Adjustable Device Research Articles

Large-area silica nanotubes with controllable geometry on silicon substrates

The synthesis of a highly uniform, large-scale nanoarrays consisting of silica nanotubes above embedded nanohole arrays in silicon substrates is demonstrated. In situ anodized aluminium oxide (AAO) thin film masks on Si substrates were employed, and the nanotubes were fabricated by Ar ion milling through the masks. The geometries of the nanoarrays, including pore diameter, interpore distance and the length of both nanopores and nanotubes could be controlled by the process parameters, which included that the outer pore diameter of silica tube was tuned from ∼80nm to ∼135nm while the inner tube diameter from ∼40nm to ∼65nm, the interpore distance of the nanotube arrays was from 100nm to 180nm and the length of silica tube changed from ∼90nm to ∼250nm. The presented nanostructure fabrication method has strong potential for application in intensity and frequency adjustable high luminescence efficiency optoelectronic devices.

Characterization of a liquid bridge microdroplet dispenser for use in molecular diagnosis

Microfluidic solutions offer the possibility of minimizing time-to-result, reagents and labour costs of molecular diagnosis, while improving their quality and accuracy. The use of droplets as microreactors represents one of the points of focus of this research. The current paper presents a geometry, referred to as a ‘two-way liquid bridge’, for dispensing microdroplets upstream of a nucleid acid amplifier. A single continuous phase, drawn through a capillary tube, can be automatically segmented into droplets of a predetermined size, with each droplet separated from its nearest neighbour and the wetted surface by an immiscible phase. The device has many advantages over previously reported segmenters. An experimental study, conducted in an adjustable device, demonstrates the effect of geometric parameters on the volume of fluid dispensed. Based on these experimental observations, a quasi-empirical theory is proposed to predict the dispensed volume for a given range of dispensed volumes, which is then demonstrated to work as a first-order design tool.

Distortion in optical pulse equalization through phase modulation and dispersive transmission

By combining phase modulation and dispersive transmission we propose an adjustable optical device to compress a time-varying input signal for producing ultrashort light pulses of high optical power. The relationship between the required properties of the input signal and the device parameters to get well-conformed sharp pulses with large energy concentration was established. High-order aberrations effects of the electro-optical modulator acting as the time lens of the employed setup are also considered. We found a mathematical analogy between the output signal of the analyzed device and the signal which would be obtained by using an equivalent first-order dispersive line. Some numerical simulations are shown which illustrate the feasibility of the method.

Multiple channel, adjustable applicator device for MR image-guided brachytherapy: Augmentation of management options in locally advanced cervical cancer

Purpose: A technique to solve the problems of the multiple exact repositioning in term of volumetric dose extend, reproductability of the treatment plan, as well as in term of lowering the risk of perforation, massive bleeding and improving the convenience for the patient has been methodically developed and introduced.

Implantation of an Adjustable Continence Therapy System Using Local Anesthesia in Patients With Post-Radical Prostatectomy Stress Urinary Incontinence: A Pilot Study

We evaluated whether transrectal ultrasound guided ProACT system implantation in patients under local anesthesia and with stress urinary incontinence after radical prostatectomy is feasible in a day hospital setting, and is safe and well tolerated. The procedure was used in 11 consecutive patients (mean age 69.9 years) with stress urinary incontinence after undergoing radical prostatectomy between November 2006 and July 2007. The ProACT system was implanted with a transrectal ultrasound guided procedure after administration of local anesthesia (40 ml ropivacaine 7.5 mg/ml) in perineal skin, subcutaneous tissue, pelvic diaphragm and laterally to the anastomosis. During surgery any reason for discomfort was collected. Pain was evaluated with the visual analogue scale, Numeric Pain Intensity Scale and Simple Descriptive Pain Intensity Scale. Transrectal ultrasound was performed 7 days after surgery to exclude device migrations due to early patient mobilization. The ProACT systems were successfully implanted in all patients under local anesthesia without any need for general anesthesia, and without perioperative surgical or anesthesia related complications. Subjective discomfort was minimal. Mean visual analogue scale was 13 mm (range 0 to 28). Mean Numeric Pain Intensity Scale was 1.4 points (range 0 to 4). On the Simple Descriptive Pain Intensity Scale 4 patients (36.3%) reported no pain, 5 (45.5%) reported mild pain and 2 (18.2%) reported moderate pain. Discharge from the hospital was possible for all patients after 6 hours. All transrectal ultrasound performed after 7 days excluded balloon migrations. Transrectal ultrasound guided ProACT system implantation with the patient under local anesthesia only is feasible, safe, well tolerated and may be performed as a day surgery procedure.

Use of a New Implantable Adjustable Pulmonary Artery Banding Device: A Report of Two Patients

Pulmonary artery banding (PAB) is a method for reducing pulmonary artery blood flow and pressure by tying a surgical band around the main pulmonary artery (MPA). Originally, the procedure was primarily performed to palliate intracardiac left to right shunts for ventricular septal defects (VSDs). Currently, the use of PAB has expanded to allow it to be used in ventricular training, prior to total corrective surgery. At the Rigshospitalet, Copenhagen, Denmark we have been trying a new device. The Flo-Watch PAB implant (EndoArt, Lausanne, Switzerland) is only currently available within certain European countries. The device is a mechanical PAB that allows noninvasive adjustment of the band post implantation, in an outpatient clinic. This has multiple advantages, not only in terms of convenience for the patient, and the reduced risk of multiple surgical interventions, but also from a financial standpoint to the health system. We would like to present our findings and comment on the use of the device in this report.

Treatment of Postprostatectomy Stress Urinary Incontinence Using a Minimally Invasive Adjustable Continence Balloon Device, ProACT: Results of a Preliminary, Multicenter, Pilot Study

To evaluate the safety and efficacy of a new minimally invasive device, Adjustable Continence Therapy (ProACT) for patients with postprostatectomy stress urinary incontinence (SUI). Sixty-two patients with urodynamic SUI after prostate surgery were evaluated according to daily pad count and a specific validated evaluation for persons with urinary incontinence. All patients were successfully implanted in a single procedure using general or spinal anaesthesia. Procedural time was 37 minutes (range, 18 to 80 minutes). Daily pad usage decreased from 4.6 pads per day to 1.06 pads per day at 12 months. Mean quality-of-life index score increased from 48 to 67 at 12 months.Fifty-nine percent of patients without adjuvant radiation were improved (greater than 50% reduction in pad use), and 30% were cured (no pads), whereas 83% of postirradiated patients failed intervention. Fifty-five patients (88%) required percutaneous balloon adjustments. The mean optimal volume after adjustments for all 45 improved patients was 3.8 mL per balloon. Complications necessitating removal occurred in 19 patients and included erosion, infection, migration, and failure to respond. Of these, 4 were successfully reimplanted. All complications occurred in the first postoperative month. Implantation of postoperatively adjustable balloons in postprostatecomy men is technically feasible, with an improvement in continence particularly in patients with nonirradiated periurethral tissues. Optimal urethral resistance is achieved, with easy postoperative adjustment. Implantation of ProACT balloons may represent a promising development in the treatment of postprostatectomy SUI.

省エネルギーを目的とした適応的剛性調節による複数周波数成分の運動実現

This paper proposes a motion control method of mechanical systems utilizing adaptive stiffness optimization for energy saving. The controlled systems in this paper are assumed to have linear dynamics and to have adjustable stiffness devices. To realize the energy saving control systems even when desired motions include multi frequency component, a new stiffness optimization concept similar to resonance is proposed. We mathematically prove the effects of the stiffness optimization and stability of the controlled systems. The proposed method can achieve trajectory tracking with high accuracy and reduce energy from actuators as much as possible. An advantage of the proposed method is that the controller works well without using parameters of the controlled systems. Simulation results demonstrate the effectiveness of the proposed method.

POS-01.07: Anatomical basis for effective placement of adjustable continence therapy (ACT®) balloons for treatment of female stress urinary incontinence

A peri-urethrally implanted prosthetic, the adjustable continence therapy device (ACT ® ) has been developed for female Intrinsic Sphincter Deficiency (ISD). We aimed to reproduce in cadaveric dissections the recommended ACT placement and determine the exact rela- tionship of this implant to the relevant internal pelvic anatomy and identify the anatomical location of the balloons in order to facilitate consi- stent clinical outcomes. Six hemi-pelves from post menopausal female cadavers were dissected after standardised insertion of 6 ACT balloons which were variously inflated to determine the best initial filling volume and to observe potential damage to the endopelvic fascia or the pelvic floor. Bilateral placement and expansion of the balloons at the posterolateral aspect of the vesico-urethral junction prevents downwards, lateral or posterior displacement. The endo-pelvic fascia forms the roof of the space with the vaginal wall acting as a barrier to movement. The floor is composed of the urogenital membrane which must be pierced by the trocar to permit successful placement. Rapid balloon expansion was associated with rupture of the overlying endopelvic fascia highlighting the importance of the slow expansion recommended by the manufactu- rer. Implantation of the ACT can be safely achieved through a thorough understanding of pelvic anatomy, and by maintaining full thickness between the surgeons' finger and the insertion instrument. Care should be exercised to correctly orientate the insertion instrument, to avoid any unintended trauma to normal structures.

Adjustable Group Velocity Dispersion and Dispersion Slope Compensation Devices With Wavelength Tunability Based on Enhanced Thermal Chirping of Fiber Bragg Gratings

We demonstrate group velocity dispersion (GVD) and dispersion slope (DS) compensation devices based on enhanced thermal chirping of glued fiber Bragg gratings (FBGs). By gluing a uniform FBG onto a uniform Zn channel for the GVD compensator and a linearly tapered Zn channel for the DS compensator, the thermal sensitivity of the FBG is enhanced. The thermal chirping of the FBG is given by the thermal expansion of a Zn channel, the thermooptic effect, and the thermal expansion of the optical fiber. Controlling the temperature distributions of the uniform FBG performs the tuning of GVD and/or DS, as well as their center wavelengths. These compensation devices can tune their GVD or DS while maintaining a constant center wavelength and change their center wavelengths while preserving constant GVD or DS values. The GVD can be tuned from -123.39 to -57.29 ps/nm with the center wavelength at 1552.9 nm, while the center wavelength can be shifted 2.2 nm with a GVD value of about -105 ps/nm. On the other hand, the DS can be tuned from -8.88 to -24.44 ps/nm2 with the center wavelength at 1554.5 nm, while the center wavelength can be shifted 0.6 nm with a DS value of about -10.4 ps/nm2.

POD-11.06: Use of the adjustable continence therapy for post prostatatectomy urodynamic stress urinary incontinence

The ProACT™ (Adjustable Continence Therapy) is a minimally invasive, post operatively adjustable device for the treatment of post prostatectomy stress urinary incontinence We evaluated the efficacy of this device and the merit of it’s adjustability over time.

A novel percutaneously adjustable device for ligature of the vertical vein in the setting of obstructive totally anomalous pulmonary venous connection

A patent vertical vein might be desirable in patients with obstructive totally anomalous pulmonary venous connection with pulmonary hypertension, in order to decrease perioperative pulmonary arterial pressure and avoid pulmonary hypertensive crises. A subset of patients with an unligated vertical vein requires interruption of the vein due to the development of significant left-to-right shunt and right heart failure. We describe here a new device, permitting adjustable ligation of the vertical vein, which permits us to avoid multiple reoperations. In five patients, aged 2, 4, 3, 4, and 3 months respectively, and undergoing rechannelling of totally anomalous pulmonary venous connection with an unligated vertical vein, were treated with a device permitting adjusted ligation of the vertical vein over the course of postoperative congestive cardiac failure. There was no early or late death. Postoperatively, all ligatures were tightened gradually over a period of 24 to 96 hours, maintaining stable haemodynamics. At a mean follow-up of 55.40 months, there was no evidence of congestive heart failure in any patient, the clinical risk score varying from zero to 2, and no requirement of anti-failure medications. Computed tomographic angiograms during follow-up revealed absence of flow through the vertical vein, and ruled out distortion of the left upper pulmonary and left brachiocephalic veins. Use of a percutaneously adjustable device to ligate the vertical vein allows gradual tightening or loosening of the ligature under optimal physiologic conditions, without re-opening the sternum, or having to resort to another thoracotomy once the reactive components of pulmonary hypertension disappear.

Early Results with a New Telemetrically Adjustable Gastric Banding

It has already been demonstrated that laparoscopic adjustable gastric banding (LAGB) is a safe and effective alternative to other permanent bariatric surgery techniques. Although clinical complications have been managed through improvements in surgical techniques, port-related complications and adjustment process inefficiencies have persisted. To reduce and manage these issues, a new type of gastric band has been developed which uses telemetric technology to eliminate the use of hydraulic ports and simplify the overall gastric band adjustment procedure. From June 2005 to October 2005, 37 patients were implanted in two German academic centers with the Easyband telemetrically adjustable gastric band (Endoart S.A., Lausanne, Switzerland), using standard gastric banding laparoscopic technique. Prospective data was collected and analyzed for a minimum of 6 months on all morbidly obese patients who underwent laparoscopic telemetrically adjustable gastric banding. Data on 37 patients was analyzed. The mean percent excess weight loss was 10.2% at 1 month, 21.6% at 3 months, and 29.4% at 6 months. In 12 hypertensive patients, the systolic blood pressure decreased from 143 +/- 24 mmHg at baseline to 131 +/- 10 mmHg after 6 months. Diastolic pressure did not change significantly. In all 5 patients with diagnosed type 2 diabetes, the fasting blood glucose normalized after 6 months (135 mg/dl at baseline, 81 mg/dl at month 6). These early results of the new telemetrically adjustable gastric banding device indicate clinical safety and efficacy comparable to that achieved by other commercially available gastric bands. Additional multi-center studies with long-term follow-up are recommended to confirm the benefits of telemetrically adjustable gastric banding.

Adjustable device for magnetic material investigation by Kerr microscopy

Adjustable device for magnetic material investigation by Kerr microscopy

An MRI-Based Method to Align the Compressive Loading Axis for Human Cadaveric Knees

There is a need to align the mechanical axis of the tibia with the axis of loading for studies involving tibiofemoral compression to interpret results and to ensure repeatability of loading within and among specimens. Therefore, the objectives of this study were (1) to develop a magnetic resonance imaging (MRI)-based alignment method for use with apparatuses applying tibiofemoral joint compression, (2) to demonstrate the usefulness of the method by aligning cadaveric knees in an apparatus that could apply tibiofemoral joint compression, and (3) to quantify the error associated with the alignment method. A four degree-of-freedom adjustable device was constructed to allow determination and alignment of the mechanical axis of the tibia of cadaveric knee joints with the axis of loading of an apparatus applying tibiofemoral joint compression. MRI was used to determine the locations of bony landmarks in three dimensions defining the mechanical axis of the tibia relative to an initial orientation of the four degree-of-freedom device. Adjustment values of the device were then computed and applied to the device to align the mechanical axis of the tibia with the axis of a compressive loading apparatus. To demonstrate the usefulness of the method, four cadaveric knees were aligned in the compressive loading apparatus. The vectors describing the mechanical axis of the tibia and the loading axis of the apparatus before and after adjustment of the four degree-of-freedom device were computed for each cadaveric knee. After adjustment of the four degree-of-freedom device, the mechanical axis of the tibia was collinear with the loading axis of the apparatus for each cadaveric knee. The errors in the adjustment values introduced by inaccuracies in the MR images were quantified using the Monte Carlo technique. The precisions in the translational and rotational adjustments were 1.20 mm and 0.90 deg respectively. The MR-based alignment method will allow consistent interpretation of results obtained during tibiofemoral compressive studies conducted using the apparatus described in this paper by providing a well-defined loading axis. The alignment method can also be adapted for use with other apparatuses applying tibiofemoral compression.

An improved design of apparatus for multi-specimen bending fatigue and fatigue behaviour for laminated composites

A previously designed fatigue apparatus to test bending fatigue behaviours of glass–fiber reinforced plastic materials is improved in the scope of this research. The advantages of the improved test apparatus are as follows: It can teste 16 samples instead of 10. The square section axis was used to connect the samples more rigid by instead of the round section. So, a good balance and less vibration were obtained on the apparatus. More functional infrared sensors were used instead of proximity sensors that are sensitive to repeated cycling. While the load stress ratio is R = 0 or 1 (two alternative), with a developed adjustable support device, it is R = −1, 0 and 1 (three alternatives). The fatigue behaviours of two groups ( A and E) of composite fiber samples which have different directions but the same volumes were tested by this new apparatus. As a result, it was observed that the directions of the fibers have an important effect on the fatigue strength.

1A1-O08 周期運動を補助する可変剛性パワーアシストシステムの実験的検討(人間機械協調)

This paper describes an experimental study of power assist systems proposed by the authors. This power assist systems utilize mechanical elastic elements and optimize stiffness of the elastic elements in order to reduce torque of actuators while generating operator's periodical motions. These systems realize amplification of its operator's torque and optimization of the stiffness simultaneously. However, we haven't carried out experiments using power assist systems which consist of mechanical devices with stiffness adjustability. Therefore, we made an experimental system which has an adjustable stiffness device. The stiffness of the elastic element installed in the experimental system could be adjusted from 1.8[Nm/rad] to 6.6[Nm/rad] within 0.7 seconds. As a result of the experiment, we confirmed that the power assist system can amplify operator's torque and optimize its stiffness. In addition, we experimentally investigated that the elastic element reduced the actuator's torque.

3.312 Application of a variable, upgradeable, individually adjustable training device in disorders of balance and gait associated with Parkinson's disease

3.312 Application of a variable, upgradeable, individually adjustable training device in disorders of balance and gait associated with Parkinson's disease

Adjustable Continence Therapy (ProACT™): Evolution of the Surgical Technique and Comparison of the Original 50 Patients with the Most Recent 50 Patients at a Single Centre

ObjectivesThe desire for an adjustable surgery for male stress urinary incontinence that avoids further surgery has produced a percutaneous adjustable device. The adjustable continence therapy (ProACT™) consists of two balloons, placed bilaterally at the bladder neck after prostatectomy. Titanium ports, attached via tubing to each balloon are placed in the scrotum allowing for volume adjustments of the balloons at any time perioperatively and postoperatively. This paper examines the evolution of the technique and the impact of this progression on patient outcomes. MethodsTwo groups, one representing the first 50 patients, the second consisting of the last 50 patients are compared for changes in pad use and incontinence quality of life (I-QOL) with a mean follow-up of 23 mo (range: 1–46 mo) in group 1 and 20 mo (range: 18–24) in group 2. A comparison of complications and retreatment is summarised. ResultsPad usage was reduced significantly in both groups (p<0.001). Overall, group 2 patients obtained more consistent outcomes compared to group 1 (80% vs. 60% dry or >50% improved). I-QOL improved in both groups although more significantly in group 2 (p=0.005). Operative time was reduced in group 2. The rate and range of complications experienced in group 1 as the technique evolved decreased dramatically in group 2. ConclusionsThe evolution of technique and expertise has facilitated an efficient surgical implantation procedure with reproducible and effective objective and subjective outcomes. The implantation of this device is now conducted in >100 centres across Europe.

Use of an adjustable restraint device for prolonged and intermittent intravenous infusion and blood sampling in ferrets

For experiments requiring repeated venipuncture or prolonged intravenous infusion or sampling techniques, the ferret can serve successfully as a surrogate nonrodent animal model. Because experimental protocols must be suitable for the test system or model used, the author describes specific restraint equipment designed to facilitate the use of ferrets in the research laboratory.