Purpose Managing a deficient acetabulum in patients with developmental dysplasia of the hip (DDH) can be challenging. The purpose of the study was to determine the mid-term results of total hip arthroplasty (THA) using a bulk structural autograft for reconstruction of the acetabular roof in patients with DDH. Methods Between 1982 and 1999, 112 patients underwent THA with acetabular roof-plasty using a bulk structural autograft for secondary osteoarthritis related to DDH. A total of 106 patients (115 hips) met inclusion criteria and were followed for an average of 11.6 years (seven to 24 years). The mean age was 52.5 years at the index operation. Clinical and radiological evaluations were performed according to the methods of Merle d'Aubigné and Postel, Johnston et al. and DeLee and Charnley. Results The overall Merle d'Aubigné hip score significantly improved (3.7 vs 10.4, p<0.01). The limb length discrepancy decreased from 30 to 6 mm (p<0.01). The average distance that the hip centre was distalised was 22.3 mm (0-56 mm). However, radiolucent lines were observed in 27 % of patients at final follow-up, and the overall rate of revision for aseptic loosening was 16 %. Further, Kaplan-Meier survivorship curves predicted a rapid increase in the failure rate at 15 years. Conclusions The mid-term functional outcome of THA with an acetabular roof-plasty using a bulk autograft is satisfactory; however, the long-term results are questionable.
OBJECTIVE: The application ofan electronic slide and a software simulated virtual microscope can contribute to a more efficient, convenient histological analysis. These techniques would also support the automation of histological analysis and three dimensional reconstruction of histological objects. STUDY DESIGN: A fully computer controlled microscope (Axioplan 2 MOT), video camera(Grundig FAC 830) and an Intel Pentium II based PC were used for the development ofthe electronic slide. The applied frame grabber had 640x560 resolution, 64 kb colour depth. A program was developed. called Pyramid, for the scanning of an entire slide.Autofocusing, image reduction and frame joining algorithms were implemented in the virtual microscope application. RESULTS :The autofocusing and digitisation of one image segment (400x magnification, 0,0725 mm2) took 8 seconds.The harddisk volume of one frame is between 60 and 100 kilobytes (kb) after JPEG compression. The overall harddisk place for a gastric biopsy is around 130-1 50 megabytes. The Pyramid program contains routines for electronic evaluation of the slide. The major microscopic functions are implemented : moving in any free directions in discrete or continuos steps, magnifications on a discrete scale (400,200, lOOx), and in continuos scale. Up to lo notes can be placed on any place ofthe slide and can be retrieved within a second. The program can be used in local area networks for slide evaluations. CONCLUSIONS : The scanning speed is now too low for routine application, however with further developments in data storage and imaging technology, the electronic slide and the virtual microscope can be alternative techniques in the computerisation of the histology laboratory. After the scanning of consecutive sections and a mathematical matching procedure supracellular organisations from gastric biopsies were reconstructed giving new insight into tumour growth.
The application of turbidimetric homogeneous immunoassays made the determination of several plasma components widely available. The sensitivity and accuracy of these assays are appropriate enough for routine laboratory use; however, in the case of many pathologically high concentration samples, prozone effect (high dose hook effect) can be observed, that leads to false-negative determination. Up to the present there are no cost-effective algorithms available for the safe detection of the prozone effect. Pathological serum ferritin values can be elevated up to 5000 ng/ml, while the measuring range covers only the 0-440 ng/ml range by a commercial assay. The determination of samples with ferritin concentration higher than 1500 ng/ml results in false-negative values because of the overlapping measuring range and prozone effect range. The prozone effect can be recognised by analysis of reaction kinetics after measurement. We have developed a neural network classifier system to analyse reaction kinetics of the measurements and check the prozone effect. One thousand five hundred determinations and 77 patient samples were used for neural network training and test. Using the trained neural networks, false-negative results can be filtered immediately after the determination, without re-run; thus, the sensitivity of plasma ferritin determination may become reliable enough, even in the case of high concentration samples. Applying this new technology, false-negative serum ferritin determinations can be avoided, thus even a relatively high hook effect rate (5-12% in different patient groups) can be handled safely.
Speech technology may soon become an integrated part of our daily routine in the endoscopy laboratory. A central speech and laboratory computer could be the most efficient alternative to having separate speech recognition units in all items of equipment.
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