The Experts below are selected from a list of 645 Experts worldwide ranked by ideXlab platform
Kenji Yamazaki - One of the best experts on this subject based on the ideXlab platform.
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Absorbable Sternal pins improve Sternal closure stability within a small deviation
General Thoracic and Cardiovascular Surgery, 2015Co-Authors: Hiroshi Koshiyama, Kenji YamazakiAbstract:Objective Sternum external fixation with a Sternal Wire is widely used. However, it was inadequate fixation in the anterior–posterior and cranial–caudal directions. Using Sternal pins can improve the stability. The utility of a small deviation was important with respect to Sternal pain. Here, we evaluated the efficacy of a Sternal pin in a small deviation in three directions. Methods Polyurethane foam was used. In the Wire group, models were closed using two stainless steel Wires. In the Wire and Sternal pin group, a hydroxyapatite/poly- l -lactide acid (HA/PLLA) Sternal pin was used for internal fixation in addition to Wire fixation. A Sternal pin was inserted inside. Both sides were fixed with the testing machine and the shear stress was directed to one side. In each group, six models were tested for three directions. The relationship between the load and displacement of the model was measured at 1-mm displacement. Results In the anterior–posterior direction, the load value was 138.8 ± 8.3 (N) in the Wire and Sternal pin group and 51.6 ± 9.5 (N) in the Wire group ( p = 0.0003). In the cranial–caudal direction, the values were 148.0 ± 12.0 (N) and 83.1 ± 26.6 (N), respectively ( p
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Absorbable Sternal pins improve Sternal closure stability within a small deviation
General thoracic and cardiovascular surgery, 2015Co-Authors: Hiroshi Koshiyama, Kenji YamazakiAbstract:Objective Sternum external fixation with a Sternal Wire is widely used. However, it was inadequate fixation in the anterior–posterior and cranial–caudal directions. Using Sternal pins can improve the stability. The utility of a small deviation was important with respect to Sternal pain. Here, we evaluated the efficacy of a Sternal pin in a small deviation in three directions.
Hiroshi Koshiyama - One of the best experts on this subject based on the ideXlab platform.
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Absorbable Sternal pins improve Sternal closure stability within a small deviation
General Thoracic and Cardiovascular Surgery, 2015Co-Authors: Hiroshi Koshiyama, Kenji YamazakiAbstract:Objective Sternum external fixation with a Sternal Wire is widely used. However, it was inadequate fixation in the anterior–posterior and cranial–caudal directions. Using Sternal pins can improve the stability. The utility of a small deviation was important with respect to Sternal pain. Here, we evaluated the efficacy of a Sternal pin in a small deviation in three directions. Methods Polyurethane foam was used. In the Wire group, models were closed using two stainless steel Wires. In the Wire and Sternal pin group, a hydroxyapatite/poly- l -lactide acid (HA/PLLA) Sternal pin was used for internal fixation in addition to Wire fixation. A Sternal pin was inserted inside. Both sides were fixed with the testing machine and the shear stress was directed to one side. In each group, six models were tested for three directions. The relationship between the load and displacement of the model was measured at 1-mm displacement. Results In the anterior–posterior direction, the load value was 138.8 ± 8.3 (N) in the Wire and Sternal pin group and 51.6 ± 9.5 (N) in the Wire group ( p = 0.0003). In the cranial–caudal direction, the values were 148.0 ± 12.0 (N) and 83.1 ± 26.6 (N), respectively ( p
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Absorbable Sternal pins improve Sternal closure stability within a small deviation
General thoracic and cardiovascular surgery, 2015Co-Authors: Hiroshi Koshiyama, Kenji YamazakiAbstract:Objective Sternum external fixation with a Sternal Wire is widely used. However, it was inadequate fixation in the anterior–posterior and cranial–caudal directions. Using Sternal pins can improve the stability. The utility of a small deviation was important with respect to Sternal pain. Here, we evaluated the efficacy of a Sternal pin in a small deviation in three directions.
Lang Yang - One of the best experts on this subject based on the ideXlab platform.
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Effect of Sternal Wire twisting on sternotomy closure rigidity
Indian Journal of Thoracic and Cardiovascular Surgery, 2018Co-Authors: Aaron Richard Casha, Alexander Manche, Marilyn Gauci, Liberato Camilleri, Caroline Jane Magri, Andee Agius, Lang YangAbstract:Introduction Wire twisting is the commonest method of median sternotomy closure. However, Wire twisting weakens the Wire and fracture may occur at the base of the twisted portion. We investigated how Wire twisting affects the physical characteristics of sternotomy closure since rigid fixation promotes quicker primary bone healing. Methodology The maximum strength and rigidity of Wire closure were tested in a steel Sternal model, with varying number of twists, ranging from none to ten twists. Pearson correlation coefficient was used to investigate the relationship between the number of twists versus the maximum closure strength and rigidity. Regression analysis was used to relate closure rigidity with test load and number of Wire twists. Results Maximum rigidity occurred at two-twists, and decreased from three to ten-twists. Pearson correlation coefficient showed a strong relationship between the number of twists versus maximum closure strength ( r = 0.833, p = 0.003) and rigidity ( r = 0.819, p = 0.004). The regression model identified load ( p
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Effect of Sternal Wire twisting on sternotomy closure rigidity
Indian Journal of Thoracic and Cardiovascular Surgery, 2017Co-Authors: Aaron Casha, Alexander Manche, Marilyn Gauci, Liberato Camilleri, Caroline Jane Magri, Andee Agius, Lang YangAbstract:Introduction Wire twisting is the commonest method of median sternotomy closure. However, Wire twisting weakens the Wire and fracture may occur at the base of the twisted portion. We investigated how Wire twisting affects the physical characteristics of sternotomy closure since rigid fixation promotes quicker primary bone healing.
Chun Ming Shih - One of the best experts on this subject based on the ideXlab platform.
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Degradation of 316L stainless steel Sternal Wire by steam sterilization
Acta Biomaterialia, 2009Co-Authors: Chun Che Shih, Yea Yang Su, Lung Ching Chen, Chun Ming ShihAbstract:Abstract Sterilization is an important step prior to the implantation of medical devices inside the human body. In this work we studied the influence of steam sterilization cycles on the oxide film properties of stainless steel Sternal Wire. Characterization techniques such as open- circuit potential, potentiodynamic measurement, electrochemical impedance spectroscopy, cathodic stripping, transmission electron microscopy, atomic force microscopy and scanning electron microscopy were employed to investigate the cycles of steam sterilization on the corrosion behavior of Sternal Wire. The results showed that the oxide properties are a function of the number of steam sterilization cycles and deteriorate as the number of cycles increases. Steam sterilization might damage the implant integrity and heavy metals could be released to the surrounding tissues due to deterioration of the oxide film.
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Potential risk of Sternal Wires
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2004Co-Authors: Chun Che Shih, Chun Ming Shih, Shing-jong LinAbstract:Objective: To understand the potential fracture mechanism of Sternal Wires, we collected extracted stainless steel Sternal Wires from patients with Sternal dehiscence following open-heart operations. Surface alterations and fractured ends of Sternal Wires were inspected and analyzed. Methods: Eight fractured and 12 non-fractured Wires extracted from five patients (closure method: figure-of-eight or straight twisted; two without and three with mediastinitis) with mean implantation interval of 13.2 ^ 4.2 days (range 8 ‐ 20 days) were studied by various techniques. The extracted Wires were cleaned and the fibrotic tissues were removed. Irregularities and fractured ends were assayed by scanning electron microscopy and energy dispersive X-ray analysis (EDXA). Results: All examined fractured Wires showed the presence of severe transversal cracks and crevice corrosion. EDAX revealed aluminum oxide inclusion on the fractured surface. Conclusions: The synergic effect of stress and poor Wire quality could be the precursors of material failure for the Sternal Wire. q 2004 Elsevier B.V. All rights reserved.
Alexander Manche - One of the best experts on this subject based on the ideXlab platform.
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Effect of Sternal Wire twisting on sternotomy closure rigidity
Indian Journal of Thoracic and Cardiovascular Surgery, 2018Co-Authors: Aaron Richard Casha, Alexander Manche, Marilyn Gauci, Liberato Camilleri, Caroline Jane Magri, Andee Agius, Lang YangAbstract:Introduction Wire twisting is the commonest method of median sternotomy closure. However, Wire twisting weakens the Wire and fracture may occur at the base of the twisted portion. We investigated how Wire twisting affects the physical characteristics of sternotomy closure since rigid fixation promotes quicker primary bone healing. Methodology The maximum strength and rigidity of Wire closure were tested in a steel Sternal model, with varying number of twists, ranging from none to ten twists. Pearson correlation coefficient was used to investigate the relationship between the number of twists versus the maximum closure strength and rigidity. Regression analysis was used to relate closure rigidity with test load and number of Wire twists. Results Maximum rigidity occurred at two-twists, and decreased from three to ten-twists. Pearson correlation coefficient showed a strong relationship between the number of twists versus maximum closure strength ( r = 0.833, p = 0.003) and rigidity ( r = 0.819, p = 0.004). The regression model identified load ( p
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Effect of Sternal Wire twisting on sternotomy closure rigidity
Indian Journal of Thoracic and Cardiovascular Surgery, 2017Co-Authors: Aaron Casha, Alexander Manche, Marilyn Gauci, Liberato Camilleri, Caroline Jane Magri, Andee Agius, Lang YangAbstract:Introduction Wire twisting is the commonest method of median sternotomy closure. However, Wire twisting weakens the Wire and fracture may occur at the base of the twisted portion. We investigated how Wire twisting affects the physical characteristics of sternotomy closure since rigid fixation promotes quicker primary bone healing.
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Mechanism of sternotomy dehiscence
Interactive cardiovascular and thoracic surgery, 2014Co-Authors: Aaron Casha, Alexander Manche, Ruben Gatt, Edward Duca, Marilyn Gauci, Pierre Schembri-wismayer, Marie-therese Camilleri-podesta, Joseph N. GrimaAbstract:OBJECTIVES: Biomechanical modelling of the forces acting on a median sternotomy can explain the mechanism of sternotomy dehiscence, leading to improved closure techniques. METHODS: Chest wall forces on 40 kPa coughing were measured using a novel finite element analysis (FEA) ellipsoid chest model, based on average measurements of eight adult male thoracic computerized tomography (CT) scans, with Pearson’s correlation coefficient used to assess the anatomical accuracy. Another FEA model was constructed representing the barrel chest of chronic obstructive pulmonary disease (COPD) patients. Six, seven and eight trans-Sternal and figure-of-eight closures were tested against both FEA models. RESULTS: Comparison between chest wall measurements from CT data and the normal ellipsoid FEA model showed an accurate fit (P< 0.001, correlation coefficients: coronal r = 0.998, sagittal r= 0.991). Coughing caused rotational moments of 92 Nm, pivoting at the supraSternal notch for the normal FEA model, rising to 118 Nm in the COPD model (t-test, P< 0.001). The threshold for dehiscence was 84 Nm with a six-Sternal-Wire closure, 107 Nm with seven Wires, 127 Nm with eight Wires and 71 Nm for three figure-of-eights. CONCLUSIONS: The normal rib cage closely fits the ellipsoid FEA model. Lateral chest wall forces were significantly higher in the barrelshaped chest. Rotational moments generated by forces acting on a six-Sternal-Wire closure at the supraSternal notch were sufficient to cause lateral distraction pivoting at the top of the manubrium. The six-Sternal-Wire closure may be successfully enhanced by the addition of one or two extra Wires at the lower end of the sternotomy, depending on chest wall shape.