Anatomic double-bundle anterior cruciate ligament reconstruction, using CT-based navigation and fiducial markers

Accurate placement of separate anteromedial and posterolateral bundle bone tunnels is crucial for anatomic, double-bundle anterior cruciate ligament (ACL) reconstruction. However, identifying the anatomic footprint at which to make the tibial and femoral bone tunnels is not a straightforward procedure. To overcome this problem, we used a CT-based navigation technique with a registration procedure based on fiducial markers (FMs). Preoperatively, 10 FM points were placed on skin around knee joint and scanned with CT. Imaging data of the knee were recorded on the computer system for preoperative registration and surgical planning. Intraoperatively, with a reference frame fixed to the distal medial aspect of femur and tibia, paired-point matching registration was performed with the use of points marked on skin through FM center holes. During tibial tunnel guide wire placement, tibial aiming guide with tracking device fed back the position of tip and direction of the guide wire on the three-dimensional (3D) tibia bone surface image and multiple image planes in real time. For the femoral side, the navigation pointer was placed at the footprint center with visual guidance of 3D image of lateral wall sagittal view on navigation monitor and marked with navigation awl. The average registration accuracy of 22 consecutive patients was 0.7 +/- A 0.2 mm and 0.6 +/- A 0.2 mm for femoral and tibial bone, respectively. Most of the bone tunnel positions evaluated with 3D-CT image were confirmed to be accurately placed in reference to the preoperative plan. There was no damage to femoral condyle cartilage and no other complication. This new CT-based computer navigation system opens the possibility for surgeons to plan bone tunnel positioning preoperatively and control it during technically demanding anatomic double-bundle ACL reconstruction.ArticleKNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 19(3):378-383 (2011)journal articl

Evolution of living donor liver transplantation over 10 years: experience of a single center.

PURPOSE: To evaluate the changes in living donor liver transplantations (LDLTs) over the last 10 years, we analyzed our experience of performing LDLT in a single center. METHODS: We performed 73 LDLTs over the 10 years between 1997 and 2007 in Nagasaki University Hospital, Japan. RESULTS: Initially, from 1997 to 2003, LDLT was performed for pediatric patients; then, between 2004 and 2007, adult-to-adult LDLT was introduced, primarily for hepatocellular carcinoma (HCC) in liver cirrhosis. We also began performing LDLTs for adults with ABO-incompatible blood type combination in the latter period. As the number of adult-to-adult LDLTs increased, left-sided grafts became fi rst choice for these patients. Survival rates were 88.3%, 77.2%, 70.2% at 1, 3, and 5 years, respectively. There was a relatively low incidence of arterial complications, and although the incidence of biliary complications was high initially, it decreased with experience. Likewise, the operative time, blood loss, and hospital stay after LDLT also improved remarkably. CONCLUSION: Over the last 10 years the indications for, and operative techniques used in LDLT have changed dramatically, even in a single center in Japan

Ag(I)/TiO2-Photocatalyzed N-Methylation of Amino Acids with Methanol

Silver(I)-loaded titanium dioxide (AgNO3/TiO2) catalyzes the direct N-methylation of amino acids with methanol under irradiation with UV light. This method produces a variety of N-methyl and N,N-dimethyl amino acids with retention of their optical purity.</div

N‑Methylation of Amines with Methanol at Room Temperature

N-Methylation of amines with methanol proceeds at room temperature in the presence of a silver-loaded titanium dioxide (Ag/TiO₂) photocatalyst under UV–vis light irradiation. This method allows facile synthesis/isolation of <i>N</i>-methylamines bearing various functional groups including <i>N</i>-benzyl, <i>N</i>-allyl, <i>N</i>-Boc, hydroxyl, ether, acetal, carboxamide, formamide, and olefin groups

Legislative Documents

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