Video-assisted lateral intertransverse process arthrodesis. Validation of a new minimally invasive lumbar spinal fusion technique in the rabbit and nonhuman primate (rhesus) models

STUDY DESIGN: Cadaveric anatomic and in vivo survival animal studies were performed to develop a new arthrodesis technique for the lumbar spine. OBJECTIVES: To examine the feasibility, efficacy, and safety of a minimally invasive lumbar intertransverse process arthrodesis technique using an osteoinductive growth factor (rhBMP-2) delivered in a collagen sponge carrier. The technique was first developed using a rabbit model and modified for the nonhuman primate (rhesus monkey), a larger animal with the most similar bone biology to humans. SUMMARY OF BACKGROUND DATA: The morbidity of conventional posterolateral lumbar intertransverse process arthrodesis includes graft donor site morbidity; paraspinal muscle devascularization, denervation, and scarring and nonunion in up to 36% of patients. Minimally invasive anterior lumbar interbody arthrodesis techniques have been developed, but these often require a metal implant and carry risks to major vessels and development of retrograde ejaculation. A minimally invasive technique for posterolateral intertransverse process arthrodesis has not been described previously. METHODS: In Part 1, we examined seven New Zealand white rabbits and five rhesus monkeys at necropsy and during nonsurvival surgeries to determine the best access routes and to develop special instruments for video-assisted lateral intertransverse process arthrodesis. In Part 2, 38 New Zealand white rabbits underwent L4-L5 intertransverse process arthrodesis: the "OPEN" group (n = 16) underwent a standard open muscle-splitting approach using rhBMP-2 (bone morphogenetic protein) and collagen as a bone graft substitute; the "video-assisted control" group (n = 6) underwent video-assisted lateral intertransverse process arthrodesis with the collagen implant only (no growth factor); and the "video-assisted-BMP" group (n = 16) underwent video-assisted lateral intertransverse process arthrodesis with rhBMP-2 and collagen as the graft material. In Part 3, rhesus monkeys (n = 4) underwent video-assisted lateral intertransverse process arthrodesis using rhBMP-2 and collagen after laminectomy of L4-L5. RESULTS: In Part 1, we identified expedient, minimally invasive routes to the intertransverse process interval appropriate for each species: an intermuscular approach for the rabbit and a lateral, extramuscular approach for the rhesus monkey. In Part 2, all rabbits in the OPEN and video-assisted-BMP groups achieved solid intertransverse process lumbar fusions when assessed at 10 weeks. There were no neurologic impairments nor any difference between the two groups in the frequency of postoperative infection or other complications. None of the animals in the video-assisted control group showed evidence of fusion. In Part 3, exposure, decortication and grafting with rh-BMP-2 and collagen was accomplished successfully in all four monkeys through the video-assisted minimally invasive approach without complications. CONCLUSION: Video-assisted lateral intertransverse process arthrodesis is a feasible, effective, and safe method of lumbar spinal fusion in the rabbit and rhesus monkey. Use of this arthrodesis procedure will minimize the morbidity of paraspinal muscle denervation and devascularization seen with open intertransverse process fusion techniques, and the use of an osteoinductive growth factor will eliminate the problem of graft donor site morbidity and possibly increase the chances for successful fusion.     

Real-Time Temperature Compensation of MEMS Oscillators Using an Integrated Micro-Oven and a Phase-Locked Loop

We present a new temperature compensation system for microresonator-based frequency references. It consists of a phase-locked loop (PLL) whose inputs are derived from two microresonators with different temperature coefficients of frequency. The resonators are suspended within an encapsulated cavity and are heated to a constant temperature by the PLL controller, thereby achieving active temperature compensation. We show repeated real-time measurements of three 1.2-MHz prototypes that achieve a frequency stability of $pm$ 1 ppm from $-20 ^{circ}hbox{C}$ to $+80 ^{circ}hbox{C}$, as well as a technique to reduce steady-state frequency errors to $pm$0.05 ppm using multipoint calibration.$hfill$[2009-0074]      

Plato: A localised orbital based density functional theory code

The Plato package allows both orthogonal and non-orthogonal tight-binding as well as density functional theory (DFT) calculations to be performed within a single framework. The package also provides extensive tools for analysing the results of simulations as well as a number of tools for creating input files. The code is based upon the ideas first discussed in Sankey and Niklewski (1989) [1] with extensions to allow high-quality DFT calculations to be performed. DFT calculations can utilise either the local density approximation or the generalised gradient approximation. Basis sets from minimal basis through to ones containing multiple radial functions per angular momenta and polarisation functions can be used. Illustrations of how the package has been employed are given along with instructions for its utilisation.

Program summary

Program title: PlatoCatalogue identifier: AEFC_v1_0Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEFC_v1_0.htmlProgram obtainable from: CPC Program Library, Queen's University, Belfast, N. IrelandLicensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.htmlNo. of lines in distributed program, including test data, etc.: 219 974No. of bytes in distributed program, including test data, etc.: 1 821 493Distribution format: tar.gzProgramming language: C/MPI and PERLComputer: Apple Macintosh, PC, Unix machinesOperating system: Unix, Linux and Mac OS XHas the code been vectorised or parallelised?: Yes, up to 256 processors testedRAM: Up to 2 Gbytes per processorClassification: 7.3External routines: LAPACK, BLAS and optionally ScaLAPACK, BLACS, PBLAS, FFTWNature of problem: Density functional theory study of electronic structure and total energies of molecules, crystals and surfaces.Solution method: Localised orbital based density functional theory.Restrictions: Tight-binding and density functional theory only, no exact exchange.Unusual features: Both atom centred and uniform meshes available. Can deal with arbitrary angular momenta for orbitals, whilst still retaining Slater–Koster tables for accuracy.Running time: Test cases will run in a few minutes, large calculations may run for several days.     

Thermal Isolation of Encapsulated MEMS Resonators

This paper presents an in-chip thermal-isolation technique for a micro-ovenized microelectromechanical-system resonator. Resonators with a microoven can be used for high-precision feedback control of temperature to compensate for the temperature dependence of resonator frequency over a wide temperature range. However, ovenization requires power consumption for heating, and the thermal time constant must be minimized for effective temperature control. This paper demonstrates an efficient local-thermal-isolation mechanism, which can reduce the power requirement to a few milliwatts and the thermal time constant to a few milliseconds. In this method, the mechanical suspension of the resonator is modified to provide thermal isolation and include an integrated resistive heater. This combination provides mechanical suspension, electrical heating, and thermal isolation in a compact structure that requires low heating power and has a small thermal time constant. A power consumption of approximately 12 mW for a 125degC temperature rise and a thermal time constant ranging from 7 to 10 ms is reported in this paper, which is orders of magnitude lower than that of commercially available ovenized quartz resonators. A CMOS-compatible wafer-scale encapsulation process is used to fabricate this device, and the thermal-isolation design is achieved without any modification to the existing resonator fabrication process.     

Structure and evolutionary implications of a "cysteine-rich" Campoletis sonorensis polydnavirus gene family

For successful parasitization, the female Campoletis sonorensis endoparasitic wasp injects a polydnavirus into its host, Heliothis virescens, during oviposition. Viral gene expression induces immunosuppression and alters development of the host. We report here that three abundantly expressed genes, VHv1.1, WHv1.0, and WHv1.6, describes a polydnavirus "cysteine-rich" gene family which may be important in inducing these host manifestations. These genes have a similar primary gene structure and their proteins contain cysteine motifs characteristic of snail ion-channel ligands, the omega-conotoxins. Like the omega-conotoxins, the intercysteine amino acid residues are hypervariable with only three identical amino acids in all motifs. The conservation of this domain in the three viral genes may reflect an important functional role for these viral proteins in the parasitization of H. virescens. The three genes also contain introns similar in sequence at comparable positions in their 5' untranslated leaders and coding sequences. VHv1.1 contains two cysteine motifs, and each motif is interrupted by an intron at the same position as in the cysteine motifs of WHv1.0 and WHv1.6. Intron 2 sequences of WHv1.0 and WHv1.6 are 92% identical, while the immediately flanking exon sequences encoding the cysteine motifs are only 76% identical. This provides an example of nuclear pre-mRNA introns which are more conserved than flanking exons among members of a gene family.     

Design of large deflection electrostatic actuators

Electrostatic, comb-drive actuators have been designed for applications requiring displacements of up to 150 /spl mu/m in less than 1 ms. A nonlinear model of the actuator relates the resonant frequency and the maximum stable deflection to the actuator dimensions. A suite of experiments that were carried out on deep reactive ion etched (DRIE), single-crystal silicon, comb-drive actuators confirm the validity of the model. Four actuator design improvements were implemented. First, a folded-flexure suspension consisting of two folded beams rather than four and a U-shaped shuttle allowed the actuator area to be cut in half without degrading its performance. Second, the comb teeth were designed with linearly increasing lengths to reduce side instability by a factor of two. Third, the folded-flexure suspensions were fabricated in an initially bent configuration, improving the suspension stiffness ratio and reducing side instability by an additional factor of 30. Finally, additional actuation range was achieved using a launch and capture actuation scheme in which the actuator was allowed to swing backward after full forward deflection; the shuttle was captured and held using the backs of the comb banks as high-force, parallel-plate actuators.     

Fabrication of collimating grids for an x-ray solar telescope using LIGA methods

 We are fabricating sub-collimating X-ray grids that are to be used in an orbiting solar X-ray telescope. The telescope optics consist of twelve rotating pairs of high aspect ratio grids. The pitch for the grids ranges from 34 μm to 317 μm. The grid thickness-to-grid-slit ratio must be approximately 50:1, resulting in grid thicknesses of 1 to 10 millimeters. We are implementing a design in which a 34 μm pitch, free-standing PMMA grid is fabricated with 20 μm wide slits through a 800 μm thickness. After exposure and developing, metal is electrodeposited into the slits in the PMMA grid and the PMMA is left in place to hold the individual metal pieces. For optimum imaging performance, the root-mean-square pitch of the two grids of each pair must match to within 1 part in 10000 and simultaneous exposures of stacked sheets of PMMA have insured that this requirement is met. Received: 30 October 1995 / Accepted: 25 January 1996     

Micromachined jets for liquid impingement cooling of VLSI chips

Two-phase microjet impingement cooling is a potential solution for removing heat from high-power VLSI chips. Arrays of microjets promise to achieve more uniform chip temperatures and very high heat transfer coefficients. This paper presents the design and fabrication of single-jets and multijet arrays with circular orifice diameters ranging from 40 to 76 /spl mu/m, as well as integrated heater and temperature sensor test devices. The performance of the microjet heat sinks is studied using the integrated heater device as well as an industry standard 1 cm/sup 2/ thermal test chip. For single-phase, the silicon temperature distribution data are consistent with a model accounting for silicon conduction and fluid advection using convection coefficients in the range from 0.072 to 4.4 W/cm/sup 2/K. For two-phase, the experimental results show a heat removal of up to 90 W on a 1 cm/sup 2/ heated area using a four-jet array with 76 /spl mu/m diameter orifices at a flowrate of 8 ml/min with a temperature rise of 100/spl deg/C. The data indicate convection coefficients are not significantly different from coefficients for pool boiling, which motivates future work on optimizing flowrates and flow regimes. These microjet heat sinks are intended for eventual integration into a closed-loop electroosmotically pumped cooling system.     

Computerized transcutaneous monitoring incorporating laser Doppler velocimetry

Measurements of transcutaneous oxygen tension, transcutaneous carbon dioxide tension, transcutaneous heater power, transcutaneous electrode temperature, and peripheral perfusion at the gas measurement site (assessed by laser Doppler velocimetry) are monitored by a microprocessor-based data acquisition system. Arterial blood pressure, central venous pressure, pulmonary artery pressure, respiration rate, and heart rate may be simultaneously captured with the system unattended for 12-hour intervals. This computerized monitoring system is mobile and easily applied by medical technologists to adult or neonatal intensive care patients. Simultaneous collection of the measurement data has facilitated research on the interrelationships of the measured parameters. It should be helpful in assessing optimal therapeutic interventions as well as the changing physiology of acutely ill patients.