Stud Health Technol Inform
November 2004
The lack of data on in-vivo material properties of soft tissues has been a significant impediment in the development of virtual reality based surgical simulators that can provide the user with realistic visual and haptic feedback. As a first step towards characterizing the mechanical behavior of organs, this work presents in-vivo force response of the liver and lower esophagus of pigs when subjected to ramp and hold, and sinusoidal indentations delivered using a haptic feedback device, Phantom, employed as a mechanical stimulator. The results show that pulse significantly affects the reaction forces and that the lower esophagus is 2 to 2.
View Article and Find Full Text PDFSevere acute respiratory syndrome (SARS) is a new respiratory viral epidemic that originated in China but has affected many parts of the world, with devastating impact on economies and the practice of medicine and rehabilitation. A novel coronavirus has been implicated, with transmission through respiratory droplets. Rehabilitation was significantly affected by SARS, because strict infection control measures run counter to principles such as multidisciplinary interactions, patients encouraging and learning from each other, and close physical contact during therapy.
View Article and Find Full Text PDFA 30-year-old Thai woman with piriformis pyomyositis presented with sciatica. Computed tomography showed swelling and enhancement of the right gluteus medius and piriformis muscles. She made a complete recovery after a course of intravenous antibiotics.
View Article and Find Full Text PDFAn outbreak of severe acute respiratory syndrome (SARS) was detected in Singapore at the beginning of March 2003. The outbreak, initiated by a traveler to Hong Kong in late February 2003, led to sequential spread of SARS to three major acute care hospitals in Singapore. The critical factor in containing this outbreak was early detection and complete assessment of movements and follow-up of patients, healthcare workers, and visitors who were contacts.
View Article and Find Full Text PDFAnn Acad Med Singap
March 2004
Introduction: As anterior cruciate ligament (ACL) reconstruction becomes more frequently performed, the expectation of earlier return to activities becomes higher; hence graft selection becomes more important. The use of hamstring tendon autograft is perceived to have less postoperative morbidities. We evaluate the early postoperative complications in this prospective study.
View Article and Find Full Text PDFSingapore Med J
October 2003
Donor site morbidity, which occurs in 15% to 20% with the use of autografts for anterior cervical fusion, is eliminated with the use of allografts. While allografts from the iliac crest, ribs, fibula, femoral head and skull have been used in anterior cervical fusion, the use of patellar allografts has not been previously reported. Twenty-two patients underwent Cloward anterior cervical decompression and fusion using bicortical patellar allografts from 1993 to 1997.
View Article and Find Full Text PDFAmorphous titanium dioxide (TiO2) thin film has been prepared by a filtered cathodic vacuum arc technique at room temperature. It was concluded from the core level of Ti 2p 3/2 (458.3 eV) and O 1s (529.
View Article and Find Full Text PDFInterferon regulatory factors (IRFs) are a large family of transcription factors involved in regulating the transcriptional response of vertebrates to interferons and viral infection. In this report we describe the cloning and genomic organization of an IRF gene from the pufferfish (Fugu rubripes). The fugu IRF gene spans 2.
View Article and Find Full Text PDFBackground Context: Discectomy is a surgical technique commonly used to treat bulging or herniated discs causing nerve root compression. Clinical data suggest discectomy may also help patients with contained discs and no clear neural compromise. However, the mechanisms of clinical efficacy are uncertain, and consequently bases for treatment optimization are limited.
View Article and Find Full Text PDFIntroduction: A prospective trial was carried out in simultaneous bilateral total knee replacement to compare the outcome of resurfaced versus non-surfaced patella.
Methods: Thirty-five patients between 1997 and 2002 had simultaneous bilateral total knee replacement with resurfaced patella on the left and non-resurfaced patella on the right knee using the same implant in both.
Results: There were 29 females and six males with a mean age of 65.
Lumbar interbody arthrodesis is a surgical technique that results in fusion of the anterior column of the spine. The indications for this procedure have evolved over time, and current indications include spinal deformity, segmental instability, and discogenic low back pain. Arthrodesis in the interbody space can be accomplished through anterior or posterior approaches to the spine, and these techniques are discussed.
View Article and Find Full Text PDFThe zygapophyseal joints in the lumbar spine are important structural components contributing to the stability of the lumbar motion segments. Pathology of the zygapophyseal joints in the lumbar spine may be a significant cause of low back pain and segmental instability within the lumbar spine. Management of pathology related to the zygapophyseal joints remains a difficult challenge for the physician caring for patients with spinal disorders.
View Article and Find Full Text PDFIntroduction: Quantitative data regarding the dimensions of the posterior cruciate ligament (PCL) and its insertions have not been studied in Asians, and concerns have been raised regarding the danger of vascular injury when the bony tunnels are created during arthroscopically-assisted reconstruction.
Materials And Methods: Ten male cadavers were used in this study, incorporating dissection and procedural arms. In the procedural arm, the path of the drill bit was tracked fluoroscopically as the tibial and femoral tunnels were created during simulated reconstructive surgery, and the effect of varying knee flexion angles was studied.
Spinal infections can occur in a variety of clinical situations. Their presentation ranges from the infant with diskitis who is unwilling to crawl or walk to the adult who develops an infection after a spinal procedure. The most common types of spinal infections are hematogenous bacterial or fungal infections, pediatric diskitis, epidural abscess, and postoperative infections.
View Article and Find Full Text PDFHeliox has a lower density than oxygen and nitrogen, and can improve ventilation rapidly in patients with critical upper airway obstruction. The choice of the best helium:oxygen ratio depends on whether the predominant problem is hypercarbia or hypoxia. In the former situation, 80% helium should be used, and in the latter, 100% oxygen is appropriate.
View Article and Find Full Text PDFThe aim of this study is to firstly ascertain the survival of autogenously grafted morselised cartilage for full thickness osteochondral defects in knee joints of pigs. Secondly, it is to determine the quality of the grafted cartilage that survives and to score to it based on a recognised and tested system of indices and thirdly, to recognise, if any, the potential for reconstitution of the osteochondral junction. Two groups of five pigs were followed up for six and 12 weeks.
View Article and Find Full Text PDFBone graft substitutes may be broadly classified as mineralized and demineralized preparations. This article reviews the basic science and biology underlying each preparation. A review of the clinical and experimental applications of each preparation follows.
View Article and Find Full Text PDFA theoretical one-compartment pharmacokinetic model is described, the aim of which is to guide factor VIII replacement therapy in patients with haemophilia A suffering from significant and ongoing haemorrhage. Based on our calculations, plasma factor VIII concentrations can decrease at a rapid rate even with non-severe blood loss.
View Article and Find Full Text PDFReg Anesth Pain Med
September 2001
Background And Objectives: Cluster headache is an uncommon debilitating condition for which effective management remains a challenge. We describe the use of gabapentin in the treatment and prophylaxis of cluster headache in a patient who was refractory to other treatments.
Case Report: A 38-year-old man had a history of intermittent right-side headaches for 24 years, diagnosed as cluster headache.
J Bone Joint Surg Am
June 2001
Background: Whether or not to remove bullets or bullet fragments from the spinal column of a neurologically intact patient has been a subject of continual debate. The controversy is due in part to a lack of information about the long-term effects of bullet fragments on spinal cord tissue. Although many studies have demonstrated the toxic effects of metal fragments on brain tissue, to our knowledge no one has evaluated the effects of the metals contained in commercially available bullets on spinal cord tissue.
View Article and Find Full Text PDFWe report a case of an unusual breathing circuit leak in the Narkomed 4 Anesthesia System due to a loose retaining ring at the junction of the expiratory valve assembly and the Spiromed Respiratory Volume Monitor. In the presence of the leak, the monitor panel displayed the messages "apnea volume" and "minute volume low," yet the low airway pressure alarm was not triggered and other parameters and clinical signs pointed to normal ventilation of the lungs. These conflicting data led to some delay in localizing the leak.
View Article and Find Full Text PDFThe results of 109 primary total hip arthroplasties in 92 patients performed in Hospital Kuala Lumpur from January 1987 to December 1996 were reviewed after a mean follow-up of 30.8 months. There were 22 males and 70 females with the average age of 49.
View Article and Find Full Text PDFCricoid pressure, when properly applied, may prevent gastric regurgitation and may improve the view of laryngoscopy. When improperly applied, however, it can impede laryngoscopy and mask-ventilation. When faced with a "cannot intubate" or "cannot mask-ventilate" situation, clinicians should reevaluate the manner with which the assistant is applying cricoid pressure and must be prepared to adjust or even to release it.
View Article and Find Full Text PDFCan J Anaesth
December 2000
Purpose: To illustrate a new airway and ventilatory management strategy for patients with unilateral penetrating lung injury. Emphasis is placed on avoiding positive pressure ventilation (PPV)-induced systemic air/gas embolism (SAE) through traumatic bronchiole-pulmonary venous fistulas.
Clinical Features: A 14-yr-old male, stabbed in the left chest, presented with hypovolemia, left hemopneumothorax, an equivocal acute abdomen, and no cardiac or neurological injury.
There is always a danger of arterial puncture during central venous access. One can usually identify an inadvertent arterial puncture when the aspirated blood is bright red. This sign is removed if one were to put saline in the aspirating syringe, as dusky venous blood turns bright red on dilution.
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