Palmar-divergent dislocation of the scaphoid and the lunate

We describe a patient with palmar-divergent dislocation of the scaphoid and lunate. After successful closed reduction, the scapholunate and lunotriquetral ligaments were sutured through the dorsal approach, and the anterior capsule was sutured through the palmar approach. The scapholunate and lunotriquetral joints were fixed with Kirschner wires for 7 weeks. At the 1-year follow-up, magnetic resonance imaging showed no evidence of avascular necrosis of the scaphoid or lunate, and radiographs showed no evidence of the dorsal and volar intercalated segment instability patterns associated with carpal instability. However, flexion of the scaphoid and a break in Gilula’s line remained. To our knowledge, this is the first report showing treatment of palmar-divergent dislocation of the scaphoid and lunate by suturing the carpal interosseous ligaments

The Design Of A Tool Kit For Case-Based Design Aids

. This paper extends the discussion of Case-Based Design Aids (CBDAs) presented at the 1992 AI in Design Conference (Domeshek and Kolodner, 1992). After reviewing the CBDA concept and its motivation, we discuss progress in implementing such systems, and focus on the generalization of our original CBDA (first developed to support architects with the conceptual design of buildings) into a tool kit applicable to a wide range of design domains. Experience in gathering and organizing case materials, and consideration of more use-scenarios have led us to reorganize and refine many aspects of the original proposal. Here we report our experience building CBDAs for architecture and for jet aircraft subsystem design using the CBDA tool kit Design-MUSE. 1. Case-Based Design Aids: Background and Review At the 1992 AI & Design Conference we presented a paper describing early work on a case-based design aid for architecture (CBDA) (Domeshek and Kolodner, 1992). That paper focused on two ideas: the..

Using Post-Occupancy Evaluation to AID Reflection in ConceptualDesign: Creating a Case-Based Design Aid for Architecture

The design of large complex "real-world" objects such as buildings requires that the intentions of many potentially competing stakeholders be understood and reconciled. The process of conceptual design itself can be understood as a set of discourses among design team participants and between the designer and the design that gradually reveal these intentions and their relationships to design moves. Our goal is to aid this discourse by creating a Case-based Design Aid (CBDA) that provides design team participants access to specific evaluated cases of experience with previous buildings. This represents a merger of two sets of theories and methodologies: case-based reasoning (CBR) in artificial intelligence, and, post-occupancy evaluation (POE) in architectural research. In developing our CBDA, we have focused on several problems in architectural design: understanding the interactions between intentions, and making links between various modes of understanding and communication, and particularly between verbal description and visual representation. This has led to a particular way of parsing experience, and to several modes of entering and browsing the system. For instance, each case is accessible as a specific building, such as the Santa Clara County Hall of Justice, that can be explored much as an architect might browse a magazine article about the building, looking at a brief text description of the building, photos, and plans. However, each plan is annotated with "problematic situations" that are actually hypertext links into the discursive part of the program. By clicking on the button, the users reaches a "story" screen that lists the intentions of various stakeholders relevant to the problematic situation, a fuller text description of the general problematic situation with a diagram, text and diagram for a specific problematic situation as it operates in a specific building, several general design responses showing how one might respond to the problematic situations, and specific design responses from specific buildings. In addition, the user can browse the system by listing his or her interests and moving directly to stories about a given space type such as "courtroom" or issue such as "way finding." In addition, the designer can access brief synopses of key issues in a building type, for a space type, or for an issue. We are currently implementing the system on the Macintosh using Common Lisp and are focusing on libraries and courthouses as initial building types. Initial feedback from designers has been encouraging. We believe that this approach provides a useful alternative to design guidelines, that often tend to be too prescriptive, and the entirely inductive approach of many designers that may miss critical intentions

Dynamic Idea Maps: A Framework for Linking Ideas with Cases during Brainstorming

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