Search results for: spinal anesthesia
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 37

Search results for: spinal anesthesia

37 Results of Percutaneous Nephrolithotomy under Spinal Anesthesia

Authors: Babak Borzouei, Seyed Habibollah Mousavi-Bahar

Abstract:

Recently, there has been a considerable increase in the number of procedures carried out under regional anesthesia. However, percutaneous nephrolithotomy (PCNL) procedures are usually performed under general anesthesia. The aim of this study was to assess the safety and efficacy of PCNL under spinal anesthesia in patients with renal calculi. We describe our 9 years experience of performing PCNL under spinal anesthesia for 387 patients with large stones of the upper urinary tract, with regard to the effectiveness and side effects. All patients received spinal anesthetics (Lidocain 5%, or Bupivacaine 0.75%) and underwent PCNL in prone position. The success rate was 94.1%. The incidence of complications was 11.6%. PCNL under spinal anesthesia is feasible, safe, and well-tolerated in management of patients with renal stones.

Keywords: percutaneous nephrolithotomy, spinal anesthesia, renal calculi

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36 Comparison of the Parameter using ECG with Bisepctrum Parameter using EEG during General Anesthesia

Authors: Seong-wan Baik, Soo-young Ye, Byeong-cheol Choi, Gye-rok Jeon

Abstract:

The measurement of anesthetic depth is necessary in anesthesiology. NN10 is very simple method among the RR intervals analysis methods. NN10 parameter means the numbers of above the 10 ms intervals of the normal to normal RR intervals. Bispectrum analysis is defined as 2D FFT. EEG signal reflected the non-linear peristalsis phenomena according to the change brain function. After analyzing the bispectrum of the 2 dimension, the most significant power spectrum density peaks appeared abundantly at the specific area in awakening and anesthesia state. These points are utilized to create the new index since many peaks appeared at the specific area in the frequency coordinate. The measured range of an index was 0-100. An index is 20-50 at an anesthesia, while the index is 90-60 at the awake. In this paper, the relation between NN10 parameter using ECG and bisepctrum index using EEG is observed to estimate the depth of anesthesia during anesthesia and then we estimated the utility of the anesthetic.

Keywords: Anesthesia, Bispectrum index, ECG, EEG

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35 Presenting a Combinatorial Feature to Estimate Depth of Anesthesia

Authors: Toktam Zoughi, Reza Boostani

Abstract:

Determining depth of anesthesia is a challenging problem in the context of biomedical signal processing. Various methods have been suggested to determine a quantitative index as depth of anesthesia, but most of these methods suffer from high sensitivity during the surgery. A novel method based on energy scattering of samples in the wavelet domain is suggested to represent the basic content of electroencephalogram (EEG) signal. In this method, first EEG signal is decomposed into different sub-bands, then samples are squared and energy of samples sequence is constructed through each scale and time, which is normalized and finally entropy of the resulted sequences is suggested as a reliable index. Empirical Results showed that applying the proposed method to the EEG signals can classify the awake, moderate and deep anesthesia states similar to BIS.

Keywords: Depth of anesthesia, EEG, BIS, Wavelet transforms.

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34 Effect of FES Cycling Training on Spasticity in Spinal Cord Injured Subjects

Authors: Werner Reichenfelser, Harald Hackl, Josef Hufgard, Karin Gstaltner, Margit Gfoehler

Abstract:

Training with Functional Electrical Stimulation (FES) has both physiological and psychological benefits for spinal cord injured subjects. Commonly used methods for quantification of spasticity have shown controversial reliability. In this study we propose a method for quick determination of spasticity in spinal cord injured subjects on a cycling and measurement system. 23 patients did training sessions on an instrumented mobile FES cycle three times a week over two months as part of their clinical rehabilitation program. Spasticity (MAS) and the legs resistance to the pedaling motion were assessed before and after the FES training and measurements were done on the subjects ability to pedal with our without motor assistance. Measurements with test persons with incomplete spastic paraplegia have shown that spasticity is decreased after a 30 min cycling training with functional electrical stimulation (FES).

Keywords: Spasticity, paraplegia, spinal cord injury, functional electrical stimulation.

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33 Clinical Comparative Study Comparing Efficacy of Intrathecal Fentanyl and Magnesium as an Adjuvant to Hyperbaric Bupivacaine in Mild Pre-Eclamptic Patients Undergoing Caesarean Section

Authors: Sanchita B. Sarma, M. P. Nath

Abstract:

Adequate analgesia following caesarean section decreases morbidity, hastens ambulation, improves patient outcome and facilitates care of the newborn. Intrathecal magnesium, an NMDA antagonist, has been shown to prolong analgesia without significant side effects in healthy parturients. The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of magnesium or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine in patients with mild preeclampsia undergoing caesarean section. Sixty women with mild preeclampsia undergoing elective caesarean section were included in a prospective, double blind, controlled trial. Patients were randomly assigned to receive spinal anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 μg fentanyl (group F) or 0.1 ml of 50% magnesium sulphate (50 mg) (group M) with 0.15ml preservative free distilled water. Onset, duration and recovery of sensory and motor block, time to maximum sensory block, duration of spinal anaesthesia and postoperative analgesic requirements were studied. Statistical comparison was carried out using the Chi-square or Fisher’s exact tests and Independent Student’s t-test where appropriate. The onset of both sensory and motor block was slower in the magnesium group. The duration of spinal anaesthesia (246 vs. 284) and motor block (186.3 vs. 210) were significantly longer in the magnesium group. Total analgesic top up requirement was less in group M. Hemodynamic parameters were similar in both the groups. Intrathecal magnesium caused minimal side effects. Since Fentanyl and other opioid congeners are not available throughout the country easily, magnesium with its easy availability and less side effect profile can be a cost effective alternative to fentanyl in managing pregnancy induced hypertension (PIH) patients given along with Bupivacaine intrathecally in caesarean section.

Keywords: Analgesia, magnesium, preeclampsia, spinal anaesthesia.

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32 A Brain Controlled Robotic Gait Trainer for Neurorehabilitation

Authors: Qazi Umer Jamil, Abubakr Siddique, Mubeen Ur Rehman, Nida Aziz, Mohsin I. Tiwana

Abstract:

This paper discusses a brain controlled robotic gait trainer for neurorehabilitation of Spinal Cord Injury (SCI) patients. Patients suffering from Spinal Cord Injuries (SCI) become unable to execute motion control of their lower proximities due to degeneration of spinal cord neurons. The presented approach can help SCI patients in neuro-rehabilitation training by directly translating patient motor imagery into walkers motion commands and thus bypassing spinal cord neurons completely. A non-invasive EEG based brain-computer interface is used for capturing patient neural activity. For signal processing and classification, an open source software (OpenVibe) is used. Classifiers categorize the patient motor imagery (MI) into a specific set of commands that are further translated into walker motion commands. The robotic walker also employs fall detection for ensuring safety of patient during gait training and can act as a support for SCI patients. The gait trainer is tested with subjects, and satisfactory results were achieved.

Keywords: Brain Computer Interface (BCI), gait trainer, Spinal Cord Injury (SCI), neurorehabilitation.

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31 Development for the Evaluation Index of an Anesthesia Depth using the Bispectrum Analysis

Authors: Soo-young Ye, Jun-mo Park, Jae-hyung Kim, Jae-hee Jung, Ah-young Jeon, In-cheol Kim, Jung-man Son, Ki-gon Nam, Seong-wan Baik, Jung-hoon Ro, Gye-rok Jeon

Abstract:

The linear SEF (Spectral Edge Frequency) parameter and spectrum analysis method can not reflect the non-linear of EEG. This method can not contribute to acquire real time analysis and obtain a high confidence in the clinic due to low discrimination. To solve the problems, the development of a new index is carried out using the bispectrum analyzing the EEG(electroencephalogram) including the non-linear characteristic. After analyzing the bispectrum of the 2 dimension, the most significant power spectrum density peaks appeared abundantly at the specific area in awakening and anesthesia state. These points are utilized to create the new index since many peaks appeared at the specific area in the frequency coordinate. The measured range of an index was 0-100. An index is 20-50 at an anesthesia, while the index is 90-60 at the awake. New index could afford to effectively discriminate the awake and anesthesia state.

Keywords: Bispectrum, anesthesia depth, EEG, SEF.

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30 Health-Related QOL of Motorists with Spinal Cord Injury in Japan

Authors: Hiroaki Hirose, Hiroshi Ikeda, Isao Takeda

Abstract:

The Japanese version of the SF-36 has been employed to assess individuals’ health-related QOL (HRQOL). This study aimed to clarify the HRQOL of motorists with a spinal cord injury, in order to compare these individuals' SF-36 scores and national standard values. A total of 100 motorists with a spinal cord injury participated in this study. Participants’ HRQOL was evaluated using the Japanese version of the SF-36 (second edition). The score for each subscale was standardized based on data on the Japanese population. The average scores for NPF, NRP, NBP, NGH, NVT, NSF, NRE, and NMH were 10.9, 41.8, 45.9, 47.1, 46.1, 46.7, 46.0, and 47.4 points, respectively. Subjects showed significantly lower scores for NPF and NRP compared with national standard values, which were both ≤ 45.0 points, but relatively normal scores for the other items: NBP, NGH, NVT, NSF, NRE and NMH (> 45.0 points). The average scores for PCS, MCS and RCS were 21.9, 56.0, and 50.0 points, respectively. Subjects showed a significantly lower PCS score (≤ 20.0 points); however, the MCS score was higher (> 55.0 points) along with a relatively normal RCS score in these individuals (= 50.0 points).

Keywords: Health-related QOL (HRQOL), SF-36, motorist, spinal cord injury, Japan.

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29 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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28 Technical Aspects of Closing the Loop in Depth-of-Anesthesia Control

Authors: Gorazd Karer

Abstract:

When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents is one of the main tasks of the anesthesiologist. That being said, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. This paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a User-Datagram-Protocol-based (UDP-based) communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of medical-device manufacturer and is implemented in MATLAB-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: Closed-loop control, Depth of Anesthesia, DoA, optical signal acquisition, Patient State index, PSi, UDP communication protocol.

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27 The Contribution of the PCR-Enzymatic Digestion in the Positive Diagnosis of Proximal Spinal Muscular Atrophy in the Moroccan Population

Authors: H. Merhni, A. Sbiti, I. Ratbi, A. Sefiani

Abstract:

The proximal spinal muscular atrophy (SMA) is a group of neuromuscular disorders characterized by progressive muscle weakness due to the degeneration and loss of anterior motor neurons of the spinal cord. Depending on the age of onset of symptoms and their evolution, four types of SMA, varying in severity, result in a mutations of the SMN gene (survival of Motor neuron). We have analyzed the DNA of 295 patients referred to our genetic counseling; since January 1996 until October 2014; for suspected SMA. The homozygous deletion of exon 7 of the SMN gene was found in 133 patients; of which, 40.6% were born to consanguineous parents. In countries like Morocco, where the frequency of heterozygotes for SMA is high, genetic testing should be offered as first-line and, after careful clinical assessment, especially in newborns and infants with congenital hypotonia unexplained and prognosis compromise. The molecular diagnosis of SMA allows a quick and certainly diagnosis, provide adequate genetic counseling for families at risk and suggest, for couples who want prenatal diagnosis. The analysis of the SMN gene is a perfect example of genetic testing with an excellent cost/benefit ratio that can be of great interest in public health, especially in low-income countries. We emphasize in this work for the benefit of the generalization of molecular diagnosis of SMA by the technique of PCR-enzymatic digestion in other centers in Morocco.

Keywords: Exon7, PCR-digestion, SMA, SMN gene.

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26 Why We Are Taller in the Morning than Going to Bed at Night – An in vivo and in vitro Study

Authors: Harcharan Singh Ranu

Abstract:

Intradiscal and intervertebral pressure transducers were developed. They were used to map the pressures in the nucleus and within the annulus of the human spinal segments. Their stressrelaxation were recorded over a period of time for nucleus pressure, applied load, and peripherial strain against time. The results show that for normal discs, pressures in the nucleus are viscoelastic in nature with the applied compressive load. Mechanical strains which develop around the periphery of the vertebral body are also viscoelastic with the applied compressive load. Applied compressive load against time also shows viscoelastic behavior. However, annulus does not respond viscoelastically with the applied load. It showed a linear response to compressive loading.

Keywords: Intradiscal pressure transducer (IDPT), intervertebral pressure transducer (IVPT), mechanical strains of vertebral bone, viscoelasticity of human spinal disc.

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25 Surgical Theater Utilization and PACU Staffing

Authors: Abdulrahim Shamayleh

Abstract:

In this work, the surgical theater of a local hospital in KSA was analyzed using simulation. The focus was on attempting to answer questions related to how many Operating Rooms (ORs) to open and to analyze the performance of the surgical theater in general and mainly the Post Anesthesia Care Unit (PACU) to assist making decisions regarding PACU staffing. The surgical theater consists of ten operating rooms and the PACU unit which has a maximum capacity of fifteen beds. Different sequencing rules to sequence the surgical cases were tested and the Longest Case First (LCF) were superior to others. The results of the different alternatives developed and tested can be used by the manager as a tool to plan and manage the OR and PACU

Keywords: Operating room, post anesthesia care unit, PACUstaffing, sequencing, healthcare

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24 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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23 Corrosion Study of Magnetically Driven Components in Spinal Implants by Immersion Testing in Simulated Body Fluids

Authors: Benjawan Saengwichian, Alasdair E. Charles, Philip J. Hyde

Abstract:

Magnetically controlled growing rods (MCGRs) have been used to stabilise and correct spinal curvature in children to support non-invasive scoliosis adjustment. Although the encapsulated driving components are intended to be isolated from body fluid contact, in vivo corrosion was observed on these components due to sealing mechanism damage. Consequently, a corrosion circuit is created with the body fluids, resulting in malfunction of the lengthening mechanism. Particularly, the chloride ions in blood plasma or cerebrospinal fluid (CSF) may corrode the MCGR alloys, possibly resulting in metal ion release in long-term use. However, there is no data available on the corrosion resistance of spinal implant alloys in CSF. In this study, an in vitro immersion configuration was designed to simulate in vivo corrosion of 440C SS-Ti6Al4V couples. The 440C stainless steel (SS) was heat-treated to investigate the effect of tempering temperature on intergranular corrosion (IGC), while crevice and galvanic corrosion were studied by limiting the clearance of dissimilar couples. Tests were carried out in a neutral artificial cerebrospinal fluid (ACSF) and phosphate-buffered saline (PBS) under aeration and deaeration for 2 months. The composition of the passive films and metal ion release were analysed. The effect of galvanic coupling, pH, dissolved oxygen and anion species on corrosion rates and corrosion mechanisms are discussed based on quantitative and qualitative measurements. The results suggest that ACSF is more aggressive than PBS due to the combination of aggressive chlorides and sulphate anions, while phosphate in PBS acts as an inhibitor to delay corrosion. The presence of Vivianite on the SS surface in PBS lowered the corrosion rate (CR) more than 5 times for aeration and nearly 2 times for deaeration, compared with ACSF. The CR of 440C is dependent on passive film properties varied by tempering temperature and anion species. Although the CR of Ti6Al4V is insignificant, it tends to release more Ti ions in deaerated ACSF than under aeration, about 6 µg/L. It seems the crevice-like design has more effect on macroscopic corrosion than combining the dissimilar couple, whereas IGC is dominantly observed on sensitized microstructure.

Keywords: Cerebrospinal fluid, crevice corrosion, intergranular corrosion, magnetically controlled growing rods.

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22 A Review of Methods for 2D/3D Registration

Authors: Panos D. Kotsas, Tony Dodd

Abstract:

2D/3D registration is a special case of medical image registration which is of particular interest to surgeons. Applications of 2D/3D registration are [1] radiotherapy planning and treatment verification, spinal surgery, hip replacement, neurointerventions and aortic stenting. The purpose of this paper is to provide a literature review of the main methods for image registration for the 2D/3D case. At the end of the paper an algorithm is proposed for 2D/3D registration based on the Chebyssev polynomials iteration loop.

Keywords: Medical image registration, review, 2D/3D

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21 A Social Cognitive Investigation in the Context of Vocational Training Performance of People with Disabilities

Authors: Majid A. AlSayari

Abstract:

The study reported here investigated social cognitive theory (SCT) in the context of Vocational Rehab (VR) for people with disabilities. The prime purpose was to increase knowledge of VR phenomena and make recommendations for improving VR services. The sample consisted of 242 persons with Spinal Cord Injuries (SCI) who completed questionnaires. A further 32 participants were Trainers. Analysis of questionnaire data was carried out using factor analysis, multiple regression analysis, and thematic analysis. The analysis suggested that, in motivational terms, and consistent with research carried out in other academic contexts, self-efficacy was the best predictor of VR performance. The author concludes that that VR self-efficacy predicted VR training performance.

Keywords: Social cognitive theory, vocational rehab, self-efficacy, proxy efficacy, people with disabilities.

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20 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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19 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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18 Close Loop Controlled Current Nerve Locator

Authors: H. A. Alzomor, B. K. Ouda, A. M. Eldeib

Abstract:

Successful regional anesthesia depends upon precise location of the peripheral nerve or nerve plexus. Locating peripheral nerves is preferred to be done using nerve stimulation. In order to generate a nerve impulse by electrical means, a minimum threshold stimulus of current “rheobase” must be applied to the nerve. The technique depends on stimulating muscular twitching at a close distance to the nerve without actually touching it. Success rate of this operation depends on the accuracy of current intensity pulses used for stimulation .In this paper, we will discuss a circuit and algorithm for closed loop control for the current, theoretical analysis and test results is discussed and results is compared to previous techniques.

Keywords: Close Loop Control, Constant Current, Nerve Locator.

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17 An Improved C-Means Model for MRI Segmentation

Authors: Ying Shen, Weihua Zhu

Abstract:

Medical images are important to help identifying different diseases, for example, Magnetic resonance imaging (MRI) can be used to investigate the brain, spinal cord, bones, joints, breasts, blood vessels, and heart. Image segmentation, in medical image analysis, is usually the first step to find out some characteristics with similar color, intensity or texture so that the diagnosis could be further carried out based on these features. This paper introduces an improved C-means model to segment the MRI images. The model is based on information entropy to evaluate the segmentation results by achieving global optimization. Several contributions are significant. Firstly, Genetic Algorithm (GA) is used for achieving global optimization in this model where fuzzy C-means clustering algorithm (FCMA) is not capable of doing that. Secondly, the information entropy after segmentation is used for measuring the effectiveness of MRI image processing. Experimental results show the outperformance of the proposed model by comparing with traditional approaches.

Keywords: Magnetic Resonance Image, C-means model, image segmentation, information entropy.

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16 Effects of Repetitive Strain/Stress Injury on the Human Body

Authors: Mohd Abdullah

Abstract:

This review describes some of the effects of repetitive strain/stress injury (RSI) on the human body especially among computer professionals today that spend extended hours of prolonged sitting in front of a computer day in and day out. The review briefly introduces the main factors that contribute to an increase of RSI among such computer professionals. The review briefly discusses how the human spinal column and knees are mainly affected by the onset of RSI resulting in poor posture. The root and secondary causes and effects of RSI are reviewed. The importance and value of the various breathing techniques are reviewed in an attempt to alleviate some of the effects of RSI. The review concludes with a small sample of suggested office stretches and poses geared towards at reducing RSI follows in this review. Readers will learn about the effects of RSI, as well as ways to cope with it. A better understanding of coping strategies may lead to well-being and a healthier overall lifestyle. Ultimately, the investment of time to connect with oneself with the poses and the power of the breath would promote a well-being that is overall healthier thus resulting in a better ability to cope/manage life stresses.

Keywords: Health, wellness, repetitive, chairs.

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15 A Simulation Study into the Use of Polymer Based Materials for Core Exoskeleton Applications

Authors: Matthew Dickinson

Abstract:

A core/trunk exoskeleton design has been produced that is aimed to assist the raise to stand motion. A 3D model was produced to examine the use of additive manufacturing as a core method for producing structural components for the exoskeleton presented. The two materials that were modelled for this simulation work were Polylatic acid (PLA) and polyethylene terephthalate with carbon (PET-C), and the central spinal cord of the design being Nitrile rubber. The aim of this study was to examine the use of 3D printed materials as the main skeletal structure to support the core of a human when moving raising from a resting position. The objective in this work was to identify if the 3D printable materials could be offered as an equivalent alternative to conventional more expensive materials, thus allow for greater access for production for home maintenance. A maximum load of lift force was calculated, and this was incrementally reduced to study the effects on the material. The results showed a total number of 8 simulations were run to study the core in conditions with no muscular support through to 90% of operational support. The study presents work in the form of a core/trunk exoskeleton that presents 3D printing as a possible alternative to conventional manufacturing.

Keywords: 3D printing, Exo-Skeleton, PLA, PETC.

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14 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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13 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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12 Compressive Properties of a Synthetic Bone Substitute for Vertebral Cancellous Bone

Authors: H. N. Mehmanparast, J.M. Mac-Thiong., Y. Petit

Abstract:

Transpedicular screw fixation in spinal fractures, degenerative changes, or deformities is a well-established procedure. However, important rate of fixation failure due to screw bending, loosening, or pullout are still reported particularly in weak bone stock in osteoporosis. To overcome the problem, mechanism of failure has to be fully investigated in vitro. Post-mortem human subjects are less accessible and animal cadavers comprise limitations due to different geometry and mechanical properties. Therefore, the development of a synthetic model mimicking the realistic human vertebra is highly demanded. A bone surrogate, composed of Polyurethane (PU) foam analogous to cancellous bone porous structure, was tested for 3 different densities in this study. The mechanical properties were investigated under uniaxial compression test by minimizing the end artifacts on specimens. The results indicated that PU foam of 0.32 g.cm-3 density has comparable mechanical properties to human cancellous bone in terms of young-s modulus and yield strength. Therefore, the obtained information can be considered as primary step for developing a realistic cancellous bone of human vertebral body. Further evaluations are also recommended for other density groups.

Keywords: Cancellous bone, Pedicle screw, Polyurethane foam, Synthetic bone

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11 Early Diagnosis of Alzheimer's Disease Using a Combination of Images Processing and Brain Signals

Authors: E. Irankhah, M. Zarif, E. Mazrooei Rad, K. Ghandehari

Abstract:

Alzheimer's prevalence is on the rise, and the disease comes with problems like cessation of treatment, high cost of treatment, and the lack of early detection methods. The pathology of this disease causes the formation of protein deposits in the brain of patients called plaque amyloid. Generally, the diagnosis of this disease is done by performing tests such as a cerebrospinal fluid, CT scan, MRI, and spinal cord fluid testing, or mental testing tests and eye tracing tests. In this paper, we tried to use the Medial Temporal Atrophy (MTA) method and the Leave One Out (LOO) cycle to extract the statistical properties of the three Fz, Pz, and Cz channels of ERP signals for early diagnosis of this disease. In the process of CT scan images, the accuracy of the results is 81% for the healthy person and 88% for the severe patient. After the process of ERP signaling, the accuracy of the results for a healthy person in the delta band in the Cz channel is 81% and in the alpha band the Pz channel is 90%. In the results obtained from the signal processing, the results of the severe patient in the delta band of the Cz channel were 89% and in the alpha band Pz channel 92%.

Keywords: Alzheimer's disease, image and signal processing, medial temporal atrophy, LOO Cycle.

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10 Application of Staining Intensity Correlation Analysis to Visualize Protein Colocalizationat a Cellular Level

Authors: Permphan Dharmasaroja

Abstract:

Mutations of the telomeric copy of the survival motor neuron 1 (SMN1) gene cause spinal muscular atrophy. A deletion of the Eef1a2 gene leads to lower motor neuron degeneration in wasted mice. Indirect evidences have been shown that the eEF1A protein family may interact with SMN, and our previous study showed that abnormalities of neuromuscular junctions in wasted mice were similar to those of Smn mutant mice. To determine potential colocalization between SMN and tissue-specific translation elongation factor 1A2 (eEF1A2), an immunochemical analysis of HeLa cells transfected with the plasmid pcDNA3.1(+)C-hEEF1A2- myc and a new quantitative test of colocalization by intensity correlation analysis (ICA) was used to explore the association of SMN and eEF1A2. Here the results showed that eEF1A2 redistributed from the cytoplasm to the nucleus in response to serum and epidermal growth factor. In the cytoplasm, compelling evidence showed that staining for myc-tagged eEF1A2 varied in synchrony with that for SMN, consistent with the formation of a SMN-eEF1A2 complex in the cytoplasm of HeLa cells. These findings suggest that eEF1A2 may colocalize with SMN in the cytoplasm and may be a component of the SMN complex. However, the limitation of the ICA method is an inability to resolve colocalization in components of small organelles such as the nucleus.

Keywords: Intensity correlation analysis, intensity correlation quotient.

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9 Wireless Based System for Continuous Electrocardiography Monitoring during Surgery

Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

Abstract:

This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: Electrocardiography, monitoring, surgery, wireless system.

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8 Animal-Assisted Therapy for Persons with Disabilities Based on Canine Tail Language Interpretation via Gaussian-Trapezoidal Fuzzy Emotional Behavior Model

Authors: W. Phanwanich, O. Kumdee, P. Ritthipravat, Y. Wongsawat

Abstract:

In order to alleviate the mental and physical problems of persons with disabilities, animal-assisted therapy (AAT) is one of the possible modalities that employs the merit of the human-animal interaction. Nevertheless, to achieve the purpose of AAT for persons with severe disabilities (e.g. spinal cord injury, stroke, and amyotrophic lateral sclerosis), real-time animal language interpretation is desirable. Since canine behaviors can be visually notable from its tail, this paper proposes the automatic real-time interpretation of canine tail language for human-canine interaction in the case of persons with severe disabilities. Canine tail language is captured via two 3-axis accelerometers. Directions and frequencies are selected as our features of interests. The novel fuzzy rules based on Gaussian-Trapezoidal model and center of gravity (COG)-based defuzzification method are proposed in order to interpret the features into four canine emotional behaviors, i.e., agitate, happy, scare and neutral as well as its blended emotional behaviors. The emotional behavior model is performed in the simulated dog and has also been evaluated in the real dog with the perfect recognition rate.

Keywords: Animal-assisted therapy (AAT), Persons with disabilities, Canine tail language, Fuzzy emotional behavior model

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