Augmented-reality-assisted K-wire placement for glenoid component positioning in reversed shoulder arthroplasty: a proof-of-concept study

The accuracy of the implant’s post-operative position and orientation in reverse shoulder arthroplasty is known to play a significant role in both clinical and functional outcomes. Whilst technologies such as navigation and robotics have demonstrated superior radiological outcomes in many fields of surgery, the impact of augmented reality (AR) assistance in the operating room is still unknown. Malposition of the glenoid component in shoulder arthroplasty is known to result in implant failure and early revision surgery. The use of AR has many promising advantages, including allowing the detailed study of patient-specific anatomy without the need for invasive procedures such as arthroscopy to interrogate the joint’s articular surface. In addition, this technology has the potential to assist surgeons intraoperatively in aiding the guidance of surgical tools. It offers the prospect of increased component placement accuracy, reduced surgical procedure time, and improved radiological and functional outcomes, without recourse to the use of large navigation or robotic instruments, with their associated high overhead costs. This feasibility study describes the surgical workflow from a standardised CT protocol, via 3D reconstruction, 3D planning, and use of a commercial AR headset, to AR-assisted k-wire placement. Post-operative outcome was measured using a high-resolution laser scanner on the patient-specific 3D printed bone. In this proof-of-concept study, the discrepancy between the planned and the achieved glenoid entry point and guide-wire orientation was approximately 3 mm with a mean angulation error of 5°

Biology of moderately halophilic aerobic bacteria

The moderately halophilic heterotrophic aerobic bacteria form a diverse group of microorganisms. The property of halophilism is widespread within the bacterial domain. Bacterial halophiles are abundant in environments such as salt lakes, saline soils, and salted food products. Most species keep their intracellular ionic concentrations at low levels while synthesizing or accumulating organic solutes to provide osmotic equilibrium of the cytoplasm with the surrounding medium. Complex mechanisms of adjustment of the intracellular environments and the properties of the cytoplasmic membrane enable rapid adaptation to changes in the salt concentration of the environment. Approaches to the study of genetic processes have recently been developed for several moderate halophiles, opening the way toward an understanding of haloadaptation at the molecular level. The new information obtained is also expected to contribute to the development of novel biotechnological uses for these organisms

Influence of hip replacement on sagittal alignment of the lumbar spine: An EOS study

INTRODUCTION: Changes in pelvic position can influence the sagittal alignment of the lumbar spine. The restoration of hip kinematics by hip replacement thus appears to offer the possibility of correcting sagittal alignment. This preliminary retrospective study used EOS imaging to investigate the influence of total hip arthroplasty on pelvic parameters in patients with normal preoperative pelvic parameters. METHODS: Twenty patients with hip osteoarthritis undergoing total hip arthroplasty (THA) between 2011 and 2012 received unilateral THA. To evaluate the preoperative and postoperative changes of the pelvic parameters, we analyzed EOS imaging of the patients to determine pelvic incidence, sacral slope, sacral tilt, pelvic tilt, anterior pelvic plane inclination and pelvic axial rotation. Additionally, anteversion and inclination of the acetabular cup position were determined. RESULTS: No statistically significant difference was found between the preoperative and postoperative measurements of pelvic parameters, although the change in pelvic tilt approached significance. Postoperatively, respective average values of 42.6. and 22.7. were measured for inclination and anteversion of the acetabular cup position. CONCLUSION: THA did not influence pelvic position and sagittal alignment in patients with normal preoperative pelvic parameters. A subsequent study will investigate whether corrections of pelvic parameters outside the norm in patients with OA are possible with THA

Tricuspid Valve Regurgitation as a Presenting Symptom of Metastasized Carcinoid Tumor

A 66-year-old woman was diagnosed with hepatic metastasized carcinoid tumor of the ileocecal junction resulting in elevated plasma chromogranin A levels and urinary 5-hydroxyindoleacetic acid (5-HIAA) levels. Further examination showed right-sided heart failure with severe tricuspid valve regurgitation. Carcinoid tumors produce serotonin which leads to flushing, secretory diarrhea, bronchospasm and hypotension, known as carcinoid syndrome. Serotonin is metabolized to 5-HIAA, which is inactive, in the liver and the lungs. However, hepatic metastases may result in direct exposure of the heart to serotonin, which induces plaque-like deformities on the tricuspid valve, and in turn induces valve regurgitation. This condition is known as carcinoid heart disease. Tricuspid valve regurgitation may induce risk of massive blood loss in case of liver surgery through high-volume backflow in the hepatic veins. This report shows the clinical relevance of carcinoid heart disease in the perioperative setting

Characterization of GmENOD40, a gene showing novel patterns of cell-specific expression during soybean nodule development.

In this paper, the soybean 'early nodulin' clone pGmENOD40 is characterized. The GmENOD40 encoded protein does not contain methionine and does not show homology to proteins identified so far. In situ hybridizations showed that this gene has a complex expression pattern during development of determinate soybean nodules. At early stages of development transcription is induced in dividing root cortical cells, the nodule primordium and the pericycle of the root vascular bundle. In mature soybean nodules, the gene is expressed in the uninfected cells of the central tissue and in the pericycle of the nodule vascular bundles. Studies on nodules devoid of intracellular bacteria and infection threads, showed that the expression of the gene in the nodule primordium is induced in these empty nodules, while the induction of the GmENOD40 gene in the nodule vascular bundle requires the presence of intracellular bacteria or infection threads. A pea cDNA clone homologous to GmENOD40 was isolated to enable in situ hybridization studies on indeterminate nodules. The expression patterns in both determinate and indeterminate nodules suggests that the ENOD40 protein might have a transport function