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PubMed1994

Kotz modular femur and tibia replacement. 28 tumor cases followed for 3 (1-8) years.

In the period 1984-1991, 33 lower limb reconstructions were performed with an uncemented Kotz modular femur tibia reconstruction (KMFTR) prosthesis after resection of 32 malignant bone tumors and 1 benign giant cell tumors. Tumor localization was proximal femur in 12, distal femur in 17, and proximal tibia in 4. The mean age of the patients was 38 years. 28 patients with a minimum follow-up of 1 year were studied after 3 (1-8) years. 7 patients were reoperated because of complications. Good or excellent results were obtained in 6 of the 10 proximal and 13 of the 14 distal femur reconstructions. In 2 of the 4 patients undergoing combined distal femur and proximal tibia resection, a deep infection developed, and above-knee amputation was performed. One local recurrence occurred after proximal femur resection.

Adolescent↗
PubMed2006

Psychophysiological analysis (PSPHA): a modular script-based program for analyzing psychophysiological data.

In psychophysiological research, complex tailor-made and interactive analyses of biosignals (e.g., skin conductance, heart rate, and respiration) are often required. Moreover, a synchronization between experimental stimuli and psychophysiolgical responses is necessary. In this article, we present Psychophysiological Analysis (PSPHA), a modular script-based program for analyzing biosignals in the time domain. The modules can be integrated in a VBScript, and a wizard allows easy adaption of parameters. PSPHA is a free, interactive, and flexible program for analyzing the data of psychophysiological experiments.

Electronic Data Processing↗
PubMed2002

Recognizing the un-real McCoy: priming and the modularity of face recognition.

Fodor (1983) has proposed that face perception is carried out by an informationally encapsulated module, whose operation is unaffected by context or expectancies. We tested the modularity hypothesis by examining whether discriminations between normal and distorted versions of famous faces can be primed, either by the name of an associated person (semantic context) or by a valid cue as to the identity of the target face (expectancy). A preliminary experiment showed that, in the absence of priming, discriminations between normal and distorted versions of a face were unaffected by whether the target faces were familiar or not, confirming that these judgments tap perceptual, not postperceptual (semantic), coding processes. In Experiment 1, accuracy was significantly higher when target face pairs were preceded by related name primes, as compared with unrelated ones. In Experiment 2, reaction times were significantly faster for targets preceded by a valid identity cue than for targets preceded by an invalid one. Neither effect could be explained as a speed-accuracy tradeoff. These results fail to support Fodor's conjecture that face processing is encapsulated.

Adult↗
PubMed1985

Modular prosthetic system for segmental bone and joint replacement after tumor resection.

The increased interest in limb saving resection for malignant bone tumors emphasizes the need for continued research and development to improve techniques of oncological reconstruction. The bioengineer plays an important role on the limb salvage team. At the present time, custom joint implants are opening up new horizons in rehabilitation of patients following resection of bone tumors. In the future, modular prosthetic systems such as the system described will eliminate the need for individual, customized manufacture of prostheses and will make these oncological reconstructive techniques more available.

Biomechanical Phenomena↗
PubMed2005

Stability advantages of a modular total hip system.

Hip instability continues to be an infrequent, yet frustrating complication of total hip arthroplasty (THA). Restoration of normal hip anatomy and biomechanics at the time ofTHA is critical to reduce the risk of dislocation. This can be difficult in some patients due to distorted hip anatomy and wide variations in "normal" hip anatomy reported in numerous studies. Modular femoral components offer a large array of femoral offset, length, and version options which can be used independently or in combination to recreate normal osseous anatomy and a well-tensioned soft tissue envelope, which should enhance hip stability following THA.

Arthroplasty, Replacement, Hip↗
PubMed2005

Modular cementless total hip arthroplasty for hip infection sequelae.

Childhood hip infection may produce significant anatomical deformations leading to the premature onset of secondary osteoarthritis. Total hip arthroplasty (THA) in these patient populations can be technically challenging and has been associated with high complication rates. This article reports the results of 58 cementless THAs with use of a modern implant design. The complication rate, including one recurrent infection, was relatively low. Cementless THA with use of a modular stem coupled with a metal-backed socket was found to be an effective and reliable treatment option for patients with the late sequelae of infective hip arthritis.

Adolescent↗
PubMed2005

Modular femoral component for conversion of previous hip surgery in total hip arthroplasty.

The conversion of previous hip surgery to total hip arthroplasty creates a durable construct that is anatomically accurate. Most femoral components with either cemented or cementless design have a fixed tapered proximal shape. The proximal femoral anatomy is changed due to previous hip surgery for fixation of an intertrochanteric hip fracture, proximal femoral osteotomy, or a fibular allograft for avascular necrosis. The modular S-ROM (DePuy Orthopaedics Inc., Warsaw, Ind) hip stem accommodates these issues and independently prepares the proximal and distal portion of the femur. In preparation and implantation, the S-ROM hip stem creates less hoop stresses on potentially fragile stress risers from screws and thin bone. The S-ROM hip stem also prepares a previously distorted anatomy by milling through cortical bone that can occlude the femoral medullar canals and recreate proper femoral anteversion and reduces the risk of intraoperative or postoperative periprosthetic fracture due to the flexible titanium-slotted stem. The S-ROM femoral stem is recommended for challenging total hip reconstructions.

Arthroplasty, Replacement, Hip↗
PubMed2003

Modular organization of the carboxyl-terminal, globular head region of human C1q A, B, and C chains.

The first step in the activation of the classical complement pathway, by immune complexes, involves the binding of the globular heads of C1q to the Fc regions of aggregated IgG or IgM. Located C-terminal to the collagen region, each globular head is composed of the C-terminal halves of one A (ghA), one B (ghB), and one C chain (ghC). To dissect their structural and functional autonomy, we have expressed ghA, ghB, and ghC in Escherichia coli as soluble proteins linked to maltose-binding protein (MBP). The affinity-purified fusion proteins (MBP-ghA, -ghB, and -ghC) bound differentially to heat-aggregated IgG and IgM, and also to three known C1q-binding peptides, derived from HIV-1, HTLV-I, and beta-amyloid. In the ELISAs, the MBP-ghA bound to heat-aggregated IgG and IgM as well as to the HIV-1 gp41 peptide; the MBP-ghB bound preferentially to IgG rather than IgM, in addition to binding beta-amyloid peptide, whereas the MBP-ghC showed a preference for IgM and the HTLV-I gp21 peptide. Both MBP-ghA and MBP-ghB also inhibited C1q-dependent hemolysis of IgG- and IgM-sensitized sheep erythrocytes. However, for IgM-coated erythrocytes, MBP-ghC was a better inhibitor of C1q than MBP-ghB. The recombinant forms of ghA, ghB, and ghC also bound specifically to apoptotic PBMCs. We conclude that the C1q globular head region is likely to have a modular organization, being composed of three structurally and functionally independent modules, which retains multivalency in the form of a heterotrimer. The heterotrimeric organization thus offers functional flexibility and versatility to the whole C1q molecule.

Amino Acid Motifs↗
PubMed2001

Pulmonary rehabilitation in outpatients with asthma or chronic obstructive lung disease. A pilot study of a "modular" rehabilitation programme.

STUDY/PRINCIPLES: Pulmonary rehabilitation programmes are often costly and dependent on the infrastructure of specialised centres. We developed a modular, outpatient-based rehabilitation programme, which is inexpensive and can be implemented in a variety of settings. The aim of this study was to determine the effects and feasibility of this programme. METHODS: Thirteen patients with COPD and 7 patients with asthma were enrolled by their primary care physician because of dyspnoea. Initial assessment included cardiopulmonary exercise testing, six-minute walking distance, lung function testing and multiple questionnaires addressing dyspnoea, depression and quality of life issues. The training consisted of 36 sessions of high intensity training of 2 hours duration to improve exercise tolerance, including 30 minutes of stationary cycling at the anaerobic threshold. Another complete assessment was done on completion of the study at 3 months. RESULTS: The six-minute walking distance improved significantly from 401 to 551 m (p < 0.0001). The maximal exercise capacity increased significantly from 85 W to 99 W (p < 0.001). The anaerobic threshold remained unchanged despite the high intensity training. There was a reduction of dyspnoea and an improvement of quality of life. CONCLUSION: This study shows that our outpatient rehabilitation programme leads to a benefit in exercise tolerance and health related quality of life comparable to other programmes published in the literature. The rehabilitation programme was very well accepted among patients, primary care physicians and health insurers.

Adult↗
PubMed2004

Women's load carriage performance using modular lightweight load-carrying equipment.

The purposes of this study were to evaluate how Modular Lightweight Load-Carrying Equipment (MOLLE) fits women while walking on level surfaces with different loads, to examine women's load carriage performance before and after a simulated march using five load levels, and to examine the relationship between shoulder and leg muscle strength and load carriage performance of women while carrying loads using MOLLE. Seven physically active women carried five levels of load (no load, 20, 30, 40, and 50 pounds) using MOLLE. With increased loads, women showed increased double-limb support time, decreased single-limb support time, increased trunk forward inclination excursion, decreased knee excursion, decreased medial-lateral excursion of center of gravity (COG), and increased vertical excursion of COG. Hip abductor strength was a strong predictor of COG vertical excursion. Some women required modification of the padded hip belt to ensure weight distributed evenly around the pelvis.

Adolescent↗
PubMed1993

Modular insert for use on a standard operating room table for performing shoulder surgery in the sitting position.

The use of the sitting position for performing shoulder surgery is not a new concept. However, a standard surgical table cannot be readily converted for shoulder surgery without extensive and expensive modifications. A modular insert is described that is inexpensive and can easily be built for use in converting, in less than one minute, a standard surgical table into a table for performing shoulder surgery.

Equipment Design↗
PubMed1997

A modular case-mix classification system for medical rehabilitation illustrated.

The authors present a modular set of patient classification systems designed for medical rehabilitation that predict resource use and outcomes for clinically similar groups of individuals. The systems, based on the Functional Independence Measure, are referred to as Function-Related Groups (FIM-FRGs). Using data from 23,637 lower extremity fracture patients from 458 inpatient medical rehabilitation facilities, 1995 benchmarks are provided and illustrated for length of stay, functional outcome, and discharge to home and skilled nursing facilities (SNFs). The FIM-FRG modules may be used in parallel to study interactions between resource use and quality and could ultimately yield an integrated strategy for payment and outcomes measurement. This could position the rehabilitation community to take a pioneering role in the application of outcomes-based clinical indicators.

Activities of Daily Living↗
PubMed1999

Multicenter evaluation of the XT modular coronary stent: clinical and angiographic results.

BACKGROUND: In the past few years, the indications for stent implantation have broadened, along with a larger number of available designs. The Bard XT stent is a new modular stent with an original structure and design. METHODS: To evaluate the new Bard XT stent, we studied its use in a multicenter experience in 163 patients, with a total of 168 lesions and 180 implanted units. RESULTS: Despite the predominance of complex lesions, the procedural success rate was 98%, with only a 2% failure of stent implantation. There was only one death (no-reflow phenomenon in a rescue primary PTCA in a patient in cardiogenic shock) without other major periprocedural complications. Centralized QCA showed a statistically significant increase of MLD (from 0.73 +/- 0.43 mm to 2.71 +/- 0.40 mm, p < 0.0001) and DS reduction (from 73.8 +/- 15.1% pre-treatment to 7.8 +/- 0.4% after stent implantation; p < 0.0001). Aspirin and ticlopidine were routinely administered after the procedure. Thirty-day follow-up reported only one case of subacute stent thrombosis (in the first day), treated with re-PTCA. CONCLUSIONS: In a group of patients with complex lesions, we obtained a high rate of success with a low incidence of complications. The Bard XT stent had a high-performance profile with normalization of vessel diameter and angiographic results similar to the ones obtained with the "slotted tube" stents.

Aged↗
PubMed1999

Micromotion measurements with hip center and modular neck length alterations.

Hip center relocation often is necessary because of acetabular deformity or in revision surgery. Superolateral relocation of the acetabular component increases the hip joint reaction forces and has been associated with early femoral implant loosening. In addition, relocation can necessitate the use of extended femoral neck lengths. The purpose of this study was to compare the initial stability (micromotion) of an anatomically placed femoral component with that of a superolaterally relocated component and with a component having an extended neck length. A six-degree of freedom device was constructed to measure three-dimensional micromotion at the proximal and distal regions of the femoral component. The instrumented femur was loaded using a unique loading device that included musculature necessary to simulate stairclimbing. Results showed that superolateral relocation of the hip center (25 mm) only moderately increased femoral component micromotion (13%). However, it was found that extending the neck length 12.5 mm produced a dramatic increase in micromotion (38%). Clinically this suggests that hip center lateralization and the use of long modular neck lengths should be avoided.

Acetabulum↗
PubMed1999

[Total knee replacement with modular Kinemax endoprosthesis in osteoarthritis and rheumatoid arthritis].

One to 7 years results (mean 3 years) of modular kinematic knee arthroplasty were compared in rheumatoid (RA, n = 29) and idiopathic (OA, n = 28) arthritis female patients. Comparisons of means showed lower age at surgery (59 yr. v. 66 yr., p = 0.002), lower body mass (66 kg v. 75 kg, p = 0.001) and lower Hospital for Special Surgery scoring (71.7 v. 80, p = 0.05) in RA patients. Two RA knees with prosthesis showed after 2-3 years deterioration of the previously good result. Late infections were indication for removal of the prosthesis in two patients with RA. Two patients of this group died due to complications of the disease. Authors point that knee arthroplasty carries higher risk in rheumatoid than in idiopathic osteoarthritis.

Aged↗
PubMed1999

A modular cinnamoyl ester hydrolase from the anaerobic fungus Piromyces equi acts synergistically with xylanase and is part of a multiprotein cellulose-binding cellulase-hemicellulase complex.

A collection of clones, isolated from a Piromyces equi cDNA expression library by immunoscreening with antibodies raised against affinity purified multienzyme fungal cellulase-hemicellulase complex, included one which expressed cinnamoyl ester hydrolase activity. The P. equi cinnamoyl ester hydrolase gene (estA) comprised an open reading frame of 1608 nt encoding a protein (EstA) of 536 amino acids and 55540 Da. EstA was modular in structure and comprised three distinct domains. The N-terminal domain was closely similar to a highly conserved non-catalytic 40-residue docking domain which is prevalent in cellulases and hemicellulases from three species of anaerobic fungi and binds to a putative scaffolding protein during assembly of the fungal cellulase complex. The second domain was also not required for esterase activity and appeared to be an atypically large linker comprising multiple tandem repeats of a 13-residue motif. The C-terminal 270 residues of EstA contained an esterase catalytic domain that exhibited overall homology with a small family of esterases, including acetylxylan esterase D (XYLD) from Pseudomonas fluorescens subsp. cellulosa and acetylxylan esterase from Aspergillus niger. This region also contained several smaller blocks of residues that displayed homology with domains tentatively identified as containing the essential catalytic residues of a larger group of serine hydrolases. A truncated variant of EstA, comprising the catalytic domain alone (EstA'), was expressed in Escherichia coli as a thioredoxin fusion protein and was purified to homogeneity. EstA' was active against synthetic and plant cell-wall-derived substrates, showed a marked preference for cleaving 1-->5 ester linkages between ferulic acid and arabinose in feruloylated arabino-xylo-oligosaccharides and was inhibited by the serine-specific protease inhibitor aminoethylbenzene-sulphonylfluoride. EstA' acted synergistically with xylanase to release more than 60% of the esterified ferulic acid from the arabinoxylan component of plant cell walls. Western analysis confirmed that EstA is produced by P. equi and is a component of the aggregated multienzyme cellulase-hemicellulase complex. Hybrid proteins, harbouring one, two or three iterations of the conserved 40-residue fungal docking domain fused to the reporter protein glutathione S-transferase, were produced. Western blot analysis of immobilized P. equi cellulase-hemicellulase complex demonstrated that each of the hybrid proteins bound to a 97 kDa polypeptide in the extracellular complex.

Amino Acid Sequence↗
PubMed1999

Modular systems in the treatment of abdominal aortic aneurysms: lessons learned in the development of designer endografts.

Treatment of abdominal aortic aneurysms with endoluminal stent-grafts is gaining increased interest. Since the original home-made stent-graft was developed in 1991, a multitude of devices have been developed for this treatment. Modular endografts have evolved during this time and offer several significant advantages. Thorough preoperative imaging and assessment is critical to the success of this new therapy for abdominal aortic aneurysms. Lessons learned during the development of the Medtronic AneuRx endograft and its early clinical trials are discussed.

Aortic Aneurysm, Abdominal↗
PubMed1999

Infected total knee arthroplasty treated with arthrodesis using a modular nail.

Failed treatment of infected total knee replacement presents few attractive surgical options. Knee arthrodesis is challenging surgically and can be complicated by nonunion, malunion, or recurrent infection. Recently, a modular titanium intramedullary nail has been used in an attempt to reduce the incidence of nonunion and the rate of complications. In the present study, a review of the results of knee arthrodesis after infected total knee arthroplasty in 21 patients at three large academic institutions was performed. All patients were followed up for a mean of 2.4 years (range, 2-7.5 years). The mean age of the patients was 64 years. The mean number of previous operations was four (range, 2-9 operations). A solid arthrodesis was achieved without additional surgical treatment in 20 of 21 patients (95%). The mean time to fusion was 6.3 months. The one patient who suffered a nonunion achieved fusion after a subsequent bone grafting procedure. Based on the present study, intramedullary arthrodesis with a coupled titanium nail, is a reliable, effective method of achieving fusion after infection of a total knee arthroplasty. This procedure resulted in a high rate of fusion and a lower rate of complications when compared with traditional methods of arthrodesis.

Aged↗