central

    Marchesseau, Stephanie; Ho, Jamie X.M.; Totman, John J.

    2016-01-01

    Purpose To define the optimal cardiac short-axis cine acquisition protocol for the assessment of the left and rightventricular functions. Materials and methods 20 volunteers were recruited and breath-hold CINE images were acquired on a Siemens Prisma 3T MRI. Four short-axis acquisition planes were defined from the 4-chamber view. AV Junctions: short-axis slices parallel to the plane that cuts through the external right and left atrioventricular junctions. Left AV Junctions: short-axis slices parallel to the plane that cuts through both left atrioventricular junctions. Septum: short-axis slices perpendicular to the septum with one cutting through the septum junction. LongAxis: short-axis slices perpendicular to the long axis with one cutting through the septum junction. Intra and inter reproducibility was assessed using Bland-Altman coefficient of variation (CV) and Lin’s concordance correlation coefficient (CCC). The influence of the protocol on the ejection fraction (EF) and stroke volume (SV) was quantified statistically using pair-wise CV and Pearson’s correlation coefficient R2. Results All protocols led to high reproducibility for the LV EF (mean intra CV = 3.83%, mean inter CV = 4.81%, lowest CV = 4.20% (AV junctions) and highest CV = 5.24% (Left AV Junctions)). Reproducibility of the RV measurements was lower (mean intra CV = 7.84%, mean inter CV = 9.17%). Septum protocol led to significantly lower variability compared to the other 3 protocols for RV EF (CV = 7.62% (Septum), CV = 8.42% (Long Axis), CV = 9.54% (Left AV Junctions) and CV = 11.08% (AV Junctions) with Lin’s CCC varying from 0.4 (AV Junctions) to 0.69 (Septum) for inter-observer reproducibility). No differences in group average for clinical parameters was found for both LV and RV clinical measurements. However, patient-specific RV EF evaluation is dependent on the chosen protocol (CV = 9.95%, R2 = 0.52). Conclusion Based on the results of the study cine mode short-axis

  19. Fine Sun Sensor Field of View Calibration

    NASA Technical Reports Server (NTRS)

    Sedlak, Joseph E.; Hashmall, J.; Harman, Richard (Technical Monitor)

    2002-01-01

    The fine Sun sensor (FSS) used on many spacecraft consists of two independent single-axis sensors, nominally mounted perpendicularly, that detect Sun angle across a typical field of view of +/- 32 degrees. The nonlinear function that maps the measured counts into an observed angle is called the transfer function. The FSS transfer function provided by the manufacturer consists of nine parameters for each of the two sensitive axes. An improved transfer function has been previously reported that achieves a significant accuracy improvement across the entire field of view. This new function expands the parameter set to 12 coefficients per axis and includes cross terms combining counts from both axes. To make best use of the FSS for spacecraft attitude determination, it must be calibrated after launch. We are interested in simplifying the postlaunch calibration procedure for estimating improvements to the 24 parameters in the transfer function. This paper discusses how to recombine the terms of the transfer function to reduce their redundancy without decreasing its accuracy and then presents an attitude dependent procedure for estimating the parameters. The end result is a calibration algorithm that is easier to use and does not sacrifice accuracy. Results of calibration using on-orbit data are presented.

  20. 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

  1. Surgical treatment of empyema after pulmonary resection using pedicle skeletal muscle plombage, thoracoplasty, and continuous cavity ablution procedures: a report on three cases

    PubMed Central

    Mizuno, Tetsuya; Kuroda, Hiroaki; Sakao, Yukinori; Uchida, Tatsuo

    2016-01-01

    We present three cases of postoperative empyema after pulmonary resection: case 1, acute empyema without fistula after lobectomy and chest wall resection; case 2, continuing empyema with fistula and total left residual lung abscess after upper divisionectomy; and case 3, chronic empyema with middle lobe bronchopleural fistula after lower lobectomy. Pedicle skeletal muscle plombage into the cavity, thoracoplasty, and continuous cavity ablution with 24-h instillation of minocycline and saline solution through drains were used for treatment. In case 2, a completion extrapleural left pneumonectomy was concurrently performed. In all three cases, the surgery was successful; however, case 2 developed a massive gastrointestinal hemorrhage, which led to blood aspiration pneumonitis, renal failure, and death. Muscle plombage effectively achieves the closure of empyema cavity and thoracoplasty complements this. When a residual space remains, cavity ablution is considered to be effective. However, concurrent completion lung parenchyma resection might be excessively aggressive. PMID:27293855

  2. Increasing pedicle screw anchoring in the osteoporotic spine by cement injection through the implant. Technical note and report of three cases.

    PubMed

    Fransen, Patrick

    2007-09-01

    Instrumented spinal fusion in patients with osteoporosis is challenging because of the poor bone quality and is complicated by an elevated risk of delayed hardware failure. The author treated two patients presenting with severe osteoporosis, spinal stenosis, and degenerative spondylolisthesis. He performed decompressive laminectomy, posterolateral fusion, and pedicle screw (PS) fixation involving screws with side openings that allow cement to be injected through the implant. The cement injection was conducted under fluoroscopic control without complications. Although this technique needs validation in a larger population of patients, the author believes that the injection of cement through these PSs can be performed safely in carefully selected patients. This technique creates not only a vertebroplasty-like effect that strengthens the vertebral body but also provides the additional stability afforded by the immediate anchoring of the screw, which may allow a shorter-length construct, save mobile segments, and finally reduce the risk of hardware failure. PMID:17877276

  3. 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.

  4. 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.

  5. View of Spacecraft 012 Command Module during installation of heat shield

    NASA Technical Reports Server (NTRS)

    1966-01-01

    High angle view of Spacecraft 012 Command Module, looking toward -Z axis, during preparation for installation of the crew compartment heat shield, showing mechanics working on aft bay (41851); Spacecraft 012 looking toward -Y axis during installation of heat shield. Note uprighting system compressor in aft bay, at right, and Reaction Control System (RCS) valve module panel, center of photo (41852); Crew compartment heat shield being prepared for installation (41853).

  6. Dual-axis hole-drilling ESPI residual stress measurements

    SciTech Connect

    Steinzig, Michael; Schajer, Gary

    2008-01-01

    A novel dual-axis ESPI hole-drilling residual stress measurement method is presented. The method enables the evaluation of all the in-plane normal stress components with similar response to measurement errors, significantly lower than with single-axis measurements. A numerical method is described that takes advantage of, and compactly handles, the additional optical data that are available from the second measurement axis. Experimental tests were conducted on a calibrated specimen to demonstrate the proposed method, and the results supported theoretical expectations.

  7. 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.}

  8. 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.

  9. Application of External Axis in Robot-Assisted Thermal Spraying

    NASA Astrophysics Data System (ADS)

    Deng, Sihao; Fang, Dandan; Cai, Zhenhua; Liao, Hanlin; Montavon, Ghislain

    2012-12-01

    Currently, industrial robots are widely used in the process of thermal spraying because of their high efficiency, security, and repeatability. Although robots are found suitable for use in industrial productions, they have some natural disadvantages because of their six-axis mechanical linkages. When a robot performs a series of stages of production, it could be hard to move from one to another because a few axes reach their limit value. For this reason, an external axis should be added to the robot system to extend the reachable space of the robots. This article concerns the application of external axis on ABB robots in thermal spraying and the different methods of off-line programming with external axis in the virtual environment. The developed software toolkit was applied to coat real workpiece with a complex geometry in atmospheric plasma spraying).

  10. Single-beam three-axis atomic magnetometer

    NASA Astrophysics Data System (ADS)

    Huang, Haichao; Dong, Haifeng; Chen, Lin; Gao, Yang

    2016-08-01

    A single-beam atomic magnetometer being operated near zero-field and measuring three-axis fields simultaneously is demonstrated. We produce a rotating field on the x-0-y plane with the frequency of 90 Hz and a modulation field in the z axis at 130 Hz. The rotating field enables a nonzero z axis output when the transverse fields are zeroed using feedback systems. Based on the phase difference of π / 2 , x and y axes fields can be measured using one lock-in amplifier. Magnetic field sensitivities of 300 fT/Hz1/2 in x and y axes and 3 pT/Hz1/2 in the z axis are achieved.

  11. 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.

  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. 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.

  14. 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.

  15. Memory hierarchies map onto the hippocampal long axis in humans.

    PubMed

    Collin, Silvy H P; Milivojevic, Branka; Doeller, Christian F

    2015-11-01

    Memories, similar to the internal representation of space, can be recalled at different resolutions ranging from detailed events to more comprehensive, multi-event narratives. Single-cell recordings in rodents have suggested that different spatial scales are represented as a gradient along the hippocampal axis. We found that a similar organization holds for human episodic memory: memory representations systematically vary in scale along the hippocampal long axis, which may enable the formation of mnemonic hierarchies.

  16. Human cancers converge at the HIF-2alpha oncogenic axis.

    PubMed

    Franovic, Aleksandra; Holterman, Chet E; Payette, Josianne; Lee, Stephen

    2009-12-15

    Cancer development is a multistep process, driven by a series of genetic and environmental alterations, that endows cells with a set of hallmark traits required for tumorigenesis. It is broadly accepted that growth signal autonomy, the first hallmark of malignancies, can be acquired through multiple genetic mutations that activate an array of complex, cancer-specific growth circuits [Hanahan D, Weinberg RA (2000) The hallmarks of cancer. Cell 100:57-70; Vogelstein B, Kinzler KW (2004) Cancer genes and the pathways they control. Nat Med 10:789-799]. The superfluous nature of these pathways is thought to severely limit therapeutic approaches targeting tumor proliferation, and it has been suggested that this strategy be abandoned in favor of inhibiting more systemic hallmarks, including angiogenesis (Ellis LM, Hicklin DJ (2008) VEGF-targeted therapy: Mechanisms of anti-tumor activity. Nat Rev Cancer 8:579-591; Stommel JM, et al. (2007) Coactivation of receptor tyrosine kinases affects the response of tumor cells to targeted therapies. Science 318:287-290; Kerbel R, Folkman J (2002) Clinical translation of angiogenesis inhibitors. Nat Rev Cancer 2:727-739; Kaiser J (2008) Cancer genetics: A detailed genetic portrait of the deadliest human cancers. Science 321:1280-1281]. Here, we report the unexpected observation that genetically diverse cancers converge at a common and obligatory growth axis instigated by HIF-2alpha, an element of the oxygen-sensing machinery. Inhibition of HIF-2alpha prevents the in vivo growth and tumorigenesis of highly aggressive glioblastoma, colorectal, and non-small-cell lung carcinomas and the in vitro autonomous proliferation of several others, regardless of their mutational status and tissue of origin. The concomitant deactivation of select receptor tyrosine kinases, including the EGFR and IGF1R, as well as downstream ERK/Akt signaling, suggests that HIF-2alpha exerts its proliferative effects by endorsing these major pathways. Consistently

  17. misr_view

    Atmospheric Science Data Center

    2013-04-01

    ... Jet Propulsion Laboratory. misr_view, which includes a User's Guide, is available for download free of charge from the  Open Channel Foundation . misr_view is a graphical user interface display and analysis tool for use with many types of MISR and AirMISR ...

  18. Hierarchical Linked Views

    SciTech Connect

    Erbacher, Robert; Frincke, Deb

    2007-07-02

    Coordinated views have proven critical to the development of effective visualization environments. This results from the fact that a single view or representation of the data cannot show all of the intricacies of a given data set. Additionally, users will often need to correlate more data parameters than can effectively be integrated into a single visual display. Typically, development of multiple-linked views results in an adhoc configuration of views and associated interactions. The hierarchical model we are proposing is geared towards more effective organization of such environments and the views they encompass. At the same time, this model can effectively integrate much of the prior work on interactive and visual frameworks. Additionally, we expand the concept of views to incorporate perceptual views. This is related to the fact that visual displays can have information encoded at various levels of focus. Thus, a global view of the display provides overall trends of the data while focusing in on individual elements provides detailed specifics. By integrating interaction and perception into a single model, we show how one impacts the other. Typically, interaction and perception are considered separately, however, when interaction is being considered at a fundamental level and allowed to direct/modify the visualization directly we must consider them simultaneously and how they impact one another.

  19. 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…

  20. Major and minor axis kinematics of 22 ellipticals

    NASA Astrophysics Data System (ADS)

    Franx, Marijn; Illingworth, Garth; Heckman, Timothy

    1989-09-01

    Rotation curves and velocity dispersion profiles have been determined for the major and the minor axes of 22 elliptical galaxies. Rotation was detected in all but one galaxy, even though the sample was biased toward round ellipticals. Minor axis rotation larger than major axis rotation was measured in two galaxies, NGC 4406 and NGC 7507. Roughly 10 percent of ellipticals may show large minor axis velocities relative to those on the major axis. A simple model is used to derive a rotational axis from the observed minor and major axis velocities to a typical accuracy of 6 deg. The rotational and photometric minor axes aligned to better than 10 deg for 60 percent of the sample, implying that the direction of the angular momentum is related to the orientation of the figure of the galaxy. IC 1459 has a kinematically distinct core with its angular momentum opposite to the angular momentum of the outer parts, and NGC 4406 has a core with its angular momentum perpendicular to that of the outer parts.

  1. Off-Axis Aspheric Surfacing Using Sub-Aperture Tools

    NASA Astrophysics Data System (ADS)

    Feng, Yunpeng; Qiao, Xiaoyan; Cheng, Haobo; Tam, Hon-Yuen

    2013-10-01

    The off-axis aspheric surface used in modern optical systems widely can obtain nearly perfect quality, realize both small packet-size and low-mass, and avoid the central obscuration. But it is difficult to fabricate because of asymmetry. There are some key technologies during the testing and fabrication of off-axis asphere. In this article, we proposed a method of the best fit sphere based on non-negative minimized removal criterion. And a measured data fitting algorithm was presented to estimate the geometry parameters of off-axis aspheric surface. Then an off-axis mirror was fabricated, and the interferometrically measured data was corrected to eliminate the distortion introduced by null compensator in every run. Finally, the surface error of off-axis mirror reduced to pv = 0.372λ, rms = 0.046λ, the surface roughness reached 0.72 nm. These methods mentioned in the article are suitable for off-axis aspheric optics.

  2. 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.

  3. 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.

  4. A retrospective study to validate an intraoperative robotic classification system for assessing the accuracy of kirschner wire (K-wire) placements with postoperative computed tomography classification system for assessing the accuracy of pedicle screw placements

    PubMed Central

    Tsai, Tai-Hsin; Wu, Dong-Syuan; Su, Yu-Feng; Wu, Chieh-Hsin; Lin, Chih-Lung

    2016-01-01

    Abstract This purpose of this retrospective study is validation of an intraoperative robotic grading classification system for assessing the accuracy of Kirschner-wire (K-wire) placements with the postoperative computed tomography (CT)-base classification system for assessing the accuracy of pedicle screw placements. We conducted a retrospective review of prospectively collected data from 35 consecutive patients who underwent 176 robotic assisted pedicle screws instrumentation at Kaohsiung Medical University Hospital from September 2014 to November 2015. During the operation, we used a robotic grading classification system for verifying the intraoperative accuracy of K-wire placements. Three months after surgery, we used the common CT-base classification system to assess the postoperative accuracy of pedicle screw placements. The distributions of accuracy between the intraoperative robot-assisted and various postoperative CT-based classification systems were compared using kappa statistics of agreement. The intraoperative accuracies of K-wire placements before and after repositioning were classified as excellent (131/176, 74.4% and 133/176, 75.6%, respectively), satisfactory (36/176, 20.5% and 41/176, 23.3%, respectively), and malpositioned (9/176, 5.1% and 2/176, 1.1%, respectively) In postoperative CT-base classification systems were evaluated. No screw placements were evaluated as unacceptable under any of these systems. Kappa statistics revealed no significant differences between the proposed system and the aforementioned classification systems (P <0.001). Our results revealed no significant differences between the intraoperative robotic grading system and various postoperative CT-based grading systems. The robotic grading classification system is a feasible method for evaluating the accuracy of K-wire placements. Using the intraoperative robot grading system to classify the accuracy of K-wire placements enables predicting the postoperative accuracy of

  5. Concomitant Correction of a Soft-Tissue Fenestration with Keratinised Tissue Augmentation By Using A Rotated Double-Pedicle Flap During Second-Stage Implant Surgery- A Case Report

    PubMed Central

    Reddy, Aileni Amarender; Kumar, P. Anoop; Sailaja, Sistla; Chakravarthy, Yshs

    2015-01-01

    Soft tissue deficiencies and defects around dental implants have been observed frequently. Soft-tissue defects after implant procedures originate from the process of modelling of periimplant mucosa and often cause aesthetic disharmony, food debris accumulation and soft tissue shrinkage. Periimplant mucogingival surgery focuses on creating an optimum band of keratinized tissue resulting in soft tissue architecture similar to the gingiva around natural teeth. A 23-year-old male reported to the Department of Periodontology with a complaint of gum soreness, foul smell and food accumulation at a site where a 3.75 x 11.5mm implant was placed previously. On clinical examination, fenestration of tissue above the cover screw was observed and there appeared to be a keratinized tissue of 1mm surrounding the implant. The case was managed by use of a rotated double-pedicle flap during second-stage implant surgery to correct the soft-tissue fenestration defect and to obtain a keratinized periimplant soft tissue. A periosteal bed was prepared by giving a horizontal incision at the mucogingival junction to a depth of 4 mm. Two split-thickness keratinized pedicles were dissected from the mesial and distal interproximal tissues near the implant. After rotation, both the pedicles were sutured to each other mid-buccally and the pedicles were rigidly immobilized with sutures. At 1 month, there was a 3mm band of stable and firm keratinized tissue over the underlying tissues. The procedure resulted in an aesthetic improvement due to enhanced soft tissue architecture and optimum integration between the peri-implant soft tissue and the final prosthesis. PMID:26816998

  6. Engineering vascularized soft tissue flaps in an animal model using human adipose-derived stem cells and VEGF+PLGA/PEG microspheres on a collagen-chitosan scaffold with a flow-through vascular pedicle.

    PubMed

    Zhang, Qixu; Hubenak, Justin; Iyyanki, Tejaswi; Alred, Erik; Turza, Kristin C; Davis, Greg; Chang, Edward I; Branch-Brooks, Cynthia D; Beahm, Elisabeth K; Butler, Charles E

    2015-12-01

    Insufficient neovascularization is associated with high levels of resorption and necrosis in autologous and engineered fat grafts. We tested the hypothesis that incorporating angiogenic growth factor into a scaffold-stem cell construct and implanting this construct around a vascular pedicle improves neovascularization and adipogenesis for engineering soft tissue flaps. Poly(lactic-co-glycolic-acid/polyethylene glycol (PLGA/PEG) microspheres containing vascular endothelial growth factor (VEGF) were impregnated into collagen-chitosan scaffolds seeded with human adipose-derived stem cells (hASCs). This setup was analyzed in vitro and then implanted into isolated chambers around a discrete vascular pedicle in nude rats. Engineered tissue samples within the chambers were harvested and analyzed for differences in vascularization and adipose tissue growth. In vitro testing showed that the collagen-chitosan scaffold provided a supportive environment for hASC integration and proliferation. PLGA/PEG microspheres with slow-release VEGF had no negative effect on cell survival in collagen-chitosan scaffolds. In vivo, the system resulted in a statistically significant increase in neovascularization that in turn led to a significant increase in adipose tissue persistence after 8 weeks versus control constructs. These data indicate that our model-hASCs integrated with a collagen-chitosan scaffold incorporated with VEGF-containing PLGA/PEG microspheres supported by a predominant vascular vessel inside a chamber-provides a promising, clinically translatable platform for engineering vascularized soft tissue flap. The engineered adipose tissue with a vascular pedicle could conceivably be transferred as a vascularized soft tissue pedicle flap or free flap to a recipient site for the repair of soft-tissue defects.

  7. A retrospective study to validate an intraoperative robotic classification system for assessing the accuracy of kirschner wire (K-wire) placements with postoperative computed tomography classification system for assessing the accuracy of pedicle screw placements.

    PubMed

    Tsai, Tai-Hsin; Wu, Dong-Syuan; Su, Yu-Feng; Wu, Chieh-Hsin; Lin, Chih-Lung

    2016-09-01

    This purpose of this retrospective study is validation of an intraoperative robotic grading classification system for assessing the accuracy of Kirschner-wire (K-wire) placements with the postoperative computed tomography (CT)-base classification system for assessing the accuracy of pedicle screw placements.We conducted a retrospective review of prospectively collected data from 35 consecutive patients who underwent 176 robotic assisted pedicle screws instrumentation at Kaohsiung Medical University Hospital from September 2014 to November 2015. During the operation, we used a robotic grading classification system for verifying the intraoperative accuracy of K-wire placements. Three months after surgery, we used the common CT-base classification system to assess the postoperative accuracy of pedicle screw placements. The distributions of accuracy between the intraoperative robot-assisted and various postoperative CT-based classification systems were compared using kappa statistics of agreement.The intraoperative accuracies of K-wire placements before and after repositioning were classified as excellent (131/176, 74.4% and 133/176, 75.6%, respectively), satisfactory (36/176, 20.5% and 41/176, 23.3%, respectively), and malpositioned (9/176, 5.1% and 2/176, 1.1%, respectively)In postoperative CT-base classification systems were evaluated. No screw placements were evaluated as unacceptable under any of these systems. Kappa statistics revealed no significant differences between the proposed system and the aforementioned classification systems (P <0.001).Our results revealed no significant differences between the intraoperative robotic grading system and various postoperative CT-based grading systems. The robotic grading classification system is a feasible method for evaluating the accuracy of K-wire placements. Using the intraoperative robot grading system to classify the accuracy of K-wire placements enables predicting the postoperative accuracy of pedicle screw

  8. Asymmetric rotational axis reconstruction of grating-based x-ray phase contrast tomography of the human cerebellum

    NASA Astrophysics Data System (ADS)

    Schulz, Georg; Weitkamp, Timm; Zanette, Irene; Pfeiffer, Franz; Müller-Gerbl, Magdalena; David, Christian; Müller, Bert

    2012-10-01

    The brain has an outstanding functional importance in the human organism. Therefore, there is a strong need for three-dimensional brain imaging modalities. Magnetic resonance imaging provides deep insights but its spatial resolution is insufficient to study the structure on the cellular level. X-ray absorption microtomography yields the necessary spatial resolution, but shows only marginal contrast between the different types of brain tissue. Alternatively, differential X-ray phase contrast obtained with grating interferometry, which is known for much better differentiations between soft tissues can be used for the visualization of the human brain. As important structures of the human brain such as the human thalamus have dimensions of several centimeters, a large field of view is required. In the present communication, we report an evaluation of grating-based X-ray phase contrast microtomography in the off-axis modus which allows to expand the field of view up to a factor of two but may reduce the image quality. We demonstrate that tomograms with comparable contrast-to-noise values, about 10%, and 50% inferior spatial resolution can be generated with off-axis measurements. As one can reduce the effective pixel size up to a factor of two, the choice of an asymmetrical rotation axis can give rise to an improvement of the spatial resolution by 20%.

  9. The anatomical tibial axis: reliable rotational orientation in knee replacement.

    PubMed

    Cobb, J P; Dixon, H; Dandachli, W; Iranpour, F

    2008-08-01

    The rotational alignment of the tibia is an unresolved issue in knee replacement. A poor functional outcome may be due to malrotation of the tibial component. Our aim was to find a reliable method for positioning the tibial component in knee replacement. CT scans of 19 knees were reconstructed in three dimensions and orientated vertically. An axial plane was identified 20 mm below the tibial spines. The centre of each tibial condyle was calculated from ten points taken round the condylar cortex. The tibial tubercle centre was also generated as the centre of the circle which best fitted eight points on the outside of the tubercle in an axial plane at the level of its most prominent point. The derived points were identified by three observers with errors of 0.6 mm to 1 mm. The medial and lateral tibial centres were constant features (radius 24 mm (SD 3), and 22 mm (SD 3), respectively). An anatomical axis was created perpendicular to the line joining these two points. The tubercle centre was found to be 20 mm (SD 7) lateral to the centre of the medial tibial condyle. Compared with this axis, an axis perpendicular to the posterior condylar axis was internally rotated by 6 degrees (SD 3). An axis based on the tibial tubercle and the tibial spines was also internally rotated by 5 degrees (sd 10). Alignment of the knee when based on this anatomical axis was more reliable than either the posterior surfaces or any axis involving the tubercle which was the least reliable landmark in the region.

  10. Asteroid Ida - 6 Views Showing Rotation

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This composite image shows the asteroid 243 Ida as seen from the Galileo spacecraft during its approach on August 28, 1993. The six views were shuttered through the camera's green filter and show Ida's rotation over a period of about 3 hours 18 minutes. The asteroid makes a complete rotation every 4 hours 38 minutes; therefore, this set of images spans about 3/4 of Ida's rotation period and shows most of Ida's surface. By combining the information in these views with that from the highest resolution images returned from the spacecraft in September 1993, the size and shape of this irregular body can now be determined accurately The asteroid appears to be about 58 kilometers (36 miles) long and about 23 kilometers wide, with a very irregular shape and volume of some 16,000 cubic kilometers. The images are arranged in chronological order from a time 3 hours 51 minutes before closest approach (upper left), through upper right, middle left, middle right lower left and lower right (33 minutes before closest approach). The six images show Ida at the same scale throughout. Ida's rotation axis is roughly vertical in these images, and the rotation causes the right-hand end of Ida to move toward the viewer as time progresses. The first image was taken from a range of about 171,000 km (106,000 miles) and provides an image resolution of about 1,700 meters per pixel (the highest resolution achieved for Ida is about 25 meters per pixel). The second, taken 70 minutes later, is from 119,000 kilometers, followed by 102,000 kilometers, 85,000 kilometers, 50,000 kilometers, and 25,000 kilometers. The features on Ida are less sharp in the earlier views because of the greater distances. Prominent in the middle three views is a deep depression across the short axis of the Asteroid. This feature tends to support the idea that Ida may have originally been formed from two or more separate large objects that collided softly and stuck together. Also visible in the lower left view is an

  11. 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

  12. 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...

  13. 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)

  14. Modulation of the hypothalamo-pituitary-adrenocortical axis by caffeine

    PubMed Central

    Patz, Michael D.; Day, Heidi E.W.; Burow, Andrew; Campeau, Serge

    2008-01-01

    Summary Although caffeine is the most consumed psychoactive substance in the world, the extents of many of its effects are unknown. High doses of caffeine have been shown to activate the HPA axis while the effects of low to moderate doses have usually not been described in detail. Moreover, although several lines of evidence suggest that low doses of caffeine may restrain some negative affective states, the possible modulatory role of caffeine on HPA axis activation induced by a stressful stimulus has not been described. Thus, the present studies investigated the possible modulatory effects of low to moderate doses of caffeine on moderate to high HPA axis activation induced by different intensities of loud noise. First, in order to test this modulation, time courses for adrenocorticotropic hormone (ACTH) and corticosterone responses to loud noise stress and to caffeine were defined, in rats. Plasma ACTH and corticosterone levels peaked 30 min from the onset of noise presentation, and rapidly declined after noise termination. A low caffeine dose of 2 mg/kg significantly increased plasma corticosterone and ACTH levels 30 min following injections, but levels returned to baseline 60 min following injections. Caffeine doses of 30 mg/kg and higher elevated plasma hormone levels for at least 2 h. Doses of 2 or 10 mg/kg, however, did not modulate endocrine responses to loud noise presentation. It is concluded that although caffeine activates the HPA axis, low to moderate doses do not modulate HPA axis responses to stressful stimuli. PMID:16413973

  15. 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).

  16. A local autocrine axis in the testes that regulates spermatogenesis.

    PubMed

    Cheng, C Yan; Mruk, Dolores D

    2010-07-01

    Spermiation--the release of mature spermatozoa from Sertoli cells into the seminiferous tubule lumen--occurs by the disruption of an anchoring device known as the apical ectoplasmic specialization (apical ES). At the same time, the blood-testis barrier (BTB) undergoes extensive restructuring to facilitate the transit of preleptotene spermatocytes. While these two cellular events take place at opposite ends of the Sertoli cell epithelium, the events are in fact tightly coordinated, as any disruption in either process will lead to infertility. A local regulatory axis exists between the apical ES and the BTB in which biologically active laminin fragments produced at the apical ES by the action of matrix metalloproteinase 2 can regulate BTB restructuring directly or indirectly via the hemidesmosome. Equally important, polarity proteins play a crucial part in coordinating cellular events within this apical ES-BTB-hemidesmosome axis. Additionally, testosterone and cytokines work in concert to facilitate BTB restructuring, which enables the transit of spermatocytes while maintaining immunological barrier function. Herein, we will discuss this important autocrine-based cellular axis that parallels the hormonal-based hypothalamic-pituitary-testicular axis that regulates spermatogenesis. This local regulatory axis is the emerging target for male contraception.

  17. 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). PMID:27516913

  18. Origin of a magnetic easy axis in pipeline steel

    NASA Astrophysics Data System (ADS)

    Clapham, L.; Heald, C.; Krause, T.; Atherton, D. L.; Clark, P.

    1999-08-01

    Oil and gas pipelines are generally magnetically anisotropic, with a magnetic easy axis in the pipe axial direction. This is of interest because magnetic flux leakage tools are commonly used for the detection and sizing of defects. In the present study we investigate the origin of this magnetic easy axis, using an angular magnetic Barkhausen noise technique to characterize the magnetic anisotropy. The texture, microstructure, and residual stress are examined as possible causes of the easy axis, using x-ray pole figure analysis and microstructural examination along with high and low temperature annealing treatments. Our results indicate that plastic deformation and residual stress are responsible for the magnetic easy axis, since an elimination of the residual stresses through low temperature "stress relief" heat treatment produces a magnetically isotropic structure without altering the texture or microstructure. X-ray pole figure analysis supports the conclusion that magnetic anisotropy is not related to texture in these materials. We conclude that the axial magnetic easy axis is due to a compressive residual hoop stress resulting from the cold bending and cold expansion of the pipe during processing.

  19. 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.

  20. 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.

  1. 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.

  2. Electrical generation using a vertical-axis wind turbine

    SciTech Connect

    Clark, R.N.

    1982-12-01

    Traditionally, windmills have been of the propeller or multiblade types, both of which have their rotational axis parallel to the flow of the wind. A vertical-axis wind turbine has its rotational axis perpendicular to the flow of wind and requires no orientation to keep the rotor in the windstream. The vertical-axis wind turbine operates on the same principle as an airfoil and produces lift and drag as any airfoil. A newly designed 100-kW vertical-axis wind turbine has been operated for one year at the USDA Conservation and Production Research Laboratory, Bushland, TX. The turbine has an induction generator and supplies power to a sprinkler irrigation system with excess power being sold to the electric utility. The turbine begins producing power at 5.5 m/s windspeed and reaches its rated output of 100-kW at 15 m/s. The unit has obtained a peak efficiency of 48% at a windspeed of 8 m/s or 81% of theoretical maximum. Using 17 years of windspeed data from the National Weather Service, the annual energy output is estimated at 200,000 kWh. The unit has experienced several operational problems during its initial testing. Guy cables were enlarged to provide greater stiffness to reduce blade stress levels, lightning shorted the main contactor, and the brake system required a complete redesign and modification. The turbine was operational about 60% of the time.

  3. 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

  4. Off-axis angular spectrum method with variable sampling interval

    NASA Astrophysics Data System (ADS)

    Kim, Yong-Hae; Byun, Chun-Won; Oh, Himchan; Pi, Jae-Eun; Choi, Ji-Hun; Kim, Gi Heon; Lee, Myung-Lae; Ryu, Hojun; Hwang, Chi-Sun

    2015-08-01

    We proposed a novel off-axis angular spectrum method (ASM) for simulating free space wave propagation with a large shifted destination plane. The off-axis numerical simulation took wave propagation between a parallel source and a destination plane, but a destination plane was shifted from a source plane. The shifted angular spectrum method was proposed for diffraction simulation with a shifted destination plane and satisfied the Nyquist condition for sampling by limiting a bandwidth of a propagation field to avoid an aliasing error due to under sampling. However, the effective sampling number of the shifted ASM decreased when the shifted distance of the destination plane was large which caused a numerical error in the diffraction simulation. To compensate for the decrease of an effective sampling number for the large shifted destination plane, we used a variable sampling interval in a Fourier space to maintain the same effective sampling number independent of the shifted distance of the destination plane. As a result, our proposed off-axis ASM with a variable sampling interval can produce simulation results with high accuracy for nearly every shifted distance of a destination plane when an off-axis angle is less than 75°. We compared the performances of the off-axis ASM using the Chirp Z transform and non-uniform FFT for implementing a variable spatial frequency in a Fourier space.

  5. 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

  6. 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

  7. 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.

  8. The Effect and Feasibility Study of Transforaminal Percutaneous Endoscopic Lumbar Discectomy Via Superior Border of Inferior Pedicle Approach for Down-Migrated Intracanal Disc Herniations.

    PubMed

    Ying, Jinwei; Huang, Kelun; Zhu, Minyu; Zhou, Beibei; Wang, Yu; Chen, Bi; Teng, Honglin

    2016-02-01

    Transforaminal percutaneous endoscopic lumbar discectomy (PELD) is gradually regarded as an effective alternative to posterior open surgery. However, migrated herniations bring a great technical challenge even for experienced surgeons due to the absence of the appropriate approaching guideline. We aimed to describe a safe and effective approaching technique for the removal of down-migrations on the basis of the clinical outcomes and complications compared with the conventional approaching method.A total of 45 patients recommended to single-level PELD with foraminoplasty were randomly divided into 2 groups, group A received foraminoplasty via upper border of inferior pedicle, group B was approached through the common transforaminal route. The clinical outcomes were evaluated by Visual Analog Scale (VAS) for leg pain and Oswestry Disability Index (ODI) scores. Then participants were classified into 2 types of migrations (high-grade and low-grade) based on the extent of migration presented on preoperative magnetic resonance imaging (MRI). The various comparisons between the 2 surgical techniques were analyzed.The postoperative VAS and ODI scores significantly decreased in both of the 2 groups after surgery (P < 0.001). The follow-up continued 1 year. With increasing length of follow-up, the disparities in clinical outcomes between the 2 groups were gradually narrowing and there was no significant difference at the end of follow-up (P = 0.32; P = 0.46). There were no differences in the operation time and duration of hospital stay (P = 0.36; P = 0.08). The highly migration group in group B showed a significant longer operation time (P = 0.02), but the extent of migration did not have a significant influence on the operation time in group A with the modified approach (P = 0.19). There were no apparent approach-related complications in group A during the procedure and follow-up period.Foraminoplastic-PELD via upper border of inferior pedicle

  9. Augmented PMMA distribution: improvement of mechanical property and reduction of leakage rate of a fenestrated pedicle screw with diameter-tapered perforations.

    PubMed

    Tan, Quan-Chang; Wu, Jian-Wei; Peng, Fei; Zang, Yuan; Li, Yang; Zhao, Xiong; Lei, Wei; Wu, Zi-Xiang

    2016-06-01

    OBJECTIVE This study investigated the optimum injection volume of polymethylmethacrylate (PMMA) to augment a novel fenestrated pedicle screw (FPS) with diameter-tapered perforations in the osteoporotic vertebral body, and how the distribution characteristics of PMMA affect the biomechanical performance of this screw. METHODS Two types of FPSs were designed (FPS-A, composed of 6 perforations with an equal diameter of 1.2 mm; and FPS-B, composed of 6 perforations each with a tapered diameter of 1.5 mm, 1.2 mm, and 0.9 mm from tip to head. Each of 28 human cadaveric osteoporotic vertebrae were randomly assigned to 1 of 7 groups: FPS-A1.0: FPS-A+1.0 ml PMMA; FPS-A1.5: FPS-A+1.5 ml PMMA; FPS-A2.0: FPS-A+2.0 ml PMMA; FPS-B1.0: FPS-B+1.0 ml PMMA; FPS-B1.5: FPS-B+1.5 ml PMMA; FPS-B2.0: FPS-B+2.0 ml PMMA; and conventional pedicle screws (CPSs) without PMMA. After the augmentation, 3D CT was performed to assess the cement distribution characteristics and the cement leakage rate. Axial pullout tests were performed to compare the maximum pullout force thereafter. RESULTS The CT construction images showed that PMMA bone cement formed a conical mass around FPS-A and a cylindrical mass around FPS-B. When the injection volume was increased from 1.0 ml to 2.0 ml, the distribution region of the PMMA cement was enlarged, the PMMA was distributed more posteriorly, and the risk of leakage was increased. When the injection volume reached 2.0 ml, the risk of cement leakage was lower for screws having diameter-tapered perforations. The pullout strengths of the augmented FPS-A groups and FPS-B groups were higher than that of the CPS group (p < 0.0001). All FPS-B groups had a higher pullout strength than the FPS-A groups. CONCLUSIONS The diameter of the perforations affects the distribution of PMMA cement. The diameter-tapered design enabled PMMA to form larger bone-PMMA interfaces and achieve a relatively higher pullout strength, although statistical significance was not reached. Study

  10. The Effect and Feasibility Study of Transforaminal Percutaneous Endoscopic Lumbar Discectomy Via Superior Border of Inferior Pedicle Approach for Down-Migrated Intracanal Disc Herniations

    PubMed Central

    Ying, Jinwei; Huang, Kelun; Zhu, Minyu; Zhou, Beibei; Wang, Yu; Chen, Bi; Teng, Honglin

    2016-01-01

    Abstract Transforaminal percutaneous endoscopic lumbar discectomy (PELD) is gradually regarded as an effective alternative to posterior open surgery. However, migrated herniations bring a great technical challenge even for experienced surgeons due to the absence of the appropriate approaching guideline. We aimed to describe a safe and effective approaching technique for the removal of down-migrations on the basis of the clinical outcomes and complications compared with the conventional approaching method. A total of 45 patients recommended to single-level PELD with foraminoplasty were randomly divided into 2 groups, group A received foraminoplasty via upper border of inferior pedicle, group B was approached through the common transforaminal route. The clinical outcomes were evaluated by Visual Analog Scale (VAS) for leg pain and Oswestry Disability Index (ODI) scores. Then participants were classified into 2 types of migrations (high-grade and low-grade) based on the extent of migration presented on preoperative magnetic resonance imaging (MRI). The various comparisons between the 2 surgical techniques were analyzed. The postoperative VAS and ODI scores significantly decreased in both of the 2 groups after surgery (P < 0.001). The follow-up continued 1 year. With increasing length of follow-up, the disparities in clinical outcomes between the 2 groups were gradually narrowing and there was no significant difference at the end of follow-up (P = 0.32; P = 0.46). There were no differences in the operation time and duration of hospital stay (P = 0.36; P = 0.08). The highly migration group in group B showed a significant longer operation time (P = 0.02), but the extent of migration did not have a significant influence on the operation time in group A with the modified approach (P = 0.19). There were no apparent approach-related complications in group A during the procedure and follow-up period. Foraminoplastic-PELD via upper border of

  11. Scalable screen-size enlargement by multi-channel viewing-zone scanning holography.

    PubMed

    Takaki, Yasuhiro; Nakaoka, Mitsuki

    2016-08-01

    Viewing-zone scanning holographic displays can enlarge both the screen size and the viewing zone. However, limitations exist in the screen size enlargement process even if the viewing zone is effectively enlarged. This study proposes a multi-channel viewing-zone scanning holographic display comprising multiple projection systems and a planar scanner to enable the scalable enlargement of the screen size. Each projection system produces an enlarged image of the screen of a MEMS spatial light modulator. The multiple enlarged images produced by the multiple projection systems are seamlessly tiled on the planar scanner. This screen size enlargement process reduces the viewing zones of the projection systems, which are horizontally scanned by the planar scanner comprising a rotating off-axis lens and a vertical diffuser to enlarge the viewing zone. A screen size of 7.4 in. and a viewing-zone angle of 43.0° are demonstrated. PMID:27505840

  12. Generation of off-axis aspherics. [optical surfaces for telescopes

    NASA Technical Reports Server (NTRS)

    Angel, J. R. P.; Parks, R. E.

    1982-01-01

    A method for precise generation of optical surfaces is described. The work is turned about one axis, while a grinding head or cutting tool is gradually moved across by an arm turning about a second axis. This geometry can be used to directly generate spherical surfaces or aspherical surfaces presently termed 'hulahoids'. The properties of these surfaces are analyzed to determine how well large paraboloids and their off-axis segments can be generated. Very close approximations are possible. For example, 1.5-m segments of a 10-m paraboloid differ by only 0.6 microns peak-to-peak from the best fit hulahoid when the focal ratio is f/2, and 60 microns when it is f/0.4. For accurate generation the cutting tool may need numerically controlled travel of 1 mm or less, with the position set as a function of the swing arm angle.

  13. Dual axis operation of a micromachined rate gyroscope

    SciTech Connect

    Juneau, T.; Pisano, A.P.; Smith, J.

    1997-04-01

    Since micromachining technology has raised the prospect of fabricating high performance sensors without the associated high cost and large size, many researchers have investigated micromachined rate gyroscopes. The vast majority of research has focused on single input axis rate gyroscopes, but this paper presents work on a dual input axis micromachined rate gyroscope. The key to successful simultaneous dual axis operation is the quad symmetry of the circular oscillating rotor design. Untuned gyroscopes with mismatched modes yielded random walk as low as 10{degrees}/{radical}hour with cross sensitivity ranging from 6% to 16%. Mode frequency matching via electrostatic tuning allowed performance better than 2{degrees}/{radical}hour, but at the expense of excessive cross sensitivity.

  14. Registration of the rotation axis in X-ray tomography

    SciTech Connect

    Yang, Yimeng; Yang, Feifei; Hingerl, Ferdinand F.; Xiao, Xianghui; Liu, Yijin; Wu, Ziyu; Benson, Sally M.; Toney, Michael F.; Andrews, Joy C.; Pianetta, Piero A.

    2015-01-01

    There is high demand for efficient, robust and automated routines for tomographic data reduction, particularly for synchrotron data. Registration of the rotation axis in data processing is a critical step affecting the quality of the reconstruction and is not easily implemented with automation. Existing methods for calculating the center of rotation have been reviewed and an improved algorithm to register the rotation axis in tomographic data is presented. The performance of the proposed method is evaluated using synchrotron-based microtomography data on geological samples with and without artificial reduction of the signal-to-noise ratio. The proposed method improves the reconstruction quality by correcting both the tilting error and the translational offset of the rotation axis. The limitation of this promising method is also discussed.

  15. Medial Axis Shape Coding in Macaque Inferotemporal Cortex

    PubMed Central

    Hung, Chia-Chun; Carlson, Eric T.; Connor, Charles E.

    2012-01-01

    SUMMARY The basic, still unanswered question about visual object representation is this: what specific information is encoded by neural signals? Theorists have long predicted that neurons would encode medial axis or skeletal object shape, yet recent studies reveal instead neural coding of boundary or surface shape. Here, we addressed this theoretical/experimental disconnect, using adaptive shape sampling to demonstrate for the first time explicit coding of medial axis shape in high-level object cortex (macaque monkey inferotemporal cortex or IT). Our metric shape analyses revealed a coding continuum, along which most neurons represent a configuration of both medial axis and surface components. Thus IT response functions embody a rich basis set for simultaneously representing skeletal and external shape of complex objects. This would be especially useful for representing biological shapes, which are often characterized by both complex, articulated skeletal structure and specific surface features. PMID:22726839

  16. Chandra X-ray Observatory Optical Axis and Aimpoint

    NASA Astrophysics Data System (ADS)

    Zhao, Ping

    2016-01-01

    Chandra X-ray Observatory revolutionized the X-ray astronomy as being the first, and so far the only, X-ray telescope achieving sub-arcsecond resolution. Chandra comprises of three principal elements: the High Resolution Mirror Assembly (HRMA), Pointing Control and Aspect Determination (PCAD) system, and the Science Instrument Module (SIM). To achieve and retain the unprecedented imaging quality, it is critical that these three principal elements stay rigid and stable for the entire life time of the Chandra operation. Tracking the Chandra optical axis and aimpoint with respect to detector positions is the most relevant measurement for understanding telescope stability. The study shows that both the optical axis and the aimpoint has been drifting since Chandra launch. I will discuss the telescope focal-point, optical axis, aimpoint, their positiondrifts during the mission, the impact to Chandra operations, and the permanent default aimpoint, to be implemented in Chandra cycle 18.

  17. The microbiota-gut-brain axis in functional gastrointestinal disorders

    PubMed Central

    De Palma, Giada; Collins, Stephen M; Bercik, Premysl

    2014-01-01

    Functional gastrointestinal disorders (FGIDs) are highly prevalent and pose a significant burden on health care and society, and impact patients’ quality of life. FGIDs comprise a heterogeneous group of disorders, with unclear underlying pathophysiology. They are considered to result from the interaction of altered gut physiology and psychological factors via the gut-brain axis, where brain and gut symptoms are reciprocally influencing each other’s expression. Intestinal microbiota, as a part of the gut-brain axis, plays a central role in FGIDs. Patients with Irritable Bowel Syndrome, a prototype of FGIDs, display altered composition of the gut microbiota compared with healthy controls and benefit, at the gastrointestinal and psychological levels, from the use of probiotics and antibiotics. This review aims to recapitulate the available literature on FGIDs and microbiota-gut-brain axis. PMID:24921926

  18. Development of a dual-axis optoelectronic precision level

    NASA Astrophysics Data System (ADS)

    Fan, Kuang-Chao; Wang, Tsung-Han; Lin, Sheng-Yi; Liu, Yen-Chih

    2011-12-01

    This paper presents the design principle and applications of a innovative dual-axis optoelectronic level. A commercially available DVD pickup head is adopted as the angle sensor in association with the double-layer pendulum mechanism for dual-axis swings. A mass-damping system is analyzed to model the mechanical dynamics. Measured angles of both axes are processed by a microprocessor and displayed on a LCD or exported to an external PC. Compared with a triple-beam laser angular interferometer, the error of the dual-axis optoelectronic level is better than +/-0.5 arc-seconds in the measuring range of +/-20 arc-seconds, and the settling time is within 0.5 sec. Two experimental results show the consistency with a Renishaw interfereometer and its practical use in industry.

  19. Measuring the off axis magnetic field within a Helmholtz Coil

    NASA Astrophysics Data System (ADS)

    Pluhar, Edward; Martell, Eric

    2013-03-01

    Helmholtz coils are used because they produce nearly uniform magnetic fields on-axis. Prior research, namely Graf's thin coil experiment [The Physics Teacher, pp. 360 (2012)], has accurately measured the axial magnetic field produced by a thin coil; however, the magnetic field off-axis is known to be significantly more complicated and cannot be calculated analytically. In this research, I have numerically determined the magnetic field off-axis in the region between the two coils and compared those calculations with measured values. I then determined the effect the deviation from uniformity has on the behavior of a charged particle moving through this region, such as in the well-known electron charge-to-mass ratio experiment.

  20. 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.

  1. 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.

  2. 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).

  3. 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.

  4. Off-axis digital holographic microscopy with LED illumination based on polarization filtering.

    PubMed

    Guo, Rongli; Yao, Baoli; Gao, Peng; Min, Junwei; Zhou, Meiling; Han, Jun; Yu, Xun; Yu, Xianghua; Lei, Ming; Yan, Shaohui; Yang, Yanlong; Dan, Dan; Ye, Tong

    2013-12-01

    A reflection mode digital holographic microscope with light emitting diode (LED) illumination and off-axis interferometry is proposed. The setup is comprised of a Linnik interferometer and a grating-based 4f imaging unit. Both object and reference waves travel coaxially and are split into multiple diffraction orders in the Fourier plane by the grating. The zeroth and first orders are filtered by a polarizing array to select orthogonally polarized object waves and reference waves. Subsequently, the object and reference waves are combined again in the output plane of the 4f system, and then the hologram with uniform contrast over the entire field of view can be acquired with the aid of a polarizer. The one-shot nature in the off-axis configuration enables an interferometric recording time on a millisecond scale. The validity of the proposed setup is illustrated by imaging nanostructured substrates, and the experimental results demonstrate that the phase noise is reduced drastically by an order of 68% when compared to a He-Ne laser-based result. PMID:24513823

  5. AERIAL VIEW FACING NORTH. DOWNSTREAM VIEW OF FABRIC BUILDING, STRUCTURAL ...

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

    AERIAL VIEW FACING NORTH. DOWNSTREAM VIEW OF FABRIC BUILDING, STRUCTURAL WAREHOUSE, RAIL MILL, & OPEN HEARTH COMPLEX. - Pittsburgh Steel Company, Monessen Works, Donner Avenue, Monessen, Westmoreland County, PA

  6. General view, showing eastern view from atop hemi circle. ...

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

    General view, showing eastern view from atop hemi circle. - Arlington Memorial Bridge, Spanning Potomac River between Lincoln Memorial & Arlington National Cemetery, Washington, District of Columbia, DC

  7. 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

  8. 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

  9. 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.

  10. [Mathematical description of the three-dimensional axis of the root canal of human teeth].

    PubMed

    Dobó, Nagy Csaba; Keszthelyi, Gusztáv; Sulyok, Péter; Ledeczky, Gábor; Szabó, József

    2002-08-01

    The objective of the present study was to describe root canal axes of natural human teeth mathematically. Two views (clinical and proximal) radiographs were taken from extracted human teeth. Geometry defines the 90-degree turn-around image pairs as Monge images. These Monge images of the root canals were positioned using photogrammetric methods. Each well-ordered axis pair of a given root canal was put into a common coordinate system resulting in three-dimensional polynomial function of the actual root canal. Testing differences between determined and repeatedly determined axes of ten samples by statistical analysis did not show any significant differences. Evaluation of data gained on a large number of samples may also yield a new type of classification. PMID:12236090

  11. Large HAWT (Horizontal-Axis Wind Turbine) wake measurement and analysis

    NASA Astrophysics Data System (ADS)

    Miller, A. H.; Wegley, H. L.; Buck, J. W.

    1984-05-01

    From the theoretical fluid dynamics point of view, the wake region of a large horizontal-axis wind turbine was defined and described, and numerical models of wake behavior were developed. Wind tunnel studies of single turbine wakes and turbine array wakes were used to verify the theory and further refine the numerical models. The effects of scaling, rotor solidity, and topography on wake behavior are questions that remain unanswered. In the wind tunnel studies, turbines were represented by anything from scaled models to tea strainers or wire mesh disks whose solidity was equivalent to that of a typical wind turbine. The scale factor compensation for the difference in Reynolds number between the scale model and an actual turbine is complex, and not typically accounted for. Though it is wise to study the simpler case of wakes in flat topography, current indications are that wind turbine farm development is actually occurring in somewhat more complex terrain.

  12. Three-axis force actuator for a magnetic bearing

    NASA Technical Reports Server (NTRS)

    Gondhalekar, Vijay (Inventor)

    1998-01-01

    This invention features a three-axis force actuator that axially, radially and rotatably supports a bearing member for frictionless rotation about an axis of rotation generally coincident with a Z-axis. Also featured is a magnetic bearing having such an actuator. The actuator includes an inner member, a magnetic member and a pole assembly having a ring member and four pole extending therefrom. The poles are equi-angular spaced from each other and radially spaced about the Z-axis. The inner member extends along the Z-axis and is a highly magnetic permeable material. The magnetic member is formed about the inner member outer surface, extends along the Z-axis and is configured so one magnetic pole polarity is located at its outer surface and the other polarity pole is located at its inner surface. Preferably, the magnetic member is a radially magnetized permanent magnet. The inner surface of the ring member is magnetically coupled to the magnetic member and a face of each pole is coupled to the bearing member. The magnetic member, the pole assembly, the inner member and the bearing member cooperate to generate a magnetic field that radially and rotatably supports a rotating member secured to the bearing member. The actuator further includes a plurality of electromagnetic coils. Preferably, a coil is formed about each pole and at least 2 coils are formed about the inner member. When energized, the electromagnetic coils generate a modulated magnetic field that stabilizes the rotating member in the desired operational position.

  13. 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.

  14. Mathematical modeling of bent-axis hydraulic piston motors

    NASA Technical Reports Server (NTRS)

    Bartos, R. D.

    1992-01-01

    Each of the DSN 70-m antennas uses 16 bent-axis hydraulic piston motors as part of the antenna drive system. On each of the two antenna axes, four motors are used to drive the antenna and four motors provide counter torque to remove the backlash in the antenna drive train. This article presents a mathematical model for bent-axis hydraulic piston motors. The model was developed to understand the influence of the hydraulic motors on the performance of the DSN 70-m antennas' servo control system.

  15. A three-axis ultrasensitive accelerometer for space

    NASA Astrophysics Data System (ADS)

    Bernard, A.

    A three-axis ultrasensitive accelerometer ASTRE (Accelerometre Spatial Triaxial Electrostatique) is a simplified version of the GRADIO accelerometer designed for the ARISTOTELES mission, which operates by measuring the force provided by a three-axis electrostatic suspension of the proof-mass. It covers the g-spectrum from 10 exp -8 to 10 exp -4 in the frequency range dc to 5 Hz. A dedicated test bench was developed in order to preserve the accelerometer from the seismic noise. The paper presents the performance parameters of the ASTRE accelerometer and some of the design schemes.

  16. Copper at the Fungal Pathogen-Host Axis*

    PubMed Central

    García-Santamarina, Sarela; Thiele, Dennis J.

    2015-01-01

    Fungal infections are responsible for millions of human deaths annually. Copper, an essential but toxic trace element, plays an important role at the host-pathogen axis during infection. In this review, we describe how the host uses either Cu compartmentalization within innate immune cells or Cu sequestration in other infected host niches such as in the brain to combat fungal infections. We explore Cu toxicity mechanisms and the Cu homeostasis machinery that fungal pathogens bring into play to succeed in establishing an infection. Finally, we address recent approaches that manipulate Cu-dependent processes at the host-pathogen axis for antifungal drug development. PMID:26055724

  17. Measurement of sensor axis misalignment in fibre-optic accelerometers

    NASA Astrophysics Data System (ADS)

    DeFreitas, J. M.; Wooler, J. P. F.; Nash, P. J.

    2006-07-01

    A method is described for the measurement of sensor axis misalignment relative to its mounting can for a fibre-optic accelerometer. The accelerometers investigated were based on the common cylindrical compliant mandrel design and mounted accelerometers showed typical angular misalignments of 2°. The influence of the misalignment on cross-axis sensitivity is also described for accelerometers orthogonally mounted in a three-component package. This paper was presented at the 13th International Conference on Sensors and Their Applications, held in Chatham, Kent, on 6-7 September 2005.

  18. Crack growth direction in unidirectional off-axis graphite epoxy

    NASA Technical Reports Server (NTRS)

    Herakovich, C. T.; Gregory, M. A.; Beuth, J. L., Jr.

    1984-01-01

    An anisotropic elasticity crack tip stress analysis is implemented using three crack extension direction criteria (the normal stress ratio, the tensor polynominal and the strain energy density) to predict the direction of crack extension in unidirectional off axis graphite-epoxy. The theoretical predictions of crack extension direction are then compared with experimental results for 15 deg off axis tensile coupons with center cracks. Specimens of various aspect ratios and crack orientations are analyzed. It is shown that only the normal stress ratio criterion predicts the correct direction of crack growth.

  19. Three axis vector atomic magnetometer utilizing polarimetric technique

    NASA Astrophysics Data System (ADS)

    Pradhan, Swarupananda

    2016-09-01

    The three axis vector magnetic field measurement based on the interaction of a single elliptically polarized light beam with an atomic system is described. The magnetic field direction dependent atomic responses are extracted by the polarimetric detection in combination with laser frequency modulation and magnetic field modulation techniques. The magnetometer geometry offers additional critical requirements like compact size and large dynamic range for space application. Further, the three axis magnetic field is measured using only the reflected signal (one polarization component) from the polarimeter and thus can be easily expanded to make spatial array of detectors and/or high sensitivity field gradient measurement as required for biomedical application.

  20. Single Vector Calibration System for Multi-Axis Load Cells and Method for Calibrating a Multi-Axis Load Cell

    NASA Technical Reports Server (NTRS)

    Parker, Peter A. (Inventor)

    2003-01-01

    A single vector calibration system is provided which facilitates the calibration of multi-axis load cells, including wind tunnel force balances. The single vector system provides the capability to calibrate a multi-axis load cell using a single directional load, for example loading solely in the gravitational direction. The system manipulates the load cell in three-dimensional space, while keeping the uni-directional calibration load aligned. The use of a single vector calibration load reduces the set-up time for the multi-axis load combinations needed to generate a complete calibration mathematical model. The system also reduces load application inaccuracies caused by the conventional requirement to generate multiple force vectors. The simplicity of the system reduces calibration time and cost, while simultaneously increasing calibration accuracy.