Technology and Health Care - Volume 19, issue 4

Authors: Petri, M. | Kruppa, C. | Haasper, C. | Broese, M. | Liodakis, E. | Krettek, C. | Hurschler, C. | Jagodzinski, M.

Article Type: Research Article

Abstract: Ruptures of tendons and ligaments are a widely common injury in traumatology. The aim of the study was the development of a substitute tissue for such defects by methods of tissue-engineering. Human bone marrow stromal cells (hBMSC) were seeded on a decellularized bovine Achilles tendon and cultivated in a special bioreactor. We examined the influence of continuous perfusion on proliferation and biomechanical stability compared to static cultivation. Samples were taken on day 0, 7 and 14. Decellularized tendons were chosen as a negative control. Cell quantity was measured by the MTS-Test. Histology was analyzed by Haematoxylin-Eosin- and Pentachrome-coulouring. The cultivated …tendons were tested biomechanically compared with the decellularized control group. MTS-Test revealed an increase of cell count of 7% in the static group and a decrease of 9% in the perfusion group. The perfusion group showed a stronger network of the fibroblasts and a higher amount of produced extracellular matrix. Biomechanical testing revealed significantly higher stability in the decellularized control group. This trial shows up new possibilities of managing defects of tendons and ligaments. The continuous perfusion in a bioreactor can improve the structure of the matrix seeded with hBMSC. Show more

Keywords: Tissue engineering, cell culture, hBMSC, tendon, ligament

DOI: 10.3233/THC-2011-0621

Citation: Technology and Health Care, vol. 19, no. 4, pp. 223-231, 2011

Authors: Boulay, Mélodie | Benveniste, Samuel | Boespflug, Sandra | Jouvelot, Pierre | Rigaud, Anne-Sophie

Article Type: Research Article

Abstract: MINWii is a music therapy game for the renarcissization of demented patients. It lets players improvise or play songs of their choice by pointing at a virtual keyboard with a Wiimote Pistol. We present the results of a three-month usability study we conducted with 7 institutionalized patients suffering from mild to moderately severe Alzheimer's disease at the LUSAGE Living Lab in Paris. We demonstrate that MINWii is indeed usable by AD patients despite their motor and cognitive impairments: our results, which were largely computed automatically thanks to MINWii's extensive logging capabilities, show either an instant mastery or a clear learning …effect depending on patients' cognitive abilities. Moreover, patients were overall very satisfied with the game and expressed a desire to repeat the experience: MINWii fosters positive interaction with the caregivers and elicits powerful reminiscence with even the most severely impaired patients. This study justifies future research to assess the lasting effects of playing MINWii on both quality of life and cognitive impairment in demented patients. Show more

Keywords: Usability, music therapy, dementia, Wiimote, video game

DOI: 10.3233/THC-2011-0628

Citation: Technology and Health Care, vol. 19, no. 4, pp. 233-246, 2011

Authors: Kumar, Sameer

Article Type: Research Article

Abstract: System dynamics modeling methodology is well suited to address the constantly changing complexity that characterizes designing a modern urban hospital's patient flow operation. It involves the development of simulation models that portray process flows and feedback that may be tested to find effective designs to overcome ineffective means of healthcare delivery. An urban county hospital (UCH) in Minnesota, USA is used to demonstrate a modular system dynamics modeling approach to simulate and optimize internal patient and process flow where major costs are also considered. This allows decision makers to visualize overall efficiencies through optimal bed capacity for peak patient flow …of emergency and routine patients in a large healthcare delivery operation. Show more

Keywords: System dynamics, hospital planning, health service, hospitals, patient flow, process analysis, modeling, capacity planning

DOI: 10.3233/THC-2011-0627

Citation: Technology and Health Care, vol. 19, no. 4, pp. 247-260, 2011

Authors: Qaddoumi, N. | Al-Nashash, H. | Sediq, A. Bin | Al-Shamsi, H. | Al-Mehrizi, M. | Khalaf, K.

Article Type: Research Article

Abstract: Healing rate of fractured bone differs from one patient to another which may lead to incorrect consequent medical procedures. Thus, quantitative assessment of bone healing after fracture becomes important. In this paper, we present a mathematical model which describes the interaction of a pulsed mode ultrasound waves with a multilayered biological structure. The model is applied to estimate the bone callus thickness and degree of hardness. Different frequencies are utilized to obtain highest measurement sensitivity and accuracy of callus thickness and degree of hardness. It is found that a transducer operating at 1 MHz has the highest sensitivity to the …different phases of callus hardening. On the other hand, a 3 MHz transducer yields the highest sensitivity to the thickness of the callus layer. Thus, using both frequencies might prove to be useful for full quantitative assessment of the bone healing process. Show more

Keywords: Bone fracture, callus, pulsed mode, ultrasound

DOI: 10.3233/THC-2011-0631

Citation: Technology and Health Care, vol. 19, no. 4, pp. 261-269, 2011

Authors: Wiebking, Ulrich | Birkenhauer, Björn | Krettek, Christian | Gösling, Thomas

Article Type: Research Article

Abstract: Background: Use of the proximal part of the femur in total hip arthroplasty enables preservation of the distal femur for later revisions. To use this advantage, different types of short-stem prosthesis have been developed in recent years. Although cementless hip arthroplasty is not common in the treatment of canine osteoarthritis, the use of cementless short-stems might be an alternative therapy. The new cementless short-stem prosthesis called Spiron® is self-tapping, and is constructed with a conical shape with threads. We measured the relative motion in the bone/prosthesis interface with specified loads in the femora of dogs to investigate two aspects: …the primary stability of two systems of uncemented prosthesis with different principles of anchoring, and the theoretical use of the Spiron® in dog bone. We measured the cyclic behaviour (i.e., reversible, elastic), subsidence (i.e., irreversible, plastic, migration) and maximal applied load. Methods: Twenty-four pairs of fresh femur bones from adult German shepherd dogs were used. After measuring the total bone mineral density (TBMD), 16 bones were used in each of the short-stem prosthesis group (group A), the Zweymuller prosthesis group (group B), and the no-prosthesis control group (group C). Micromotion between bone and prostheses was measured for 16,200 N axial load steps, beginning with 200 N and increasing to 3000 N (1600 cycles/femur). Simple analysis of variance and non-parametric tests were used to compare the groups. Results: The Spiron prosthesis had significantly less motion in the bone/prosthesis interface compared with the Zweymuller prosthesis. Conclusions: The new principle of anchoring of the Spiron short-stem prosthesis may provide higher primary stability compared with conventional techniques. The findings of this study support the assumption that the use of the Spiron prosthesis to treat osteoarthritis in the dog is feasible. Show more

Keywords: Short-stem prosthesis, proximal anchorage, primary stability, in vitro study, canine

DOI: 10.3233/THC-2011-0634

Citation: Technology and Health Care, vol. 19, no. 4, pp. 271-282, 2011

Authors: Niederer, Peter

Article Type: Editorial

DOI: 10.3233/THC-2011-19408

Citation: Technology and Health Care, vol. 19, no. 4, pp. 283-283, 2011

Authors: Reilly, Richard B. | Lee, T. Clive

Article Type: Research Article

DOI: 10.3233/THC-2011-0625

Citation: Technology and Health Care, vol. 19, no. 4, pp. 285-293, 2011

Authors: Nugent, Chris D. | Finlay, Dewar | Davies, Richard | Donnelly, Mark | Hallberg, Josef | Black, Norman D. | Craig, David

Article Type: Research Article

DOI: 10.3233/THC-2011-0626

Citation: Technology and Health Care, vol. 19, no. 4, pp. 295-306, 2011