bluuebunny/crossref_metadata_2025 huggingface dataset:
What impact do systemically administrated bisphosphonates have on oral implant therapy? A systematic review
Authors: Madrid Carlos , Sanz Mariano
Published: July 2009

Objectives: The aim of this systematic review is to evaluate, analysing the dental literature, whether:

• Patients on intravenous (IV) or oral bisphosphonates (BPs) can receive oral implant therapy and what could be the risk of developing bisphosphonate‐related osteonecrosis of the jaw (BRONJ)?

• Osseointegrated implants could be affected by BP therapy.

Material and methods: A Medline search was conducted and all publications fulfilling the inclusion and exclusion criteria from 1966 until December 2008 were included in the review. Moreover, the Cochrane Data Base of Systematic Reviews, and the Cochrane Central Register of Controlled Trials and EMBASE (from 1980 to December 2008) were searched for English‐language articles published between 1966 and 2008. Literature search was completed by a hand research accessing the references cited in all identified publications.

Results: The literature search rendered only one prospective and three retrospective studies. The prospective controlled non‐randomized clinical study followed patients with and without BP medication up to 36 months after implant therapy. The patients in the experimental group had been on oral BPs before implant therapy for periods ranging between 1 and 4 years. None of the patients developed BRONJ and implant outcome was not affected by the BP medication. The three selected retrospective studies (two case–controls and one case series) yielded very similar results. All have followed patients on oral BPs after implant therapy, with follow‐up ranging between 2 and 4 years. BRONJ was never reported and implant survival rates ranged between 95% and 100%. The literature search on BRONJ including guidelines and recommendations found 59 papers, from which six were retrieved. Among the guidelines, there is a consensus on contraindicating implants in cancer patients under IV‐BPs and not contraindicating dental implants in patients under oral‐BPs for osteoporosis.

Conclusions: From the analysis of the one prospective and the three retrospective series (217 patients), the placement of an implant may be considered a safe procedure in patients taking oral BPs for <5 years with regard to the occurrence of BRONJ since in these studies no BRONJ has been reported. Moreover, the intake of oral‐BPs did not influence short‐term (1–4 years) implant survival rates.
Ceramics in implant dentistry (Working Group 1)
Authors: Hobkirk J. A. , Wiskott H. W. A.
Published: July 2009

Introduction: The remit of this working group was to update the existing knowledge base in ceramics in implant dentistry. The reviews from working group 1 formed the basis for this update. Moreover, clinical applications as well as suggestions for further research have been formulated.

Materials and methods: The papers in the working group critically reviewed the literature on the topic. Manuscripts were produced on: 1. The performance of ceramic and metal implant abutments supporting fixed implant reconstructions. 2. The viability of ceramic implants as alternatives to titanium implants. 3. The survival and complications of CAD–CAM reconstructions as compared with FDPs which have been fabricated using conventional techniques.

Results: The results and conclusions of the review process are presented in the following papers, together with the group consensus statements, clinical implications and directions for future research:

Sailer I., Philipp A., Zembic A., Pjetursson B. E., Hämmerle C. H. F., Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions.

Andreiotelli M., Wenz H. J., Kohal R.‐J. Are ceramic implants a viable alternative to titanium implants? A systematic literature review.

Harder S., Kern M. Survival and complications of CAD‐CAM vs. conventionally fabricated reconstructions: a systematic review.
Biofilm formation on rat skin wounds by Pseudomonas aeruginosa carrying the green fluorescent protein gene
Authors: Kanno Emi , Toriyabe Souhachi , Zhang Lianbo , Imai Yoshimichi , Tachi Masahiro
Published: July 2009

Please cite this paper as: Biofilm formation on rat skin wounds by Pseudomonas aeruginosa carrying the green fluorescent protein gene. Experimental Dermatology 2010; 19:154–156.

Abstract:  Most chronic wounds are covered by biofilms. However, questions remain about whether biofilms are a causative factor in delayed wound healing and whether the biofilm state contributes to this pathology. The purpose of this study was to develop an experimental model for convenient observation of biofilm formation on skin wounds. Full‐thickness wounds were created on the backs of SD rats. Suspensions of Pseudomonas aeruginosa carrying the gene encoding green fluorescent protein were then applied to the wounds. The wounds were harvested at 8 h, and at 1, 3 and 7 days postwounding for histological and immunohistochemical examinations. Fluorescence microscopy confirmed the presence of a biofilm as early as 8 h. Comparing with non‐infected wounds, epithelialization was not delayed. In conclusion, wound healing of rat acute wounds was unaffected by biofilm formation.
Analysis of ionizing radiation‐induced DNA damage and repair in three‐dimensional human skin model system
Authors: Su Yanrong , Meador Jarah A. , Geard Charles R. , Balajee Adayabalam S.
Published: July 2009

Please cite this paper as: Analysis of ionizing radiation‐induced DNA damage and repair in three‐dimensional human skin model system. Experimental Dermatology 2010; 19: e16–e22.

Abstract:  Knowledge of cellular responses in tissue microenvironment is crucial for the accurate prediction of human health risks following chronic or acute exposure to ionizing radiation (IR). With this objective, we investigated the radio responses for the first time in three‐dimensional (3D) artificial human skin tissue microenvironment after γ‐rays radiation. IR‐induced DNA damage/repair response was assessed by immunological analysis of well‐known DNA double strand break (DSB) repair proteins, i.e. 53BP1 and phosphorylated ataxia telangiectasia mutatedser1981 (ATMser1981). Efficient 53BP1 and phosphorylated ATM foci formation was observed in human EpiDerm tissue constructs after low and high doses of γ‐rays. Interestingly, EpiDerm tissue constructs displayed less 53BP1 and ATM foci number at all radiation doses (0.1, 1, 2.5 and 5 Gy) than that observed for 2D human fibroblasts. DSB repair efficiency judged by the disappearance of 53BP1 foci declined with increasing doses of γ‐rays and tissue constructs irradiated with 2.5 and 5 Gy of γ‐rays displayed 53BP1 foci persisting up to 72 h of analysis. Pretreatment of EpiDerm tissue constructs with LY294002, [an inhibitor of phosphatidylinositol‐3 kinase and PI‐3 kinase like kinases (PIKK)] completely abolished IR‐induced 53BP1 foci formation and increased the apoptotic death. This observation indicates the importance of PIKK signalling pathway for efficient radiation responses in intact tissue constructs. In summary, we have successfully demonstrated the feasibility of monitoring the DNA damage response in human skin tissue microenvironment. In this system, 53BP1 can be used as a useful marker for monitoring the DSB repair efficiency.
In vivo distribution of carotenoids in different anatomical locations of human skin: comparative assessment with two different Raman spectroscopy methods
Authors: Darvin Maxim E. , Fluhr Joachim W. , Caspers Peter , Van Der Pool André , Richter Heike , Patzelt Alexa , Sterry Wolfram , Lademann Jürgen
Published: July 2009

Background:  The cutaneous antioxidants form an efficient protection system against the destructive potential of free radicals, produced by environmental factors, such as UV‐sun irradiation, hazardous substances and lifestyle habits. Most of the antioxidants cannot be produced by the human organism. Thus, they have to be incorporated by food and beverages.

Material and Methods:  In the present manuscript, the distribution of carotenoids as a marker for antioxidative potential in human skin was investigated with two different in vivo Raman spectroscopy methods with an excitation wavelength of 785 nm (Skin Analyzer) and at 488 nm (resonance Raman spectroscopy). The carotenoid profile was assessed at three different anatomical locations (palm, forehead and volar forearm) in 12 healthy volunteers.

Results:  In untreated skin, the major fraction of the carotenoids is located in the upper part of the stratum corneum (SC). The amount of carotenoid is lower in the upper part of the SC on the forearm compared to forehead and palm shown with both methods. Both methods detect similar distinction patterns of carotenoid levels for the three anatomical locations.

Conclusion:  The present study supports the hypothesis that antioxidative substances; here carotenoids, are secreted via eccrine sweat glands and/or sebaceous glands to the skin surface. Raman spectroscopic methods are an efficient tool to analyze the distribution of carotenoids in the human skin over time and with the Skin Analyzer over different layers of the epidermis. Resonance Raman spectroscopy is suited to analyze deeper parts of the skin.
How to run an effective and efficient dermato‐oncology unit: a Dutch approach
Authors: Van Der Geer Simone , Reijers Hajo , Krekels Gertruud
Published: July 2009

The worldwide incidence of skin cancer (especially non‐melanoma skin cancer) has risen dramatically over the last decades. Skin cancer, including pre‐malignant lesions, is becoming a chronic disease. Adjustments in skin cancer health care need to be made. A disease management system for skin cancer is mandatory in order to avoid waiting lists and insure adequate treatment quality with ever growing numbers of patients requiring treatment. At the Catharina Hospital Eindhoven adjustments are being made on several levels of the dermato‐oncology unit in collaboration with Eindhoven University of Technology. The model combines technological improvements, training health care workers, training of general practitioners and prevention of skin cancer. We discuss our ideas and clinical experiences with managing a dermato‐oncology unit.
Very unusual solitary metastasis of testicular seminoma to the skull
Authors: Chiang David T. , Tan Elaine I. , Wood Glen
Published: July 2009

We present a rare presentation of testicular seminoma. A 60‐year‐old man presented with a solitary subcutaneous metastasis to the skull, 4 years after radical orchidectomy and adjuvant prophylatic radiotherapy for stage T1 seminomatous germ cell tumour. The patient was treated with surgical excision of the solitary metastasis, adjuvant radiation therapy and chemotherapy. He has been followed up for two and a half years with no further recurrence.
Cholangiocarcinoma arising from bile duct hamartoma
Authors: Li Wing‐Hong , Tsang Yick‐Woon , Cheung Moon‐Tong
Published: July 2009

Bile duct hamartoma/von Meyenburg complex is a rare condition and it is even rarer for cholangiocarcinoma to arise from this congenital malformation. The exact clinical course of this condition is uncertain. The purpose of the present paper was to report a case and review the literature concerning this topic.
Bland‐White‐Garland syndrome: Choice of surgical technique
Authors: Rajaii‐Khorasani Ahmad , Kahrom Mahdi , Mohajeri Jamshid , Kahrom Hadi
Published: July 2009

An anomalous origin of the left coronary artery from the pulmonary artery (Bland‐White‐Garland syndrome) was diagnosed in a 48‐year‐old woman complaining of angina for 2 years. The patient underwent surgical repair with ligation of the left coronary artery at the ostium, and a left internal mammary artery (LIMA) to the left anterior descending (LAD) coronary artery bypass. Arterial pressure monitoring and blood gas analysis of pulmonary artery and LAD was carried out before and after ligation and after LIMA to LAD anastomosis. We demonstrated an increase in systolic blood pressure in the LAD with the ligation of the fistula which did not improve significantly with LIMA to LAD reperfusion. However, there was an increase in coronary diastolic pressure with a persistent diastolic gradient. Review of the available literature and comparative analysis of different procedures suggests that ligation of the ostium plus off‐pump LIMA to LAD grafting could be the procedure of choice in adults with this rare but potentially life‐threatening, congenital coronary anomaly.
Recapturing quality field experiences and strengthening teaching–research links
Authors: Spronken‐Smith Rachel , Hilton Mike
Published: July 2009

Because of unwieldy numbers, and in an attempt to strengthen teaching–research links, the teaching team of ‘Field Research Methods’ discarded a class fieldtrip in favour of more flexible fieldwork. The new approach continues to use inquiry‐based learning but has research problems more closely linked to staff interests. Students are responsible for most aspects of the research process including some logistical planning of fieldwork. Although often anxious at first, students welcomed this approach and appreciated the host of transferable and research skills they developed. Tutors benefited from the enhanced learning outcomes for students and a strengthening of teaching–research links.
Managing NCEA assessment practice more effectively
Authors: Fastier Murray
Published: July 2009

The National Certificate of Educational Achievement (NCEA), introduced early this decade, is the national qualification for New Zealand senior secondary school students. Commencing with Level 1 in 2002, the implementation of NCEA represented a marked change from previous norm‐referenced‐based qualifications and required a considerable paradigm shift in teacher assessment practice. During the transition period, learner needs often took second place to assessment in geography classrooms. This paper identifies the practices that Year 11 geography teachers used post NCEA implementation to manage assessment practice more effectively and to address the perceived over‐emphasis on assessment.
Studying Synchronization to a Musical Beat in Nonhuman Animals
Authors: Patel Aniruddh D. , Iversen John R. , Bregman Micah R. , Schulz Irena
Published: July 2009

The recent discovery of spontaneous synchronization to music in a nonhuman animal (the sulphur‐crested cockatoo Cacatua galerita eleonora) raises several questions. How does this behavior differ from nonmusical synchronization abilities in other species, such as synchronized frog calls or firefly flashes? What significance does the behavior have for debates over the evolution of human music? What kinds of animals can synchronize to musical rhythms, and what are the key methodological issues for research in this area? This paper addresses these questions and proposes some refinements to the “vocal learning and rhythmic synchronization hypothesis.”
Effects of Context on Electrophysiological Response to Musical Accents
Authors: Palmer Caroline , Jewett Lisa R. , Steinhauer Karsten
Published: July 2009

Listeners’ aesthetic and emotional responses to music typically occur in the context of long musical passages that contain structures defined in terms of the events that precede them. We describe an electrophysiological study of listeners’ brain responses to musical accents that coincided in longer musical sequences. Musically trained listeners performed a timbre‐change detection task in which a single‐tone timbre change was positioned within 4‐bar melodies composed of 350‐ms tones to coincide or not with melodic contour accents and temporal accents (induced with temporal gaps). Event‐related potential responses to (task‐relevant) attended timbre changes elicited an early negativity (MMN/N2b) around 200 ms and a late positive component around 350 ms (P300), reflecting updating of the timbre change in working memory. The amplitudes of both components changed systematically across the sequence, consistent with expectancy‐based context effects. Furthermore, melodic contour changes modulated the MMN/N2b response (but not the P300) to timbre changes in later sequence positions. In contrast, task‐irrelevant temporal gaps elicited an MMN that was not modulated by position within the context; absence of a P300 indicated that temporal‐gap accents were not updated in working memory. Listeners’ neural responses to musical structure changed systematically as sequential predictability and listeners’ expectations changed across the melodic context.
The Music Instinct
Authors: Mithen Steven
Published: July 2009

Why does music pervade our lives and those of all known human beings living today and in the recent past? Why do we feel compelled to engage in musical activity, or at least simply enjoy listening to music even if we choose not to actively participate? I argue that this is because musicality—communication using variations in pitch, rhythm, dynamics and timbre, by a combination of the voice, body (as in dance), and material culture—was essential to the lives of our pre‐linguistic hominin ancestors. As a consequence we have inherited a desire to engage with music, even if this has no adaptive benefit for us today as a species whose communication system is dominated by spoken language. In this article I provide a summary of the arguments to support this view.
Self‐recognition in the Perception of Actions Performed in Synchrony with Music
Authors: Sevdalis Vassilis , Keller Peter E.
Published: July 2009

This study investigated self‐recognition in point‐light displays depicting actions performed in synchrony with music. Participants were recorded executing three different actions (dancing, walking, and clapping) and were subsequently required to identify the agent (self versus other) from point‐light displays with or without the accompanying music. Results indicate that while recognition accuracy was better than chance for all actions, it was best for the relatively complex dance actions. The presence of music did not affect accuracy, suggesting that self‐recognition was based on information about personal movement kinematics rather than individual differences in synchrony between movements and music.
Motor Timing and Precursor Literacy Skills in Very Young Children
Authors: Wigley Charles , Fletcher Janet , Davidson Jane
Published: July 2009

It is generally agreed that efficiency in processing basic speech sounds is a strong indicator of literacy outcomes. However, there is some debate about the extent to which this capacity is encapsulated within the language system. We report results based on pretest data obtained in an early music training study investigating the relationship between a motor‐rhythmic measure of ability (synchronous tapping) and the purported purely linguistically based processing measures, Rapid Automatized Naming (RAN) and Phonological Awareness (PA). Results suggest that RAN ability relies to some extent on nonlinguistic temporal processing skills.
Musical Morphology
Authors: Chakravarty M. Mallar , Vuust Peter
Published: July 2009

Morphologic measures have long been used to determine the patho‐anatomical signature of different neurologic disorders. However, these measures can also be used to determine effects of specific learning tasks and quantifiable human abilities on cerebral structure. Musicians provide interesting opportunities for this type of analysis as their various skills, such as rhythmic ability and pitch and harmony discrimination (acquired through years of practicing and playing) can be quantified and compared using distinct morphologic analyses. Here, we review magnetic resonance imaging–based morphologic analyses in the music and neuroscience literature and provide some results from our own analysis of rhythmic ability in a cohort of musicians.
Imagery Mismatch Negativity in Musicians
Authors: Herholz Sibylle C. , Lappe Claudia , Knief Arne , Pantev Christo
Published: July 2009

The present study investigated musical imagery in musicians and nonmusicians by means of magnetoencephalography (MEG). We used a new paradigm in which subjects had to continue familiar melodies in their mind and then judged if a further presented tone was a correct continuation of the melody. Incorrect tones elicited an imagery mismatch negativity (iMMN) in musicians but not in nonmusicians. This finding suggests that the MMN component can be based on an imagined instead of a sensory memory trace and that imagery of music is modulated by musical expertise.
Memory for Tonal Pitches
Authors: Akiva‐Kabiri Lilach , Vecchi Tomaso , Granot Roni , Basso Demis , Schön Daniele
Published: July 2009

One of the most studied effects of verbal working memory (WM) is the influence of the length of the words that compose the list to be remembered. This work aims to investigate the nature of musical WM by replicating the word length effect in the musical domain. Length and rate of presentation were manipulated in a recognition task of tone sequences. Results showed significant effects for both factors (length and presentation rate) as well as their interaction, suggesting the existence of different strategies (e.g., chunking and rehearsal) for the immediate memory of musical information, depending upon the length of the sequences.
Music Programs Designed to Remedy Burnout Symptoms Show Significant Effects after Five Weeks
Authors: Brandes Vera , Terris Darcey D. , Fischer Claudia , Schuessler Marc N. , Ottowitz Gernot , Titscher Georg , Fischer Joachim E. , Thayer Julian F.
Published: July 2009

Earlier studies have demonstrated that music interventions can lessen symptoms of depression. Depression and burnout are closely related. We hypothesized that specially designed receptive music therapy programs and protocols might reduce the symptoms of burnout. In a four‐arm randomized, placebo‐ and waiting‐list‐controlled double‐blind study, including 150 participants, two specific music programs significantly reduced burnout symptoms after 5 weeks. The effects were maintained over a long time period. This newly developed method of receptive music therapy was also evaluated for the treatment of depression and dysthymia, with significant outcomes.
Similarity and Repetition
Authors: Neuhaus Christiane , Knösche Thomas R. , Friederici Angela D.
Published: July 2009

In this ERP study we investigate how consecutive phrase patterns in the musical form types AABB and ABAB are conjoined perceptually. An anterior N300 reflects recognition of motif similarity in adjacent (A‐A) and nonadjacent (A‐B‐A) phrase patterns, indicating perceptual coherence between (similar) parts in linear order. A marginally significant late anterior negativity reflects the processing of the second B in ABAB. It probably reveals some global aspects of “structural integration” when nonadjacent parts are perceived in the context of the whole melody.
Reestablishing Speech Understanding through Musical Ear Training after Cochlear Implantation
Authors: Petersen Bjørn , Mortensen Malene V. , Gjedde Albert , Vuust Peter
Published: July 2009

Cochlear implants (CIs) provide impressive speech perception for persons with severe hearing loss, but many CI recipients fail in perceiving speech prosody and music. Successful rehabilitation depends on cortical plasticity in the brain and postoperative measures. The present study evaluates the behavioral and neurologic effects of musical ear training on CI users’ speech and music perception. The goal is to find and work out musical methods to improve CI users’ auditory capabilities and, in a longer perspective, provide an efficient strategy for improving speech understanding for both adults and children with CIs.
Spatial Properties of Perceived Pitch
Authors: Sonnadara Ranil R. , Gonzalez David A. , Hansen Steve , Elliott Digby , Lyons James L.
Published: July 2009

We present three experiments that show a clear influence of pitch on reaching movements. The first experiment shows that when there are incompatibilities between the spatial representations of target coordinates and perceived pitches, response times are longer than when spatial representations are congruous. The second experiment shows that pitch can influence motor responses, biasing their direction. The third experiment shows that in the absence of any other spatial cues, tones are assigned spatial coordinates based on frequency. Our results suggest that pitch may indeed have inherent spatial properties, and that these properties may affect movement planning and execution.
Musical Experience Promotes Subcortical Efficiency in Processing Emotional Vocal Sounds
Authors: Strait Dana L. , Kraus Nina , Skoe Erika , Ashley Richard
Published: July 2009

To understand how musical experience influences subcortical processing of emotionally salient sounds, we recorded brain stem potentials to affective vocal sounds. Our results suggest that auditory expertise engenders subcortical auditory processing efficiency that is intricately connected with acoustic features important for the communication of emotion. This establishes a subcortical role in the auditory processing of emotional cues, providing the first biological evidence for musicians’ enhanced perception of vocally expressed emotion.
Physical Simulation Environment for Arthroscopic Joint Irrigation
Authors: Tuijthof Gabriëlle J. M. , Heeman Paul M. , Van Dijk C. Niek , Blankevoort Leendert
Published: July 2009

Good arthroscopic view is important to perform arthroscopic operations (minimally invasive surgery in joints) safely and fast. To obtain this, the joint is irrigated. However, optimal irrigation settings are not described. To study the complex clinical practice of irrigation, a physical simulation environment was developed that incorporates the main characteristics for performing arthroscopy. Its irrigation capacities were validated with patient data. The physical simulation environment consists of a specially designed knee phantom, all normally used arthroscopic equipment, and registration devices for two video streams, pressures, and flows. The physical embodiment of the knee phantom matches that of human knee joints during arthroscopic operations by the presence of important anatomic structures in sizes comparable to human knee joints, the presence of access portals, and the ability to stress the joint. The hydrostatic and hydrodynamic behavior of the knee phantom was validated with pressure and flow measurements documented during arthroscopic knee operations. Surgeons confirmed that the knee phantom imitated human knee joints sufficiently. The hydrostatic parameters of the knee phantom could be tuned within the range of the human knee joints (restriction: 0.0266–29.3 N s2/m8 versus 0.0143–1.22×1018 N s2/m8 and capacitance: 6.89 m5/N versus 7.50×10−9 m5/N). The hydrodynamic properties of the knee phantom were acceptably comparable to those of the human knee joints. The physical simulation environment enables realistic and conditioned experimental studies to optimize joint irrigation. The foundation has been laid for evaluation of other surgical instruments and of training of surgical skills.
Improved Cardiopulmonary Resucitation Device
Authors: Andreen B. , Croatt R. , Driscoll T. , Savela J. , Schwanbeck A. , Zimmel A. , Belalcazar A.
Published: July 2009

Cardio-pulmonary resuscitation (CPR) plays an important role in the outcome of sudden cardiac arrest, where survival rates continue to be very low, about 5%. CPR has evolved significantly from the days when it was standard practice to flap the arms of victimes, or roll their bodies back and forth over a wooden barrel. Today, many people know the standard technique of giving chest compressions. Others may know about enhancement devices (e.g., ResQPOD) that use a basic mechanics concept of creating negative thoracic pressure during the decompression phase of CPR. This is done by adding inflow resistance to the patient's airway, such that a vacuum is created at each chest decompression. The vacuum pulls blood into the thorax, in effect “priming the pump” with more blood, which is then ejected in the next compression phase. We present an enhancement to the above proven concept of airway restriction during CPR by further adding total airway occlusion to the inflow and outflow of air at appropriate times, by use of a CPR enhancement device (CED). With a face mask and electronic airway valve, maximal vacuum and positive pressures are created in the thorax to enhance blood circulation during cardiac arrest. A CPR cycle is proposed with five phases including two for free air exchange, without the need to interrupt compressions, and adhering to AHA guidelines of 100 compressions per minute. To test the CED, a human cardiopulmonary model is described that allows blood pressure changes to be measured with the various forms of CPR, new and conventional. Preliminary data from testing both CED and standard CPR on the thorax model were found in terms of mean, systolic and diastolic pressure. T-tests evaluated statistical significance. During normal CPR, average systolic pressure was found to be 35.3±0.6 mmHg. When the CED was applied, the average systolic pressure was found to be 62.9±4.5 mmHg (p=0.0002). Average diastolic pressure for normal CPR was found to be 30.4±0.4 mmHg while that of the CED was observed to be 28.6±1.2 mmHg (p=0.095,NS). The MAP calculated from standard CPR resulted in an average of 32.0±0.4 mmHg, while that using the CED was 40±2.1 mmHg, (p=0.002). Based on this preliminary testing and data analysis, the CED shows a significant improvement in systolic and mean arterial pressure in comparison to standard CPR. This supports the CED five phase method that provides positive pressure and vacuum in the cardiopulmonary system during resuscitation. Future work will compare the CED to other CPR enhancement devices.
Design of a Bending Section Auto-Driven Mechanism for Colonoscope
Authors: Zhou D. , McMurray G.
Published: July 2009

Colon cancer is the second leading cause of cancer-related death in the United States. Colonoscopy is the best technology available to detect and treat abnormalities within the colon. It is a procedure that enables a gastroenterologist to evaluate the appearance of the inside of the colon by inserting a flexible tube with about 3/8 in diameter into the anus, and then advancing it slowly, under visual control, into the rectum and through the colon. This procedure is often onerous due to that the driving of the bending section (tip) of the scope and perforation may occur with the rate of 1 out of 1700 procedures. The tip driving system consists of two angulation knobs, two chain-sprocket mechanisms, a series of ring-pivot mechanism, and two pair of wires. Rotating each knob extends and retracts a pair of wires which changes the orientation of the bending section. The up/down angulation knob generates an elevation motion and the left/right angulation knob generates an azimuth motion. Based on the traditional colonoscopy, this work developed an intelligent technology to extend and enhance the diagnostic and surgical capability of the instrument. This intelligent colonoscope includes an image-based control of the tip to release a doctor from onerous work, advanced imaging systems for diagnostics, and advanced human-machine interfaces to facilitate the doctor's operation in an effective manner. In the realization of the bending section driving automation, the driving mechanism design is one of the key issues. In our design of the bending section motion control mechanism, the handle of the colonoscope and the motors are fixed on a holder. The holder can travel along a track. The track can be fixed on any flat surface such as a desk in order to enlarge the motion range of the colonoscope body. Belt mechanism is used to translate the motion from motors to the knobs. The belt pulley is fixed on the driving knob through four equally distributed screws. In order to keep the belt tied all the time, a rocker mechanism with a spring is used between the motor and the knob. Two motors are used to drive the two angulation knobs. Two limit switches are used to identify the homing position of the two motors. The driving torque is limited through the constraint of the current supplied to the motor by an amplifier to avoid the damage to the mechanical system. Together with the motion control system, the mechanism has been lab-tested using an artificial colon. It is observed that the mechanism performs well to accomplish the automation of the knob driving tasks. The system has also been tested using a pig in the animal lab of a hospital satisfactory results have been obtained.
Novel Approach Against Central Venous Catheter Associated Infection With Acinetobacter Baumannii Biofilm
Authors: Elkhatib W. , Noreddin A.
Published: July 2009

Central venous catheter (CVC)-associated infections have substantial impacts on morbidity, mortality, and overall cost of health care. Acinetobacter baumannii causes severe infections, survives on abiotic surfaces, colonizes and develops resistant biofilm on different medical devices including CVC. The cranberry contains proanthocyanidines which possess antiadherent activity against colonic bacteria. This study aimed to assess the use of moxifloxacin/cranberry extract combination against A. baumannii biofilm established on CVC. A. baumannii bioflim was developed on silicone CVC and visualized by electron microscopy. The biofilm was treated according to the method described by Aslam et al. Briefly, segments (1 cm) of silicone CVC (Cook, Inc., Bloomington, IN) were incubated in bacterial suspensions (106 CFU/ml) in Mueller Hinton broth to allow biofilm formation. After incubation at 37°C for 24 h, segments were aseptically removed. Four sets of catheter segments (3 segments/each) were suspended for 6 h at 37°C in one of the following solutions: moxifloxacin (0.16 ug/mL), cranberry aqueous extract (10 mg/mL), Mox-Cran combination, or normal saline (NS) as a control. Catheter segments were rinsed 3 times with NS to remove planktonic bacteria. These segments were individually sonicated for 5 min and vortexed for 30s in 1 ml NS. Aliquots (100 uL) of the sonicated fluids and their dilutions were inoculated onto Mueller Hinton agar plates. Each set of experiments was repeated three times. Bacterial colonies (CFU/cm) were counted after incubation for 24 h. The average colony count of each set of experiment was calculated. The average values of the treated sets were divided by the average value of the control percent for calculation of the percentage biofilm reduction in each treatment as compared to the untreated control (NS). Using ANOVA, the significance level for all analyses was <0.05. The effect of moxifloxacin alone was similar to the untreated control. Cranberry extract could reduce the biofilm by almost 90%. Moreover, MoxDran combination could synergistically and completely (100%) eradicate. A. Baumannii biofilm from CVC. There is a dire need for developing novel strategies against microbial biofilms on medical devices, such as the use of combination between safe anti-adherent extracts with antimicrobial agent as a catheter lock solution, to retrieve the infected vascular catheters. The results of this study revealed a promising antibiofilm activity of moxifloxacin/cranberry extract combination for eradication of mature A. baumannii biofilm from CVC (therapeutic approach). Since biofilm prevention is much easier than its eradication, we hypothesize that impregnation or coating of medical devices, including CVC, with such novel and safe combination might be an outstanding tool against biofilm development (prophylactic approach).
3D CAD Based Conceptual Design of a Novel Aortic Valve Stent
Authors: Praveen Kumar G. V. , Mathew L.
Published: July 2009

Vascular support structures are an important tool for treating valve stenosis. A large population of patients are treated for valvular disease and the principal mode of treatment is the use of percutaneous valvuloplasty. Stent devices are proving to be an improved treatment method; these devices now account for 20% of treatments in Europe. This new technology provides highly effective results at minimal cost and short duration of hospitalization. Accurate and reliable structural analysis provides essential information to the design team in an environment where in vivio experimentation is extremely expensive, or impossible. This paper describe the design of vascular support structure (stents), to provide designers with estimates of the critical parameters which are essential to restore the functions of the endothelium of the Aorta during and after implantation without injuring it. Stent geometries were uniquely defined using the following parameters. (a) Diameter of the aorta; (b) Distance between the aortic root and the coronary artery roots; (c) Position of the coronary arteries; (d) Diameter of the coronaries; (e) Stent–Endothelium Mechanics. Keeping these parameters into consideration a novel stent model was designed to suit its requirement for percutaneous replacement. The 3D geometry of the repeatable units of the stent was generated using SOLIDWORKS modeling software. Using the repeating unit geometry of each stent design, solid models were generated. The unit consisted of 8 lips with two non crossing struts making a circular diameter of 16 mm at the center and 18 mm at either ends. The upper and the lower portions of the prosthesis has a high radial force, the upper portion flared to fix the stent firmly in the ascending aorta and the lower portion to expand against the calcified leaflets and to avoid recoil. The middle portion which bears the valve is constrained and narrower to avoid obstruction of the coronary arteries. This varying diameter of different parts of the stent creates the blunt hooks at either end of the stent. The methodology described in this paper is proposed as a method to compare and analyze the existing stents and the ones proposed here. However, further analysis and studies are needed before these stents are fabricated and deployed. Animal experiments are being planned currently for this purpose.
A Wireless Insufflation System for Capsular Endoscopes
Authors: Toennies J. L. , Webster R. J.
Published: July 2009

Swallowable capsule-based cameras (e.g., the Given Imaging PillCam and competitors) are rapidly becoming the gold standard for diagnosis in the gastrointestinal (GI) tract. However, definitive diagnosis is still often precluded by the inability to control capsule position and orientation. This has inspired a number of active positioning strategies including augmenting the capsule with legs or other appendages, or incorporating magnets which can apply forces and torques in response to an external magnetic field. Furthermore, the loose, mucous coated, elastic intestine is generally deflated during capsule passage, making it challenging to view the entire internal surface adequately without the insufflation that is relied upon in traditional endoscopy. To address these challenges, we propose a new fluid-powered system that permits insufflation from a wireless capsule platform. This is accomplished by carrying a small reservoir of biocompatible liquid onboard the capsule which vaporizes and expands when released through a small onboard solenoid valve. The internal components of the capsule consist of two 3V Lithium coin cell batteries (VL621, Panasonic, Inc.) which charge 3 Tantalum capacitors (TAJB157M006R, AVX Corporation, Inc.) that fire the solenoid valve (S120, Lee Company, Inc.). In our initial proof-of-concept study, we have packaged all components in a 26 mm long by 11 mm diameter capsule. The fluid used in initial experiments is biocompatible Perfluoropentane, although any of a variety of biocompatible fluids that can be liquefied with light pressurization may be used. Perfluoropentane, developed for lung lavage, is a liquid at room temperature and becomes gaseous at body temperature. We note that pneumatic pressure produced in this way may be used for a variety of objectives, including powering biopsy collection devices or other mechanisms within the capsule, or being vented to inflate the intestine. In initial experiments, we have harnessed the pressure to inflate a balloon at the front of the capsule which can distend tissue and thereby improve image quality. In experimental tests, only 0.2 ml of fluid was consumed in inflating the balloon to sufficient pressure to distend porcine intestine (see http://research.vuse.vanderbilt.edu/MEDLab for images of these experiments). Optimization of the capsule body and electrical components is currently underway. Including a wireless camera, all components are expected to fit within the dimensions of a commercial PillCam.
Effect of Laminin on the Interaction Between Islets and an Implantable Immunoisolation Polyurethane Membrane
Authors: Harpstead S. D.
Published: July 2009

The development of bio-artificial organs (sequestered cell cultures, implanted within an isolating membrane) is complicated by dynamic and interrelated variables. The primary objective of an implanted membrane for sequestration of insulin producing cells is to provide a barrier to the host's immune system. Implicit in this structural relationship in systems designed for the treatment of diabetes is the ability to create an environment that is favorable to the sequestered cells' viability and at the same time facilitate the availability of the released insulin in a kinetic relationship consistent with the normal physiology. This investigation conducted under a Phase I SBIR grant explored methods to promote a favorable interaction between islets harvested from neonate rats with a polyurethane membrane during in-vitro culture experiments. Laminin (LAM) extracellular matrix was used to stabilize islets within polyurethane membranes or within cell culture well inserts. Results indicated that insulin produced by islets enclosed within the polyurethane membranes with and without LAM was present for up to six weeks. However, when evaluating the Glucose Stimulated Insulin Secretion (GSIS) there was no evidence of Insulin Response in any of the treatment groups. Further study using LAM and islets in the presence of a cell culture insert (8.0 micron polycarbonate membrane) demonstarted that LAM impeded flow of media through the membrane. When media sampled from the well was compared to inside the insert at the 11.2 mM glucose phase of the GSIS, the average insulin concentration from the well was <45.8% of that found inside the cup. In addition, there was evidence of a positive effect on β-cell rate of cell division in the presence of LAM. The average number of brdU labeled cells per islet was significantly greater following prolactin (PRL; positive control @ 500 ng/ml), laminin–1 (50 μg/ml) or the combination of PRL and LAM. The increases relative to the control islets averaged across the replications were: Laminin +1.5 times, Prolactin +5.9 times, PRL and LAM +6.8 times. In summary, there was no evidence of GSIS in experiments where laminin–1 was used to stabilize neonate rat islets within a polyurethane membrane. These results suggest that the presence of ECM on the inside of the polyurethane membrane impeded the insulin of the polyurethane membrane impeded the insulin diffusion kinetics through the membrane. The only potentially positive results from this study are that there is evidence of insulin diffusion over time indicating that the islets are functional, but a an unknown level of physiologic utility. Support for this study was provided by NIH SBIR Grant #1 R43 DK75220-01. Dr. Robert Sorenson, University of MN, and his lab graciously provided the neonate rat islets and advice.
Utility of Periurethral Electric Stimulation to Reduce Voiding Frequency in Rats
Authors: Forrest A. , Zhang Y. , Bicek A. , Timm G.
Published: July 2009

Urinary continence is maintained through coordination of electrical (nervous) and mechanical (muscles, ligaments and other structures) systems in the body. During micturition, the central nervous system sends a signal to the detrusor and sphincter muscles to coordinate voiding. Pathological problems can undermine either of the two systems and result in urinary incontinence (UI). Thirteen million people in the United States live with UI. Clinical treatments to date are largely mechanical in nature, restoring function through surgical interventions. However, electrically-based treatments, such as electric stimulation, offer a promising alternative. Here we investigate the utility of electrical stimulation of the periurethral neuromusculature to reduce voiding contractions in well-controlled animal experiments. Female Sprague Dawley rats were anesthetized with a ketamine/xylazine/acepromazine cocktail and the bladder was catheterized through a small incision in the bladder dome and was infused with saline. Continuous filling of the bladder triggered related cycles of voiding which was identified through bladder pressure increases and visual urination. The pubic symphysis bone was cut to expose the urethra and a stimulating electrode was placed in the periurethral region. The electrical stimulation parameters were 2.8 mA of current, 200 us pluses, and 20 Hz. The electrical stimulation was done in fifteen minute intervals. Statistically, the rats without electrical stimulation have an average contraction period of 63.1 sec (+/– 31.3 sec) and the rats with electrical stimulation have an average contraction period of 97.2 sec (+/– 43.0 sec). The results showed that the electrical stimulation of the periurethral neuromusculature in the group revealed 54.0% increase in average contraction period and decrease in voiding frequency. Electrical stimulation of the periurethral neuromusculature increases the voiding interval and void volume for the rats. This suggests the existence of an external urinary sphincter to the bladder inhibitory pathway and supports periurethral neuromusculature stimulation as an alternative to spinal nerve stimulation for the treatment of bladder overactivity.
Cardiac Axial Blood PUmp Analysis and Performance Prediction
Authors: Hussein D. H. , Gitano-Briggs H. , Addullah M. Z.
Published: July 2009

Computational fluid dynamics (CFD) has been used for developing and evaluating the performance of a novel design of the cardiac axial blood pump (CABP). This device could be used as an implantable pump for boosting blood circulation in patients whose hearts are not providing sufficient output. Based on the Berlin Heart configuration the blood pump has been designed for a flow rate of 5 L/mine and 100 mmHg of head pressure. Finite element analysis method has been performed to predict the shear stress, pressure, velocity, pressure drop on the fluid through the pump and the shear stress on the pump impeller. Also, flow streamlines has been discussed in detail in this study to predict the flow streamlines behavior and the stagnation points. The goal of this work is to design an efficient blood pump to support the blood circulatory system and reduce the shear stress and blood hemolysis during transport through the pump. Our design simulated at several rotational speeds (5000 to 7000) rpm to investigate the relationship between the rotational speeds and shear stress. Results indicate that the rotational speed has a direct correlation with shear stress and pressure drop and at 6500 rpm the pump gives its optimal pressure drop.