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[Navigated implantation of total knee endoprostheses--a comparative study with conventional instrumentation].

OBJECTIVE: A navigation system should improve the quality of a total knee prosthesis implantation in comparison to the classical, surgeon-controlled operative technique. METHODS: The authors have implanted 40 knee total prostheses with an optical infrared navigation system (Orthopilot AESCULAP, Tuttlingen--group A). The quality of implantation was studied on postoperative long leg AP and lateral X-rays, and compared to a control group of 40 computer-paired total knee prostheses o the same model (Search Prosthesis, AESCULAP, Tuttlingen) implanted with a classical, surgeon-controlled technique (group B). RESULTS: An optimal mechanical femorotibial angle (3 degrees valgus to 3 degrees varus) was obtained by 33 cases in group A and 31 cases in group B (p > 0.05). Better results were seen for the coronal and sagittal orientation of both tibial and femoral components in group A. Globally, 26 cases of the group A and 12 cases of the group B were implanted in an optimal manner for all studied criteria (p < 0.01). CONCLUSIONS: The used navigation system allows a significant improvement of the quality of implantation of a knee total prosthesis in comparison to a classical, surgeon-controlled instrumentation. Long-term outcome could be consequently improved.

Arthroplasty, Replacement, Knee↗

Brushing into haptics.

Explore the source record for details and available documents.

Computer Graphics↗

["Spatial shift alignment (SSA)"--a new method for determining blood flow velocity in video capillary microscopy].

A new technique (spatial shift alignment [SSA]) for measuring capillary blood velocity in human capillaries in the skin is described. A capillaroscopic image is digitized by means of a frame grabber. Within the lumen of a suitable capillary limb a region of interest known as a slot is placed. At a frame frequency of 25 per second, this slot is copied in a free part of the frame grabber store along a horizontal axis. A static space-time image with light diagonal bands representing the plasma gaps in their passage through the capillary limb is obtained. By determining the gradient of the diagonal bands, a measure of the capillary blood velocity is obtained. The SSA system was validated by means of a simulated model using known fixed velocities between 0 and 1.0 mm/sec (r = 0.979, n = 24). The procedure can be employed with any image processing systems, and enables continuous monitoring of the velocity measurements. Since it is time-saving and just as accurate as the frame-to-frame method, SSA could be widely applied to the measurement of blood cell velocity in capillaroscopy.

Blood Flow Velocity↗

Electrophoretic gel image analysis software for the molecular biology laboratory.

We present GelReader 1.0, a microcomputer program designed to make precision, digital analysis of one-dimensional electrophoretic gels accessible to the molecular biology laboratory of modest means. Images of electrophoretic gels are digitized via a desktop flatbed scanner from instant photographs, autoradiograms or chromogenically stained blotting media. GelReader is then invoked to locate lanes and bands and generate a report of molecular weights of unknowns, based on specified sets of standards. Frequently used standards can be stored in the program. Lanes and bands can be added or removed, based upon users' subjective preferences. A unique lane histogram feature facilitates precise manual addition of bands missed by the software. Image enhancement features include palette manipulation, histogram equalization, shadowing and magnification. The user interface strikes a balance between program autonomy and user intervention, in recognition of the variability in electrophoretic gel quality and users' analytical needs.

Computer Peripherals↗

Bone density reduction in various measurement sites in men and women with osteoporotic fractures of spine and hip: the European quantitation of osteoporosis study.

We have measured bone mineral density (BMD) using dual X-ray absorptiometry (DXA) of the spine and hip, spinal quantitative computed tomography (QCTspi), and peripheral radial quantitative computed tomography (pQCTrad) in 334 spine and 51 hip fracture patients. The standardized hip and spine BMD for each patient was calculated and compared with the combined reference ranges published previously, each densitometer having been cross-calibrated with the prototype European Spine Phantom (ESPp) or the European Forearm Phantom (EFP). Male and female fracture cases had similar BMD values after adjusting for body size, where appropriate. This suggests that the relationship between bone density (mass per unit volume) and fracture risk is similar between men and women. However, compared with age-matched controls, mean decreases in BMD ranged from 0.78 SD units (women with hip fracture, DXAspi) to 2.57 SD units (men with spine fractures, QCTspi). The proportion of spine and hip fracture patients falling below the cutoff for osteoporosis (T-score <-2.5 SD) proposed by the World Health Organization (WHO) study group varied according to different BMD measurement procedures (range 18-94%). This finding suggests that the WHO definition requires different thresholds when used with non-DXA BMD measurement techniques. Receiver operator characteristic (ROC) analysis was used to compare measurement techniques for their ability to discriminate between cases and controls. Among DXA sites, the proximal femur was preferred when evaluating generalized bone loss, particularly in elderly people. An additional spinal BMD measurement may add clinical value if spine fracture risk assessment has a high priority. Both axial and peripheral QCT techniques performed comparably to DXA in spinal osteoporosis, so investigators and clinicians may use any of the three technologies with similar degrees of confidence for the diagnosis of generalized or site-specific bone loss providing straightforward clinical guidelines are followed.

Absorptiometry, Photon↗

Corrected formula for estimating peripheral blood flow by impedance plethysmography.

In this paper, the limitations of the conventional formula for the computation of peripheral blood flow from impedance plethysmograms are highlighted, and a correction to the formula is suggested. A conductivity cell experiment is described to show the dependence of the value of the blood flow index (BFI), obtained from the conventional formula, on the mean resistivity of the cell. It is also shown that the value of the corrected BFI is independent of the mean resistivity. Anomalies observed in the amplitude of systolic waves in impedance plethysmograms of patients with oedema are explained.

Adult↗

A general framework for characterizing studies of brain interface technology.

The development of brain interface (BI) technology continues to attract researchers with a wide range of backgrounds and expertise. Though the BI community is committed to accurate and objective evaluation of methods, systems, and technology, the very diversity of the methods and terminology used in the field hinders understanding and impairs technology cross-fertilization and cross-group validation of findings. Underlying this dilemma is a lack of common perspective and language. As seen in our previous works in this area, our approach to remedy this problem is to propose language in the form of taxonomy and functional models. Our intent is to document and validate our best thinking in this area and publish a perspective that will stimulate discussion. We encourage others to do the same with the belief that focused discussion on language issues will accelerate the inherently slow natural evolution of language selection and thus alleviate related problems. In this work, we propose a theoretical framework for describing BI-technology-related studies. The proposed framework is based on the theoretical concepts and terminology from classical science, assistive technology development, human-computer interaction, and previous BI-related works. Using a representative set of studies from the literature, the proposed BI study framework was shown to be complete and appropriate perspective for thoroughly characterizing a BI study. We have also demonstrated that this BI study framework is useful for (1) objectively reviewing existing BI study designs and results, (2) comparing designs and results of multiple BI studies, (3) designing new studies or objectively reporting BI study results, and (4) facilitating intra- and inter-group communication and the education of new researchers. As such, it forms a sound and appropriate basis for community discussion.

Brain↗

Biopotentials as command and feedback signals in functional electrical stimulation systems.

Today Functional Electrical Stimulation (FES) is available as a clinical tool in muscle activation used for picking up objects, for standing and walking, for controlling bladder emptying, and for breathing. Despite substantial progress in development and new knowledge, many challenges remain to be resolved to provide a more efficient functionality of FES systems. The most important task of these challenges is to improve control of the activated muscles through open loop or feedback systems. Command and feedback signals can be extracted from biopotentials recorded from muscles (Electromyogram, EMG), nerves (Electroneurogram, ENG), and the brain (Electroencephalogram (EEG) or individual cells). This paper reviews work in which EMG, ENG, and EEG signals in humans have been used as command and feedback signals in systems using electrical stimulation of motor nerves to restore movements after an injury to the Central Nervous System (CNS). It is concluded that the technology is ready to push for more substantial clinical FES investigations in applying muscle and nerve signals. Brain-computer interface systems hold great prospects, but require further development of faster and clinically more acceptable technologies.

Action Potentials↗

Dose evaluation and effective dose estimation from multi detector CT.

Computed tomography (CT) has evolved remarkably through device improvement and advancement of peripherals, including computers. In 1999, multi detector-row CT (MDCT) appeared and rapid high-speed scanning became possible. However, usefulness of MDCT in actual clinical application cannot be assessed until the exposure doses are assessed appropriately. Since CT examinations need a comparatively high dose, it is necessary to evaluate patient exposure for introduction of MDCT. Patient doses by three types of MDCTs were evaluated for cases of scanning of the chest and abdomen-pelvis. The examination conditions were the same as those in actual clinical examinations. The obtained effective doses were 9.4-28 mSv for the chest examination and 13-28 mSv for the abdomen-pelvis. The average surface doses varied between 16-43 mGy for the chest examination and 20-37 mGy for the abdomen-pelvis. The highest surface dose was 57 mGy for the abdomen-pelvis examination. The exposed doses differed according to scanning method and imaging conditions such as tube current, slice thickness and so on. It seemed that there is room for dose reduction by proper adjustment of scan conditions in MDCT examinations.

Humans↗

Distal radius: in vivo assessment with quantitative MR imaging, peripheral quantitative CT, and dual X-ray absorptiometry.

PURPOSE: To evaluate in vivo the relationship between magnetic resonance (MR) imaging relaxation time and bone mineral density (BMD) at the distal radius. MATERIALS AND METHODS: The 1/T2* MR imaging relaxation rates and dual X-ray absorptiometry (DXA) measurements were evaluated in the trabecular bone of the distal 5 cm of the radius in 14 healthy premenopausal women and 11 healthy postmenopausal women and in 11 women with osteoporosis. Trabecular and total BMD were measured with peripheral quantitative computed tomography (CT). RESULTS: In healthy women, 1/T2* values and trabecular BMD at peripheral quantitative CT were significantly correlated but 1/T2* and total BMD were not. Statistically significant (P = .03) correlations between 1/T2* and DXA were found only in the most distal area covered with DXA. The 1/T2* values were more closely correlated with age and showed higher relative annual decreases (0.47%-0.81%) than peripheral quantitative CT (0.20%-0.59%) or DXA (0.10%-0.39%). Pre- and postmenopausal healthy subjects could be distinguished only with MR imaging, and postmenopausal healthy and osteoporotic subjects only with CT and DXA. CONCLUSION: MR imaging relaxation rates correlate well with trabecular BMD in vivo.

Absorptiometry, Photon↗

Accuracy of pQCT for evaluating the aged human radius: an ashing, histomorphometry and failure load investigation.

INTRODUCTION: Quantifying the determinants of bone strength is essential to understanding if or how the structure will fail under load. Determining failure requires knowledge of material and geometric properties. However, characterizing the relative contributions of geometric parameters of bone to overall bone strength has been difficult to date because of limitations in imaging technology. Peripheral quantitative computed tomography (pQCT) uses digital images to derive estimates of bone strength in the peripheral skeleton and is a relatively safe technique to differentiate cortical from trabecular bone and assess bone geometry and density. However, in a compromised osteoporotic bone, thin cortices and low scan resolution can limit accurate analysis. METHODS: Therefore, in this two-part investigation we scanned ten pairs (n=20) of fresh-frozen radial specimens [female, mean (SD) age 79(6) years] using pQCT (XCT 2000) at the 4 and 30% sites of the distal radius. We investigated the accuracy of four different acquisition resolutions (200, 300, 400, 500 microm) and several analysis modes and thresholds. We evaluated (1) the accuracy of the Norland/Stratec XCT 2000 pQCT in assessing low-density bones by comparing pQCT outcomes to ashing and histomorphometry and (2) the association of geometric parameters by pQCT and areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) to failure load at the distal radius. RESULTS: Using histomorphometry and ashing as reference standards, we found that pQCT scans varied systematically and underestimated or overestimated total area and mineral content at the radial midshaft depending on the analysis algorithm and selected threshold. Overall, most pQCT analysis modes were accurate. In the mechanical testing studies, bone mineral content and cortical bone content at the midshaft were strongly associated with failure load. The pQCT parameters that best accounted for failure load were total content at the 4% site and cortical thickness at the 30% site and they accounted for up to 81% of the variance. The best DXA predictor of failure load was total density at the distal third site and it explained 75% of the variance. CONCLUSIONS: In summary, analysis mode, resolution and thresholding affected pQCT outputs at the radial midshaft. This study extends our understanding of pQCT analysis and provides important data regarding determinants of bone strength at the distal radius.

Aged↗