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Cai J.,Ruijing Hospital | Luo Z.,Shanghai JiaoTong University | Gu L.,Shanghai JiaoTong University | Xu R.,Shanghai JiaoTong University | Zhao Q.,Ruijing Hospital
International Journal of Medical Robotics and Computer Assisted Surgery | Year: 2010

Background: Preoperative planning and surgical navigation are two crucial aspects of a computer-assisted system for the success of minimally invasive cardiac surgery. Methods: In the first part, port placement planning was mainly discussed. We proposed an algorithm based on four criteria to achieve optimized placement. In the second part, an optical tracker was used to locate the thoracoscope and surgical instruments accurately and to show the relative positions between the thoracoscope, surgical instruments and the patient's anatomical structures. An image-matching technique was employed to help the surgeon locate the target, using real-time thoracoscopic video images during the procedure. Results: In order to verify our proposed algorithms, several clinical planning cases were performed to compare our port placement algorithm to the traditional method. Both phantom test and animal study experiments were also done to demonstrate the validity of the target tracking of the system. Both the phantom test and the animal study revealed that the fiducial registration error (FRE) was 1.08 ± 0.16 mm and system error was 5.05 ± 0.67 mm, respectively. Conclusion: A novel computer-assisted system for minimally invasive cardiac surgery has been developed. This method has shown its capability to achieve the preoperative planning and real-time surgery navigation. Copyright © 2010 John Wiley & Sons, Ltd.

Wang W.,Ruijing Hospital | Cao J.-M.,Ruijing Hospital | Yang Z.-F.,Shanghai JiaoTong University | Wang H.-W.,Shanghai JiaoTong University | And 3 more authors.
Journal of Shanghai Jiaotong University (Medical Science) | Year: 2010

Objective: To investigate the effects of Hesperidin on cardiac electrophysiology of diabetic rats. Methods: Thirty SD rats were randomly divided into three groups. Diabetic model group (n = 12): diabetic model was induced by intraperitoneal injection of large amount of streptozotocin (STZ); Hesperidin intervention group (n = 12): diabetic model was established, and were intragastrically administrated with 10 mg/kg Hesperidin daily; control group (n = 6): without model establishment and intervention. After treatment for 4 weeks, in vivo and in vitro ECG and characteristics of action potentials of ventricular muscles were recorded and compared. Papillary muscles of ventricle of diabetic model group were perfused with 1 × 10 -6 mol/L or 5 × 10 -6 mol/L Hesperidin, and changes of action potentials were continuously recorded. Results: In vivo ECG analysis revealed that the heart rates of diabetic model group and Hesperidin intervention group were much faster than that of control group (P < 0.01, P < 0.05), QT interval of diabetic model group significantly prolonged (P < 0.05), while there was no significant difference in QT interval between control group and Hesperidin intervention group (P > 0.05). In vitro ECG analysis indicated that the prevalence of tachyarrhythmia in diabetic model group was 75.0%, significantly higher than that of Hesperidin intervention group (16.7%) (P < 0.05). Analysis of action potentials of ventricular muscles revealed that the resting membrane potential, amplitude of action potential and maximum upstroke velocity of phase 0 of diabetic model group were significantly lower than those of control group, while the action potential duration was longer than that of control group. Compared with diabetic model group, the parameters of action potentials in Hesperidin intervention group were more approximate with those of control group. Perfusion tests with two concentrations of Hesperidin demonstrated that 5 × 10 -6 mol/L Hesperidin perfusion performed better than 1 × 10 -6 mol/L Hesperidin perfusion in recovery of action potentials of papillary muscles of ventricle of diabetic rats. Conclusion: Hesperidin may dose-dependently decrease the prevalence of arrhythmia by reversing the abnormal electrophysiological activities in diabetic rats.

Luo Z.,Shanghai JiaoTong University | Zhao Q.,Ruijing Hospital | Cai J.,Ruijing Hospital | Wang S.,Ruijing Hospital | Gu L.,Shanghai JiaoTong University
IFMBE Proceedings | Year: 2013

This research proposes an electromagnetic navigation system for thoracic aortic stent-graft deployment. The system employed patient's preoperative image (CT) to construct a 3D cardiac model based on a GPU acceleration technique. Then a preoperative planning is performed on the cardiac model. During the surgery, we employ electromagnetic tracker to trace the sensors which are embedded in the catheter and ultrasound probe, when a landmark based registration is used to map the patient's coordinate to image coordinate in real-time. In order to "see" the real condition of inter surgical environment, an intra-operated ultrasound image is fused to the cardiac model by using a calibration panel to compute the transform from 2D ultrasound image coordinate to coordinate of sensor which was attached to the ultrasound probe in a virtual reality environment. © 2013 Springer-Verlag.

Xu J.-Q.,Ruijing Hospital | Zhang W.-B.,Ruijing Hospital | Wan R.,Ruijing Hospital | Hao P.,Ruijing Hospital | And 2 more authors.
Journal of Clinical Rehabilitative Tissue Engineering Research | Year: 2010

BACKGROUND: The proximal tibia is the second common site for primary bony sarcomas, which lacks adequate soft tissue coverage. Resection and reconstruction by any technique leave the reconstructed area in a subcutaneous position. This has been a major source of necrosis of skin and infections. OBJECTIVE: To observe the effect of gastrocnemius muscle transfer to obtain soft-tissue coverage and extensor mechanism reconstruction for limb-sparing resection of the proximal tibia with endoprosthetic reconstruction. METHODS: From January 2001 to June 2008, 27 patients with osteosarcoma of the proximal tibia confirmed by biopsy were selected. All the tumours were assigned to stage IIB based on Enneking's classical staging system. Neoadjuvant chemotherapy (Bacci, IOR/OS-N4) was utilized for the patients. All the patients adopted limb-sparing surgery, i.e. resection of proximal tibia with endoprosthetic reconstruction. A gastrocnemius flap was utilized to improve implant coverage and enhance the patellar tendon repair. MSTS was used to measure the functional status of patients with a sarcoma in the leg. RESULTS AND CONCLUSION: The follow-up was averagely 53.1 months. Of 27 patients, 2 cases (7%) died of lung metastasis within 2 years, 1(4%) suffered from amputation due to infection and underwent amputation. The others developed no complications or recurrence. The MSTS score was averagely 25.1 points. Results show that resection with endoprosthetic reconstruction utilizing a gastrocnemius muscle flap for osteosarcoma of the proximal tibia is reliable and predictable in combination with neoadjuvant chemotherapy.

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