Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 50

Search results for: Cervical spine

50 The Effect of Screw Parameters on Pullout Strength of Screw Fixation in Cervical Spine

Authors: S. Ritddech, P. Aroonjarattham, K. Aroonjarattham

Abstract:

The pullout strength had an effect on the stability of plate screw fixation when inserted in the cervical spine. Nine different titanium alloy bone screws were used to test the pullout strength through finite element analysis. The result showed that the Moss Miami I can bear the highest pullout force at 1,075 N, which causes the maximum von Mises stress at 858.87 MPa, a value over the yield strength of titanium. The bone screw should have large outer diameter, core diameter and proximal root radius to increase the pullout strength.

Keywords: Pullout strength, Screw parameter, Cervical spine, Finite element analysis.

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49 Simulating Dynamics of Thoracolumbar Spine Derived from Life MOD under Haptic Forces

Authors: K. T. Huynh, I. Gibson, W. F. Lu, B. N. Jagdish

Abstract:

In this paper, the construction of a detailed spine model is presented using the LifeMOD Biomechanics Modeler. The detailed spine model is obtained by refining spine segments in cervical, thoracic and lumbar regions into individual vertebra segments, using bushing elements representing the intervertebral discs, and building various ligamentous soft tissues between vertebrae. In the sagittal plane of the spine, constant force will be applied from the posterior to anterior during simulation to determine dynamic characteristics of the spine. The force magnitude is gradually increased in subsequent simulations. Based on these recorded dynamic properties, graphs of displacement-force relationships will be established in terms of polynomial functions by using the least-squares method and imported into a haptic integrated graphic environment. A thoracolumbar spine model with complex geometry of vertebrae, which is digitized from a resin spine prototype, will be utilized in this environment. By using the haptic technique, surgeons can touch as well as apply forces to the spine model through haptic devices to observe the locomotion of the spine which is computed from the displacement-force relationship graphs. This current study provides a preliminary picture of our ongoing work towards building and simulating bio-fidelity scoliotic spine models in a haptic integrated graphic environment whose dynamic properties are obtained from LifeMOD. These models can be helpful for surgeons to examine kinematic behaviors of scoliotic spines and to propose possible surgical plans before spine correction operations.

Keywords: Haptic interface, LifeMOD, spine modeling.

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48 Comparison of Knowledge Regarding Human Papillomavirus (HPV) and Cervical Cancer in Students with or without Sexual Intercourse

Authors: F. Bakiri, T. Rexha, A. Mitre

Abstract:

The aim of our study was to compare knowledge of regarding HPV and cervical cancer in female student of 18 to 26 years old, with or without sexual intercourse. We conducted a questionnaire survey of the students (N=568), in Faculty of Natural Sciences, Tirana, Albania. Sexually experienced students were more likely to have heard of risk factors such as multiple sex partners, sexual intercourse before age 18, having contracted any sexually transmitted diseases, having genital warts, smoking cigarettes, use of oral contraceptive, poor diet or nutrition and using tampons. No significant sexually experience differences were observed in knowledge of the way of transmission of the virus associated with cervical cancer knowledge, the virus associated with cervical cancer knowledge, the prevention of cervical cancer knowledge. On the other hand strong significant sexually experience differences were observed in knowledge of the diagnostic way of cervical cancer and what HPV can cause knowledge.

Keywords: Risk factors, HPV, Cervical cancer, Albanian students.

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47 Modelling of a Stress-Strain State of Screws of Transpedicular Spine Fixation System

Authors: Oleksandr Poliakov, Genadiy Olinichenko, Yevgen Pashkov, Vadym Kramar, Mykhaylo Kalinin

Abstract:

For maintenance of a spine stability during the postoperative period a transpedicular fixing of its elements is often used. Usually the transpedicular systems are formed of rods which as a result form a design of the frame type, fastening by screws to vertebras. Such design should be rigid and perceive loadings operating from the spine without essential deformations. From the perfection point of view of known designs their stress whole, and each of elements, in particular is of interest. In this study the modeling of the transpedicular screw is performed and estimation of its deformations taking into account interaction with a vertebra body having variable structure is made.

Keywords: Spine, screw, stress-strain state, transpedicular fixation system, vertebra

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46 Morphological Description of Cervical Cell Images for the Pathological Recognition

Authors: N. Lassouaoui, L. Hamami, N. Nouali

Abstract:

The tracking allows to detect the tumor affections of cervical cancer, it is particularly complex and consuming time, because it consists in seeking some abnormal cells among a cluster of normal cells. In this paper, we present our proposed computer system for helping the doctors in tracking the cervical cancer. Knowing that the diagnosis of the malignancy is based in the set of atypical morphological details of all cells, herein, we present an unsupervised genetic algorithm for the separation of cell components since the diagnosis is doing by analysis of the core and the cytoplasm. We give also the various algorithms used for computing the morphological characteristics of cells (Ratio core/cytoplasm, cellular deformity, ...) necessary for the recognition of illness.

Keywords: Cervical cell, morphological analysis, recognition, segmentation.

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45 Uniformity of Dose Distribution in Radiation Fields Surrounding the Spine using Film Dosimetry and Comparison with 3D Treatment Planning Software

Authors: Sadegh Masoudi , Vahid Fayaz , Hassan Zandi, Asieh Tavakol

Abstract:

The overall penumbra is usually defined as the distance, p20–80, separating the 20% and 80% of the dose on the beam axis at the depth of interest. This overall penumbra accounts also for the fact that some photons emitted by the distal parts of the source are only partially attenuated by the collimator. Medulloblastoma is the most common type of childhood brain tumor and often spreads to the spine. Current guidelines call for surgery to remove as much of the tumor as possible, followed by radiation of the brain and spinal cord, and finally treatment with chemotherapy. The purpose of this paper was to present results on an Uniformity of dose distribution in radiation fields surrounding the spine using film dosimetry and comparison with 3D treatment planning software.

Keywords: Absorbed Dose , Spine , Radiotherapy, 3D treatment planning software

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44 Spine Evaluation Device with Visual Feedback

Authors: T. Hirata, G. H. Yokoyama, L. H. M. Duque

Abstract:

The posteroanterior manipulation technique is usually include in the procedure of the lumbar spine to evaluate the intervertebral motion according to mechanical resistance. The mechanical device with visual feedback was proposed that allows one to analysis the lumbar segments mobility “in vivo" facilitating for the therapist to take its treatment evolution. The measuring system uses load cell and displacement sensor to estimate spine stiffness. In this work, the device was tested by 2 therapists, female, applying posteroanterior force techniques to 5 volunteers, female, with frequency of approximately 1.2-1.8 Hz. A test-retest procedure was used for 2 periods of day. The visual feedback results small variation of forces and cycle time during 6 cycles rhythmic application. The stiffness values showed good agreement between test-retest procedures when used same order of maximum forces.

Keywords: Biomechanics, lumber spine stiffness, intervertebral manipulation device, visual feedback

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43 Sociodemographic Risk Factors of Cervical Cancer in Imphal, Manipur

Authors: Arundhati Devi Maibam, K. Ingocha Singh

Abstract:

Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.

Keywords: Cervical cancer, Manipuri women, RIIMS, Socio-demographic risk factors.

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42 Enzymes Activity in Bovine Cervical Mucus Related to the Time of Ovulation And Insemination

Authors: S. Benbia, A.Kalla, M. Yahia, K. Belhadi, A. Zidani

Abstract:

Forty-five dairy cows were used to compare the enzyme activity of alkaline phosphatase (ALP), lactate dehydrogenase (LDH), α -amylase in the cervical mucus of cows during spontaneous and induced estrus using progestagen or PGF2 α and to determine whether these enzymes affect the fertility in cows with induced estrus, at the time of Al. The animals were assigned to 3 groups (no treatment, a Crestar® for 12 days, a double im injection of PGF2 α). The cows were artificially inseminated (AI). Cervical mucus samples were collected from all cows 3 to 5 min before the AI. The results are summarized as follows: ALP and α -amylase activity for spontaneous estrus were similar to those for induced estrus (P>0.05) . LDH activity levels during spontaneous and PGF2 α induced estrus was significantly lower (P < 0.001) than that in progestagene induced estrus groups. While no difference was found between the first and the third groups. Our result showed a significant difference in LDH activity levels between cows conceived with 2 or more AI and those conceived with 1 AI. The result of this study showed that the enzyme activity in cervical mucus is helpful for detection of ovulation and time of AI.

Keywords: cervical mucus, dairy cow, enzyme, induced, estrus, ovulation, AI

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41 The Effect of Aerobic Training and Taxol Consumption on IL 8 and PAI-1 in Cervical Cancer

Authors: Alireza Barari, Maryam Firoozi, Maryam Ebrahimzadeh, Romina Roohani Ardeshiri, Maryam Kamarloeei

Abstract:

Background: The purpose of this study was to analyze the effect of six-week aerobic training and taxol consumption on interleukin-8 and Plasminogen Activator Inhibitor-1 (PAI-1) in mice with cervical cancer. Materials and Methods: In this experimental study, 40 female C57 mice with cervical cancer, eight weeks old, were randomly divided into 4 groups including: control, taxol supplement, training, and training-taxol supplement. The implantation of cancerous tumors was performed under the skin at the upper of the pelvis. The program training was included: endurance training for six weeks, 3 sessions per week and 50 minutes per session, at the speed of 14-18 m/s. Taxol supplement at a dose of 60 mg/kg per day was injected intraperitoneally. Data analysis was performed using t-test and one-way ANOVA and if statistically significant, Bonferroni post hoc was used at the significance level p < .05. Results: The results showed that there was a significant difference between the levels of interleukin 8 (P < 0.05, F = 12.25) and the PAI-1 (P < 0.05, P = 0.10737 between the 4 groups. The results of this study showed a significant difference between the control group and the training - complementary group. Six weeks of aerobic training and taxol consumption have a significant effect on the level of PAI-1 and interleukin-8 mice with cervical cancer. Conclusion: Considering the effect of training on these variables, this type of exercise can be used as a complementary therapeutic approach with other therapies for cervical cancer.

Keywords: Cervical cancer, taxol, endurance training, interleukin 8, plasminogen activator inhibitor-1.

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40 Construction and Validation of a Hybrid Lumbar Spine Model for the Fast Evaluation of Intradiscal Pressure and Mobility

Authors: Ali Hamadi Dicko, Nicolas Tong-Yette, Benjamin Gilles, François Faure, Olivier Palombi

Abstract:

A novel hybrid model of the lumbar spine, allowing fast static and dynamic simulations of the disc pressure and the spine mobility, is introduced in this work. Our contribution is to combine rigid bodies, deformable finite elements, articular constraints, and springs into a unique model of the spine. Each vertebra is represented by a rigid body controlling a surface mesh to model contacts on the facet joints and the spinous process. The discs are modeled using a heterogeneous tetrahedral finite element model. The facet joints are represented as elastic joints with six degrees of freedom, while the ligaments are modeled using non-linear one-dimensional elastic elements. The challenge we tackle is to make these different models efficiently interact while respecting the principles of Anatomy and Mechanics. The mobility, the intradiscal pressure, the facet joint force and the instantaneous center of rotation of the lumbar spine are validated against the experimental and theoretical results of the literature on flexion, extension, lateral bending as well as axial rotation. Our hybrid model greatly simplifies the modeling task and dramatically accelerates the simulation of pressure within the discs, as well as the evaluation of the range of motion and the instantaneous centers of rotation, without penalizing precision. These results suggest that for some types of biomechanical simulations, simplified models allow far easier modeling and faster simulations compared to usual full-FEM approaches without any loss of accuracy.

Keywords: Hybrid, modeling, fast simulation, lumbar spine.

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39 An Efficient Pixel Based Cervical Disc Localization

Authors: J. Preetha, S. Selvarajan

Abstract:

When neck pain is associated with pain, numbness, or weakness in the arm, shoulder, or hand, further investigation is needed as these are symptoms indicating pressure on one or more nerve roots. Evaluation necessitates a neurologic examination and imaging using an MRI/CT scan. A degenerating disc loses some thickness and is less flexible, causing inter-vertebrae space to narrow. A radiologist diagnoses an Intervertebral Disc Degeneration (IDD) by localizing every inter-vertebral disc and identifying the pathology in a disc based on its geometry and appearance. Accurate localizing is necessary to diagnose IDD pathology. But, the underlying image signal is ambiguous: a disc’s intensity overlaps the spinal nerve fibres. Even the structure changes from case to case, with possible spinal column bending (scoliosis). The inter-vertebral disc pathology’s quantitative assessment needs accurate localization of the cervical region discs. In this work, the efficacy of multilevel set segmentation model, to segment cervical discs is investigated. The segmented images are annotated using a simple distance matrix.

Keywords: Intervertebral Disc Degeneration (IDD), Cervical Disc Localization, multilevel set segmentation.

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38 Metal Streak Analysis with different Acquisition Settings in Postoperative Spine Imaging: A Phantom Study

Authors: N. D. Osman, M. S. Salikin, M. I. Saripan

Abstract:

CT assessment of postoperative spine is challenging in the presence of metal streak artifacts that could deteriorate the quality of CT images. In this paper, we studied the influence of different acquisition parameters on the magnitude of metal streaking. A water-bath phantom was constructed with metal insertion similar with postoperative spine assessment. The phantom was scanned with different acquisition settings and acquired data were reconstructed using various reconstruction settings. Standardized ROIs were defined within streaking region for image analysis. The result shows increased kVp and mAs enhanced SNR values by reducing image noise. Sharper kernel enhanced image quality compared to smooth kernel, but produced more noise in the images with higher CT fluctuation. The noise between both kernels were significantly different (P <0.05) with increment of noise in the bone kernel images (mean difference = 54.78). The technical settings should be selected appropriately to attain the acceptable image quality with the best diagnostic value.

Keywords: Computed tomography, metal streak, noise, CT fluctuation.

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37 Bone Mineral Density and Trabecular Bone Score in Ukrainian Men with Obesity

Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Dzerovych, Roksolana Povoroznyuk

Abstract:

Osteoporosis and obesity are widespread diseases in people over 50 years associated with changes in structure and body composition. Нigher body mass index (BMI) values are associated with greater bone mineral density (BMD). However, trabecular bone score (TBS) indirectly explores bone quality, independently of BMD. The aim of our study was to evaluate the relationship between the BMD and TBS parameters in Ukrainian men suffering from obesity. We examined 396 men aged 40-89 years. Depending on their BMI all the subjects were divided into two groups: Group I – patients with obesity whose BMI was ≥ 30 kg/m2 (n=129) and Group II – patients without obesity and BMI of < 30 kg/m2 (n=267). The BMD of total body, lumbar spine L1-L4, femoral neck and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1- L4 was assessed by means of TBS iNsight® software installed on DXA machine (product of Med-Imaps, Pessac, France). In general, obese men had a significantly higher BMD of lumbar spine L1-L4, femoral neck, total body and ultradistal forearm (p < 0.001) in comparison with men without obesity. The TBS of L1-L4 was significantly lower in obese men compared to non-obese ones (p < 0.001). BMD of lumbar spine L1-L4, femoral neck and total body significantly differ in men aged 40-49, 50-59, 60-69, and 80-89 years (p < 0.05). At the same time, in men aged 70-79 years, BMD of lumbar spine L1-L4 (p=0.46), femoral neck (p=0.18), total body (p=0.21), ultra-distal forearm (p=0.13), and TBS (p=0.07) did not significantly differ. A significant positive correlation between the fat mass and the BMD at different sites was observed. However, the correlation between the fat mass and TBS of L1-L4 was also significant, though negative.

Keywords: Bone mineral density, trabecular bone score, obesity, men.

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36 Ranking Genes from DNA Microarray Data of Cervical Cancer by a local Tree Comparison

Authors: Frank Emmert-Streib, Matthias Dehmer, Jing Liu, Max Muhlhauser

Abstract:

The major objective of this paper is to introduce a new method to select genes from DNA microarray data. As criterion to select genes we suggest to measure the local changes in the correlation graph of each gene and to select those genes whose local changes are largest. More precisely, we calculate the correlation networks from DNA microarray data of cervical cancer whereas each network represents a tissue of a certain tumor stage and each node in the network represents a gene. From these networks we extract one tree for each gene by a local decomposition of the correlation network. The interpretation of a tree is that it represents the n-nearest neighbor genes on the n-th level of a tree, measured by the Dijkstra distance, and, hence, gives the local embedding of a gene within the correlation network. For the obtained trees we measure the pairwise similarity between trees rooted by the same gene from normal to cancerous tissues. This evaluates the modification of the tree topology due to tumor progression. Finally, we rank the obtained similarity values from all tissue comparisons and select the top ranked genes. For these genes the local neighborhood in the correlation networks changes most between normal and cancerous tissues. As a result we find that the top ranked genes are candidates suspected to be involved in tumor growth. This indicates that our method captures essential information from the underlying DNA microarray data of cervical cancer.

Keywords: Graph similarity, generalized trees, graph alignment, DNA microarray data, cervical cancer.

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35 Development and Assessment of Measuring/Rehabilitation Device for Myelopathy Patients with Lower Extremity Function

Authors: Hironobu Murayama, Shohei Shimizu, Masakazu Ohnuki, Hisanori Mihara, Tohru Kanada

Abstract:

Disordered function of maniphalanx and difficulty with ambulation will occur insofar as a human has a failure in the spinal marrow. Cervical spondylotic myelopathy as one of the myelopathy emanates from not only external factors but also increased age. In addition, the diacrisis is difficult since cervical spondylotic myelopathy is evaluated by a doctor-s neurological remark and imaging findings. As a quantitative method for measuring the degree of disability, hand-operated triangle step test (for short, TST) has formulated. In this research, a full automatic triangle step counter apparatus is designed and developed to measure the degree of disability in an accurate fashion according to the principle of TST. The step counter apparatus whose shape is a low triangle pole displays the number of stepping upon each corner. Furthermore, the apparatus has two modes of operation. Namely, one is for measuring the degree of disability and the other for rehabilitation exercise. In terms of usefulness, clinical practice should be executed before too long.

Keywords: Cervical spondylotic myelopathy, disorder of lower limbs, measuringfunction, rehabilitation function, full automatic apparatus, triangle step test.

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34 Quality Evaluation of Compressed MRI Medical Images for Telemedicine Applications

Authors: Seddeq E. Ghrare, Salahaddin M. Shreef

Abstract:

Medical image modalities such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), X-ray are adapted to diagnose disease. These modalities provide flexible means of reviewing anatomical cross-sections and physiological state in different parts of the human body. The raw medical images have a huge file size and need large storage requirements. So it should be such a way to reduce the size of those image files to be valid for telemedicine applications. Thus the image compression is a key factor to reduce the bit rate for transmission or storage while maintaining an acceptable reproduction quality, but it is natural to rise the question of how much an image can be compressed and still preserve sufficient information for a given clinical application. Many techniques for achieving data compression have been introduced. In this study, three different MRI modalities which are Brain, Spine and Knee have been compressed and reconstructed using wavelet transform. Subjective and objective evaluation has been done to investigate the clinical information quality of the compressed images. For the objective evaluation, the results show that the PSNR which indicates the quality of the reconstructed image is ranging from (21.95 dB to 30.80 dB, 27.25 dB to 35.75 dB, and 26.93 dB to 34.93 dB) for Brain, Spine, and Knee respectively. For the subjective evaluation test, the results show that the compression ratio of 40:1 was acceptable for brain image, whereas for spine and knee images 50:1 was acceptable.

Keywords: Medical Image, Magnetic Resonance Imaging, Image Compression, Discrete Wavelet Transform, Telemedicine.

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33 Defining of the Shape of the Spine Using Moiré Method in Case of Patients with Scheuermann Disease

Authors: Petra Balla, Gabor Manhertz, Akos Antal

Abstract:

Nowadays spinal deformities are very frequent problems among teenagers. Scheuermann disease is a one dimensional deformity of the spine, but it has prevalence over 11% of the children. A traditional technology, the moiré method was used by us for screening and diagnosing this type of spinal deformity. A LabVIEW program has been developed to evaluate the moiré pictures of patients with Scheuermann disease. Two different solutions were tested in this computer program, the extreme and the inflexion point calculation methods. Effects using these methods were compared and according to the results both solutions seemed to be appropriate. Statistical results showed better efficiency in case of the extreme search method where the average difference was only 6,09⁰.

Keywords: Spinal deformity, picture evaluation, moiré method, Scheuermann disease, curve detection, moiré topography.

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32 A Systems Approach to Gene Ranking from DNA Microarray Data of Cervical Cancer

Authors: Frank Emmert Streib, Matthias Dehmer, Jing Liu, Max Mühlhauser

Abstract:

In this paper we present a method for gene ranking from DNA microarray data. More precisely, we calculate the correlation networks, which are unweighted and undirected graphs, from microarray data of cervical cancer whereas each network represents a tissue of a certain tumor stage and each node in the network represents a gene. From these networks we extract one tree for each gene by a local decomposition of the correlation network. The interpretation of a tree is that it represents the n-nearest neighbor genes on the n-th level of a tree, measured by the Dijkstra distance, and, hence, gives the local embedding of a gene within the correlation network. For the obtained trees we measure the pairwise similarity between trees rooted by the same gene from normal to cancerous tissues. This evaluates the modification of the tree topology due to progression of the tumor. Finally, we rank the obtained similarity values from all tissue comparisons and select the top ranked genes. For these genes the local neighborhood in the correlation networks changes most between normal and cancerous tissues. As a result we find that the top ranked genes are candidates suspected to be involved in tumor growth and, hence, indicates that our method captures essential information from the underlying DNA microarray data of cervical cancer.

Keywords: Graph similarity, DNA microarray data, cancer.

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31 A Retrospective Study of Vaginal Stenosis Following Treatment of Cervical Cancers and the Effectiveness of Rehabilitation Interventions

Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

Abstract:

Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: Dilator, sexually active, vaginal dilation, vaginal stenosis.

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30 Concept of Transforaminal Lumbar Interbody Fusion Cage Insertion Device

Authors: Sangram A. Sathe, Neha A. Madgulkar, Shruti S. Raut, S. P. Wadkar

Abstract:

Transforaminal lumbar interbody fusion (TLIF) surgeries have nowadays became popular for treatment of degenerated spinal disorders. The interbody fusion technique like TLIF maintains load bearing capacity of the spine and a suitable disc height. Currently many techniques have been introduced to cure Spondylolisthesis. This surgery provides greater rehabilitation of degenerative spines. While performing this TLIF surgery existing methods use guideway, which is a troublesome surgery technique as the use of two separate instruments is required to perform this surgery. This paper presents a concept which eliminates the use of guideway. This concept also eliminates problems that occur like reverting the cage. The concept discussed in this paper also gives high accuracy while performing surgery.

Keywords: Degenerative disc diseases, pedicle screw, spine, spondylolisthesis, transforaminal lumbar interbody fusion.

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29 Computer-aided Lenke Classification of Scoliotic Spines

Authors: Neila Mezghani, Philippe Phan, Hubert Labelle, Carl Eric Aubin, Jacques de Guise

Abstract:

The identification and classification of the spine deformity play an important role when considering surgical planning for adolescent patients with idiopathic scoliosis. The subject of this article is the Lenke classification of scoliotic spines using Cobb angle measurements. The purpose is two-fold: (1) design a rulebased diagram to assist clinicians in the classification process and (2) investigate a computer classifier which improves the classification time and accuracy. The rule-based diagram efficiency was evaluated in a series of scoliotic classifications by 10 clinicians. The computer classifier was tested on a radiographic measurement database of 603 patients. Classification accuracy was 93% using the rule-based diagram and 99% for the computer classifier. Both the computer classifier and the rule based diagram can efficiently assist clinicians in their Lenke classification of spine scoliosis.

Keywords: Scoliosis, Lenke model, decision-rules, computer aided classifier.

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28 Comparative Evaluation of Accuracy of Selected Machine Learning Classification Techniques for Diagnosis of Cancer: A Data Mining Approach

Authors: Rajvir Kaur, Jeewani Anupama Ginige

Abstract:

With recent trends in Big Data and advancements in Information and Communication Technologies, the healthcare industry is at the stage of its transition from clinician oriented to technology oriented. Many people around the world die of cancer because the diagnosis of disease was not done at an early stage. Nowadays, the computational methods in the form of Machine Learning (ML) are used to develop automated decision support systems that can diagnose cancer with high confidence in a timely manner. This paper aims to carry out the comparative evaluation of a selected set of ML classifiers on two existing datasets: breast cancer and cervical cancer. The ML classifiers compared in this study are Decision Tree (DT), Support Vector Machine (SVM), k-Nearest Neighbor (k-NN), Logistic Regression, Ensemble (Bagged Tree) and Artificial Neural Networks (ANN). The evaluation is carried out based on standard evaluation metrics Precision (P), Recall (R), F1-score and Accuracy. The experimental results based on the evaluation metrics show that ANN showed the highest-level accuracy (99.4%) when tested with breast cancer dataset. On the other hand, when these ML classifiers are tested with the cervical cancer dataset, Ensemble (Bagged Tree) technique gave better accuracy (93.1%) in comparison to other classifiers.

Keywords: Artificial neural networks, breast cancer, cancer dataset, classifiers, cervical cancer, F-score, logistic regression, machine learning, precision, recall, support vector machine.

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27 Bone Mineral Density and Trabecular Bone Score in Ukrainian Women with Obesity

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Larysa Martynyuk, Tetiana Kovtun

Abstract:

Obesity and osteoporosis are the two diseases whose increasing prevalence and high impact on the global morbidity and mortality, during the two recent decades, have gained a status of major health threats worldwide. Obesity purports to affect the bone metabolism through complex mechanisms. Debated data on the connection between the bone mineral density and fracture prevalence in the obese patients are widely presented in literature. There is evidence that the correlation of weight and fracture risk is sitespecific. This study is aimed at determining the connection between the bone mineral density (BMD) and trabecular bone score (TBS) parameters in Ukrainian women suffering from obesity. We examined 1025 40-89-year-old women, divided them into the groups according to their body mass index: Group A included 360 women with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women with no obesity and BMI of <30 kg/m2. The BMD of total body, lumbar spine at the site L1-L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1- L4 was assessed by means of TBS iNsight® software installed on our DXA machine (product of Med-Imaps, Pessac, France). In general, obese women had a significantly higher BMD of lumbar spine, femoral neck, proximal femur, total body and ultradistal forearm (p<0.001) in comparison with women without obesity. The TBS of L1-L4 was significantly lower in obese women compared to nonobese women (p<0.001). The BMD of lumbar spine, femoral neck and total body differed to a significant extent in women of 40-49, 50- 59, 60-69 and 70-79 years (p<0.05). At same time, in women aged 80-89 years the BMD of lumbar spine (p=0.09), femoral neck (p=0.22) and total body (p=0.06) barely differed. The BMD of ultradistal forearm was significantly higher in women of all age groups (p<0.05). The TBS of L1-L4 in all the age groups tended to reveal the lower parameters in obese women compared with the nonobese; however, those data were not statistically significant. By contrast, a significant positive correlation was observed between the fat mass and the BMD at different sites. The correlation between the fat mass and TBS of L1-L4 was also significant, although negative. Women with vertebral fractures had a significantly lower body weight, body mass index and total body fat mass in comparison with women without vertebral fractures in their anamnesis. In obese women the frequency of vertebral fractures was 27%, while in women without obesity – 57%.

Keywords: Bone mineral density, trabecular bone score, obesity, women.

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26 Rehabilitation Robot in Primary Walking Pattern Training for SCI Patient at Home

Authors: Taisuke Sakaki, Toshihiko Shimokawa, Nobuhiro Ushimi, Koji Murakami, Yong-Kwun Lee, Kazuhiro Tsuruta, Kanta Aoki, Kaoru Fujiie, Ryuji Katamoto, Atsushi Sugyo

Abstract:

Recently attention has been focused on incomplete spinal cord injuries (SCI) to the central spine caused by pressure on parts of the white matter conduction pathway, such as the pyramidal tract. In this paper, we focus on a training robot designed to assist with primary walking-pattern training. The target patient for this training robot is relearning the basic functions of the usual walking pattern; it is meant especially for those with incomplete-type SCI to the central spine, who are capable of standing by themselves but not of performing walking motions. From the perspective of human engineering, we monitored the operator’s actions to the robot and investigated the movement of joints of the lower extremities, the circumference of the lower extremities, and exercise intensity with the machine. The concept of the device was to provide mild training without any sudden changes in heart rate or blood pressure, which will be particularly useful for the elderly and disabled. The mechanism of the robot is modified to be simple and lightweight with the expectation that it will be used at home.

Keywords: Training, rehabilitation, SCI patient, welfare, robot.

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25 Associations between Metabolic Syndrome and Bone Mineral Density and Trabecular Bone Score in Postmenopausal Women with Non-Vertebral Fractures

Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

Abstract:

Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m2), B – 442 females with obesity (BMI >29.9 kg/m2)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

Keywords: Bone mineral density, trabecular bone score, metabolic syndrome, fracture.

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24 Modelling of a Biomechanical Vertebral System for Seat Ejection in Aircrafts Using Lumped Mass Approach

Authors: R. Unnikrishnan, K. Shankar

Abstract:

In the case of high-speed fighter aircrafts, seat ejection is designed mainly for the safety of the pilot in case of an emergency. Strong windblast due to the high velocity of flight is one main difficulty in clearing the tail of the aircraft. Excessive G-forces generated, immobilizes the pilot from escape. In most of the cases, seats are ejected out of the aircrafts by explosives or by rocket motors attached to the bottom of the seat. Ejection forces are primarily in the vertical direction with the objective of attaining the maximum possible velocity in a specified period of time. The safe ejection parameters are studied to estimate the critical time of ejection for various geometries and velocities of flight. An equivalent analytical 2-dimensional biomechanical model of the human spine has been modelled consisting of vertebrae and intervertebral discs with a lumped mass approach. The 24 vertebrae, which consists of the cervical, thoracic and lumbar regions, in addition to the head mass and the pelvis has been designed as 26 rigid structures and the intervertebral discs are assumed as 25 flexible joint structures. The rigid structures are modelled as mass elements and the flexible joints as spring and damper elements. Here, the motions are restricted only in the mid-sagittal plane to form a 26 degree of freedom system. The equations of motions are derived for translational movement of the spinal column. An ejection force with a linearly increasing acceleration profile is applied as vertical base excitation on to the pelvis. The dynamic vibrational response of each vertebra in time-domain is estimated.

Keywords: Biomechanical model, lumped mass, seat ejection, vibrational response.

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23 Screening Post-Menopausal Women for Osteoporosis by Complex Impedance Measurements of the Dominant Arm

Authors: Fırat Matur, Yekta Ülgen

Abstract:

Cole-Cole parameters of 40 post-menopausal women are compared with their DEXA bone mineral density measurements. Impedance characteristics of four extremities are compared; left and right extremities are statistically same, but lower extremities are statistically different than upper ones due to their different fat content. The correlation of Cole-Cole impedance parameters to bone mineral density (BMD) is observed to be higher for dominant arm. With the post-menopausal population, ANOVA tests of the dominant arm characteristic frequency, as a predictor for DEXA classified osteopenic and osteoporic population around lumbar spine, is statistically very significant. When used for total lumbar spine osteoporosis diagnosis, the area under the Receiver Operating Curve of the characteristic frequency is 0.830, suggesting that the Cole-Cole plot characteristic frequency could be a useful diagnostic parameter when integrated into standard screening methods for osteoporosis. Moreover, the characteristic frequency can be directly measured by monitoring frequency driven angular behavior of the dominant arm without performing any complex calculation.

Keywords: Bio-impedance spectroscopy, bone mineral density, characteristic frequency, osteoporosis, receiver operating curve.

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22 Comparative Study in Dentinal Tubuli Occlusion Using Bioglass and Copper-Bromide Laser

Authors: Sun Woo Lee, Tae Bum Lee, Yoon Hwa Park, Yoo Jeong Kim

Abstract:

Cervical dentinal hypersensitivity (CDH) affects 8-30% of adults and nearly 85% of perio-treated patients. Various treatment schemes have been applied for treating CDH, among them being fluoride application, laser irradiation, and, recently, bioglass. The purpose of this study was to investigate the influence of bioglass, copper-bromide (Cu-Br) laser irradiation and their combination on dentinal tubule occlusion as a potential dentinal hypersensitivity treatment for CDH. 45 human dentin surfaces were organized into three equal groups: group A received Cu-Br laser only; group B received bioglass only; group C received bioglass followed by Cu-Br laser irradiation. Specimens were evaluated with regard to dentinal tubule occlusion under environmental scanning electron microscope. Treatment modality significantly affected dentinal tubule occlusion (p<0.001). Groups B and C scored higher dentinal tubule occlusion than group A. Binary logistic regression showed that bioglass application significantly (p<0.001) contributed to dentinal tubule occlusion, compared with other variables. Under the conditions used herein and within the limitations of this study, bioglass application, alone or combined with Cu-Br laser irradiation, is a superior method for producing dentinal tubule occlusion, and may lead to an effective treatment modality for CDH.

Keywords: Bioglass, Cu-Br laser, cervical dentinal hypersensitivity, dentinal tubule occlusion.

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21 Bone Mineral Density and Quality, Body Composition of Women in the Postmenopausal Period

Authors: Vladyslav Povoroznyuk, Oksana Ivanyk, Nataliia Dzerovych

Abstract:

In the diagnostics of osteoporosis, the gold standard is considered to be bone mineral density; however, X-ray densitometry is not an accurate indicator of osteoporotic fracture risk under all circumstances. In this regard, the search for new methods that could determine the indicators not only of the mineral density, but of the bone tissue quality, is a logical step for diagnostic optimization. One of these methods is the evaluation of trabecular bone quality. The aim of this study was to examine the quality and mineral density of spine bone tissue, femoral neck, and body composition of women depending on the duration of the postmenopausal period, to determine the correlation of body fat with indicators of bone mineral density and quality. The study examined 179 women in premenopausal and postmenopausal periods. The patients were divided into the following groups: Women in the premenopausal period and women in the postmenopausal period at various stages (early, middle, late postmenopause). A general examination and study of the above parameters were conducted with General Electric X-ray densitometer. The results show that bone quality and mineral density probably deteriorate with advancing of postmenopausal period. Total fat and lean mass ratio is not likely to change with age. In the middle and late postmenopausal periods, the bone tissue mineral density of the spine and femoral neck increases along with total fat mass.

Keywords: Osteoporosis, bone tissue mineral density, bone quality, fat mass, lean mass, postmenopausal osteoporosis.

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