Corporoplasty with small soft axial prostheses （VIRILIS ） and bovine pericardial graft （HYDRIX） in Peyronie＇s disease

The surgical techniques used by Austoni and Egydio in the treatment of Peyronie＇s disease are based on geometric principles. The aim of this paper is to report our multicentric experience and technical changes to Austoni＇s original technique, focusing on several tips and tricks to make this technique easy to perform, even by less experienced practitioners. We performed operations in three different Italian institutions. We implanted a small soft Virilis I~ axial prostheses （Ф 7 Fr.）, using a bovine pericardium collagen matrix patch （Hydrix） to cover the defect in the tunica albuginea. Sixty patients with a mean age of 58 years （range 44-76 years） underwent surgery between September 2005 and January 2010. After surgery, mean lengthening of the shaft was 2 cm （range 1.2-2.3 cm） with complete correction of penile recurvatum. Thirty-nine patients resumed sexual activity 60 days later, 14 after 90 days and 7 after 120 days. The international index of erectile function （IIEF） score was 15.5 before surgery and it improved to 23 at 12 and 24 months after surgery. Furthermore, the visual analogue scale （VAS） showed good results in terms of the recovery of natural sexual intercourse （over 80% of couples） and of the original length and girth of the penis. The soft implant we used takes advantage of erection that occurs spontaneously, using the residual erection of the spared cavernous tissue. The method is easy to learn and reproducible, and the use of pericardium speeds up the operation, while also covering large defects of the tunica albuginea that result from complex recurvatum.

Microstructure and dry wear properties of Ti-Nb alloys for dental prostheses

The microstructure and properties of a series of binary Ti-Nb alloys for dental prostheses with niobium contents ranging from 5% to 20% were investigated. The experimental results indicate that the crystal structure and morphology of Ti-Nb alloys are sensitive to their niobium contents. When Nb content is 5%, the acicular α crystal grain is observed. When Nb content is 10%, the coarse equiaxed crystal grain and the fine, acicular α crystal grain are observed. When Nb content is 15%, only the α equiaxed crystal grain is observed. When the alloy contains 20%Nb, the equiaxed and dendritic α crystal grain are observed. For Ti-Nb alloys, the increase of Nb content modifies the microstructure of Ti-Nb alloys significantly and decreases their compression elastic modulus, in which Ti-20Nb alloy shows the largest compression strength and Ti-5Nb alloy shows the best plasticity. The dry wear resistance of Ti-Nb alloys against Gr15 ball was investigated on CJS111A ball-disk wear instrument. For Ti-Nb alloys, Ti-10Nb alloy shows a smallest steady friction coefficient, Ti-5Nb alloy shows the smallest wear depth and best wear resistance, and Ti-15Nb alloy shows the largest wear depth and worst wear resistance. The phenomenon of furrow cut happens and furrows form during wear tests.

Neural prostheses for restoring functions lost after spinal cord injury

Spinal cord injury（SCI）is a debilitating condition that affects more than 2.5 million individuals worldwide（Thuret et al.,2006）.In addition to its devastating effects on the individual,this disease is a heavy burden to the society in terms of health care costs, which are estimated in billions of dollars annually in most developed countries （Cadotte and Fehlings, 2011）.

Comparison of the Radial Compliance of Three Kinds of Vascular Prostheses and Pig′s Carotid Based on Dynamic-simulated Condition

There are some problems in the vascular prostheses, which influence the health of the patients. This paper aims to the radial compliance of three kinds of vascular prostheses and the pig＇s carotid based on the dynamic-simulated condition. The radial compliance of knitted structure vascular prostheses with crimps ranged from 2.52% to 0.94%/100 mmHg, which was superior to e-FFFE and woven prostheses＇, ranged from 0.73% to 0.31%/100 mmHg and from 0.81% to 0.22%/100 mmHg. But comparing with the radial compliance of pig＇s carotid, ranged from 7.21% to 10.04% /100 mmHg, there was a big gap between them. And also the trend of the radial compliance of vascular prostheses was different from the real pig＇s carotid. There is a lot of work left to improve the radial compliance, not only to change the vascular prostheses＇ compliance, but also to meet with the real vascular.

Preparation and Mechanical Performance of Blended Polyester/Silk Small Diameter Arterial Prostheses

Small diameter arterial prostheses were required to treat coronary and cerebrovascular arterial diseases. The diameters of the artificial blood vessels should match the diameters of the host arteries. Besides,the mechanical properties of the arterial prostheses should be strong enough to endure the forces in the body after implantation. In this study,silk and polyester were woven into small diameter arterial prostheses and the dimensional and mechanical properties,as well as the water permeability,were investigated. The woven samples had an inner diameter ranging from 3. 65 to 3. 94mm. The wall thickness of the samples ranged from 0. 26 to 0. 28mm. Compared with polytetrafiuoroethylene( ePTFE) commercial devices,whose probe bursting strength was measured to be 15. 64 N /mm2,the woven samples had superior strength values ranging from20. 53 to 28. 97 N /mm2. In addition,the radial compliance of the woven samples was found to lie between the ePTFE sample and the pig's carotid artery,and the water permeability of all the woven samples was less than 300 mL /( cm2·min) which indicated that these woven samples could be implanted without preclotting.

New Design of Textile Vascular Prostheses for the Reconstruction of Small Diameter Vascular Blood Vessels

The general object of research is to design new idea of the semi-biodegradable,multilayered vascular prosthesis used for the reconstruction of significantly small diameter vascular vessels( microreconstruction). The paper studies the selection of appropriate sterilization technique for resorbable tubular structures made of poly( L-lactide-co-glicolide)( PLAGA) and nonbiodegradable tubular structures made of polypropylene( PP). The designed grafts are characterized by the physical properties as well as mechanical properties according to ISO 7198 ∶ 1998 Standard.Moreover,the process of the grafts fabrication will be explained considering the stages affected the critical properties of the elaborated textile implants. The increase of PLAGA melt-electrospun tubular structures mechanical properties was observed due to the thermal stabilization use. The ethylene oxide( EO) and steam sterilization had a destructive effect on the designed PLAGA meltelectrospun tubular, fibrous structures, whereas the irradiation yielded in the changes in mechanical and physical properties on the acceptable level,taking into account the future clinical applications.

Binding mechanism of interface of porous coated titanium alloy prostheses

In the experiment, we inserted the implants coated with TC4 fibers and particles into the bones of dogs.The histological characters of the bone ingrowth and the state of bone remodelling at interface were observed. And then the whole course of the fatigue injuries accumulation at the interface was monitored by scanning electron microscopy equipped with fatigue stage. Experiments show that the collagen fibers of bone interweave in the porosity of implants, which were strengthened by hydroxyapatite crystal. The collagen fibers were bound to the porous layer implant and the binding strength was enhanced by hydroxyapatite crystal. The remodelling state of bone in pores of implant and around the interface play a key role in determining the fatigue strength and the life span of the interface between bone and implant. Therefore, we consider that the interlocking fixation between bone and implant can be more exactly explained as binding mechanism.

Anatomical and Functional Preliminary Results of Total Non-Cemented Hip Prostheses

The aim of this work was to assess the preliminary anatomical and functional results of patients to establish prospects. Materials and method: We report here the preliminary results of a retrospective mono-centric, homogeneous and continuous series, of 21 non-cemented total hip implants, implanted from January 2011 to December 2014. The mean follow-up time was 24 months. The patients were evaluated by Harris’s hip at the last follow-up. Results: The mean age of the intervention was 30 years. In our series, we observed a male predominance (60% of cases). Clinically, the Harris score varied significantly from 52.6 ± 11.4 pre-operatively to 85.1 ± 5.1 during the last follow-up visit. Among the items in the score, pain was the parameter that showed the greatest improvement. Thigh pain was observed in only one patient operated on the two sides. At the level of radiology, the femoral implant showed great stability. Bone resorption was suspected in 14 cases (66.66%), and confirmed in 4 cases (19.04%) with excellent bone remodeling, illustrated by the Engh and Massin scores. A loosening and a prosthetic dislocation was observed in a patient (4.76%). Any heterotopic ossification was observed. Conclusion: Our study confirmed good clinical and radiological results of the non-cemented hip prosthesis series in young patients. The rates of aseptic loosening, acetabular edges or osteolysis are low and stable over time.

Anticoagulation in Pregnant Women with Mechanical Heart Valve Prostheses: 25-Year Experience at a Tertiary Care Hospital in a Developing Country

The aim of this retrospective study was to compare the different anticoagulation regimens used in pregnant women with prosthetic heart valves. We reviewed 86 pregnancies in 57 women from 1987 to 2011. The patients were divided into two groups: group A (39 pregnancies) had oral acenocoumarol throughout pregnancy;and in group B (47 pregnancies), acenocoumarol was replaced by subcutaneous heparin during the first trimester. Both groups received heparin at the time of delivery. The valves replaced were mitral (59.65%), aortic (12.28%), or both (28.07%). 74 pregnancies (86.04%) resulted in live births, 9 (10.46%) had stillbirths, 1 (1.16%) had spontaneous abortion and 2 (2.32%) underwent therapeutic abortions. The live birth rate was higher in women on heparin (87.23%) compared with those on acenocoumarol (84.61%). No malformations appeared in the 74 newborns, except for one case of hydrocephalus. There was one maternal death due to acute mitral valvular thrombosis while on heparin in the first trimester. Hemorrhagic complications occurred in 13 patients in the postpartum period, 4 of whom required transfusion. No anticoagulant regimen can be said to be entirely safe for use during pregnancy as there is a degree of risk with each regimen. Heparin does not offer a clear advantage over oral anticoagulation in the pregnancy outcome.

Iatrogenic Oesophageal Perforations in Neoplastic Lesions: Management with Covered Self-Expanding Prostheses

Background:Perforation of the oesophagus is a serious condition. Most of them are iatrogenic and are associated with significant morbidity and mortality, especially with late diagnosis. Aim: To prospectively analyse the results of the endoscopic management of iatrogenic perforations in oesophageal neoplasia, through the immediate insertion of a covered self-expanding prosthesis (CSES). Materials and Methods: Between 01.01.2006 and 12.30.2016, a series of 19 consecutive patients attended the Teaching Unit of Endoscopic Surgery of the Regional de Concepción Hospital, Chile, with the diagnosis of oesophageal neoplasia confirmed by biopsy were prospectively studied. All were subjected to a prior evaluation by the oncology team and subsequently referred for endoscopic palliative management of dysphagia. The average age was 77 ± 9.3 years, 8 (42.1%) were female and 11 (57.9%) were male. In 17 patients (89.5%) the stenosis compromised the oesophagus, in 2 (10.5%) the gastro-oesophageal junction, 16 had a squamous carcinoma (84.2%) and 3 an adenocarcinoma (15.8%). Results: Perforation was diagnosed during the procedure in 18 patients (94.7%) and in 1 (5.3%) 22 hours later. Follow-up was done for a minimum of 90 days or until death. The prostheses were inserted successfully in all cases. The immediate evolution was satisfactory in 12 patients (63.2%). In the rest (36.8%), 18 complications appeared. The most frequent were retrosternal pain, subcutaneous emphysema and fever. The early evolution was satisfactory in 12/19 cases (63.2%). Complication was evidenced in 7 (36.8%), the most frequent was retrosternal pain (36.8%). Fever occurred in 3 (15.8%), pleural effusion in 3 (15.8%) and mediastinitis in 2 of these. The prosthesis was kept in situ as a definitive palliation method for neoplastic dysphagia. In 10 of the 18 cases that survived more than a month, there were late complications (55.6%), none of them associated with the perforation itself. The only death (5.3%) was due to an oesophagus-pleural fistula, associated with an early prosthetic migration. Recovery of the oral intake occurred, on average, at 3.7 days. The hospital stay averaged 9.6 days. Conclusion: The use of CSES for the treatment of iatrogenic oesophageal perforations in the context of neoplasia, is a safe and effective method, with low morbidity, adequate recovery of the oral intake and prompt discharge from hospital.

Influence of Ni and Cr Content on Corrosion Resistance of Ni-Cr-Mo Alloys for Fixed Dental Prostheses in 0.05% NaF Aqueous Solution

The Ni-Cr-Mo alloys have been used as dental prostheses because they own a good mechanical strength, high corrosion resistance and even to be economically viable. These alloys corrosion protection against in salt solutions typical of physiological media is due to passivation phenomenon with an oxide surface layer formation, mainly chromium oxides. This protective film, subjected to a mechanical stress in a corrosive environment, can partially dissolve by releasing ions, which have deleterious effects in a human body. Fluoride ions, existing in hygiene products, change the buccal environment and their presence may enable a localized corrosion process initiation. The aim of this work has been to investigate the chemical composition influence of three alloys in corrosion resistance to: A (Ni-73% Cr-14% Mo-8.5% Be-1.8% Al-1.8%), B (Ni-61% Cr-25% Mo-10.5% Si-1.5%) and C (Ni-65% Cr-22.5% Mo-9.5%) in media containing fluorides that simulate mouthwashes solution. The study has been done in a 0.05% NaF solution, pH 6, at 37°C using electrochemical techniques. The alloy with the highest nickel and the lowest chromium content is not passive in the middle studied, showing a continuous increase in current density with the potential increasing, while the other alloys show passivation range of 600 mV and passive current density of about 10-6 A/cm2.

Visual prostheses, optogenetics, stem cell and gene therapies: splitting the cake

The size of the blind population in 2015 was estimated to be approximately 36 million（Bourne et al.,2017）.According to the predictions by Bourne and co-workers,the number of the visually impaired is expected to reach nearly 100 million by 2050.

Implant-Supported Full Fixed Prostheses with a Removable Oro-Nasal Obturator for the Edentulous Maxilla with Palatal Fistula due to Surgical Procedures for Oral Cancer

Open oro-nasal defects resulting after oral tumor resection need structural and functional rehabilitation using dental prostheses. Conventional removable prostheses have usually been indicated and performed for prosthodontics. When the patient has an edentulous maxilla, the unfavorable stability of the prosthesis will cause dysfunction of mastication and pronunciation. To achieve improvement of the impaired functional situation, implant-supported full fixed prostheses (IPSPs) for the edentulous maxilla with a removable obturator offer a reasonable solution. We present herein the case of a 70-year-old Japanese man who has presented with oro-nasal defect due to surgical procedures for oral cancer. He was treated with implant-supported full fixed prostheses in a conventional two-step procedure. After prosthesis treatment, a palatal obturator was set. The patient has shown no clinical or radiological evidence of failure as of 24 months after the end of treatment. Functional evaluation of mastication and pronunciation showed dramatic improvements. For a patient with an edentulous maxilla and palatal fistula, full-arch fixed prostheses supported by a combination of axially and non-axially positioned implants and a removable oro-nasal obturator, using the anterior alveolar bone, without bone transplantation or maxillary sinus elevation, could offer an effective, minimally invasive treatment alternative.

Towards Long-Life Replacement Joint Prostheses - A Surface Engineering Approach

How to improve the wear resistance of bearing surfaces, hereby achieving long life of orthopaedic joint prostheses has long been a technical challenge with much fundamental interest and social and economic impacts. Surface engineering has been emerging as one of the most promising technologies to improve the tribological properties of biomedical materials. A current area of research within the Birmingham Surface Engineering Group has been directed at developing novel surface engineering technologies for biomedical materials towards long-life joint prostheses. Following a brief introduction, the author reports their recent progress in the surface engineering of biomedical materials particular for joint prosthesis. The potential of these innovative surface engineering technologies in enhancing the performance of oral and maxillofacial implants and surgical devices is also discussed.

单节段Mobi-C人工间盘置换术后颈椎活动度的变化

目的观察单节段Mobi-C人工间盘置换术后颈椎曲度、活动度的变化。方法 2012-07-2015-01我院行22例单节段Mobi-C人工间盘置换术,年龄27-55岁,平均42.3岁,置换节段C_(4-5)5例,C_(5-6)10例,C_(6-7)7例。测量术前及末次随访时颈椎曲度和活动度。结果随访时间3-26个月,平均9.3个月。术后颈椎整体曲度和置换节段局部曲度均较术前改善:颈椎整体曲度术前(0.91±9.77)°,术后(4.91±10.67)°,脊柱功能单位角术前(0.23±5.17)°,术后(5.73±4.45)°,置换节段前柱高度术前(34.07±3.29)mm,术后(35.73±3.46)mm,差异均具有统计学意义(P<0.05)。末次随访时,颈椎整体活动度、置换节段活动度、相邻节段活动度较术前差异均无统计学意义。结论Mobi-C置换术后颈椎整体曲度和置换节段局部曲度均较术前改善,保留了置换节段活动度,相邻节段活动度无明显增大。

Mobi-C人工颈椎间盘置换术与ROI-C辅助的颈椎前路减压融合术治疗单节段颈椎病的临床研究

目的比较Mobi-C人工颈椎间盘置换术与ROI-C辅助的颈椎前路减压融合术治疗单节段颈椎病的效果。方法回顾性分析2016年3月至2017年9月在我院治疗的单节段颈椎病患者,对符合标准的35例患者资料进行分组,其中Mobi-C人工颈椎间盘置换术15例,ROI-C辅助的颈椎前路减压融合术20例,术后随访12个月以上。记录手术时间、术中出血量和手术相关并发症。采用日本矫形外科协会(Japanese orthopedic association,JOA)评分、颈部残障功能指数(neck disability index,NDI)及疼痛视觉模拟评分法(visual analogue scale,VAS)评价临床疗效。颈椎侧位X线片测量手术节段局部前凸椎间盘Cobb角和颈椎整体前凸C 2~7 Cobb角,过伸过屈位X线片测量颈椎整体活动度(range of motion,ROM),对术前及随访时的数据进行比较。结果35例患者均完成随访。两组患者末次随访的JOA评分、NDI评分及VAS评分均较术前有明显改善,两组术前的JOA评分、NDI评分及VAS评分组间比较差异无统计学意义( P >0.05),两组末次随访的JOA评分、NDI评分及VAS评分组间比较差异无统计学意义( P >0.05)。Mobi-C人工颈椎间盘置换术组末次随访椎间盘Cobb角、C 2~7 Cobb角、颈椎整体活动度与术前相比差异无统计学意义( P >0.05);ROI-C辅助的颈椎前路减压融合术末次随访椎间盘Cobb角及C 2~7 Cobb角与术前相比差异无统计学意义( P >0.05),末次随访颈椎整体活动度与术前相比差异有统计学意义( P <0.05)。两组术前椎间盘Cobb角、C 2~7 Cobb角、颈椎整体活动度的组间比较差异无统计学意义( P >0.05);两组末次随访时椎间盘Cobb角、C 2~7 Cobb角、颈椎整体活动度的组间比较差异有统计学意义( P <0.05)。结论相比于ROI-C辅助的颈椎前路减压融合术,Mobi-C人工颈椎间盘置换术可以取得与前路减压融合内固定术相同的临床效果,而且更好地保持了颈椎活动度,可以作为颈椎病的有效治疗方法.

Mobi-C人工颈椎间盘在颈前路手术的临床应用

目的探讨观察Mobi-C人工颈椎间盘置换技术治疗颈椎病、颈椎间盘脱出症的临床疗效。方法自2008-10-2010-03,应用Mobi-C人工颈椎间盘置换术治疗颈椎病8例13个椎间隙、颈椎间盘脱出症5例6个间隙,对手术操作、术中出血、术后影像学检查及临床疗效等进行了分析。结果患者手术后1周均感到上胸部紧缩感及手指麻木等神经症状明显好转,手指持物及下肢肌力增加。术后1周X线片检查显示：椎间隙高度、位置良好。随访6~23个月,根据JOA评分：从手术前的平均9.5分增加到随访时16.5分,术后改善率93.4%。X线摄片示无椎间隙的高度丢失、椎体后缘自发骨化及后凸畸形,动力性摄片未见不稳、假体移位、松动征象。术后未出现喉头水肿、伤口血肿、切口感染、声音嘶哑等并发症。结论 Mobi-C人工颈椎间盘置换术治疗颈椎病、颈椎间盘突出症能获得优良的近期疗效。

Mobi-C人工颈椎间盘置换:5年19例随访报告

背景:颈椎前路椎间盘切除减压、人工椎间盘置换目前已广泛应用于颈椎退行性疾患的治疗,其近期疗效虽令人鼓舞,但仍缺乏长期、综合评价。目的:观察一组颈椎前路椎间盘切除减压、Mobi-C人工椎间盘置换病例5年以上随访结果。方法:2009年1至9月解放军第309医院收治符合颈椎间盘置换指征的颈椎病变手术患者25例,至今获随访19例。所有患者均行经前路椎间盘切除减压、Mobi-C人工颈椎间盘假体置换,共植入Mobi-C人工颈椎间盘假体23枚。所有患者在颈椎伸屈侧位X射线片上测量置换节段活动度;在侧位X射线片上采用Mc Afee异位骨化分级方法评定异位骨化情况;根据颈椎MRI片,参考Pearce分级判断邻近节段退变情况;采用NDI评分评估患者颈椎功能;目测类比评分评价患者疼痛改善情况。结果与结论:19例患者获得59-65个月随访,平均随访62个月。术前及末次随访时置换节段活动度比较差异无显著性意义(P>0.05)。随访期内发生异位骨化2例,发生邻近节段退变1例,未见假体松动、移位等并发症。末次随访时目测类比评分及NDI评分均较术前明显降低,差异有显著性意义(P<0.05)。提示在合理选择适应证的前提下,采用Mobi-C人工颈椎间盘假体行人工椎间盘置换治疗退行性颈椎疾患,5年随访临床疗效满意:置换节段活动度维持较好,异位骨化及邻近节段退变的发生率较低。