Search PubMed⌕ Search

Biomedical subjects

D L Hill

Publications and source records attributed to D L Hill.

At least 19 recordsLinked to original sources

Age-related decrease of the chorda tympani nerve terminal field in the nucleus of the solitary tract is prevented by dietary sodium restriction during development.

Institution of a low-NaCl diet beginning at embryonic day 3 and continued throughout pre- and postnatal development has widespread effects on the neuroanatomical organization of the first gustatory relay in the nucleus of the solitary tract. To determine when these effects are expressed postnatally, the terminal field of the chorda tympani nerve was compared between sodium-restricted and sodium-replete rats at postnatal days 15-17, postnatal days 25-27, postnatal days 35-37, and adults. Total terminal fields were significantly larger in postnatal days 35-37 and adult sodium-restricted rats compared with aged-matched controls. The group-related differences appear related more to a remodeling of the terminal field in the dorsal zone of the terminal field in controls. Specifically, the terminal field volume in the dorsal zone in controls decreased dramatically from postnatal days 25-27 to postnatal days 35-37 and then again from postnatal days 35-37 to adulthood. In contrast, the fields did not change during development in sodium-restricted rats. These findings suggest that remodeling of the chorda tympani field occurs in controls at about the developmental period of taste response maturation. The lack of remodeling in sodium-restricted rats may be explained by a corresponding lack of functional response development to sodium salts. These results also illustrate the specificity and extent of how early dietary manipulations shape the developing brainstem.

Aging↗

Smart orthosis for the treatment of adolescent idiopathic scoliosis.

There is considerable controversy regarding the effectiveness of orthotic treatment for patients with adolescent idiopathic scoliosis. Most researchers believe that, to be effective, the orthosis must be worn as prescribed for both compliance and tightness. Compliance is the time the brace is worn relative to the prescribed time. A battery-powered microcomputer system was developed to monitor and maintain the loads exerted by orthoses used to treat children with spinal deformities during daily living. This system not only records how well and for how much time the brace has been used, but also helps patients to ensure that the brace is being worn at the prescribed tightness. Laboratory tests were performed, and five patients used the system for four weeks. The patients reported that the system helped them to wear the orthoses correctly and comfortably. The time that the patients wore the orthoses at the prescribed tightness level increased from 53 +/- 9% during the monitoring period (first 2 weeks) to 68 +/- 14% during the automatic adjustment period (last 2 weeks).

Adolescent↗

Correlation between quantity and quality of orthosis wear and treatment outcomes in adolescent idiopathic scoliosis.

Orthotic treatment is the most commonly used non-surgical treatment method for adolescent idiopathic scoliosis (AIS). This study determined whether treatment outcome correlates with how often and how well children with AIS wear their orthoses. Eighteen (18) subjects (3M, 15F) who were diagnosed with idiopathic scoliosis and had worn their orthoses from 6 months up to 1 year participated in this study. All subjects were prescribed Boston braces to be worn full time (23 hrs/day). Twelve (12) subjects who completed their brace treatment were included in the data analysis. Three (3) treatment outcomes were classified as improvement, no change and deterioration. The quality of the brace wear was assessed by how often the brace was worn with zero force, below 80%, between 80 to 120%, and above 120% of the load level prescribed in the clinic. The quantity of brace wear was determined by how many hours per day they wore their brace. Subjects who wear their braces tighter and for more hours per day seem to have better outcomes.

Adolescent↗

Bluetooth wireless database for scoliosis clinics.

A database system with Bluetooth wireless connectivity has been developed so that scoliosis clinics can be run more efficiently and data can be mined for research studies without significant increases in equipment cost. The wireless database system consists of a Bluetooth-enabled laptop or PC and a Bluetooth-enabled handheld personal data assistant (PDA). Each patient has a profile in the database, which has all of his or her clinical history. Immediately prior to the examination, the orthopaedic surgeon selects a patient's profile from the database and uploads that data to the PDA over a Bluetooth wireless connection. The surgeon can view the entire clinical history of the patient while in the examination room and, at the same time, enter in any new measurements and comments from the current examination. After seeing the patient, the surgeon synchronises the newly entered information with the database wirelessly and prints a record for the chart. This combination of the database and the PDA both improves efficiency and accuracy and can save significant time, as there is less duplication of work, and no dictation is required. The equipment required to implement this solution is a Bluetooth-enabled PDA and a Bluetooth wireless transceiver for the PC or laptop.

Computers, Handheld↗

Using three-dimensional difference maps to assess changes in scoliotic deformities.

The three-dimensional nature of scoliosis, coupled with changes due to natural history or treatment, is often difficult to quantify and visualise. A difference map was developed to compare the sequential surface topography of subjects over their treatment period. Three-dimensional surface maps representing patients' trunk surfaces were captured with a laser scanner. Patient surface maps from two clinic visits were matched using a manual best-fit technique that accounted for growth and positioning. The surfaces were subtracted, generating a colour-coded three-dimensional difference map displaying the surface changes. The difference maps were compared with known clinical measures, indicating good agreement (78% specific) with the clinical parameters in detecting change. Full agreement or agreement with the clinical parameters occurred in the surgical, brace and no treatment groups: 76%, 80% and 85%, respectively. A difference index (average of the absolute value of differences on a point-by-point basis) was calculated from the difference map, enabling quantification of change. The difference index, with zero being a perfect match, averaged 5 +/- 1 for repeated measures 7 +/- 2 for subjects deemed to have no change, 9 +/- 2 for subjects with slight change, and 14 +/- 2 for subjects with significant change. The difference map showed the extent and location of changes and is a useful tool for assessing surface topography changes.

Adolescent↗

Instrumented rod rotator system for spinal surgery.

An electronically instrumented rod rotator has been developed to monitor forces and moments applied by surgeons during the derotation manoeuver to correct spinal curvature. This instrumented rod rotator consisted of an inclinometer and two pairs of strain gauges, with all the support circuitry. The strain gauge and the inclinometer data were sampled with a data-acquisition system, and the results were displayed in real time. The device was calibrated in the laboratory and used on seven subjects. The precision of the load measurement of this device was +/- 5 N in the range of 5-65N. The distance between the middle of the rod rotator handle to the rod position was 0.21 m. The maximum loads applied by the surgeon during seven surgeries were from 22 to 57N, with a torque (force x distance) from 4.6 to 12 Nm.

Adolescent↗

The daily force pattern of spinal orthoses in subjects with adolescent idiopathic scoliosis.

The efficacy of orthotic treatment for children with abnormal spinal curvature has been hampered by the lack of comprehensive information about wear characteristics. A battery-powered microcomputer system was developed to monitor loads exerted by orthoses used to treat children with spinal deformities during daily living. The system not only records how well the orthosis has been used, but also helps to ensure that the orthosis is being worn as prescribed. Data acquisition is controlled by a microcontroller and can be programmed to have sample intervals ranging from 1 second to 1 hour. Low power control circuitry is designed so that the system can be operated by a battery. In a preliminary study, 16 subjects (3M, 13F) used this system from 1 to 16 days (9.3 +/- 5.0) with the prescribed hours between 16 to 23 hours (22.3 +/- 1.3). This study demonstrated the feasibility of the approach, and that this device may increase the understanding of orthotic mechanics, and may help patients to wear their orthoses in a better way.

Adolescent↗

Evaluation of a laser scanner for surface topography.

A Minolta VIVID 700 portable non-contact 3D laser scanner was evaluated on 15 subjects with idiopathic scoliosis. The 3D map was compared to two structured light pattern (lines and dots) techniques to determine the reliability, ease of use, speed, and quality. The parameters used for the clinical assessment of scoliosis were measured twice for the Minolta and light projection systems. The edges of the image and areas where occlusion typically occur were examined. The absolute distance in calculated depth between adjacent points was examined to determine errors. The Minolta system and the dot pattern produced regular grids of points. The light projection pattern produced an irregular grid, with more resolution along the video line and less resolution between projected lines, resulted in a somewhat jagged appearance of the surface map. The Minolta system was less sensitive to edge effects, occlusion, and sharp transitions of depth. The comparison of clinical parameters showed good results between repetitions but moderate results between techniques.

Adolescent↗

Image coding technique for 3-D back reconstruction.

This work investigated the use of coded-line patterns to improve image correspondence and 3D reconstruction. The objective was to define an optimum structured light pattern to facilitate the construction of topographic maps of the trunks of scoliosis patients. The system consisted of stereo CCD television cameras, a slide projector to create the coded-line pattern and a computer with video acquisition card. The optimum pattern in terms of generating correct results with minimum computing time was a line pattern consisting of 6 groupings of 3-level grey lines. This chosen pattern was investigated using known 3D objects to determine the effectiveness, resolution and computational time to correlate stereo images. The selected structured light pattern consisted of a repeated pattern of white (W), grey (G) and black (B) lines. Each line was 4mm wide on the back surface. The pattern consisted of 6 groups of 3 lines, WBG WGB GWB GBW BGW BWG. Using known 3D models of a section of a cylinder, a plate with steps and a ramp-like object; the coded line system was tested under typical clinical lighting conditions. For the 3D test objects, errors in correspondence occurred in 2-4 % of stereo pixels. The processing time varied from 10-12 minutes. The 3D resolution obtained was 4mm.

Back↗

Computer modelling of hooks for use as intra-operative force sensors.

There are a number of forces applied during scoliosis surgery, the magnitude and direction of which remains unknown. There is little literature concerning the in vivo distribution of forces along the spine. Computer modelling (ANSYS) was used to investigate the possibility of using an instrumented hook to intra-operatively measure the antero-posterior and distraction/compression forces applied by the surgeon during corrective scoliosis surgery. Three hook designs were evaluated based on specific design criteria. ANSYS provided the preliminary analysis to determine the strain distribution in these hooks. One design, the "membrane" design, was selected and a prototype was manufactured. Preliminary tests demonstrate that this prototype will be able to differentiate between the four major forces applied during the surgical correction.

Biomechanical Phenomena↗

Assessing changes in three dimensional scoliotic deformities with difference maps.

Topographical difference maps were used to compare the trunk surfaces of subjects over the course of their treatment. Three-dimensional points representing the trunk surfaces were aligned accounting for growth and positioning. A goodness-of-fit score was calculated and a color map used to display trunk surface changes. Fifty-one successive subjects were assessed with difference maps. Two subjects each had 10 repetitions taken on the same day to assess reliability. A blinded observer used a five-point scale that extended from full agreement to full disagrment to judge the maps according to the extent and location of changes. The observations were compared to clinical measures mapped onto the same scale by another blinded observer. Goodness of fit for repeated measures averaged 5 +/- 1, for subjects deemed to have no change 7 +/- 2, for subjects with slight change 9 +/- 2, and 14 +/- 2 for subjects with significant change. Judges were in full agreement or in agreemnt with forty of the fifty-one subjects (78%) and in slight disagreement with the remaining eleven. When the cohort was subdivided in surgical, brace and no treatment groups, the judges were in full agreement or in agreement 76%, 80%, and 85% respectively. The difference map provides a qualitative and quantitative measure of how the trunk surface has changed as a whole.

Adolescent↗

Local energy as a measure of back symmetry in scoliosis.

The Cobb angle has been the most commonly used method in measuring the severity of scoliosis and its progression. However, in recent years a number of researchers have chosen to monitor scoliosis by examining the severity of the surface deformity resulting from the scoliosis. Each of these approaches has been limited by errors introduced in manual location of landmarks. Scoliosis results in an asymmetry of the back. It would be very desirable to have a computer-based method of measuring this asymmetry. This paper investigates the use of wavelets and the concept of local energy to measure asymmetry associated with scoliosis. The local energy model uses wavelet theory to obtain information about shading and boundaries of objects in an image. Edges and sharp discontinuities are areas of high local energy in an image. Features such as scapular prominence, shoulder edges, waist creases and other anomalies that contribute to the scoliotic back asymmetry have high local energy. A preliminary study was completed to determine if this approach was applicable to measurement of back asymmetry. Two-dimensional local energy images were created from photographs of the backs of patients with scoliosis. The local energy was integrated across each image and a left-to right line of symmetry was calculated. This line of symmetry was then correlated with the scoliotic score developed by our group. This technique shows promise of providing an automatic method of measuring scoliosis progression.

Back↗

Is the Boston brace mechanically effective in AIS?

The application of three-point loading is thought to be the essential basis for effective bracing of adolescent idiopathic scoliosis. Care is taken to ensure that active pressure pad is located to provide maximum support to the apex of the scoliosis while minimizing its lordosising effect. Paradoxically, while cited as an essential factor in the design of braces, there is no consensus as to the importance of such loading to the clinical effectiveness of braces. It may be that braces are effective but that they are effective for reasons unrelated to mechanics. There are few studies that link brace mechanics and change in spinal alignment. Optimal bracing for AIS requires a much better understanding of the role of the mechanical support of braces used to treat AIS. Sixteen subjects, 3 males and 13 females, were participated to this study to determine the correlation between quantity and quality of brace wear and treatment outcomes in AIS. This study showed that the target force levels set for the active pad in braces prescribed for the treatment of AIS vary considerably and that brace applies the desired load 25% of the prescribed time.

Adolescent↗

Retinoic acid (RA) receptor transcriptional activation correlates with inhibition of 12-O-tetradecanoylphorbol-13-acetate-induced ornithine decarboxylase (ODC) activity by retinoids: a potential role for trans-RA-induced ZBP-89 in ODC inhibition.

Evaluation of retinoic acid receptor (RAR) subtype-selective alpha and gamma agonists and antagonists and a retinoid X receptor (RXR) class-selective agonist for efficacy at inhibiting both induction of ornithine decarboxylase (ODC) by the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) in mouse epidermis and rat tracheal epithelial cells and the appearance of papillomas in mouse epidermis treated in the 2-stage tumor initiation-promotion model indicated that (i) RXR class-selective transcriptional agonists, such as MM11246, were not involved in ODC inhibition; (ii) RAR-selective agonists that induce gene transcription from RA-responsive elements (RAREs) were active at low concentrations; (iii) RAR-selective antagonists that bind RARs and inhibit AP-1 activation on the collagenase promoter but do not activate RAREs to induce gene transcription were less effective inhibitors; and (iv) RARgamma-selective retinoid agonists were more effective inhibitors of TPA-induced ODC activity than RARalpha-selective agonists. These results suggest that RARE activation has a more important role in inhibition of ODC activity than RXR activation or AP-1 inhibition and that RARgamma-selective agonists would be the most useful inhibitors of epithelial cell proliferation induced by tumor promoters. The natural retinoid all-trans-RA induced expression of transcription factor ZBP-89, which represses activation of the GC box in the ODC promoter by the transcription factor Sp1.

9,10-Dimethyl-1,2-benzanthracene↗

Medical image registration.

Radiological images are increasingly being used in healthcare and medical research. There is, consequently, widespread interest in accurately relating information in the different images for diagnosis, treatment and basic science. This article reviews registration techniques used to solve this problem, and describes the wide variety of applications to which these techniques are applied. Applications of image registration include combining images of the same subject from different modalities, aligning temporal sequences of images to compensate for motion of the subject between scans, image guidance during interventions and aligning images from multiple subjects in cohort studies. Current registration algorithms can, in many cases, automatically register images that are related by a rigid body transformation (i.e. where tissue deformation can be ignored). There has also been substantial progress in non-rigid registration algorithms that can compensate for tissue deformation, or align images from different subjects. Nevertheless many registration problems remain unsolved, and this is likely to continue to be an active field of research in the future.

Algorithms↗

Community interdisciplinary education to promote partnerships in family violence prevention.

Family violence is a major social and health problem in the United States. Educational approaches are needed that help professionals and communities develop more effective skills to work with families and communities. This article describes a statewide, interdisciplinary, community-based educational program for professionals and paraprofessionals and a 6-month post-evaluation. Participants reported knowledge and skill development in assessment and interventions, improved use of violence prevention data for planning and interventions, and increased community partnerships and collaborations. Recommendations address violence prevention leadership, funding, infrastructure, interdisciplinary professional education, greater community awareness, and policy development.

Cooperative Behavior↗

Validation of a two- to three-dimensional registration algorithm for aligning preoperative CT images and intraoperative fluoroscopy images.

We present a validation of an intensity based two- to three-dimensional image registration algorithm. The algorithm can register a CT volume to a single-plane fluoroscopy image. Four routinely acquired clinical data sets from patients who underwent endovascular treatment for an abdominal aortic aneurysm were used. Each data set was comprised of two intraoperative fluoroscopy images and a preoperative CT image. Regions of interest (ROI) were drawn around each vertebra in the CT and fluoroscopy images. Each CT image ROI was individually registered to the corresponding ROI in the fluoroscopy images. A cross validation approach was used to obtain a measure of registration consistency. Spinal movement between the preoperative and intraoperative scene was accounted for by using two fluoroscopy images. The consistency and robustness of the algorithm when using two similarity measures, pattern intensity and gradient difference, was investigated. Both similarity measures produced similar results. The consistency values were rotational errors below 0.74 degree and in-plane translational errors below 0.90 mm. These errors approximately relate to a two-dimensional projection error of 1.3 mm. The failure rate was less than 8.3% for three of the four data sets. However, for one of the data sets a much larger failure rate (28.5%) occurred.

Algorithms↗