\u3ci\u3eMedicine Meets Virtual Reality 15\u3c/i\u3e

Chapter, Virtual Reality for Robotic Laparoscopic Surgical Training, co-authored by Nicholas Stergiou, UNO faculty member. Our culture is obsessed with design. Sometimes designers can fuse utility and fantasy to make the mundane appear fresh—a cosmetic repackaging of the same old thing. Because of this, medicine—grounded in the unforgiving realities of the scientific method and peer review, and of flesh, blood, and pain—can sometimes confuse “design” with mere “prettifying.” Design solves real problems, however. This collection of papers underwrites the importance of design for the MMVR community, within three different environments: in vivo, in vitro and in silico. in vivo: we design machines to explore our living bodies. Imaging devices, robots, and sensors move constantly inward, operating within smaller dimensions: system, organ, cell, DNA. in vitro: Using test tubes and Petri dishes, we isolate in vivo to better manipulate and measure biological conditions and reactions. in silico: We step out of the controlled in vitro environment and into a virtual reality. The silica mini-worlds of test tubes and Petri dishes are translated into mini-worlds contained within silicon chips. The future of medicine remains within all three environments: in vivo, in vitro, and in silico. Design is what makes these pieces fit together—the biological, the informational, the physical/material—into something new and more useful.https://digitalcommons.unomaha.edu/facultybooks/1235/thumbnail.jp

Bilateral Claudication Results in Alterations in the Gait Biomechanics at the Hip and Ankle Joints

Claudication is the most common symptomatic manifestation of peripheral arterial disease (PAD), producing significant ambulatory compromise. The purpose of this study was to use advanced biomechanical gait analysis to determine the gait alterations occurring in claudicating patients both before and after onset of claudication pain in their legs. Hip, knee, and ankle joint moments were measured in claudicating patients (age: 64.46±8.47 years; body mass: 80.70±12.64 kg; body height: 1.72±0.08 m) and were compared to gender–age–body mass–height-matched healthy controls (age 66.27±9.22 years; body mass: 77.89±10.65 kg; body height: 1.74±0.08 m). The claudicating patients were evaluated both before (pain-free (PF) condition) and after (pain condition) onset of claudication pain in their legs. Thirteen symptomatic PAD patients (26 claudicating limbs) with bilateral intermittent claudication (IC) and 11 healthy controls (22 control limbs) were tested during level walking at their self-selected speed. Compared to controls, PAD hip and ankle joints demonstrated significant angular kinematics and net internal moment changes. Alterations were present both in PF and pain conditions with several of them becoming worse in the pain condition. Both PF and pain conditions resulted in significantly reduced peak hip extensor moment (5.62±1.40 and 5.63±1.33% BW x BH, respectively) during early stance as compared to controls (7.53±1.16% BW x BH). In the pain condition, PAD patients had a significantly reduced ankle plantar flexor moment (7.56±1.41% BW x BH) during late stance as compared to controls (8.65±1.27% BW x BH). Furthermore, when comparing PF to pain conditions, there was a decreased peak plantar flexor moment (PF condition: 8.23±1.37 vs. pain condition: 7.56±1.41% BW x BH) during late stance. The findings point to a weakness in the posterior compartment muscles of the hip and calf as being the key factor underlying the PAD gait adaptations. Our findings establish a detailed baseline description of the changes present in PAD patient’s joint angles and moments during walking. Since IC is primarily a gait disability, better understanding of the abnormalities in joint and muscle function will enhance our understanding of the gait impairment and may lead to novel, gait-specific treatments

Spontaneous Rupture of the Patellar and Contralateral Quadriceps Tendons Associated with Secondary Hyperparathyroidism in a Patient Receiving Long-term Dialysis

Although spontaneous rupture of the extensor tendon of the knee is more likely to occur in uremic patients with secondary hyperparathyroidism, simultaneous ruptures of bilateral knee extensor tendons is a rarely reported condition. We describe a 30-year-old man with uremia who underwent subtotal parathyroidec-tomy because of secondary hyperparathyroidism with very high serum parathyroid hormone (PTH) level (1940.4 pg/mL). Two weeks later, he complained of a sharp pain in both knees without trauma when he walked downstairs with his left knee forward and right knee behind. Spontaneous simultaneous ruptures of the right patellar tendon and the left quadriceps tendon were diagnosed and surgically repaired. The mechanism of spontaneous tendon rupture in uremic patients with secondary hyperparathyroidism seems to be related to high PTH level which results in osteolytic bone resorption at the tendon insertion site. Early surgical repair, control of secondary hyperparathyroidism, early use of vitamin D analogs, and total parathyroidectomy with or without autotransplantation of part of the parathyroid gland, can treat and prevent tendon rupture or re-rupture with satisfactory results

Bilateral Claudication Results in Alterations in the Gait Biomechanics at the Hip and Ankle Joints

Claudication is the most common symptomatic manifestation of peripheral arterial disease (PAD), producing significant ambulatory compromise. The purpose of this study was to use advanced biomechanical gait analysis to determine the gait alterations occurring in claudicating patients both before and after onset of claudication pain in their legs. Hip, knee, and ankle joint moments were measured in claudicating patients (age: 64.46±8.47 years; body mass: 80.70±12.64 kg; body height: 1.72±0.08 m) and were compared to gender–age–body mass–height-matched healthy controls (age 66.27±9.22 years; body mass: 77.89±10.65 kg; body height: 1.74±0.08 m). The claudicating patients were evaluated both before (pain-free (PF) condition) and after (pain condition) onset of claudication pain in their legs. Thirteen symptomatic PAD patients (26 claudicating limbs) with bilateral intermittent claudication (IC) and 11 healthy controls (22 control limbs) were tested during level walking at their self-selected speed. Compared to controls, PAD hip and ankle joints demonstrated significant angular kinematics and net internal moment changes. Alterations were present both in PF and pain conditions with several of them becoming worse in the pain condition. Both PF and pain conditions resulted in significantly reduced peak hip extensor moment (5.62±1.40 and 5.63±1.33% BW x BH, respectively) during early stance as compared to controls (7.53±1.16% BW x BH). In the pain condition, PAD patients had a significantly reduced ankle plantar flexor moment (7.56±1.41% BW x BH) during late stance as compared to controls (8.65±1.27% BW x BH). Furthermore, when comparing PF to pain conditions, there was a decreased peak plantar flexor moment (PF condition: 8.23±1.37 vs. pain condition: 7.56±1.41% BW x BH) during late stance. The findings point to a weakness in the posterior compartment muscles of the hip and calf as being the key factor underlying the PAD gait adaptations. Our findings establish a detailed baseline description of the changes present in PAD patient’s joint angles and moments during walking. Since IC is primarily a gait disability, better understanding of the abnormalities in joint and muscle function will enhance our understanding of the gait impairment and may lead to novel, gait-specific treatments

An efficient titanium-based photoanode fordye-sensitized solar cell under back-side illumination

Pretreatment of H2O2 is performed on titanium (Ti) foil as an efficient photoanode substrate for dye-sensitized solar cell(DSSC). The H2O2-treated Ti shows high surface area because of the formation of networked TiO2 nanosheets, whichenhances electrical contact between screen-printed TiO2 nanoparticles and Ti foil. Electron transfer on the photoanode isimproved, as identified by reduced charge transfer resistance and improved electron transport properties. Compared withDSSC based on non-treated Ti photoanode, DSSC with this H2O2-treated Ti photoanode exhibits remarkable increasesin short-circuit current density (from 8.55 to 14.38 mA/cm2) and energy conversion efficiency (from 4.68 to 7.10%) underAM1.5 back-side illumination. Copyright © 2011 John Wiley & Sons, Ltd

Spontaneous Rupture of the Patellar and Contralateral Quadriceps Tendons Associated with Secondary Hyperparathyroidism in a Patient Receiving Long-term Dialysis

Although spontaneous rupture of the extensor tendon of the knee is more likely to occur in uremic patients with secondary hyperparathyroidism, simultaneous ruptures of bilateral knee extensor tendons is a rarely reported condition. We describe a 30-year-old man with uremia who underwent subtotal parathyroidec-tomy because of secondary hyperparathyroidism with very high serum parathyroid hormone (PTH) level (1940.4 pg/mL). Two weeks later, he complained of a sharp pain in both knees without trauma when he walked downstairs with his left knee forward and right knee behind. Spontaneous simultaneous ruptures of the right patellar tendon and the left quadriceps tendon were diagnosed and surgically repaired. The mechanism of spontaneous tendon rupture in uremic patients with secondary hyperparathyroidism seems to be related to high PTH level which results in osteolytic bone resorption at the tendon insertion site. Early surgical repair, control of secondary hyperparathyroidism, early use of vitamin D analogs, and total parathyroidectomy with or without autotransplantation of part of the parathyroid gland, can treat and prevent tendon rupture or re-rupture with satisfactory results

Intraosseous Ganglion Cyst of the Capitate Treated by Intralesional Curettage, Autogenous Bone Marrow Graft and Autogenous Fibrin Clot Graft

We report a very rare case of intraosseous ganglion cyst of the capitate in a 54-year-old female who complained of a painful right wrist mass for 1 year. Computed tomography study showed an expansile osteolytic lesion with sclerotic margin and thinning of the cortex. Combined soft tissue ganglion cyst was also noted at operation and confirmed by pathologic study. The case was treated by a new method of autogenous bone marrow and fibrin clot graft after intralesional curettage. After a 2-year follow-up, the capitate revealed complete bony union and the symptoms were relieved with good functional results