804 Kenyon Rd
Fort Dodge IA 50501
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Comparison of the Mechanical Characteristics of a Universal Small Biplane Plating Technique Without Compression Screw and Single Anatomic Plate With Compression Screw. - The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
To better understand the mechanical characteristics of biplane locked plating in small bone fixation, the present study compared the stability under cyclic cantilever loading of a 2-plate locked biplane (BPP) construct without interfragmentary compression with that of a single-plate locked construct with an additional interfragmentary screw (SPS) using surrogate bone models simulating Lapidus arthrodesis. In static ultimate plantar bending, the BPP construct failed at significantly greater load than did the SPS construct (556.2Â Â±Â 37.1Â N versus 241.6Â Â±Â 6.3Â N, pÂ =Â .007). For cyclic failure testing in plantar bending at a 180-N starting load, the BPP construct failed at a significantly greater number of cycles (158,322Â Â±Â 50,609 versus 13,718Â Â±Â 10,471 cycles) and failure load (242.5Â Â±Â 25.0Â N versus 180.0Â Â±Â 0.0Â N) than the SPS construct (pÂ =Â .002). For cyclic failure testing in plantar bending at a 120-N starting load, the results were not significantly different between the BPP and SPS constructs for the number of cycles (207,646Â Â±Â 45,253 versus 159,334Â Â±Â 69,430) or failure load (205.0Â Â±Â 22.4Â N versus 185.0Â Â±Â 33.5Â N; pÂ =Â .300). For cyclic testing with 90Â° offset loading (i.e., medial to lateral bending) at a 120-N starting load, all 5 BPP constructs (tension side) and 2 of the 5 SPS constructs reached 250,000 cycles without failure. Overall, the present study found the BPP construct to have superior or equivalent stability in multiplanar orientations of force application in both static and fatigue testing. Thus, the concept of biplane locked plating, using 2 low profile plates and unicortical screw insertion, shows promise in small bone fixation, because it provides consistent stability in multiplanar orientations, making it universally adaptable to many clinical situations.Copyright Â© 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
FEASIBILITY AND SAFETY OF CONTRAST-ENHANCED ULTRASOUND IN THE DISTAL LIMB OF SIX HORSES. - Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association
Vascular alterations play important roles in many orthopedic diseases such as osteoarthritis, tendonitis, and synovitis in both human and equine athletes. Understanding these alterations could enhance diagnosis, prognosis, and treatment. Contrast-enhanced ultrasound (CEUS) could be a valuable method for evaluation of blood flow and perfusion of these processes in the equine distal limb, however no reports were found describing feasibility or safety of the technique. The goal of this prospective, experimental study was to describe the feasibility and safety of distal limb CEUS in a sample of six horses. For each horse, CEUS of the distal limb was performed after intravenous injections of 5 and 10 ml, as well as intra-arterial injections of 0.5 and 1 ml contrast medium. Vital parameters were monitored and CEUS images were assessed qualitatively and quantitatively for degree of contrast enhancement. None of the horses had clinically significant changes in their vital parameters after contrast medium injection. One horse had a transient increase in respiratory rate, and several horses had mild increases of systolic blood pressure of short duration after intravenous, but not after intra-arterial injections. Intra-arterial injection was possible in all horses and resulted in significantly improved contrast enhancement both quantitatively (P = 0.027) and qualitatively (P = 0.019). Findings from this study indicated that CEUS is a feasible and safe diagnostic test for evaluation of the equine distal limb. Future studies are needed to assess the clinical utility of this test for horses with musculoskeletal diseases.Â© 2016 American College of Veterinary Radiology.
Targeted Transthoracic Acoustic Activation of Systemically Administered Nanodroplets to Detect Myocardial Perfusion Abnormalities. - Circulation. Cardiovascular imaging
Liquid core nanodroplets containing condensed gaseous fluorocarbons can be vaporized at clinically relevant acoustic energies and have been hypothesized as an alternative ultrasound contrast agent instead of gas-core agents. The potential for targeted activation and imaging of these agents was tested with droplets formulated from liquid octafluoropropane (C3) and 1:1 mixtures of C3 with liquid decafluorobutane (C3C4).In 8 pigs with recent myocardial infarction and variable degrees of reperfusion, transthoracic acoustic activation was attempted using 1.3 to 1.7 MHz low (0.2 mechanical index [MI]) or high MI (1.2 MI) imaging in real time (32-64 Hertz) or triggered 1:1 at end systole during a 20% C3 or C3C4 droplet infusion. Any perfusion defects observed were measured and correlated with delayed enhancement magnetic resonance imaging and postmortem staining. No myocardial contrast was produced with any imaging setting when using C3C4 droplets or C3 droplets during low MI real-time imaging. However, myocardial contrast was observed in all 8 pigs with C3 droplets when using triggered high MI imaging and in 5 of 6 pigs that had 1.7 MHz real time-high MI imaging. Although quantitative myocardial contrast was lower with real-time high MI imaging than 1:1 triggering, the correlation between real-time resting defect size and infarct size was good (r=0.97; P<0.001), as was the correlation with number of transmural infarcted segments by delayed enhancement imaging.Targeted transthoracic acoustic activation of infused intravenous C3 nanodroplets is effective, resulting in echogenic and persistent microbubbles which provide real-time high MI visualization of perfusion defects.Â© 2015 American Heart Association, Inc.
Molecular Acoustic Angiography: A New Technique for High-resolution Superharmonic Ultrasound Molecular Imaging. - Ultrasound in medicine & biology
Ultrasound molecular imaging utilizes targeted microbubbles to bind to vascular targets such as integrins, selectins and other extracellular binding domains. After binding, these microbubbles are typically imaged using low pressures and multi-pulse imaging sequences. In this article, we present an alternative approach for molecular imaging using ultrasound that relies on superharmonic signals produced by microbubble contrast agents. Bound bubbles were insonified near resonance using a low frequency (4 MHz) element and superharmonic echoes were received at high frequencies (25-30 MHz). Although this approach was observed to produce declining image intensity during repeated imaging in both inÂ vitro and inÂ vivo experiments because of bubble destruction, the feasibility of superharmonic molecular imaging was demonstrated for transmit pressures, which are sufficiently high to induce shell disruption in bound microbubbles. This approach was validated using microbubbles targeted to the Î±vÎ²3 integrin in a rat fibrosarcoma model (nÂ = 5) and combined with superharmonic images of free microbubbles to produce high-contrast, high-resolution 3-D volumes of both microvascular anatomy and molecular targeting. Image intensity over repeated scans and the effect of microbubble diameter were also assessed inÂ vivo, indicating that larger microbubbles yield increased persistence in image intensity. Using ultrasound-based acoustic angiography images rather than conventional B-mode ultrasound to provide the underlying anatomic information facilitates anatomic localization of molecular markers. Quantitative analysis of relationships between microvasculature and targeting information indicated that most targeting occurred within 50 Î¼m of a resolvable vessel (>100 Î¼m diameter). The combined information provided by these scans may present new opportunities for analyzing relationships between microvascular anatomy and vascular targets, subject only to limitations of the current mechanically scanned system and microbubble persistence to repeated imaging at moderate mechanical indices.Copyright Â© 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
An Integrated System for Super-Harmonic Contrast-Enhanced Ultrasound Imaging: Design and Intravascular Phantom Imaging Study. - IEEE transactions on bio-medical engineering
Super-harmonic contrast-enhanced ultrasound imaging, also called acoustic angiography, has previously been used for imaging of microvasculature. This approach excites microbubble contrast agents near their resonance frequency and receives echoes at non-overlapping super-harmonic bandwidths. No integrated system currently exists could fully support this application. To fulfill this need, an integrated dual-channel transmit/receive system for super-harmonic imaging was designed, built and characterized experimentally.The system was uniquely design for super-harmonic imaging and high-resolution B-mode imaging. A complete ultrasound system including a pulse generator, a data acquisition unit and a signal processing unit were integrated into a single package. The system was controlled by a field programmable gate array, on which multiple user-defined modes were implemented. A 6 MHz, 35 MHz dual-frequency dual-element intravascular ultrasound transducer was designed and used for imaging.The system successfully obtained high resolution B-mode images of coronary artery ex vivo with 45 dB dynamic range. The system was capable of acquiring in vitro super-harmonic images of a vasa vasorum mimicking phantom with 30 dB contrast. It could detect a contrast agent filled tissue mimicking tube of 200 Î¼m diameter.For the first time, high-resolution B-mode images and super-harmonic images were obtained in an intravascular phantom, made possible by the dedicated integrated system proposed. The system greatly reduced the cost and complexity of the super-harmonic imaging intended for preclinical study. Significant: The system showed promise for high-contrast intravascular microvascular imaging, which may have significant importance in assessment of the vasa vasorum associated with atherosclerotic plaques.
Rossella podagrosa Kirkpatrick, 1907-A valid species after all. - Zootaxa
In this study we provide evidence that the species Rossella podagrosa Kirkpatrick, 1907, commonly considered a synonym of Rossella racovitzae Topsent, 1901, is truly a valid species. We show that it can be clearly distinguished from other species especially when taking into consideration the in situ habitus of the sponge in combination with the spicules. Furthermore we demonstrate the weaknesses in the so far published synonymy concept for the very complicated genus Rossella Carter, 1872. From this we conclude that the best strategy for further analysis of Rossella and establishment of acceptable synonymies will need to be based on detailed examination of the spicules, the holotypes, and in situ habitus. When possible it will be useful to analyze specimens from all Antarctic oceanographic regions.
Management of Indeterminate Cystic Kidney Lesions: Review of Contrast-enhanced Ultrasound as a Diagnostic Tool. - Urology
Indeterminate cystic kidney lesions found incidentally are an increasingly prevalent diagnostic challenge. Standard workup includes Bosniak classification with contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI). However, these tests are costly and not without risks. Contrast-enhanced ultrasound (CEUS) is a relatively new technique with lower risk of adverse events than iodine-containing contrast or gadolinium. In our review of the evidence for characterization of cystic kidney lesions with CEUS, CEUS displayed sensitivity (89%-100%) and negative predictive value (86%-100%) comparable to contrast-enhanced CT or MRI, with no decrease in specificity compared with CT and only a slight decrease compared with MRI.Copyright Â© 2015 Elsevier Inc. All rights reserved.
Quantitative Analysis of the Degree of Frontal Rotation Required to Anatomically Align the First Metatarsal Phalangeal Joint During Modified Tarsal-Metatarsal Arthrodesis Without Capsular Balancing. - The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
The data from 35 consecutive patients with hallux valgus undergoing triplane arthrodesis at the first tarsal metatarsal joint were studied to determine the amount of first metatarsal frontal plane rotation (supination) needed to anatomically align the first metatarsal phalangeal joint on an anterior posterior radiograph without soft tissue balancing at the first metatarsal phalangeal joint. Radiographs were measured both pre- and postoperatively to assess the 1-2 intermetatarsal angle, hallux abductus angle, and tibial sesamoid position (TSP). The mean amount of varus (supination) rotation performed during correction was 22.1Â°Â Â±Â 5.2Â° and the mean amount of intermetatarsal angle reduction achieved after completion of the procedure was 6.9Â°Â Â±Â 3.0Â°. The TSP changed by a mean of 3.3Â°Â Â±Â 1.2Â°. A series of univariate linear regression analyses was performed to analyze the relationship between the frontal plane rotation of the first metatarsal performed during the operation and the preoperative intermetatarsal angle, hallux abductus angle, and TSP. Greater preoperative TSP scores were associated with greater intraoperative varus (supination) rotation required for joint alignment. Direct observation of the alignment changes at the first metatarsal phalangeal joint after metatarsal rotation without distal procedures strengthened the notion that the frontal plane rotational position plays an important role in the bunion deformity.Copyright Â© 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Dual-frequency acoustic droplet vaporization detection for medical imaging. - IEEE transactions on ultrasonics, ferroelectrics, and frequency control
Liquid-filled perfluorocarbon droplets emit a unique acoustic signature when vaporized into gas-filled microbubbles using ultrasound. Here, we conducted a pilot study in a tissue-mimicking flow phantom to explore the spatial aspects of droplet vaporization and investigate the effects of applied pressure and droplet concentration on image contrast and axial and lateral resolution. Control microbubble contrast agents were used for comparison. A confocal dual-frequency transducer was used to transmit at 8 MHz and passively receive at 1 MHz. Droplet signals were of significantly higher energy than microbubble signals. This resulted in improved signal separation and high contrast-to-tissue ratios (CTR). Specifically, with a peak negative pressure (PNP) of 450 kPa applied at the focus, the CTR of B-mode images was 18.3 dB for droplets and -0.4 for microbubbles. The lateral resolution was dictated by the size of the droplet activation area, with lower pressures resulting in smaller activation areas and improved lateral resolution (0.67 mm at 450 kPa). The axial resolution in droplet images was dictated by the size of the initial droplet and was independent of the properties of the transmit pulse (3.86 mm at 450 kPa). In post-processing, time-domain averaging (TDA) improved droplet and microbubble signal separation at high pressures (640 kPa and 700 kPa). Taken together, these results indicate that it is possible to generate high-sensitivity, high-contrast images of vaporization events. In the future, this has the potential to be applied in combination with droplet-mediated therapy to track treatment outcomes or as a standalone diagnostic system to monitor the physical properties of the surrounding environment.
The 'fingerprint' of cancer extends beyond solid tumor boundaries: assessment with a novel ultrasound imaging approach. - IEEE transactions on bio-medical engineering
Abnormalities of microvascular morphology have been associated with tumor angiogenesis for more than a decade, and are believed to be intimately related to both tumor malignancy and response to treatment. However, the study of these vascular changes in living models has been challenged due to the lack of imaging approaches which can assess the microvasculature in 3-D volumes non-invasively. Here, we use contrast-enhanced "acoustic angiography" ultrasound imaging to observe and quantify heterogeneity in vascular morphology around solid tumors.Acoustic angiography, a recent advance in contrastenhanced ultrasound imaging, generates high resolution microvascular images unlike anything possible with standard ultrasound imaging techniques. Acoustic angiography images of a genetically engineered mouse breast cancer model were acquired to develop an image acquisition and processing routine that isolated radially expanding regions of a 3-D image from the tumor boundary to the edge of the imaging field for assessment of vascular morphology of tumor and surrounding vessels.Quantitative analysis of vessel tortuosity for the tissue surrounding tumors 3 to 7 mm in diameter revealed that tortuosity decreased in a region 6 to 10 mm from the tumor boundary, but was still significantly elevated when compared to control vasculature.Our analysis of angiogenesis-induced changes in the vasculature outside the tumor margin reveals that the extent of abnormal tortuosity extends significantly beyond the primary tumor mass.Visualization of abnormal vascular tortuosity may make acoustic angiography an invaluable tool for early tumor detection based on quantifying the vascular footprint of small tumors and a sensitive method for understanding changes in the vascular microenvironment during tumor progression.
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