Utilizing image guided surgery for user interaction in medical augmented reality

The graphical overlay of additional medical information over the patient during a surgical procedure has long been considered one of the most promising applications of augmented reality. While many experimental systems for augmented reality in medicine have reached an advanced state and can deliver high-quality augmented video streams, they usually depend heavily on specialized dedicated hardware. Such dedicated system components, which originally have been designed for engineering applications or VR research, often are ill-suited for use in the clinical practice. We have described a novel medical augmented reality application, which is based almost exclusively on existing, commercially available, and certified medical equipment. In our system, a so-called image guided surgery device is used for tracking a webcam, which delivers the digital video stream of the physical scene that is augmented with the virtual information. In this paper, we show how the capability of the image guided surgery system for tracking surgical instruments can be harnessed for user interaction. Our method enables the user to define points and freely drawn shapes in 3-d and provides selectable menu items, which can be located in immediate proximity to the patient. This eliminates the need for conventional touchscreen- or mouse-based user interaction without requiring additional dedicated hardware like dedicated tracking systems or specialized 3-d input devices. Thus the surgeon can directly interact with the system, without the help of additional personnel. We demonstrate our new input method with an application for creating operation plan sketches directly on the patient in an augmented view

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

Adaptive Vision Based Scene Registration for Outdoor Augmented Reality

Augmented Reality (AR) involves adding virtual content into real scenes. Scenes are viewed using a Head-Mounted Display or other display type. In order to place content into the user's view of a scene, the user's position and orientation relative to the scene, commonly referred to as their pose, must be determined accurately. This allows the objects to be placed in the correct positions and to remain there when the user moves or the scene changes. It is achieved by tracking the user in relation to their environment using a variety of technology. One technology which has proven to provide accurate results is computer vision. Computer vision involves a computer analysing images and achieving an understanding of them. This may be locating objects such as faces in the images, or in the case of AR, determining the pose of the user. One of the ultimate goals of AR systems is to be capable of operating under any condition. For example, a computer vision system must be robust under a range of different scene types, and under unpredictable environmental conditions due to variable illumination and weather. The majority of existing literature tests algorithms under the assumption of ideal or 'normal' imaging conditions. To ensure robustness under as many circumstances as possible it is also important to evaluate the systems under adverse conditions. This thesis seeks to analyse the effects that variable illumination has on computer vision algorithms. To enable this analysis, test data is required to isolate weather and illumination effects, without other factors such as changes in viewpoint that would bias the results. A new dataset is presented which also allows controlled viewpoint differences in the presence of weather and illumination changes. This is achieved by capturing video from a camera undergoing a repeatable motion sequence. Ground truth data is stored per frame allowing images from the same position under differing environmental conditions, to be easily extracted from the videos. An in depth analysis of six detection algorithms and five matching techniques demonstrates the impact that non-uniform illumination changes can have on vision algorithms. Specifically, shadows can degrade performance and reduce confidence in the system, decrease reliability, or even completely prevent successful operation. An investigation into approaches to improve performance yields techniques that can help reduce the impact of shadows. A novel algorithm is presented that merges reference data captured at different times, resulting in reference data with minimal shadow effects. This can significantly improve performance and reliability when operating on images containing shadow effects. These advances improve the robustness of computer vision systems and extend the range of conditions in which they can operate. This can increase the usefulness of the algorithms and the AR systems that employ them

Osteoarthritis

Osteoarthritis is one of the most debilitating diseases affecting millions of people worldwide. However, there is no FDA approved disease modifying drug specifically for OA. Surgery remains an effective last resort to restore the function of the joints. As the aging populations increase worldwide, the number of OA patients increases dramatically in recent years and is expected to increase in many years to come. This is a book that summarizes recent advance in OA diagnosis, treatment, and surgery. It includes wide ranging topics from the cutting edge gene therapy to alternative medicine. Such multifaceted approaches are necessary to develop novel and effective therapy to cure OA in the future. In this book, different surgical methods are described to restore the function of the joints. In addition, various treatment options are presented, mainly to reduce the pain and enhance the life quality of the OA patients

Smoking and Second Hand Smoking in Adolescents with Chronic Kidney Disease: A Report from the Chronic Kidney Disease in Children (CKiD) Cohort Study

The goal of this study was to determine the prevalence of smoking and second hand smoking [SHS] in adolescents with CKD and their relationship to baseline parameters at enrollment in the CKiD, observational cohort study of 600 children (aged 1-16 yrs) with Schwartz estimated GFR of 30-90 ml/min/1.73m2. 239 adolescents had self-report survey data on smoking and SHS exposure: 21 [9%] subjects had “ever” smoked a cigarette. Among them, 4 were current and 17 were former smokers. Hypertension was more prevalent in those that had “ever” smoked a cigarette (42%) compared to non-smokers (9%), p\u3c0.01. Among 218 non-smokers, 130 (59%) were male, 142 (65%) were Caucasian; 60 (28%) reported SHS exposure compared to 158 (72%) with no exposure. Non-smoker adolescents with SHS exposure were compared to those without SHS exposure. There was no racial, age, or gender differences between both groups. Baseline creatinine, diastolic hypertension, C reactive protein, lipid profile, GFR and hemoglobin were not statistically different. Significantly higher protein to creatinine ratio (0.90 vs. 0.53, p\u3c0.01) was observed in those exposed to SHS compared to those not exposed. Exposed adolescents were heavier than non-exposed adolescents (85th percentile vs. 55th percentile for BMI, p\u3c 0.01). Uncontrolled casual systolic hypertension was twice as prevalent among those exposed to SHS (16%) compared to those not exposed to SHS (7%), though the difference was not statistically significant (p= 0.07). Adjusted multivariate regression analysis [OR (95% CI)] showed that increased protein to creatinine ratio [1.34 (1.03, 1.75)] and higher BMI [1.14 (1.02, 1.29)] were independently associated with exposure to SHS among non-smoker adolescents. These results reveal that among adolescents with CKD, cigarette use is low and SHS is highly prevalent. The association of smoking with hypertension and SHS with increased proteinuria suggests a possible role of these factors in CKD progression and cardiovascular outcomes