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PubMed2006

Midterm results of mitral valve repair with the Carpentier-Edwards rigid ring.

OBJECTIVE: Prosthetic annuloplasty rings play an important role in mitral valve repair. This clinical study was undertaken to evaluate the midterm results obtained with the Carpentier-Edwards rigid ring. METHODS: Between October 1991 and March 2005, 112 patients (mean age 53.0 years) underwent mitral valve repair with a Carpentier-Edwards rigid ring at our institution. Degenerative disease was the most frequent cause and a small number had other conditions such as endocarditis and rheumatic disease. Ten patients were in Carpentier's functional class Type I, 101 patients in Type II and 1 patient in Type III, based on valve pathology. Ischemic mitral regurgitation was excluded. The mean follow-up time was 5.3+/-3.6 years (range: 8 days to 12.3 years). All patients were completely followed by echocardiography. RESULTS: The rigid ring ranged from 26 to 36 mm in diameter and the most common size was 30 mm. Although the mitral orifice area was decreased after mitral valve repair in all patients, none of them required reoperation because of mitral stenosis or left ventricular outflow tract obstruction (systolic anterior motion). Reduction of both systolic and diastolic left ventricular volumes was observed postoperatively. Ejection fractions were preserved in all cases. The actuarial survival rate was 92.0+/-3.0% at 10 years and the reoperation-free rate at 10 years was 96.0+/-2.0%. CONCLUSION: The rigid ring has produced promising midterm results in terms of reoperation-free and survival rates.

Adolescent↗
PubMed2006

Rigid and flexible control of eating behavior and their relationship to dieting status.

This study examined whether or not rigid and flexible dimensions of restraint could differentiate between women who self-identified as dieting to lose weight versus those who self-identified as dieting to maintain weight. Four hundred thirty-three women responded to dichotomous questions regarding their dieting status and completed the Eating Inventory and Rigid and Flexible Control Scales (RC16 and FC12, respectively). Logistic regressions were conducted using dieting status as the dependent variable and RC16 scores, FC12 scores, susceptibility to overeating, and BMI as the independent variables. Scores on the RC16 and BMI correctly identified 73.6% of women as dieting to lose weight; scores on the RC16 and FC12 correctly identified 52.6% of women as dieting to maintain weight. Susceptibility to overeating was unrelated to dieting status. Results indicate that rigid control over eating is strongly related to dieting to lose weight and that both rigid and flexible control are related to dieting to maintain weight. This latter relationship is in need of further exploration. Results of this study support the contention that restraint and dieting are related, however, they are not equivalent constructs.

Adult↗
PubMed2001

[A new video documentation system for rigid procto-rectoscopy].

INTRODUCTION: Disadvantages of rigid procto-rectoscope systems are the lack of sufficient visual documentation, data processing and the insufficient demonstration for educational purposes. Therefore a video documentation system for rigid procto-rectoscopy (Endovision Telecam SL) was developed. METHOD: For evaluation of the Endovision Telecam SL, the system was compared to the conventional technique over a 6-month period. RESULTS: The Endovision Telecam SL offers the advantage of flexible video-endoscopy and displays an excellent quality of documentation for rigid procto-rectoscopy. The handling of the system is slightly more time-consuming and difficult and the use is limited to cases without severe bleeding and stool contamination. CONCLUSIONS: The Endovision Telecam SL combines the advantages of flexible video-endoscopy in documentation, demonstration and data processing with the practibility of rigid instruments for procto-rectoscopy. In the present set-up the system is still limited to special indications and should be combined with conventional procedures.

Documentation↗
PubMed2001

2D and 3D CT imaging correlated to rigid endoscopy in complex laryngo-tracheal stenoses.

The aim of this study was to compare 2D and 3D CT imaging in the pre- and postoperative evaluation of complex benign larynges-tracheal airway stenoses with rigid endoscopy, considered as the gold standard. Six patients (aged 5-72 years) with a total of nine complex laryngo-tracheal stenoses underwent non-contrast helical CT scans (slice thickness 3 mm, pitch 1.3, reconstruction interval 1.5 mm) before and after surgical resection. With prototype software, virtual endoscopy (VE) post-processing algorithms were applied to the imaging data sets. The VE and multiplanar 2D findings were compared with rigid endoscopy, considered as standard of reference. All nine stenoses were correctly identified on 3D images and their anatomical locations correctly assessed on 2D reconstructions. Artifacts were met when patients were unable to suspend their breath, leading to one false-positive result. Two-dimensional images and 3D VE of tracheal stenoses proved to be efficient and complementary to the rigid endoscopy, permitting a reliable endoluminal 3D view and evaluation of the surrounding anatomical structures. Limitations of this technique relate to the maximal spatial resolution of 1.5 mm, the lack of color, and the inability to assess the mucosa. Virtual endoscopy is for complex laryngo-tracheal stenoses an excellent complement for rigid endoscopy, remaining the method of reference, and may be indicated with complicated pathological structures.

Adolescent↗
PubMed1999

Rigid videosigmoidoscopy vs conventional sigmoidoscopy. A randomized controlled study.

BACKGROUND: Not only is rigid sigmoidoscopy uncomfortable for patients, but visualisation of the rectosigmoid junction and sigmoid colon is successful in only 40-70% of examinations. A novel fine-bore rigid videosigmoidoscope is described and then compared with a rigid conventional sigmoidoscope for patient discomfort and length of insertion. METHOD: A total of 58 patients were examined with both sigmoidoscopes in a random order. Discomfort was scored on a visual analogue scale; length of insertion was scored by the surgeon. Patients were blinded to which sigmoidoscope was being used. The images from the video examination were transmitted in real time for a second opinion in a different hospital. RESULTS: The mean (SD) insertion distance of the videosigmoidoscope was 23.2 (5.9) cm, which was significantly further than with the conventional sigmoidosocpe 16.5 (3.8) cm (p < 0.01). The discomfort on a visual analogue score for the videosigmoidoscope was 3.0 (1.8), which was significantly less than for the conventional sigmoidoscope 5.5 (2.7) (p < 0.01). The five users of the equipment (four surgeons and one colorectal nurse practitioner) preferred the videosigmoidoscope for image quality and ease of examination. CONCLUSIONS: A thinner, longer, rigid videosigmoidoscope is a more effective means of looking at the proximal sigmoid colon. Despite being inserted further, it caused less discomfort than the conventional sigmoidoscope. High-quality video images can be recorded or transmitted for real-time teleconsultation.

Humans↗
PubMed2002

Mechanical supplementation by non-rigid fixation in degenerative intervertebral lumbar segments: the Wallis system.

A first-generation implant for non-rigid stabilization of lumbar segments was developed in 1986. It included a titanium interspinous blocker and an artificial ligament made of dacron. Following an initial observational study in 1988 and a prospective controlled study from 1988 to 1993, more than 300 patients have been treated for degenerative lesions with this type of implant with clinical and mechanical follow-up. After careful analysis of the points that could be improved, a second-generation implant called the "Wallis" implant, was developed. This interspinous blocker, which was made of metal in the preliminary version, is made of PEEK (polyetheretherketone) in the new model. The overall implant constitutes a "floating" system, with no permanent fixation in the vertebral bone, to avoid the risk of loosening. It achieves an increase in the rigidity of destabilized segments beyond normal values. The clinical trials of the first-generation implant provided evidence that the interspinous system of non-rigid stabilization is efficacious against low-back pain due to degenerative instability and free of serious complications. The first-generation devices achieved marked, significant resolution of residual low-back pain. These results warrant confirmation. A randomized clinical trial and an observational study of the new implant are currently underway. Non-rigid fixation clearly appears to be a useful technique in the management of initial forms of degenerative intervertebral lumbar disc disease. This method should rapidly assume a specific role along with total disc prostheses in the new step-wise surgical strategy to obviate definitive fusion of degenerative intervertebral segments. At present, the Wallis system is recommended for lumbar disc disease in the following indications: (i) discectomy for massive herniated disc leading to substantial loss of disc material, (ii) a second discectomy for recurrence of herniated disc, (iii) discectomy for herniation of a transitional disc with sacralization of L5, (iv) degenerative disc disease at a level adjacent to a previous fusion, and (v) isolated Modic I lesion leading to chronic low-back pain.

Clinical Trials as Topic↗
PubMed1984

Osseous adaptation to continuous loading of rigid endosseous implants.

Titanium implants, with an acid-etched surface, were screwed into holes 3 mm in diameter, about 1 cm apart, carefully prepared with an internally irrigated, surgical bur in the femurs of 3- to 6-month-old rabbits. During the first 3 days after surgery, fluorescent bone labels revealed extensive bone formation, particularly at the endosteal margin of the surgical defect, indicating preservation of a high degree of osteogenic capacity. A lattice of coarse, woven bone began encapsulating the implant within 3 days. By the end of 6 weeks, mature, lamellar bone filled voids at or near the implant surface and a rigid bone/implant interface was routinely achieved. Nonspecific, subperiosteal bony hypertrophy was noted within 6 weeks after implants were placed in young, growing animals (3 months old), but not in adults (6 months old). After 6 to 12 weeks of healing, a 100-gm load was applied for 4 to 8 weeks by stretching a stainless steel spring between the implants. All but one of twenty loaded implants remained rigid. Immediate loading of four pairs of implants resulted in spontaneous spiral-type ("torsional") fractures of the femur within 1 week. These results indicate that (1) relatively simple and inexpensive titanium implants develop a rigid osseous interface, (2) 6 weeks is an adequate healing period, prior to loading, to attain rigid stability and avoid spontaneous fracture, (3) continuously loaded implants remain stable within the bone, (4) bone formation is observed on periosteal surfaces subjected to concave flexure (compression), (5) cancellous-type bone orients perpendicularly between loaded implants, apparently corresponding to lines of stress, (6) new secondary osteons are propagated at or near the surface of loaded implants, (7) the remodeling (turnover) cycle for rabbit compact bone is about 6 weeks, and (8) endosseous implants have potential as a source of firm osseous anchorage for orthodontics and dentofacial orthopedics.

Animals↗
PubMed1986

Visualization of domains in rigid ganglioside/phosphatidylcholine bilayers: Ca2+ effects.

We have considered the extent to which details of lectin binding directly visualized by freeze-etch electron microscopy are consistent with current concepts of ganglioside arrangement in phosphatidylcholine bilayer membranes. Native lectins in general seem appropriate labels for this type of study. Wheat germ agglutinin, Ricinus communis agglutinin, and peanut agglutinin are adequately resolved on membrane surfaces as spherical particles of diameters 6 nm, 10 nm, and 13 nm, respectively (uncorrected for platinum shadow thickness). The finite areas covered by these markers correspond to some 56, 157, and 265 lipid molecules, respectively, on the surfaces of the shadowed rigid phosphatidylcholine matrices employed here; and this constitutes a basic limitation to the precision with which one can localize a given glycolipid receptor. Ricinus communis agglutinin provides a marker whose size permits adequate quantitation of bound material while minimally obscuring detail. Using it we estimated the size limits of GM1-enriched domains, since this is the ganglioside which has shown the greatest evidence of discontinuous distribution in our hands (Peters, M.W., Mehlhorn, I.E., Barber, K.R. and Grant, C.W.M. (1984) Biochim. Biophys. Acta 778, 419-428). Results of such analyses indicate the probable existence of phase separated domains selectively enriched in GM1 up to 60 nm in extent (5600 lipid molecules) for rigid dipalmitoylphosphatidylcholine membranes bearing up to 14 mol% GM1. Similar observations were true of rigid bilayers of dimyristoylphosphatidylcholine; however, if domains enriched in GM1 exist in fluid dimyristoylphosphatidylcholine, they are on the order of 6 nm or less in diameter (or are dispersed by lectin binding). Employing the small lectin, wheat germ agglutinin, which binds to all gangliosides, we then examined the effect of exposure to Ca2+ ions (while in the fluid state) on the ganglioside 'domain structure' referred to above in rigid dipalmitoylphosphatidylcholine host matrices. GM1, GD1a and GT1b were studied at 0, 2 and 10 mM Ca2+ concentrations. It was demonstrated by spin label measurements that the dipalmitoylphosphatidylcholine matrix retained its basic melting characteristics in the presence of added Ca2+ and ganglioside under these conditions. Within the technique's functional resolution limit of some 6 nm we were unable to identify any effect of Ca2+ in physiological concentration on ganglioside topography as reflected by bound lectin distribution.(ABSTRACT TRUNCATED AT 400 WORDS)

1,2-Dipalmitoylphosphatidylcholine↗
PubMed1987

A rigid-body method for finding centers of rotation and angular displacements of planar joint motion.

A rigid-body method for determining the center of rotation (CR) and the angular displacement in a plane is developed. A comparison of this method to the graphical method of Reuleaux (Theoretische Kinematik: Grundzüge einer Theorie des Maschinenwerens, 1875) is found to have fewer constraints while meeting or exceeding the Reuleaux method in accuracy. The rigid-body method is not constrained by the location of the markers, as they can be placed radially or juxtapositioned about the CR. Magnitude of the rotation angle does not affect the accuracy in calculating the rotation angle. When applying both methods to locate the CR in a simulated knee joint, a substantial decrease in error is found with the new method. In a comparison of optimal marker angles used to locate the CR and find the angular displacement, the rigid-body method is found to be more accurate in both the mean and range of error. Effects of parameters specified by Panjabi (J. Biomechanics 12, 911-920, 1979) are applied to both methods. Results are then used in setting up guidelines for increasing accuracy with the rigid-body method.

Algorithms↗
PubMed1989

Rigidity of major connectors when subjected to bending and torsion forces.

Rigidity tests were performed on maxillary major connectors of different designs and mandibular major connectors of the lingual bar-type with different cross-sectional shapes and thicknesses. Each major connector was clamped on one side while the other side was subjected to bending, torsion, and bending under torsion forces. Deformation was measured with a micrometer microscope. The most rigid maxillary major connector was the design incorporating the anterior-posterior palatal bar. The most flexible was the U-shaped palatal bar. The full pear-shaped lingual bar (4 x 4 mm) was the most rigid of the major connectors. Among the more conventional lingual bars, the semielliptical bar (3.75 X 1.75 mm) was the most rigid, and the narrow semielliptical bar (4 x 1.5 mm) was the most flexible.

Chromium Alloys↗
PubMed1990

An examination of the rigidity of major connectors for removable partial dentures: an in-vitro study investigating horizontal loading of mandibular connectors.

This study investigated the rigidity imparted by the dimensions and cross-sectional shape of major connectors for a range of arch-forms. Sixteen cobalt chromium castings in all were fabricated, four in the form of standardised lingual bars, four as thickened lingual bars, four as lingual plates and two as modified sublingual bars. Arch-forms varied in length, radius of curvature and mid-sagittal angulation. All connectors were tested in compression on an Instron machine with and without a resilient base. The latter simulated the displacement of the periodontal membrane. A further apparatus was constructed to record the transmission of applied loads to the contralateral side of the arch; again resilient material was used as an analogue to the periodontal ligament. Results indicated that connector deflection varied directly with its length and inversely with its radius of curvature and the minimum cross-section of the anterior third. A 20 degrees change in mid-sagittal angulation was not significant. The theoretical relationships between a connector's dimensions and its rigidity were not confirmed. Regions of minimum connector dimension limited rigidity. The lingual bars and plates did not distribute lateral stresses effectively to the contralateral side of the arch and were found to be less rigid than the modified sublingual bars.

Chromium Alloys↗
PubMed1995

The effects of testosterone replacement on nocturnal penile tumescence and rigidity and erectile response to visual erotic stimuli in hypogonadal men.

Nocturnal penile tumescence (NPT) and erectile response to visual erotic stimuli (VES) were measured, by means of a Rigiscan device, in nine hypogonadal men, and repeated after 3 months of androgen replacement. The same assessments were carried out once in 12 eugonadal controls. The number of satisfactory NPT responses, in terms of both circumference increase and rigidity, were less in the hypogonadal men than the controls and were significantly increased by androgen replacement, confirming the results of earlier studies. In terms of circumference increase, erectile response to VES did not differ between the hypogonadal men and the controls, and did not increase with androgen replacement. In terms of rigidity, the erectile response to VES did not differ between hypogonadal men and controls. However, in terms of both duration and maximum level of rigidity, there was a significant increase following androgen replacement in the hypogonadal men. These new findings, in relation to rigidity, require a modification of the earlier formulation, which saw NPT as androgen dependent and erectile response to VES as androgen independent. NPT, and possibly spontaneous erections at other times, clearly involve an androgen sensitive system. Erectile response to VES predominantly involves an androgen independent system but may also be influenced by androgen sensitive mechanisms.

Adult↗
PubMed2005

The importance of rigid nasal endoscopy in the diagnosis and treatment of rhinolithiasis.

OBJECTIVES: Rhinolithiasis is the presence of mineralized and calcareous formations located in the nasal cavity. They have rare occurrence and can be easily confused with infection or obstruction of upper airways. If they are undetected for a long time, they may grow large enough to cause of nasal obstruction, mimicking sinusitis. Seven cases of rhinolithiasis were presented, and their diagnosis was made by rigid endoscopic nasal examination. Also computerized tomography scan was used to describe the size and site of the rhinoliths accurately. Our purpose was to determine the role of rigid nasal endoscopy in the diagnosis and the treatment of rhinolithiasis. METHODS: In this study, seven cases of rhinolithiasis, who were diagnosed and treated by rigid nasal endoscopy were presented. RESULTS: Between January 2000 and November 2004, seven cases (four males and three females; age ranged from 8 to 45 years) with rhinolithiasis were diagnosed. The most frequent symptoms were nasal obstruction with purulent rhinorhea, nasal and oral malodor. As complementary examinations, computerized tomography and simple X-ray of paranasal sinuses were used to locate and measure the dimension of calcareous mass, and to reveal possible invasion of the adjacent structures. The removal of rhinolithiasis was done with rigid nasal endoscopy under topical anesthesia in six cases and general anesthesia in one case. CONCLUSION: Rhinolithiasis is a rare condition but must always be suspected in patients with long standing nasal obstruction, nasal and oral malodor, purulent rhinorrhea and chronic headache.

Adolescent↗
PubMed2005

Flexible versus rigid intrauterine insemination catheters: a prospective, randomized, controlled study.

OBJECTIVE: To prospectively compare pregnancy rates for couples undergoing IUI by a single healthcare provider with random assignment to either rigid (Tomcat; Kendall Sovereign, Mansfield, MA) or flexible (Soft Pass; Cook, Spencer, IN) catheters. DESIGN: Randomized, controlled study. SETTING: Tertiary care infertility practice. PATIENT(S): One hundred infertile women enrolled from a single infertility practice who met the inclusion and exclusion criteria for IUI were enrolled. Of the 100 patients, 95 underwent ovarian stimulation before IUI: 35 with clomiphene citrate alone, 60 with clomiphene citrate combined with a single dose of gonadotropins. INTERVENTION(S): Timed IUI was performed with either rigid (Tomcat) or flexible (Cook) insemination catheters. MAIN OUTCOME MEASURE(S): Pregnancy rate per cycle. RESULT(S): No differences were noted between groups for the following: age, length of infertility, day-3 FSH level, number of prior IUI cycles, total motile sperm count, days of abstinence, infertility diagnoses, insemination ratings, and stimulation protocols. No difference in pregnancy rates was observed between rigid and flexible catheter groups. CONCLUSION(S): There is no statistically significant difference between flexible and rigid catheters for IUI.

Adult↗
PubMed2005

Long-term effects of hormone therapy on skin rigidity and wrinkles.

OBJECTIVE: To evaluate the effects of long-term hormone therapy (HT) on skin rigidity and wrinkling. DESIGN: Single blinded cross-sectional analysis. SETTING: Academic medical center. PATIENT(S): Sixty-five long-term HT users who underwent menopause at least 5 years before evaluation and who have either consistently used HT or have never used HT. INTERVENTION(S): Visual assessment of severity of wrinkles at 11 facial locations using the Lemperle scale by a plastic surgeon blinded to HT use. Measurement of skin rigidity at the cheek and forehead with a durometer. MAIN OUTCOME MEASURE(S): Lemperle wrinkle score and skin rigidity. RESULT(S): Twenty women met inclusion criteria. Eleven women who had not used HT were compared to nine long-term HT users. Demographics including age, race, sun exposure, sunscreen use, tobacco use, and skin type were similar. Rigidity was significantly decreased in HT users compared to nonusers at both the cheek (1.1 vs. 2.7) and forehead (20 vs. 29). Average wrinkle scores were lower in hormone users than in nonhormone users (1.5 vs. 2.2). CONCLUSION(S): Long-term postmenopausal HT users have more elastic skin and less severe wrinkling than women who never used HT, suggesting that hormone therapy may have cosmetic benefits.

Cross-Sectional Studies↗
PubMed2005

The feasibility of rigid stroboscopy in children.

OBJECTIVE: Voice disorders in children are common but ways of their analysis are limited. We conducted a prospective feasibility study of rigid stroboscopy in children. METHODS: All children referred for voice analysis during the years 2002-2003 were evaluated including subjective perception of voice, voice recording, flexible or rigid laryngoscopy and stroboscopy. Children were prepared by an explanation and visual demonstration. Local anesthesia was introduced through inhalation of Lidocaine (2%) solution prior to examination. Stroboscopy was performed either by a 70 degrees rigid laryngoscope or by a 3.0 mm fiberoptic-flexible endoscope. RESULTS: Forty-two children were analyzed. Rigid stroboscopy was feasible in 31 children of whom 7 were under 10 years of age. Short phonation time (7), gag reflex (6), impaired view due to high and posteriorly inclined epiglottis (4) were the main reasons of failure. CONCLUSIONS: Standard telescopic stroboscopy can be safely and effectively implemented in the majority of children over 10 years of age.

Adolescent↗
PubMed2004

Flexible versus rigid catheters for chronic administration of exogenous agents into central nervous system tissues.

INTRODUCTION: Neuropharmacology studies depend on consistency in drug delivery. Drug infusions into central nervous system (CNS) tissues have been described as unreliable. Speculation has focused on infusion pumps as the source of variation. This report demonstrates that the catheter may be a source of variability. The inconsistency can be significantly reduced by a change in catheter design. METHODS: Normal and tumor cell-challenged (abnormal) brains of Fischer rats were infused with small and large molecular weight cytotoxic drugs via rigid and flexible catheters placed directly into the parenchyma. Coronal tissue sections rostral and caudal to the infusion point were analyzed for drug concentrations. Carboplatin, estimated through atomic absorption assays, and doxorubicin and transferrin-bound doxorubicin, measured by fluorescent spectroscopy, were mapped in serial sections at various distances from the infusion point. RESULTS: The expected drug distribution pattern approximates a bell-shaped curve with a maximum drug concentration near the infusion point and approximately equal, declining concentrations rostral and caudal to the infusion. This expected distribution was found in only 10 of the 17 normal brains and 15 of the 28 abnormal brains infused with a rigid catheter. In contrast, 10 of the 10 normal brains and 16 of the 16 abnormal rat brains infused with a flexible catheter had the expected distribution pattern. The distribution pattern was not associated with the molecular weight of the infused drug. CONCLUSION: Replacement of rigid infusion tubes with flexible tubing increases the reliability of local CNS drug infusions. Rigid catheters may allow backflow of the infused drug along the path of the catheters into the subdural space.

Animals↗
PubMed2006

An information theoretic approach for non-rigid image registration using voxel class probabilities.

We propose two information theoretic similarity measures that allow to incorporate tissue class information in non-rigid image registration. The first measure assumes that tissue class probabilities have been assigned to each of the images to be registered by prior segmentation of both of them. One image is then non-rigidly deformed to match the other such that the fuzzy overlap of corresponding voxel object labels becomes similar to the ideal case whereby the tissue probability maps of both images are identical. Image similarity is assessed during registration by the divergence between the ideal and actual joint class probability distributions of both images. A second registration measure is proposed that applies in case a segmentation is available for only one of the images, for instance an atlas image that is to be matched to a study image to guide the segmentation thereof. Intensities in one image are matched to the fuzzy class labels in the other image by minimizing the conditional entropy of the intensities in the first image given the class labels in the second image. We derive analytic expressions for the gradient of each measure with respect to individual voxel displacements to derive a force field that drives the registration process, which is regularized by a viscous fluid model. The performance of the class-based measures is evaluated in the context of non-rigid inter-subject registration and atlas-based segmentation of MR brain images and compared with maximization of mutual information using only intensity information. Our results demonstrate that incorporation of class information in the registration measure significantly improves the overlap between corresponding tissue classes after non-rigid matching. The methods proposed here open new perspectives for integrating segmentation and registration in a single process, whereby the output of one is used to guide the other.

Algorithms↗