Search results for: Surgical trauma.

Authors: Jia-Rong Yeh, Tzu-Yu Lin, Jiann-Shing Shieh, Yun Chen

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A mammal-s body can be seen as a blood vessel with complex tunnels. When heart pumps blood periodically, blood runs through blood vessels and rebounds from walls of blood vessels. Blood pressure signals can be measured with complex but periodic patterns. When an artery is clamped during a surgical operation, the spectrum of blood pressure signals will be different from that of normal situation. In this investigation, intestinal artery clamping operations were conducted to a pig for simulating the situation of intestinal blocking during a surgical operation. Similarity theory is a convenient and easy tool to prove that patterns of blood pressure signals of intestinal artery blocking and unblocking are surely different. And, the algorithm of Hilbert Huang Transform can be applied to extract the character parameters of blood pressure pattern. In conclusion, the patterns of blood pressure signals of two different situations, intestinal artery blocking and unblocking, can be distinguished by these character parameters defined in this paper.

Keywords: Blood pressure, spectrum, intestinal artery, similarity theory and Hilbert Huang Transform.

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Authors: Yusuf Bulale, Mark Prince, Geoff Tansley, Peter Brett

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Cochlear Implantation (CI) which became a routine procedure for the last decades is an electronic device that provides a sense of sound for patients who are severely and profoundly deaf. The optimal success of this implantation depends on the electrode technology and deep insertion techniques. However, this manual insertion procedure may cause mechanical trauma which can lead to severe destruction of the delicate intracochlear structure. Accordingly, future improvement of the cochlear electrode implant insertion needs reduction of the excessive force application during the cochlear implantation which causes tissue damage and trauma. This study is examined tool-tissue interaction of large prototype scale digit embedded with distributive tactile sensor based upon cochlear electrode and large prototype scale cochlea phantom for simulating the human cochlear which could lead to small scale digit requirements. The digit, distributive tactile sensors embedded with silicon-substrate was inserted into the cochlea phantom to measure any digit/phantom interaction and position of the digit in order to minimize tissue and trauma damage during the electrode cochlear insertion. The digit have provided tactile information from the digitphantom insertion interaction such as contact status, tip penetration, obstacles, relative shape and location, contact orientation and multiple contacts. The tests demonstrated that even devices of such a relative simple design with low cost have potential to improve cochlear implant surgery and other lumen mapping applications by providing tactile sensory feedback information and thus controlling the insertion through sensing and control of the tip of the implant during the insertion. In that approach, the surgeon could minimize the tissue damage and potential damage to the delicate structures within the cochlear caused by current manual electrode insertion of the cochlear implantation. This approach also can be applied to other minimally invasive surgery applications as well as diagnosis and path navigation procedures.

Keywords: Cochlear electrode insertion, distributive tactile sensory feedback information, flexible digit, minimally invasive surgery, tool/tissue interaction.

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Authors: G. Aloisio, L. T. De Paolis, A. De Mauro, A. Mongelli

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One of the essential requirements of a realistic surgical simulator is to reproduce haptic sensations due to the interactions in the virtual environment. However, the interaction need to be performed in real-time, since a delay between the user action and the system reaction reduces the immersion sensation. In this paper, a prototype of a coronary stent implant simulator is present; this system allows real-time interactions with an artery by means of a specific haptic device. To improve the realism of the simulation, the building of the virtual environment is based on real patients- images and a Web Portal is used to search in the geographically remote medical centres a virtual environment with specific features in terms of pathology or anatomy. The functional architecture of the system defines several Medical Centres in which virtual environments built from the real patients- images and related metadata with specific features in terms of pathology or anatomy are stored. The searched data are downloaded from the Medical Centre to the Training Centre provided with a specific haptic device and with the software necessary both to manage the interaction in the virtual environment. After the integration of the virtual environment in the simulation system it is possible to perform training on the specific surgical procedure.

Keywords: Medical Simulation, Web Portal, Virtual Reality.

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Authors: J. Bartnicka, J. A. Piedrabuena, R. Portilla, L. Moyano - Cuevas, J. B. Pagador, P. Augat, J. Tokarczyk, F. M. Sánchez Margallo

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Orthopaedic surgeries are characterized by a high degree of complexity. This is reflected by four main groups of resources: 1) surgical team which is consisted of people with different competencies, educational backgrounds and positions; 2) information and knowledge about medical and technical aspects of surgery; 3) medical equipment including surgical tools and materials; 4) space infrastructure which is important from an operating room layout point of view. These all components must be integrated and build a homogeneous organism for achieving an efficient and ergonomically correct surgical workflow. Taking this as a background, there was formulated a concept of international project, called “Online Vocational Training course on ergonomics for orthopaedic Minimally Invasive” (Train4OrthoMIS), which aim is to develop an e-learning tool available in 4 languages (English, Spanish, Polish and German). In the article, there is presented the first project research outcomes focused on three aspects: 1) ergonomic needs of surgeons who work in hospitals around different European countries, 2) the concept of structure of e-learning course, 3) the definition of tools and methods for knowledge assessment adjusted to users’ expectation.  The methodology was based on the expert panels and two types of surveys: 1) on training needs, 2) on evaluation and self-assessment preferences. The major findings of the study allowed describing the subjects of four training modules and learning sessions. According to peoples’ opinion there were defined most expected test methods which are single choice test and right after quizzes: “True or False” and “Link elements” The first project outcomes confirmed the necessity of creating a universal training tool for orthopaedic surgeons regardless of the country in which they work. Because of limited time that surgeons have, the e-learning course should be strictly adjusted to their expectation in order to be useful.

Keywords: International e-learning, ergonomics, orthopaedic surgery, Train4OrthoMIS.

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Authors: Ahmed Mostafa, Mohamed Mahmoud, Nesreen H. Hafez, Mohamed Fahim

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This retrospective study includes 60 patients with pre-invasive breast cancer. Aim of the study: Evaluation of premalignant lesions of the breast (DCIS), different treatment methods and outcome. Patients and methods: 60 patients with DCIS were studied from the period between 2005 to 2012, for 38 patients the primary surgical method was wide local resection (WLE) (63.3%) and the other cases (22 patients, 36.7%) had mastectomy, fourteen cases from those who underwent local excision received radiotherapy, while no adjuvant radiotherapy was given for those who underwent mastectomy. In case of hormonal receptor positive DCIS lesions hormonal treatment (Tamoxifen) was given after local control. Results: No difference in overall survival between mastectomy & breast conserving therapy (wide local excision and adjuvant radiotherapy), however local recurrence rate is higher in case of breast conserving therapy, also no role of Axillary evacuation in case of DCIS. The use of hormonal therapy decreases the incidence of local recurrence by about 98%. Conclusion: The main management of DCIS is local treatment (wide local excision and radiotherapy) with hormonal treatment in case of hormone receptor positive lesions.

Keywords: Ductal carcinoma in situ, surgical treatment, radiotherapy, breast conserving therapy, hormonal treatment.

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Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

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Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, antibiotic misuse, Iraq, prescribing.

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Authors: L. Siva Rama Krishna, Sriram Venkatesh, M. Sastish Kumar, M. Uma Maheswara Chary

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Rapid Prototyping (RP) is a technology that produces models and prototype parts from 3D CAD model data, CT/MRI scan data, and model data created from 3D object digitizing systems. There are several RP process like Stereolithography (SLA), Solid Ground Curing (SGC), Selective Laser Sintering (SLS), Fused Deposition Modeling (FDM), 3D Printing (3DP) among them SLS and FDM RP processes are used to fabricate pattern of custom cranial implant. RP technology is useful in engineering and biomedical application. This is helpful in engineering for product design, tooling and manufacture etc. RP biomedical applications are design and development of medical devices, instruments, prosthetics and implantation; it is also helpful in planning complex surgical operation. The traditional approach limits the full appreciation of various bony structure movements and therefore the custom implants produced are difficult to measure the anatomy of parts and analyze the changes in facial appearances accurately. Cranioplasty surgery is a surgical correction of a defect in cranial bone by implanting a metal or plastic replacement to restore the missing part. This paper aims to do a comparative study on the dimensional error of CAD and SLS RP Models for reconstruction of cranial defect by comparing the virtual CAD with the physical RP model of a cranial defect.

Keywords: Rapid Prototyping, Selective Laser Sintering, Cranial defect, Dimensional Error.

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Authors: Ayat E. Ali, Christeen R. Aziz, Merna A. Helmy, Mohammed M. Malek, Sherif H. El-Gohary

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Goal: Purpose of the project was to make a plastic surgery prediction by using pre-operative images for the plastic surgeries’ patients and to show this prediction on a screen to compare between the current case and the appearance after the surgery. Methods: To this aim, we implemented a software which used data from the internet for facial skin diseases, skin burns, pre-and post-images for plastic surgeries then the post- surgical prediction is done by using K-nearest neighbor (KNN). So we designed and fabricated a smart mirror divided into two parts a screen and a reflective mirror so patient's pre- and post-appearance will be showed at the same time. Results: We worked on some skin diseases like vitiligo, skin burns and wrinkles. We classified the three degrees of burns using KNN classifier with accuracy 60%. We also succeeded in segmenting the area of vitiligo. Our future work will include working on more skin diseases, classify them and give a prediction for the look after the surgery. Also we will go deeper into facial deformities and plastic surgeries like nose reshaping and face slim down. Conclusion: Our project will give a prediction relates strongly to the real look after surgery and decrease different diagnoses among doctors. Significance: The mirror may have broad societal appeal as it will make the distance between patient's satisfaction and the medical standards smaller.

Keywords: K-nearest neighbor, face detection, vitiligo, bone deformity.

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Authors: Catherine A. Todd, Fazel Naghdy

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In this work a surgical simulator is produced which enables a training otologist to conduct a virtual, real-time prosthetic insertion. The simulator provides the Ear, Nose and Throat surgeon with real-time visual and haptic responses during virtual cochlear implantation into a 3D model of the human Scala Tympani (ST). The parametric model is derived from measured data as published in the literature and accounts for human morphological variance, such as differences in cochlear shape, enabling patient-specific pre- operative assessment. Haptic modeling techniques use real physical data and insertion force measurements, to develop a force model which mimics the physical behavior of an implant as it collides with the ST walls during an insertion. Output force profiles are acquired from the insertion studies conducted in the work, to validate the haptic model. The simulator provides the user with real-time, quantitative insertion force information and associated electrode position as user inserts the virtual implant into the ST model. The information provided by this study may also be of use to implant manufacturers for design enhancements as well as for training specialists in optimal force administration, using the simulator. The paper reports on the methods for anatomical modeling and haptic algorithm development, with focus on simulator design, development, optimization and validation. The techniques may be transferrable to other medical applications that involve prosthetic device insertions where user vision is obstructed.

Keywords: Haptic modeling, medical device insertion, real-time visualization of prosthetic implantation, surgical simulation.

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Authors: M. Shukry

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According to the United Nations Declaration of Human Rights in 1948, every human being is entitled to rights in life that should be respected by others and protected by the state and community. Such rights are inherent regardless of colour, ethnicity, gender, religion or otherwise, and it is expected that all humans alike have the right to live without discrimination of any sort. However, that has not been the case with Aborigines in Australia. Over a long period of time, the governments of the State and the Territories and the Australian Commonwealth denied the Aboriginal and Indigenous inhabitants of the Torres Strait Islands such rights. Past Australian governments set policies and laws that enabled them to forcefully remove Indigenous children from their parents, which resulted in creating lost generations living the trauma of the loss of cultural identity, alienation and even their own selfhood. Intending to reduce that population of natives and their Aboriginal culture while, on the other hand, assimilate them into mainstream society, they gave themselves the right to remove them from their families with no hope of return. That practice has led to tragic consequences due to the trauma that has affected those children, an experience that is depicted by Jane Harrison in her play Stolen. The drama is the outcome of a six-year project on lost children and which was first performed in 1997 in Melbourne. Five actors only appear on the stage, playing the role of all the different characters, whether the main protagonists or the remaining cast, present or non-present ones as voices. The play outlines the life of five children who have been taken from their parents at an early age, entailing a disastrous negative impact that differs from one to the other. Unknown to each other, what connects between them is being put in a children’s home. The purpose of this paper is to analyse the play’s text in light of the 1948 Declaration of Human Rights, using it as a lens that reflects the atrocities practiced against the Aborigines. It highlights how such practices formed an outrageous violation of those natives’ rights as human beings. Harrison’s dramatic technique in conveying the children’s experiences is through a non-linear structure, fluctuating between past and present that are linked together within each of the five characters, reflecting their suffering and pain to create an emotional link between them and the audience. Her dramatic handling of the issue by fusing tragedy with humour as well as symbolism is a successful technique in revealing the traumatic memory of those children and their present life. The play has made a difference in commencing to address the problem of the right of all children to be with their families, which renders the real meaning of having a home and an identity as people.

Keywords: Aboriginal, audience, Australia, children, culture, drama, home, human rights, identity, indigenous, Jane Harrison, memory, scenic effects, setting, stage, stage directions, Stolen, trauma.

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Authors: Glenda Wrenn, Juliet Muzere, Meldra Hall, Allyson Belton, Kisha Holden, Chanita Hughes-Halbert, Martha Kent, Bekh Bradley

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Understanding the help seeking decision making process and experiences of health disparity populations with posttraumatic stress disorder (PTSD) is central to development of trauma-informed, culturally centered, and patient focused services. Yet, little is known about the decision making process among adult Black women who are non-treatment seekers as they are, by definition, not engaged in services. Methods: Audiotaped interviews were conducted with 30 African American adult women with clinically significant PTSD symptoms who were engaged in primary care, but not in treatment for PTSD despite symptom burden. A qualitative interview guide was used to elucidate key themes. Independent coding of themes mapped to theory and identification of emergent themes were conducted using qualitative methods. An existing quantitative dataset was analyzed to contextualize responses and provide a descriptive summary of the sample. Results: Emergent themes revealed that active mental avoidance, the intermittent nature of distress, ambivalence, and self-identified resilience as undermining to help seeking decisions. Participants were stuck within the help-seeking phase of ‘recognition’ of illness and retained a sense of “it is my decision” despite endorsing significant social and environmental negative influencers. Participants distinguished ‘help acceptance’ from ‘help seeking’ with greater willingness to accept help and importance placed on being of help to others. Conclusions: Elucidation of the decision-making process from the perspective of non-treatment seekers has implications for outreach and treatment within models of integrated and specialty systems care. The salience of responses to trauma symptoms and stagnation in the help seeking recognition phase are findings relevant to integrated care service design and community engagement.

Keywords: Culture, help-seeking, integrated care, PTSD.

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Authors: Chaudhary Itisha, Shankar Manu

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Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: Patient education, post-operative pain, patient satisfaction, post-operative outcome.

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Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The article represents the results of clinical researches of composite herbal medicinal product based on essential oils of Sedum plants growing in Kazakhstan in commercial reserves at the territory of Kazakhstan. The results of comparative analysis are represented in obstetric-gynecologic practice during combined therapy for postnatal complications, inflammatory infiltrates in the area of surgical wounds including wounds after caesarean section.

Keywords: Anti-inflammatory, bioactive substances, essential oils, isolation, Sedum L., wound healing.

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Authors: Karel Frydrýšek, Pavel Koštial, Karla Barabaszová, Jana Kukutschová

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This paper deals with a new way for designing external fixators applied in traumatology and orthopaedics. These fixators can be applied in the treatment of open and unstable fractures or for lengthening human or animal bones etc. The new design is based on the development of Ilizarov and other techniques (i.e. shape and weight optimalization based on composite materials, application of smart materials, nanotechnology, low x-ray absorption, antibacterial protection, patient's comfort, reduction in the duration of the surgical treatment, and cost).

Keywords: biomechanics, design, external fixators, newmaterials, traumatology

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Authors: Nicole S. McKinney

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The purpose of the study was to determine if, among 32 brain injured adults in community rehabilitation programs, there is a statistically significant relationship between the degree of severity of brain injury and these adults- level of self-esteem and stress. The researcher hypothesized there would be a statistically significant difference and a statistically significant relationship in self-esteem and stress levels among and TBI adults. A Pearson product moment correlational analysis was implemented and results found a statistically significant relationship between self-esteem and stress levels. Future recommendations were suggested upon completion of research.

Keywords: anxiety, community recovery center, head-trauma persons, self-concept

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Authors: Abhishek Soni, Bhagat Singh

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Distal femur fractures are the cause of abnormal gloomy. Several types of surgical treatments have been adopted by the practitioners to restore the fractured region of distal femur. Still within this domain of study, unstable fixation remains a challenge for orthopedists. In the present study, a fixation implant is designed and analyzed under physiological loading conditions for cobalt-chromium-molybdenum alloy (Co-Cr-Mo). It has been found that the stresses and deformation developed are quite low. It means that customized fixation plates will provide stable fixation resulting in improved fracture union.

Keywords: Biomechanical evaluations, customized implant, Co-Cr-Mo alloy, reverse engineering.

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Authors: Dimitar Karastoyanov, Vladimir Monov

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The paper is concerned with the state examination as well as the problems during the post surgical (orthopedic) rehabilitation of the knee and ankle joint. An observation of the current appliances for a passive rehabilitation devices is presented. The major necessary and basic features of the intelligent rehabilitation devices are considered. An approach for a new intelligent appliance is suggested. The main advantages of the device are: both active as well as passive rehabilitation of the patient based on the human - patient reactions and a real time feedback. The basic components: controller; electrical motor; encoder, force – torque sensor are discussed in details. The main modes of operation of the device are considered.

Keywords: Ankle, knee, rehabilitation, computer control.

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Authors: P. Paengkoum, T. Phonmun, S. Paengkoum

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Twenty four male Thai native × Anglo-Nubian crossbred goats were randomly allocated to receive four treatments. The experiment was conducted for four months and slaughtered that the Longissimus dorsi muscle was collected for fatty acid analysis. The results conclude that either castrated method or ages had no significantly different on monounsaturated fatty acid (MUFA) (P>0.05) except erucic acid (C22:1n9). Interaction between castrated method and ages had significantly different in MUFA (P<0.01). Although the effect of castration method and age are not difference on fatty acid composition, it contributed to known that difference castration method and age (surgical and budizzo) no effect on accumulation fatty acid in meat goats.

Keywords: Castration, goat, CLA, meat.

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Authors: Rita C. Ramos

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Aggression is a multi- factorial concept and multilevel in nature. The Young Adolescent is being influenced by family, school and community. This paper is aimed to determine the following: aggression level among young adolescents, difference of level of aggression on school and year levels and to determine the correlates of aggression. There were 142 high school students from two different national highs schools (Region 3 and National Capital Region).Convenience sampling was use in this study. The following measures were used namely: Aggression Scale, Parental Support Fighting Scale, Positive Behavior Scale and Exposure to Violence and Trauma questionnaire. There was no significant difference in aggression level among different year level and schools. The findings of the study suggested that high level of community violence and having low parental support for non-aggressive behavior contribute to the prediction of aggression.

Keywords: Aggression, Determinants, Young Adolescents.

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Authors: A. Mathieu, B. Aubry, E. Chhim, M. Jobe, M. Arnaud

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Present project consists in a study and a development of piezoelectric devices for supplying power to new generation pacemakers. They are miniaturized leadless implants without battery placed directly in right ventricle. Amongst different acceptable energy sources in cardiac environment, we choose the solution of a device based on conversion of the energy produced by pressure variation inside the heart into electrical energy. The proposed energy harvesters can meet the power requirements of pacemakers, and can be a good solution to solve the problem of regular surgical operation. With further development, proposed device should provide enough energy to allow pacemakers autonomy, and could be good candidate for next pacemaker generation.

Keywords: Energy harvester, heart, leadless pacemaker, piezoelectric cells, pressure variation.

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Authors: Fatahian Dehkordi R.F, Parchami A.

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Steroidal hormones with the efficient changes on the epiphyseal growth plate may influence tissue structure properties. Presents paper to investigate the effects of gonadectomy in the pattern distribution of the epiphyseal structure. Fifteen adult female New Zealand white rabbits were separated into three groups. One group was intact and others groups were selected for surgical operation. From these two groups, one group carried out steroidal administration. The results obtained showed that there is no statistically difference in the mean diameter of the growth plate cells between all three groups. The maximum value of the cartilage cells were allocated to the gonadectomized group and the minimum number were observed in Hormonal induced group significantly. Growth plate height was significantly greater in gonadectomized group than in two other groups.

Keywords: Steroidal hormones, Ovariectomy, Rabbit, Epiphyseal structure

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Authors: Roselyn A. Maaño

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Eyes are an essential and conspicuous organ of the human body. Human eyes are outward and inward portals of the body that allows to see the outside world and provides glimpses into ones inner thoughts and feelings. Inevitable blindness and visual impairments may results from eye-related disease, trauma, or congenital or degenerative conditions that cannot be corrected by conventional means. The study emphasizes innovative tools that will serve as an aid to the blind and visually impaired (VI) individuals. The researchers fabricated a prototype that utilizes the Microsoft Kinect for Windows and Arduino microcontroller board. The prototype facilitates advanced gesture recognition, voice recognition, obstacle detection and indoor environment navigation. Open Computer Vision (OpenCV) performs image analysis, and gesture tracking to transform Kinect data to the desired output. A computer vision technology device provides greater accessibility for those with vision impairments.

Keywords: Algorithms, Blind, Computer Vision, Embedded Systems, Image Analysis.

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Authors: Fernando Pérez, Humberto Sossa, Rigoberto Martínez, Daniel Lorias, Arturo Minor

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This paper presents a system for tracking the movement of laparoscopic instruments which is based on an orthogonal system of webcams and video image processing. The movements are captured with two webcams placed orthogonally inside of the physical trainer. On the image, the instruments were detected by using color markers placed on the distal tip of each instrument. The 3D position of the tip of the instrument within the work space was obtained by linear triangulation method. Preliminary results showed linearity and repeatability in the motion tracking with a resolution of 0.616 mm in each axis; the accuracy of the system showed a 3D instrument positioning error of 1.009 ± 0.101 mm. This tool is a portable and low-cost alternative to traditional tracking devices and a trustable method for the objective evaluation of the surgeon’s surgical skills.

Keywords: Laparoscopic Surgery, Orthogonal Vision, Tracking Instruments, Triangulation.

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Authors: Dara Singh, Keikhosrow Firouzbakhsh, Mohammad Taghi Ahmadian

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In this paper, conventional laser Keratoplasty surgeries in the human eye are studied. For this purpose, a validated 3D finite volume model of the human eye is introduced. In this model the fluid flow has also been considered. The discretized domain of the human eye incorporates a bio-heat transfer equation coupled with a Boussinesq equation. Both continuous and pulsed lasers have been modeled and the results are compared. Moreover, two different conventional surgical positions that are upright and recumbent are compared for these laser therapies. The simulation results show that in these conventional surgeries, the temperature rises above the critical values at the laser insertion areas. However, due to the short duration and the localized nature, the potential damages are restricted to very small regions and can be ignored. The conclusion is that the present day lasers are acceptably safe to the human eye.

Keywords: Eye, heat-transfer, keratoplasty laser, surgery.

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Authors: Javier Ordorica Villalvazo, Claudia Camargo Wilson, Jesus Everardo Olguin Tiznado

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This paper presents an experimental case using sensory thermography to describe temperatures behavior on median nerve once an activity of repetitive motion was done. Thermography is a noninvasive technique without biological hazard and not harm at all times and has been applied in many experiments to seek for temperature patterns that help to understand diseases like cancer and cumulative trauma disorders (CTD’s). An infrared sensory thermography technology was developed to execute this study. Three women in good shape were selected for the repetitive motion tests for 4 days, two right-handed women and 1 left handed woman, two sensory thermographers were put on both median nerve wrists to get measures. The evaluation time was of 3 hours 30 minutes in a controlled temperature, 20 minutes of stabilization time at the beginning and end of the operation. Temperatures distributions are statistically evaluated and showed similar temperature patterns behavior.

Keywords: Median nerve, temperature, sensory thermography, wrists, CTD’s.

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Authors: Abdulrahim Shamayleh, John Fowler, Muhong Zhang

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Operating rooms are important assets for hospitals as they generate the largest revenue and, at the same time, produce the largest cost for hospitals. The model presented in this paper helps make capacity planning decisions on the combination of open operating rooms (ORs) and estimated overtime to satisfy the allocated OR time to each specialty. The model combines both decisions on determining the amount of OR time to open and to allocate to different surgical specialties. The decisions made are based on OR costs, overutilization and underutilization costs, and contribution margins from allocating OR time. The results show the importance of having a good estimate of specialty usage of OR time to determine the amount of needed capacity and highlighted the tradeoff that the OR manager faces between opening more ORs versus extending the working time of the ORs already in use.

Keywords: capacity planning, contribution margins, operating room, overutilization

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Authors: John Tolentino, Yong Seok Park

Abstract:

There are currently many people living with limb loss in the USA. The main causes for amputation can range from vascular disease, to trauma, or cancer. This number is expected increase over the next decade. Many patients have a single prosthetic for the first year but end up getting a second one to accommodate their changing physique. Afterwards, the prosthesis gets replaced every three to five years depending on how often it is used. This could cost the patient up to $500,000 throughout their lifetime. Complications do not end there, however. Due to the absence of nerves, it becomes more difficult to traverse terrain with a prosthetic. Moving on an incline or decline becomes difficult, thus curbs and stairs can be a challenge. Certain physical activities, such as cycling, could be even more strenuous. It will need to be relearned to accommodate for the change in weight, center of gravity, and transfer of energy from the leg to the pedal. The purpose of this research project is to develop a new, alternate below-knee cycling prosthetic using Dieter & Schmidt’s design process approach. It will be subjected to fatigue analysis under dynamic loading to observe the limitations as well as the strengths and weaknesses of the prosthetic. Benchmark comparisons will be made between existing prosthetics and the proposed one, examining the benefits and disadvantages. The resulting prosthetic will be 3D printed using acrylonitrile butadiene styrene (ABS) or polycarbonate (PC) plastic.

Keywords: 3D printing, cycling, prosthetic design, synthetic design.

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Authors: Katarzyna Mleczko

Abstract:

Processes of production of innovative medical tools have interdisciplinary character. They consist of direct and indirect close cooperation of specialists of different scientific branches. The Knowledge they have seems to be important for undertaken design, construction and manufacturing processes. The Knowledge exchange between participants of these processes is therefore crucial for the final result, which are innovative medical products. The paper draws attention to the necessity of feedback from the end user to the designer / manufacturer of medical tools which will allow for more accurate understanding of user needs. The study describes prerequisites of production processes of innovative medical (surgical) tools including participants and category of knowledge resources occurring in these processes. They are the result of research in selected Polish organizations involved in the production of medical instruments and are the basis for further work on the development of knowledge sharing model in interdisciplinary teams geographically dispersed.

Keywords: Interdisciplinary production processes, knowledge exchange, knowledge sharing, medical tools, user-centered design.

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Authors: Elina Ligere, Valts Ozolins, Lauris Smits, Normunds Sikora, Ivars Melderis, Laila Feldmane, Aris Lacis, Vladimir Kasyanov

Abstract:

Biomechanical properties of infantile aorta in vitro in cases of different standard anastomoses: end-to-end (ETE), extended anastomosis end-to-end (EETE) and subclavian flap aortoplasty (SFA) used for surgical correction of coarctation were analyzed to detect the influence of the method on the biomechanics of infantile aorta and possible changes in haemodinamics. 10 specimens of native aorta, 3 specimens with ETE, 4 EEET and 3 SFA were investigated. The experiments showed a non-linear relationship between stress and strain in the infantile aorta, the modulus of elasticity of the aortic wall increased with the increase of inner pressure. In the case of anastomosis end-to-end the modulus was almost constant, relevant to the modulus of elasticity of the aorta with the inner pressure 100-120 mmHg. The anastomoses EETE and SFA showed elastic properties closer to native aorta, the stiffness of ETE did not change with the changes in inner pressure.

Keywords: biomechanics, coarctation, mechanical properties, neonatal aorta

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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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