A new approach to implant alignment and ligament balancing in total knee arthroplasty focussing on joint loads.

Preservation and recovery of the mechanical leg axis as well as good rotational alignment of the prosthesis components and well-balanced ligaments are essential for the longevity of total knee arthroplasty (TKA). In the framework of the OrthoMIT project, the genALIGN system, a new navigated implantation approach based on intra-operative force-torque measurements, has been developed. With this system, optical or magnetic position tracking as well as any fixation of invasive rigid bodies are no longer necessary.

Assessment of optical localizer accuracy for computer aided surgery systems.

The technology for localization of surgical tools with respect to the patient's reference coordinate system in three to six degrees of freedom is one of the key components in computer aided surgery. Several tracking methods are available, of which optical tracking is the most widespread in clinical use. Optical tracking technology has proven to be a reliable method for intra-operative position and orientation acquisition in many clinical applications; however, the accuracy of such localizers is still a topic of discussion.

Electromagnetic tracking for CT-guided spine interventions: phantom, ex-vivo and in-vivo results.

An electromagnetic-based tracking and navigation system was evaluated for interventional radiology. The electromagnetic tracking system (CAPPA IRAD EMT, CASinnovations, Erlangen, Germany) was used for real-time monitoring of punctures of the lumbar facet joints and intervertebral disks in a spine phantom, three pig cadavers and three anaesthesized pigs. Therefore, pre-interventional computed tomography (CT) datasets were transferred to the navigation system and puncture trajectories were planned.

[Soft-tissue management in primary knee arthroplasty: common techniques, navigation and force-sensing devices].

Soft-tissue management is essential for the outcome in total knee arthroplasty. In combination with osseous resections and component positioning, correction of the underlying ligamentous dysbalance should yield a stable joint throughout the flexion arc. Different "philosophies" with regard to technique, timing and tactics in ligament balancing are described.

A comparison of continuous wave Doppler radar to impedance cardiography for analysis of mechanical heart activity.

The paper compares the data obtained from a continuous wave Doppler radar sensor based on a commercially available microwave motion sensor KMY24 to an impedance cardiograph measured using a Cardiac Output Monitor (Medis Niccomo). Both sensors are used to analyze the mechanical activity of the heart. System parameters, signal content and robustness are discussed.

Perinatal expression of IGFBPs in rat lung and its hormonal regulation in fetal lung explants.

To gain more insight into the regulation of the expression of insulin-like growth factor (IGF) binding proteins (IGFBPs) in the lung, the developmental patterns of the abundance of the mRNAs encoding IGFBPs were measured in the perinatal rat lung and in explant cultures of fetal rat lung. In hormone-free explant cultures, the levels of the mRNAs encoding IGFBP-2 through -5 changed with a pattern similar to that occurring in vivo (although in the case of IGFBP-3 to -5 at a faster rate), indicating that the developmental regulation of the expression of these IGFBPs in perinatal lung is mimicked in the explants. For the IGFBP-6 mRNA level, the pattern in vitro differed from that in vivo.

Ontogeny of surfactant proteins and lipid-synthesizing enzymes in cultured fetal lung epithelial cells.

Fetal rat lung epithelial cells were isolated on gestational day 17 (term is 22), separated from fibroblasts, and cultured up to 6 days in a serum-free medium on a basement membrane matrix. Surfactant protein (SP) A, barely detectable by immunostaining at the beginning of the culture, considerably increased in cells and subsequently in the lumen of the epithelial cell clusters. SP-A mRNA, already detectable at culture initiation, progressively increased.

Phospholipid-transfer proteins and their mRNAs in developing rat lung and in alveolar type-II cells.

Gene expression of non-specific lipid-transfer protein (nsL-TP; identical with sterol carrier protein 2) and phosphatidylinositol-transfer protein (PI-TP) was investigated in developing rat lung. During the late prenatal period (between days 17 and 22) there is a 7-fold increase in the level of nsL-TP and a 2-fold rise in that of PI-TP. The prenatal increases in the levels of nsL-TP and PI-TP are accompanied by parallel increases in the levels of their mRNAs, indicating pretranslational regulation.

Pre-translational regulation by glucocorticoid of fatty acid and phosphatidylcholine synthesis in type II cells from fetal rat lung.

Exposure to fibroblast-conditioned cortisol-containing medium increased fatty acid synthase activity and fatty acid synthase, acetyl-CoA carboxylase and ATP citrate lyase mRNA abundance in fetal type II alveolar epithelial cells. Both fibroblast conditioning and cortisol in the medium were required for maximal effect on the mRNA levels, indicating involvement of mesenchymal-epithelial interaction in the cortisol effects. The observed effects provide evidence for an earlier hypothesis that increased activity of CTP:phosphocholine cytidylyltransferase in lung tissue caused by glucocorticoid is due to increased fatty acid synthesis.

The lung lectin surfactant protein A aggregates phospholipid vesicles via a novel mechanism.

Surfactant protein A (SP-A), a lung-specific glycoprotein, consists of an N-terminal collagen-like domain and a C-terminal domain with a sequence similar to that of several Ca2(+)-dependent lectins. SP-A induces a rapid Ca2(+)-dependent aggregation of phospholipid vesicles. We report here that vesicle aggregation is mediated by Ca2(+)-induced interactions between carbohydrate-binding domains and oligosaccharide moieties of SP-A.

Synthesis and degradation of glycogen by Schistosoma mansoni worms in vitro.

The glycogen stores of adult Schistosoma mansoni worms could be labelled by incubation of the worms, after an initial reduction of their glycogen content, in the presence of [6-14C]glucose. Subsequent breakdown of the labelled glycogen by the parasite revealed that glycogen was degraded to lactate and carbon dioxide. The degradation of glycogen, as compared to that of glucose, resulted in slightly different ratios of these two end-products.