Energy cost of propulsion in standard and ultralight wheelchairs in people with spinal cord injuries.
BACKGROUND AND PURPOSE: Wheelchair- and subject-related factors influence the efficiency of wheelchair propulsion. The purpose of this study was to compare wheelchair propulsion in ultralight and standard wheelchairs in people with different levels of spinal cord injury. SUBJECTS: Seventy-four subjects (mean age=26.2 years, SD=7.14, range=17-50) with spinal cord injury resulting in motor loss (30 with tetraplegia and 44 with paraplegia) were studied. METHOD: Each subject propelled standard and ultralight wheelchairs around an outdoor track at self-selected speeds, while data were collected at 4 predetermined intervals. Speed, distance traveled, and oxygen cost (VO2 mL/kg/m) were compared by wheelchair, group, and over time, using a Bonferroni correction. RESULTS: In the ultralight wheelchair, speed and distance traveled were greater for both subjects with paraplegia and subjects with tetraplegia, whereas VO2 was less only for subjects with paraplegia. Subjects with paraplegia propelled faster and farther than did subjects with tetraplegia. CONCLUSION AND DISCUSSION: The ultralight wheelchair improved the efficiency of propulsion in the tested subjects. Subjects with tetraplegia, especially at the C6 level, are limited in their ability to propel a wheelchair. (+info)
Filter-based coded-excitation system for high-speed ultrasonic imaging.
We have recently presented a new algorithm for high-speed parallel processing of ultrasound pulse-echo data for real-time three-dimensional (3-D) imaging. The approach utilizes a discretized linear model of the echo data received from the region of interest (ROI) using a conventional beam former. The transmitter array elements are fed with binary codes designed to produce distinct impulse responses from different directions in ROI. Image reconstruction in ROI is achieved with a regularized pseudoinverse operator derived from the linear receive signal model. The reconstruction operator can be implemented using a transversal filter bank with every filter in the bank designed to extract echoes from a specific direction in the ROI. The number of filters in the bank determines the number of image lines acquired simultaneously. In this paper, we present images of a cyst phantom reconstructed based on our formulation. A number of issues of practical significance in image reconstruction are addressed. Specifically, an augmented model is introduced to account for imperfect blocking of echoes from outside the ROI. We have also introduced a column-weighting algorithm for minimizing the number of filter coefficients. In addition, a detailed illustration of a full image reconstruction using subimage acquisition and compounding is given. Experimental results have shown that the new approach is valid for phased-array pulse-echo imaging of speckle-generating phantoms typically used in characterizing medical imaging systems. Such coded-excitation-based image reconstruction from speckle-generating phantoms, to the best of our knowledge, have not been reported previously. (+info)
Ex vivo evaluation of a Taylor-Couette flow, immobilized heparinase I device for clinical application.
Efficient and safe heparin anticoagulation has remained a problem for continuous renal replacement therapies and intermittent hemodialysis for patients with acute renal failure. To make heparin therapy safer for the patient with acute renal failure at high risk of bleeding, we have proposed regional heparinization of the circuit via an immobilized heparinase I filter. This study tested a device based on Taylor-Couette flow and simultaneous separation/reaction for efficacy and safety of heparin removal in a sheep model. Heparinase I was immobilized onto agarose beads via cyanogen bromide activation. The device, referred to as a vortex flow plasmapheretic reactor, consisted of two concentric cylinders, a priming volume of 45 ml, a microporous membrane for plasma separation, and an outer compartment where the immobilized heparinase I was fluidized separately from the blood cells. Manual white cell and platelet counts, hematocrit, total protein, and fibrinogen assays were performed. Heparin levels were indirectly measured via whole-blood recalcification times (WBRTs). The vortex flow plasmapheretic reactor maintained significantly higher heparin levels in the extracorporeal circuit than in the sheep (device inlet WBRTs were 1. 5 times the device outlet WBRTs) with no hemolysis. The reactor treatment did not effect any physiologically significant changes in complete blood cell counts, platelets, and protein levels for up to 2 hr of operation. Furthermore, gross necropsy and histopathology did not show any significant abnormalities in the kidney, liver, heart, brain, and spleen. (+info)
An animal exposure system using ultrasonic nebulizer that generates well controlled aerosols from liquids.
Various aerosol generators have been developed for animal inhalation experiments and the performance tests of measuring instruments and respirators. It has been, however, difficult to generate aerosols from an aqueous solution or suspension keeping the concentration and particle size distribution constant for a long time. Resolving such difficulties, the present study developed an animal exposure system that generates well-controlled and stable aerosols from liquids. The exposure system consists of an aerosol generator using ultrasonic nebulizer, a mixing chamber and an exposure chamber. The validity of this system was confirmed in the generation of NiCl2 and TiO2 aerosol from solution and suspension, respectively. The concentration levels of NiCl2 aerosol were kept at 3.2 mg/m3 and 0.89 mg/m3 for 5 hours with good coefficients of variation (CVs) of 2.5% and 1.7%, respectively. For TiO2 aerosol, the concentration levels of 1.59 mg/m3 and 0.90 mg/m3 were kept for 5 hours with small CVs of 1.3% and 2.0%, respectively. This exposure system could be sufficiently used for inhalation experiments with even high toxic aerosols such as NiCl2 because a momentary high concentration possibly affects results and an extremely stable concentration is required. (+info)
Penetrating sledding injuries to the lower torso--2 case reports.
Sledding accidents are frequent and vary in severity. Penetrating sledding injuries are uncommon but may be devastating. Snow-racers--sleds with both steering and braking devices--may be associated with an increased rate of injury. The authors present 2 cases of lower-torso penetrating trauma associated with the use of snow-racers. Both cases involved penetration--of the perineum in one case and the inguinal area in the other--by wooden sticks. Both patients recovered fully after prompt surgical intervention. The authors suggest that the absence of a protective panel at the front of the snow-racer may result in the sledder's lower torso being more exposed to objects encountered while sledding. The injuries reported raise concerns about the safety of modern sleds and the possibility that design changes are needed. (+info)
Balloon-artery interactions during stent placement: a finite element analysis approach to pressure, compliance, and stent design as contributors to vascular injury.
Endovascular stents expand the arterial lumen more than balloon angioplasty and reduce rates of restenosis after coronary angioplasty in selected patients. Understanding the factors involved in vascular injury imposed during stent deployment may allow optimization of stent design and stent-placement protocols so as to limit vascular injury and perhaps reduce restenosis. Addressing the hypothesis that a previously undescribed mechanism of vascular injury during stent deployment is balloon-artery interaction, we have used finite element analysis to model how balloon-artery contact stress and area depend on stent-strut geometry, balloon compliance, and inflation pressure. We also examined superficial injury during deployment of stents of varied design in vivo and in a phantom model ex vivo to show that balloon-induced damage can be modulated by altering stent design. Our results show that higher inflation pressures, wider stent-strut openings, and more compliant balloon materials cause markedly larger surface-contact areas and contact stresses between stent struts. Appreciating that the contact stress and contact area are functions of placement pressure, stent geometry, and balloon compliance may help direct development of novel stent designs and stent-deployment protocols so as to minimize vascular injury during stenting and perhaps to optimize long-term outcomes. (+info)
Endovascular stent graft repair of aortopulmonary fistula.
Two patients who had aortopulmonary fistula of postoperative origin with hemoptysis underwent successful repair by means of an endovascular stent graft procedure. One patient had undergone repeated thoracotomies two times, and the other one time to repair anastomotic aneurysms of the descending aorta after surgery for Takayasu's arteritis. A self-expanding stainless steel stent covered with a Dacron graft was inserted into the lesion through the external iliac or femoral artery. The patients recovered well, with no signs of infection or recurrent hemoptysis 8 months after the procedure. Endovascular stent grafting may be a therapeutic option for treating patients with aortopulmonary fistula. (+info)
Retrograde esophageal balloon dilatation for caustic stricture in an outpatient clinic setting.
Caustic injury to the esophagus, with resultant esophageal stricture, is a challenge for the surgeon. These strictures require multiple esophageal dilatations, which are usually performed under general anesthesia and frequently under fluoroscopic control. Because of the risks of multiple general anesthetics and frequent radiation, a technique is described for retrograde esophageal balloon dilatation in an outpatient clinic setting without a general anesthetic or fluoroscopic control. (+info)