Submitted by (edna.saturno@ufrpe.br) on 2016-11-03T12:20:51Z No. of bitstreams: 1 Ricardo Chiorato.pdf: 2030423 bytes, checksum: fa8d57bc2bf8364b72b7eef6136d34c7 (MD5) / Made available in DSpace on 2016-11-03T12:20:51Z (GMT). No. of bitstreams: 1 Ricardo Chiorato.pdf: 2030423 bytes, checksum: fa8d57bc2bf8364b72b7eef6136d34c7 (MD5) Previous issue date: 2010-02-25 / The use of radiographic visualization of static procedure using, are guiding means to transoperatory implantation of orthopedic element, especially where direct visualization is not possible. The aim of this study was verify, the provents of the transoperatory radiographic procedure in surgery of bone fractures, of dogs and cats. A total of 100 animals, 81 dogs and 19 cats with bone fractures, were used. The first x-ray was obtained after the surgeon had reduced the fracture and/or positioned the metal implants. From the analysis of this transsurgical exam and osseous estructures, if the metalic implants and bone reductions were in absolute accuracy with the principles of orthopedic surgery, the surgeon would conclude the surgery, but if these were not in appropriate place, the necessary arrangements had to be made to relocate it in the right place, and thus more transoperatory radiographic exams were made up the observation of the perfect alignment, positioning or coaptation of fractures and the correct placement of orthopedic implants .It was found that after the transoperatory radiographic examination additional adjustments were necessary for repositioning of metallicimplants and/or bone structures in 95% of procedures. In view of the results, we can conclude that the use of transoperatory radiographic examination in orthopedic surgery of dogs and cats, regardless of the surgeon, animal species or fractured bone is important on the final result of the reductions and stabilizations of fractures, allowing greater efficiency in the placement of the osseous fragments and surgical implants. More specifically in the closed stabilizations or through minimal invasive approach, with the insertion of intramedullary pins and in the cominutive and obliquous type located in the humerus, tibia and calcaneus. / A utilização de imagem radiográfica estática durante o procedimento cirúrgico é um meio de orientação transoperatória que proporciona maior precisão na colocação de implantes ortopédicos, bem como a avaliação do grau de coaptação e estabilização dos fragmentos da fratura, principalmente nas reduções fechadas, onde a visualização direta não é possível. Este trabalho teve como objetivo verificar a utilidade do exame radiográfico transoperatório na cirurgia reparadora de fraturas, previamente diagnosticadas, em cães e gatos. Foram utilizados 100 animais, 81 cães e 19 gatos, com fraturas ósseas, sendo obtido o primeiro exame radiográfico logo após o cirurgião ter reduzido à fratura e posicionado os implantes metálicos. A partir da análise dos exames transoperatórios, se os implantes metálicos e as reduções ósseas estivessem em absoluta exatidão com os princípios da cirurgia ortopédica, o cirurgião concluiria a cirurgia; caso contrário seriam tomadas as providências necessárias para reposicioná-los corretamente, devendo-se assim realizar mais exames radiográficos transoperatórios até a observação do perfeito alinhamento, aposicionamento ou coaptação dasfraturas e a apropriada localização dos implantes ortopédicos. Foi verificado que após o primeiro exame radiográfico transoperatório foram necessários ajustes adicionais para reposicionamento dos implantes metálicos e ou estruturas ósseas em 95% dos procedimentos. Pode-se concluir que a utilização desse exame em ortopedia de cães e gatos, independente da espécie é importante, no resultado final das reduções e estabilizações de fraturas, por possibilitar uma maior precisão no posicionamento dos fragmentos ósseos e dos implantes, principalmente nas estabilizações fechadas ou por abordagem minimamente invasiva, com inserção de pinos intramedulares, e nas do tipo oblíqua e cominutiva e nas situadas no úmero, tíbia e calcâneo.

La radiologie est actuellement la modalité d'imagerie la plus utilisée en chirurgie orthopédique, que ce soit en planification opératoire, en contrôle per-opératoire ou pour le suivi du patient. Un de ses inconvénients est de ne pas permettre un référencement géométrique des objets représentés. Il est donc impossible tout au long du processus chirurgical orthopédique, de mesurer précisément les modifications de géométrie des structures osseuses. En salle d'opération les instruments chirurgicaux sont référencés spatialement et permettent par palpations de points de référence une identification géométrique des structures osseuses. Ceci est limité au contexte chirurgical car ces palpations requièrent des incisions. Dans cette thèse, nous proposons d'introduire en chirurgie orthopédique une nouvelle approche fondée sur l'utilisation d'un capteur d'images ultrasonores dont le positionnement spatial est connu. Nous présentons une méthode d'analyse d'images ultrasonores qui aboutit à la détection des points de référence dans un contexte non chirurgical. Cet apport est fondamental car il introduit une continuité dans le contrôle précis de la géométrie des structures osseuses tout au long du processus chirurgical orthopédique de la planification opératoire jusqu'au suivi du patient. Pour déterminer la position des points de référence sur les images ultrasonores osseuses nous sommes passés par une étape intermédiaire consistant en la détection de l'interface osseuse par des approches fondées sur des modèles de contours. Devant la difficulté du problème lié à la très faible qualité des images ultrasonores osseuses, nous nous sommes orientés vers une approche coopérative innovante. Dès que la sonde est positionnée sur le patient, le système affiche en temps réel le contour détecté et le clinicien peut, par un mouvement continu de la sonde, faire converger le système vers une solution optimale au regard de son expertise et des propriétés images. La validation de nos algorithmes s'est tout d'abord effectuée en mode non coopératif sur une base de données contenant 651 images ultrasonores. Le meilleur algorithme fondé sur la recherche d'un chemin optimal parmi un ensemble de points de contours candidats a été validé en mode coopératif sur un prototype appelé PhysioPilot dédié à la mesure de paramètres physiologiques dans un contexte non chirurgical / X-rays remain the preferred imaging modality for orthopedic surgery for surgical planning, intra-operative control or patient follow-up. Nevertheless, it does not allow anatomical bone structures referencing. It is then impossible to control geometrical modifications of bone structures during the surgical process. However, surgical tools are referenced in the operating-room space and allow the surgeon to define anatomical structures geometrically by defining landmark positions. This process is only allowed during surgical procedures because it requires to do cuts on the patient. In this work, we propose a new approach using an ultrasound probe that is referenced in the operating-room space. We present an image processing algorithm to extract anatomical landmark position in a surgical context. It is a crucial improvement because it allows a complete patient follow-up from pre-operative planning to post-operative consults. To determine anatomical landmark positions on ultrasound images we added an intermediate step to extract the bone/soft tissues interface via several segmentation methods as active contours. Due to the low quality of ultrasound images we decided to design a innovative cooperative process. As the surgeon positions the ultrasound probe on the patient, the bone interface appears on the system screen in real time. Then the clinician can help the segmentation result to converge to the final solution by a soft movement of the probe. The validation of our work was performed on a database of 651 ultrasound images, in a non-cooperative way. The best algorithm that extracts the bone interface by defining the optimal path in a graph of potential candidates was validated with a cooperative protocol on a prototype called PhysioPilot, in order to perform physiological measurements in a non-surgical context

Conselho Nacional de Desenvolvimento Científico e Tecnológico / In arthopedic surgery thera are.frequentlysituations in that the surgeon faces severa bone losses caused by high-energy trauma, tumors of infections. Repairing these losses require knowledge about fillingmateriais. Those materiais can be biological, synthetic or metallic, with emphasis in bony grafts and biomaterial implants. The increase of the use of birds as pets is leading to an increasing number of clinicaland surgical cases related to this taxon, where fractures are the most commonly observed surgical problems. The objective of this study was to evaluate clinical, radiological,macroscopic and microscopic effects of the polyurethane derived from castor oU(Ricinus communis) polymer,when implanted in the humerus of domestic quails (Cotumixjaponica).There were used twenty male and female quails, randomly distributedin four groups of tive individuais.The birds received the implantsin the left hurnerus, being submitted to daily physical examination during the postoperative period, immediate and biweekll radíological examination, and maaoscopic and microscopicevaluation at the 15 ,30th, 60thand 90thdays. Clinically,there were not observed local, regional or systemic changas. Radiologically, it was observed increase in local density with no signs of changes in bone or adjacent tissue, as well as in the air sacs. Macroscopicanalysis revealed that the polyurethane derived trom castor oi!polymerwas not absorbed in none of the four groups, remaining implanted within the pneumatic bone. Its resistance, however, have changed. Microscopic examination evidenced minimum inflammatoryreadion, slight fibrosis around the implants, and osteo-integration with presence of trabeculi and bone marrow inside the implants. Concluding, implants of polyurethane derived trom castor oil polymer are biocompatiblein quails, with occurrence of osteo-integration, and can be used in orthopedic surgery in this species. / Na cirurgia ortopédica são freqüentes as situações em que o cirurgião se depara com grandes perdas ósseas, provocadas especialmente por traumatismos de alta energia. A reparação de tais perdas requer grande conhecimento a respeito de materiais que possam ser utilizados para seu preenchimento. Esses materiais podem ser biológicos.sintéticos ou metálicos, destacando-se os enxertos ósseos e os implantes de biomateriais.O incremento no emprego de aves como animais de estimação tem levado ao aumento na casu(stica clínica e cirúrgica relacionada a esse grupo taxonOmico.Dentre os problemas cirúrgicos observados em aves, as fraturas têm maior destaque. O objetivo deste estudo foi avaliar os efeitos: d(nico, radiológico,macroscópico e histológicodo poHmerode mamona (Ricinus communis) implantado no úmero de codornas domésticas (Cotumixjaponica). Para isso, foram empregadas 20 codornas, machos e fêmeas, separadas aleatoriamente em quatro grupos de cinco indivlduos. As aves receberam o implante no úmero esquerdo, passando por exame flsico diário durante o perlodo pós-operatório, avaliação radiológicaimediata e quinzenal, e avaliação macroscópica e histológicaaos 15, 30, 60 e 90 dias. Clinicamente, não foram observadas alterações locais, regionais ou sistêmicas. Ao exame radiológico,notou-se aumento da densidade local, sem sinais de alteração óssea ou dos tecidos adjacentes, bem como das sacos aéreos. A análise macrosc6pica revelou que a poliuretana derivada do poUmerode mamona não foi absorvida em nenhum dos quatro grupos, permanecendo implantada no interior do osso pneumático, notando-se, porém, alteração em sua resistência. O exame histopatológico evidenciou mlnima reação inflamatória,discreta fibrose ao redor do implante e osseointegração, pela presença de trabéculas e medula óssea no interior do implante. Conduiu-se que a poliuretana derivada do poUmero de mamona é biocompatlvel em codornas, com ocorrência de osseointegração, podendo, portanto ser utilizadaem cirurgiaortopédica.

Ces travaux s'inscrivent dans le cadre d'un projet de recherche translationnel visant à améliorer la conception des corsets orthopédiques de traitement de la scoliose par la mise en place, par méthode inverse, d'un modèle biomécanique global, simplifié et personnalisé, propre au tronc de chaque patient scoliotique. Ils constituent la première étape de ce projet, à savoir, développer et mettre en œuvre des techniques, outils et protocoles permettant, d'une part, la construction d'un modèle géométrique 3D de la surface externe et des éléments internes du tronc du patient à partir de radiographies bi-planes issues d'un équipement standard et du système Model Maker (Proteor), et d'autre part, la mesure des pressions exercées par le corset ainsi que leur recalage sur les géométries reconstruites. Des reconstructions géométriques 3D du tronc avec et sans corset ainsi que des mesures de pressions ont été réalisées pour 11 patients. La conception d'un unique dispositif de calibration associé à un protocole spécifique permet l'acquisition des différentes données quasi sans déplacements du patient. Sa facilité de transport, d'installation et son faible coût, associés à un temps d'acquisition ne pénalisant pas le confort du patient, rendent envisageable son utilisation en routine clinique. L'utilisation de modèles géométriques paramétriques, associée à des équations de prédiction des paramètres anatomiques, permet d'obtenir une initialisation rapide des géométries des éléments internes du tronc à partir d'un nombre réduit de points anatomiques à numériser. Les mesures de la pression exercée par le corset, effectuées à l'aide d'un dispositif innovant muni de capteurs entièrement réalisés en fibres textiles lui permettant d'épouser parfaitement les courbes anatomiques, ont mis en avant les variations de correction, non négligeables, qu'entraînent la modification de la position du patient. / This thesis is a part of a translational research project to improve scoliosis orthopedic brace design through the use, by inverse method, of a simplified and personalized comprehensive biomechanical model for each scoliotic patient’s trunk. It represents the first step of this project, namely, to develop and to implement methods, tools and protocols allowing, on one hand, 3D reconstruction of the external shape and internal components of patient’s trunk from biplanar X-rays (performed with a standard device) and the Model Maker system (Proteor), and on the other hand, measurements of the pressure infered by the brace and their registration on the reconstructed geometry. 3D modeling of the trunk with and without brace as well as pressure measurement were carried out on 11 patients. The development of a common calibration device associated to a specific protocol allows data acquisition nearly without displacements of the patient. Its ease of transportation, installation and a low cost associated with an acquisition time which not penalize the patient’s comfort make possible its use in clinical routine. The use of parametrics geometrical models associated with prediction equations of anatomical parameters provides fast initialization of the geometries of trunk’s internal elements from a reduced number of anatomical landmarks to digitize. Measurements of the pressure infered by the brace, performed thanks to an innovative device made of pressure-sensitive textile fibers allowing it to perfectly fit anatomical curves, have highlighted significant correction variations according to the patient’s position.

Orientador: Maria Clara Filippini Ierardi / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecânica / Made available in DSpace on 2018-08-26T21:12:43Z (GMT). No. of bitstreams: 1 Longhitano_GuilhermeArthur_2015_M.pdf: 10352364 bytes, checksum: 6157c8c85d67a80202c0078ff2bd5901 (MD5) Previous issue date: 2016 / Resumo: No presente trabalho, a liga de titânio Ti-6Al-4V, empregada em implantes ortopédicos permanentes ou temporários devido à sua biocompatibilidade, foi produzida a partir da manufatura aditiva utilizando o processo de Sinterização Direta de Metais por Laser (DMLS). O material foi submetido a diferentes tratamentos térmicos com o intuito de modificar suas propriedades mecânicas, e a acabamentos de jateamento, ataque químico e polimento eletroquímico para analisar os efeitos dos mesmos no acabamento de superfície. As modificações resultantes após os tratamentos térmicos e acabamentos de superfície foram analisadas por microscopia óptica, microscopia eletrônica de varredura, difração de raios-X, medidas de rugosidade e massa, microdureza Vickers, e ensaios de tração e compressão. No estudo de acabamentos de superfície, o menor valor de rugosidade foi obtido após as etapas de jateamento e ataque químico combinadas. O acabamento de jateamento é responsável por deixar uma superfície com rugosidade uniforme, enquanto o ataque químico é responsável pela limpeza da superfície e redução da rugosidade. As amostras foram submetidas aos tratamentos térmicos nas temperaturas de 850 ºC, 950 ºC e 1050 ºC durante uma hora com resfriamento em forno. Foi constatado que quanto maior a temperatura empregada, maior é a ductilidade do material e, por outro lado, menor é a resistência mecânica. Tal fato ocorreu devido à maior nucleação e crescimento da fases 'alfa' e 'beta' no material, que apresentava inicialmente uma estrutura constituída por martensita hexagonal ('alfa'). A condição de tratamento térmico a 950 ºC foi a que apresentou a melhor relação de propriedades mecânicas, satisfazendo os requerimentos da norma ASTM F136 para a utilização da liga Ti-6Al-4V em implantes / Abstract: In this study, the Ti-6Al-4V titanium alloy, used in permanent or temporary orthopedic implants due to its biocompatibility, was produced by additive manufacturing using the Direct Metal Laser Sintering (DMLS) process. The material was subjected to different heat treatments in order to modify their mechanical properties, and to the surface finishes of blasting, chemical etching and electropolishing to analyze their effects on surface finish. The resulting changes after the heat treatments and surface finishes were analyzed by optical microscopy, scanning electron microscopy, X-ray diffraction, roughness and mass measurements, Vickers microhardness, and tensile and compression tests. In surface finishes study, the lowest roughness value was obtained after the combined steps of blasting and chemical etching. The blasting finish is responsible for leaving a surface with uniform roughness, while the chemical etching is responsible for cleaning the surface and reducing roughness. The samples were subjected to heat treatments at temperatures of 850 °C, 950 °C and 1050 °C for one hour followed by furnace cooling. It has been found that the higher the temperature employed, the higher the ductility of the material and, on the other hand, the lower the mechanical strength. This happened due to increased nucleation and growth of 'alfa' and 'beta' phases in the material, which initially had a structure made of hexagonal martensite ('alfa'). The condition of heat treatment at 950 ° C showed the best relation of mechanical properties, meeting the requirements of ASTM F136 for the use of Ti-6Al-4V alloy in implants / Mestrado / Materiais e Processos de Fabricação / Mestre em Engenharia Mecânica

The diploma thesis focuses on the issue of the international marketing mix of a Czech company entering the German market. It specifies the motives and forms of entering the foreign market and defines the individual components of the international marketing mix. It contains a suggestion for a suitable form of entry, elaboration of an international marketing mix of the company and based on a survey of competitive prices of selected products, it recommends choosing a suitable pricing strategy when entering a foreign market.

Purpose The purpose of this study was to quantify the number of surgical programs currently training osteopathic residents and to solicit advice for current osteopathic medical students who are interested in pursuing a surgical residency. Methods A questionnaire was sent to all listed Electronic Residency Application Service® (ERAS®) email contacts for the following specialties: General Surgery, Neurological Surgery, Orthopedic Surgery, Otolaryngology, Urology, Integrated Vascular Surgery, Integrated Plastic Surgery, and Integrated Thoracic Surgery. The questionnaire was sent a total of three times. Results Two hundred sixty-four of the 1,040 surgical residency programs responded to the questionnaire. Of these responses, 19% were formerly American Osteopathic Association (AOA) accredited programs. About 47.3% of responding programs indicated they are not currently training an osteopathic physician. One hundred thirteen programs provided additional comments on how osteopathic medical students may improve the competitiveness of their residency applications. These comments included increasing volumes of research activities, performing well on the United States Medical Licensing Exam (USMLE), and completing a sub-internship in the desired field or at a specific institution. Conclusion Osteopathic students still face many barriers to matching into surgical residencies. This study provides concrete steps students may take to increase the competitiveness of their application.

<p dir="ltr">Developing functional metallic nanostructured surfaces has seen significant growth in various applications, including sensors, electronics, and biomedical devices. However, conventional fabrication techniques for these nanostructures face limitations such as complexity, high costs, and unstable coatings. Laser-assisted surface processing has emerged as a promising solution to address these challenges by enabling localized processing and modification without altering bulk properties. This dissertation focuses on the development of multifunctional devices using selective laser processing of metallized surfaces, categorized into three routes. The first part explores the utilization of laser-induced oxides (LIO) for simple processing and formation of functional metal oxide nanostructures as electrochemical sensing elements. Different laser processing conditions were systematically studied for cost-effective metals like copper and nickel, evaluating their potential as non-enzymatic glucose sensors. The second part investigates laser selective processing for removing metal coatings on temperature-sensitive substrates, providing a cost-effective and scalable alternative to conventional photolithography and etching processes. Various laser processing conditions were examined to achieve selective patterning of metalized fabric structures for wearable electronics production. The third part explores localized laser processing to create intermetallic nanotexturing mixtures without altering bulk properties. The study involved silver spray- coating onto titanium implants, followed by a post-laser processing. The aim was to achieve simultaneous texturing and intermixing of silver in titanium alloy structures, enhancing antibacterial properties and bone mineralization while preserving mechanical properties.</p><p dir="ltr">Through the comprehensive examination of these three routes, this dissertation demonstrates the immense potential of commercial laser processing systems in the design, fabrication, and characterization of functional metallic nanostructured surfaces. It emphasizes the often-overlooked aspect of chemical alterations in laser-assisted surface processing, bridging the gap between physical and chemical modifications. The research opens new avenues for the development and optimization of multifunctional devices in electronics and biomedical applications.</p>

Knee osteoarthritis (KOA) is the primary cause of chronic immobility in populations over the age of 65. It is a joint degenerative disease in which the articular cartilage in the knee joint wears down over time, leading to symptoms of pain, instability, joint stiffness, and misalignment of the lower extremities. Without intervention, these symptoms gradually worsen over time, decreasing the overall knee range of motion (ROM) and ability to walk. Current clinical interventions include offloading braces, which mechanically realign the lower extremities to alleviate the pain experienced in the medial compartment of the knee joint. Though these braces have proven effective in pain management, studies have shown a significant decrease in knee ROM while using the brace. Concurrently, development of active exoskeletons for rehabilitative gait has increased within recent years in efforts to provide patients with a more effective intervention for dealing with KOA. Though some developed exoskeletons are promising in their efficacy of fostering gait therapy, these devices are heavy, tethered, difficult to control, unavailable to patients, or costly due to the number of complicated components used to manufacture the device. However, the idea that an active component can improve gait therapy for patients motivates this study. This study proposes the design of an adjustable lower extremity exoskeleton which features a single linear actuator adapted onto a commercially available offloading brace. This design hopes to provide patients with pain alleviation from the brace, while also actively driving the knee through flexion and extension. The design and execution of this exoskeleton was accomplished by 3D computer simulation, 3D CAD modeling, and rapid prototyping techniques. The exoskeleton features 3D printed, ABS plastic struts and supports to achieve successful adaptation of the linear actuator to the brace and an electromechanical system with a rechargeable operating capacity of 7 hours. Design validation was completed by running preliminary gait trials of neutral gait (without brace or exoskeleton), offloading brace, and exoskeleton to observe changes between the different gait scenarios. Results from this testing on a single subject show that there was an observed, significant decrease in average knee ROM in the offloading brace trials from the neutral trials and an observed, significant increase in average knee ROM in the exoskeleton trials when compared to the brace trials as hypothesized. Further evaluation must be completed on the clinical efficacy of this device with a larger, and clinically relevant sample size to assess knee ROM, pain while using the device, and overall comfort level. Further development of this design could focus on material assessment, cost analysis, and risk mitigation through failure mode analysis.

No description available.