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The role of robotic sample processing in the modernisation of pathology services at Manchester Royal Infirmary is described by Peter Jones, centralised in vitro diagnostics market manager at Roche Diagnostics. Stemming from the modernisation are valuable pointers for managers of facilities and designers of healthcare premises.
As the field of surgical robotics continues to evolve, it is important to keep patient safety in mind. This paper describes a safety control architecture aimed at moving an experimental system in the direction of intrinsically safe operation. The system includes safety features such as: a small number of states, Programmable Logic Controller (PLC) state transition control, active enable, brakes, E-STOP, and a surgeon foot pedal.
Combined robotic sample processors allow economic and ergonomic laboratory screening of blood donors without mismatching of samples. The modular configuration of the whole system serves as basis for easily achievable adaptation to future performance claims or installation at other institutions.
According to the hardware characters of the high intensive focused ultrasound (HIFU) serial-parallel robots, this paper presents an algorithm of 2-grade interpolation scheme which includes the rough and fine interpolations. Both pre-acceleration and post-acceleration are employed to meet the restrictive requirements of coordinated dynamic performance and the detailed procedure of the interpolation algorithm is given too.
CD11a-blocking efalizumab has recently been approved as a systemic treatment of moderate to severe chronic plaque psoriasis. When treating 6 psoriasis patients with efalizumab over 12 weeks in the present study, we observed an overall good tolerability and 5 treatment responders characterized by a decrease of PASI from 21.3 +/- 5.4 to 3.9 +/- 0.6. The accompanying significant increase of peripheral blood lymphocytes from 1.9 +/- 0.7 to 4.3 +/- 1.0 x 10(9)/L (p < 0.05) was analyzed by multi epitope ligand cartography (MELC) robot microscopy. Thereby a high-dimension simultaneous multiplex immunophenotyping was pursued using 39 fluorophore-labeled antibodies including labeled efalizumab and 3 other affinity reagents such as lectins. Due to efalizumab treatment there was a substantial decrease of the cellular expression of CD11a (detected by mab clone 25.3.1) and efalizumab binding sites (EfaBSs). This was paralleled by an increase of the number of EfaBS- and EfaBS+ lymphocytes by a factor of 2.4x and 2.2x, respectively. The latter effect was mainly derived from a subpopulation showing a low degree of EfaBS expression. Efalizumab treatment led furthermore to an increase of the numbers of CD3+, CD4+, CD8+, CD44+, CD45+, CD45R0+, CD45 RA+, CD52+, CD58+, CD247+, HLA-DR+ and Sambucus nigra lectin-reactive lymphocytes (by factors from 2.0 to 3.3x). In terms of a combinatorial molecular phenotype we identified a CD3+/CD4+/CD44+/CD52+ lymphocyte subpopulation which accumulated most predominantly from 0.824 +/- 0.270 x 10(9)/L up to 1.616 +/- 0.152 x 10(9)/L under efalizumab treatment (p < 0.01). Thus, the current study extends the knowledge of efalizumab-dependent perturbations of recirculating blood lymphocyte subpopulations in psoriasis patients.
This paper describes a number of techniques for rapid restriction mapping of cosmid clones. First, we have replaced the cloning site of cosmid vector pWE15 with a polylinker containing 15 infrequently cleaved restriction enzyme sites that are placed asymmetrically on each side of the BamHI cloning site. DNA cloned into this vector can be fully recovered by using several pairs of restriction enzymes. Second, we have designed a simple electrical circuit device that allows the performance of asymmetric voltage gradient field inversion gel electrophoresis (AFIGE) to improve the resolution of DNA molecules in the range of 20-50 kbp. AFIGE can be obtained by simply placing the device in between a commercially available switching unit and the gel box in a standard field inversion system. Finally, the restriction digestion procedure has been automated by using a Beckman Biomek 1000 robotic workstation. Using this automated system, 96 restriction reactions, including gel loading, can be performed in less than two hours. In summary, these methods represent at least a tenfold improvement in the speed and/or mapping data that can be obtained in a single gel.
We demonstrate the possibility of automation of whole-cell functionality assays, e.g., mitogen-activated DNA synthesis, DNA repair synthesis, and assessment of drug-metabolizing enzymes, by use of magnetic separation technology. We have attached antibody-coupled magnetic microspheres to the surface of human T-lymphocytes before performing various assays. Evaluating the biological functions of T-cells estimated by the DNA-synthesis assays showed that the presence of antibody-coupled magnetic microspheres did not affect the results (P greater than 0.05). The concentration of adenosine diphosphate ribosyltransferase (EC 2.4.2.30) was shown to be influenced by the magnetic microspheres. However, the amount of enzyme activity induced by oxidative stress was not significantly altered. The results from assays of the phase II drug-metabolizing enzymes glutathione transferase (EC 2.5.1.18) and epoxide hydrolase (EC 3.3.2.3) as well as evaluation of the proliferative response of polyclonal activators (phytohemagglutinin, staphylococcal enterotoxin A, and pokeweed mitogen) support our conclusion that assays can be performed on viable magnetized cells. The use of magnetized cells holds promise for further applications in automated genotoxic and immunological cell assays of mononuclear leukocyte subsets. Laboratory robotics will be essential in bringing these assays into routine use.
Creating a reliable system from discrete laboratory instruments is often a task fraught with difficulties. While many modern analytical instruments are marvels of detection and data handling, attempts to create automated analytical systems incorporating such instruments are often frustrated by their human-oriented control structures and their egocentricity. The laboratory robot, while fully susceptible to these problems, extends such compatibility issues to the physical dimensions involving sample interchange, manipulation, and event timing. The workcell concept was conceived to describe the procedure and equipment necessary to carry out a single task during sample preparation. This notion can be extended to organize all operations in an automated system. Each workcell, no matter how complex its local repertoire of functions, must be minimally capable of accepting information (commands, data), returning information on demand (status, results), and being started, stopped, and reset by a higher level device. Even the system controller should have a mode where it can be directed by instructions from a higher level.
The authors expound the principles of making up of the algorithm (program) for diagnosis and implementation of the optimal variations of rod insertion in various types of fractures of the extremities and the method of adaptation of the program to a specific fracture according to its biomechanical characteristics. The succession of the realization of the program of insertion of the rods, reposition of the fragments and application of the apparatus with the aid of the robot are described.
We report here a system for automation of the dideoxynucleotide DNA sequencing method. The system consists of a Beckman Biomek 1000 robotic workstation which has been modified by the addition of a thin heater/cooler block directly on the instrument table. The heater/cooler block, which is regulated by a user-specified program integrated into the Biomek software, facilitates the use of both single- and double-stranded DNA sequencing procedures. Using this system, we are able to perform 24 sets of dideoxynucleotide DNA sequencing reactions in approximately 45 min. The reactions are performed in 96-well microtiter plates, using a prepared reagent pack which includes primer, enzyme, nucleotide mixes and radioactive label. Using standard gel electrophoresis technology, we are able to resolve over 500 nucleotides per sequencing reaction in about 5 h. Currently, we are able to perform three runs of 24 samples each, with subsequent gel analysis per 8-h period. Excluding autoradiography, this represents a daily data output of 36,000 base pairs.
A 2D-model for the kinematics of the cranio-cervical system is developed from algorithms applied for robot kinematics. The model is proposed for avian cranio-cervical systems. Three main problems were to be solved. The problem of underdetermination in an open multi-element kinematic chain, which develops because only kinematics were included, is solved by the application of two approximations for economic motion. The straight-line approximation for the course of the bill tips and the least-motion approximation for all articulations are both assumed to occur in selected phases of pecking and drinking behaviour. The problem that internal constraints and constraints resulting from demands for proper functioning may be operating is solved by incorporating the measured maximal dorsal and ventral flexion of each joint, and also both the target location of the bill tips and the target orientation of head and beak. The third problem, viz. how to handle variations in initial conditions, which developed from the relatively independent working locomotory part, is solved by standardizing the foot-food distance in the experiments, and further by running the simulations for the locomotory components over the trajectories they cover in reality, rather than to allow them to move over their full work-envelope. The model is highly adaptable to changes in the number of bars involved, in bar lengths, in work-envelopes, and in motion patterns. The predicted patterns were tested against combined film- and radiographic analyses. The comparisons lead to some general conclusions. The economy principles tested appear to be confirmed from the observations. Also, the fixed-target orientation approximation seems to be confirmed while the locomotory components clearly operate primarily under different constraints.
The experience with sophisticated remote handling systems for nuclear operations in inaccessible rooms can to a large extent be transferred to the development of robotics and telemanipulators for endoscopic surgery. A telemanipulator system is described consisting of manipulator, endeffector and tools, 3-D video-endoscope, sensors, intelligent control system, modeling and graphic simulation and man-machine interfaces as the main components or subsystems. Such a telemanipulator seems to be medically worthwhile and technically feasible, but needs a lot of effort from different scientific disciplines to become a safe and reliable instrument for future endoscopic surgery.
This paper describes the safety features of the ROBODOC Surgical Assistant System, an image-driven robotic system which has been used to perform Total Hip Replacement surgery. These features include a dedicated processor for continuous monitoring of system status, shared data areas (dual-ported RAM), and external sensors (force-torque sensor, redundant positional encoders, and bone motion monitor).
Immunoaffinity column-based sample preparation procedures for determination of aflatoxins B1, B2, G1, and G2 in several food matrixes and aflatoxin M1 in milk have been automated by using flexible automation, or robotics. Components used to assemble the system were purchased commercially or developed and built in-house. A liquid-level sensor developed in-house to assist elution of the immunoaffinity column is described. After immunoaffinity column cleanup, aflatoxins are separated by reversed-phase liquid chromatography and determined by fluorescence without derivatization. Mean recoveries of aflatoxins B1, B2, and G1 added to corn and nuts at 9-36 ng/g total aflatoxins were > 85% (coefficient of variation [CV] = 16%). Recoveries of aflatoxin G2 averaged 50% (CV = 28%). Recoveries of aflatoxin M1 added to milk at 0.12-0.50 ng/mL averaged 78% (CV = 19%). The ability of the automated system to reproduce its results is demonstrated by the fact that the CV of replicate assays is generally better than 10%. Comparability between the automated procedure and the AOAC official method is demonstrated.
The article gives the outlines of all principles used in computing included the non-electrical and analog computers and the artifical intelligence followed by citing examples as well. The principles and medical utilization of virtual reality are also mentioned. There are discussed: surgical planning, image guided surgery, robotic surgery, telepresence and telesurgery, and telemedicine implemented partially via Internet.
In an ideal human-computer interface, the computer would be able to understand and use modalities such as speech, hearing, facial gestures and body language in as realistic and natural a manner as a human. This paper discusses two kinds of computer-to-human interaction techniques which involve computerizea facial gestures: the first is the graphics representation of the human face projected on a video display; the second is the physical embodiment of facial expressions using an android robot. These simulated facial gestures may be accompanied by computerized speech synthesis, voice recognition capability or machine vision for recognition of the facial expressions of the human viewer. The author reviews both major techniques, then discusses current and proposed applications of this methodology.
The learning curve for utilization of the voice-controlled AESOP Robot security apparatus for laparoscopic procedures is short. A short experience and the first trials suggest that this security apparatus could allow better intra operative ergonomics, the practice of solosurgery or telementoring. The high cost requires a homogeneous and dense practice in laparoscopic surgery.
A recently developed robotic platform termed "Genepaint" can carry out large-scale nonradioactive in situ hybridization (ISH) on tissue sections. We report a series of experiments that validate this novel platform. Signal-to-noise ratio and mRNA detection limits were comparable to traditional ISH procedures, and hybridization was transcript-specific, even in cases in which probes could have hybridized to several transcripts of a multigene family. We established an atlas of expression patterns of fibroblast growth factors (Fgfs) and their receptors (Fgfrs) for the embryonic day 14.5 mouse embryo. This atlas provides a comprehensive overview of previously known as well as novel sites of expression for this important family of signaling molecules. The Fgf/Fgfr atlas was integrated into the transcriptome database (www.genepaint.org), where individual Fgf and Fgfr expression patterns can be interactively viewed at cellular resolution and where sites of expressions can be retrieved using an anatomy-based search.