Accuracy of using computed tomography to identify pedicle screw placement in cadaveric human lumbar spine

STUDY DESIGN: Utility of using computed tomography to predict pedicle screw misplacement. OBJECTIVE: This study defines the sensitivity and specificity of predicting pedicle screw placement by experienced clinicians using a CT scan image. SUMMARY OF BACKGROUND DATA: In clinical and research settings, the method most commonly used to evaluate pedicle screws placement has been computed tomography. However, no current literature describes the accuracy of this method of evaluating screw placement. METHOD: Cobalt-chrome and titanium alloy pedicle screws of identical size were placed in six cadaveric human lumbar spine. Wide laminectomy was performed to allow complete visualization of the pedicles. Three consecutive lumbar levels were instrumented in each spine, giving 36 pedicle screw placements to identify. The instrumented spines were imaged, and four orthopaedic spine surgeons and a musculoskeletal radiologist were asked to read the images to identify the accuracy of screw placement within the pedicles. RESULTS: The sensitivity rate of identifying a misplaced screw was 67 +/- 6% for cobalt-chrome screws compared with 86 +/- 5% for titanium screws (P < 0.005). The specificity rates of radiographic diagnosis of misplaced pedicle screws were 66 +/- 10% for cobalt-chrome screws and 88 +/- 8% for titanium screws (P < 0.005). Similarly, a statistically significant difference was found in the sensitivity rates of identifying screws placed correctly in the pedicle: 70 +/- 10% for cobalt-chrome screws versus 89 +/- 8% for titanium screws (P < 0.005). Overall accuracy rates were 68 +/- 7% for cobalt chrome screws versus 87 +/- 3% for titanium screws (P < 0.002). CONCLUSION: Reliance on the computed tomography scan data alone in determining accuracy of pedicle screws can lead to inaccuracies in both clinical and research conditions.     

Three-dimensional reconstruction of live embryos using roboticmacroscope images

To determine the three-dimensional (3-D) shape of a live embryo is a technically challenging task. The authors show that reconstructions of live embryos can be done by collecting images from different viewing angles using a robotic macroscope, establishing point correspondences between these views by block matching, and using a new 3-D reconstruction algorithm that accommodates camera positioning errors. The algorithm assumes that the images are orthographic projections of the object and that the camera scaling factors are known. Point positions and camera errors are found simultaneously. Reconstructions of test objects and embryos show that meaningful reconstructions are possible only when camera positioning and alignment errors are accommodated since these errors can be substantial. Reconstructions of early-stage axolotl embryos were made from sets of 33 images. In a typical reconstruction, 781 points, each visible in at least three different views, were used to form 1511 triangles to represent the embryo surface. The resulting reconstruction had a mean radius of error of 0.27 pixels (1.1 μm). Mathematical properties of the reconstruction algorithm are identified and discussed     

Motion Perception Using Analog VLSI

Motion perception is arguably a fundamental mechanism used by natural species to accomplish a number of tasks, such as navigating freely in an unknown environment. Traditional motion perception methods tend to be computationally intensive, requiring powerful computers and large memories. However, by copying biological mechanisms, such as elementary motion discrimination at the early stages of the visual processing paths, it should be possible to build small and efficient motion perception systems. This paper describes the manner in which a simple motion perception model based on the insect visual system has been implemented using mixed analog/digital VLSI. The device has been fabricated in a 2 micron double metal, double polysilicon process, and comprises 61 photo-detectors, and associated analog and digital circuitry. While not entirely successful in that component mismatches hamper the detection of dark-to-bright changes in contrast, the results clearly show the feasibility of using such a device in autonomous control systems.     

Small-signal modeling and control of the quasi-square-wave boostconverter

Sampled-data techniques are used to examine the dynamic characteristics and closed-loop performance of the quasi-square-wave boost converter. Direct duty-ratio control and current-mode control are considered. With direct duty-ratio control, the system poles remain well damped under all load conditions, and there is no zero in the control-to-output transfer function. Good closed-loop performance is therefore achieved. Under current-mode control, the requirement for a stabilizing ramp is seen to depend on load conditions, and the achievable voltage control-loop bandwidth is smaller than that using direct duty-ratio control; however, there is a significant reduction in the magnitude of the DC source to output-voltage frequency response     

The Kepler problem in relativistic multi-time formalism. Part II

Summary The differential equation of the Kepler orbit is formulated within the framework of a relativistic Hamiltonian multi-time formalism. The calculation takes into consideration terms of the order 1/c ². The integration of the differential equation yields an orbit with backward movement of the perihelion.     

Activity-composition relations of MnO in MnO-CrO x -CaO-SiO2-containing melts

The MnO activities in (MnO-CrO _x -CaO-SiO₂)-containing melts, which were saturated with the (Mn, Cr)₃O₄ spinel phase, were determined at 1500 °C under an oxygen partial pressure of 10^−8.99 atm. This was done by equilibrating the samples with platinum. The activity of MnO in the melt was then calculated from the activity coefficient of manganese in the resultant Pt-Cr-Mn alloy. Darken’s quadratic formalism for ternary metallic solutions was used to calculate the activity coefficient of manganese in the Pt-Cr-Mn system, in which platinum was considered to be the solvent. It was found that an increase in the concentration of MnO in the melt increases both the MnO activity and the activity coefficient of MnO. For a constant MnO concentration in the (MnO-CrO _x -CaO-SiO₂)-containing melts, the activity of MnO can be increased by increasing the basicity of the melt. In order to obtain high-manganese recoveries from (MnO-CrO _x -CaO-SiO₂)-containing melts into an alloy phase, basic slags in which the activity coefficient of MnO is high should therefore be used.     

Infrequent association: massive inguinoscrotal bladder hernia, multiple scrotal lithiasis, and bilateral obstructive uropathy]

BACKGROUND AND AIMS OF THE STUDY: Surgical treatment of functional tricuspid regurgitation associated with advanced valvular disease remains controversial, mainly due to the difficulty in choosing between valve replacement or reconstructive surgery. Failure to correct tricuspid regurgitation during valvular surgery carries a poor prognosis, as reoperation may represent a significant risk to the patient. Thus correct tricuspid valve surgery is vital to achieve improved early and long-term clinical results. METHODS: A total of 142 patients underwent concomitant tricuspid annuloplasty with mitral valve replacement and their clinical outcome was assessed. RESULTS: Overall hospital mortality rate was 11.3%. Seven patients died during follow up. The overall actuarial survival rate for 10 years was 74.1 +/- 14.2%. Postoperatively, 75.8% of the patients had no residual tricuspid insufficiency, while 24.2% had first- or second-degree tricuspid insufficiency and were treated medically. All patients were in NHYA functional class I or II postoperatively. CONCLUSION: Clinically, it is important to assess the severity of functional tricuspid insufficiency before and/or during the operation. Bicuspidalization annuloplasty for functional tricuspid insufficiency has provided good results, with a low incidence of reoperation and significant clinical improvement. The technique could be used in most patients with functional tricuspid regurgitation.     

Determination of dissociation constants of loop diuretics in acetonitrile-water mixtures

The dissociation pK values of the representative loop diuretics furosemide, bumetanide and ethacrynic acid in 10, 30, 40, 50 and 70% (w/w) acetonitrile-water mixtures at 298.15 K were determined, according to the rules and procedures endorsed by IUPAC. The variation in pK values over the whole composition range studied can be explained by tacking into account the preferential solvation of ionizable substances in acetonitrile-water mixtures. With a view to determining the pK values of the loop diuretics studied in any of the binary solvent acetonitrile-water mixtures, correlations of pK values and different bulk properties of the solvent were examined, and the linear solvation energy relationships method, LSER, has been applied. The pK values were then correlated with the pi*, alpha and beta solvatochromic parameters of acetonitrile-water mixtures. The resulting equations allowed us to calculate pK values for the loop diuretics in any acetonitrile-water mixture up to 70% (w/w) acetonitrile.