医用机器人与计算机辅助外科手术的进展和应用

医用机器人与计算机辅助外科手术的进展和应用费保蔚庄天戈上海交通大学生物医学工程研究所（２０００３０）前言机器人技术、计算机技术、成象技术及图像处理技术与外科手术相结合，产生了一个崭新的研究领域——医用机器人与计算机辅助外科手术（ｍｅｄｉｃａｒｏｂｏｔ...     

脊柱导航辅助机器人技术的现状及远期展望

椎弓根螺钉内固定技术是脊柱外科固定技术的核心。自1985年机器人PUMA 200参与完成了历史上第一台机器人辅助手术以来,已有18款脊柱外科领域相关的辅助机器人出现。本文在概述传统椎弓根螺钉内固定技术的基础上,首先分析了导航辅助机器人辅助椎弓根螺钉置入技术的重要性。其次,比较了串联式及并联式脊柱导航辅助机器人各自的特点,即串联式脊柱导航辅助机器人结构简单、控制简单、灵活性高、运动空间大,而并联式机器人具有体积小、定位精度高、状态维持性好等优点。最后,提出了脊柱导航辅助机器人技术现阶段的问题,并展望了该技术的发展前景。     

机器人在外科领域应用现状

机器人是机电一体化和现代生产自动化的典型代表,手术机器人则是现代远程信息技术、智能化工程技术与微创外科技术结合的精美之作。目前它在医学中得到广泛应用,并具有常规手术无法比拟的优点。本文从手术机器人的发展历史、手术机器人的优点和缺点、机器人手术的形式、医用机器人在各外科领域的广泛应用等方面进行了综述,并对机器人在医疗领域的发展提出了展望。     

计算机辅助微创外科的现状

随着计算机技术的不断发展，计算机技术已广泛应用于各个领域。计算机在外科手术中的应用，不但极大地降低了患者肉体上的痛苦，同时也提高了疾病的治疗效果，使外科手术水平产生了一次新的飞跃。计算机在外科手术中的应用，为现代外科医学的发展开辟了一条新的出路。     

计算机辅助外科手术系统技术进展和应用

计算机辅助外科手术（ＣＡＳ）系统是一种全新的神经外科、整形外科和矫形外科手术的模拟仿真系统及术中导航系统。本主要介绍了计算机辅助外科所需的支撑技术及其进展。利用三维坐标测量技术、体素处理技术、以及各种医学图像的伪三维显示技术，可进行术前的手术模拟、治疗计划的制订，手术中的手术路径的查找，术中的治疗控制。然后，给出了应用例子。最后，讨论了计算机辅助外科手术系统的发展趋势。     

机器人辅助微损伤神经外科手术系统的研究及其临床应用

本文介绍了机器人技术在微损伤神经外科手术中的应用,系统的研究包括图形规划,微损伤和无损伤空间映射、机器人辅助手术和遥操作放射性同位素植入。在大量的实验式和实际手术模拟实验的基础上,系统已成功应用于临床手术。     

医学图像的自动调窗与分割

计算机辅助外科系统中,图像引导的手术导航系统是一种技术含量最高、发展最快的外科手术设备,在神经外科、骨科、耳鼻喉科等有着广阔的应用前景。目前,手术导航系统在图像调窗、分割、配准均采用的是手工方式,迫切需要提高图像处理的自动化程度。本文提出的自动调窗与分割算法,比较好地实现了医学图像的自动调窗和自动分割功能:(1)通过对大量MRI和CT图像的灰度直方图分析,根据这一类图像的共性,给出相应的调窗算法,实验表明,该算法绝大部分MRI和CT图像的自动调窗效果接近于最佳;(2 )本文给出的种子生长分割方法,是基于灰度连通性原理,只需点击病灶,就可以将病灶及边缘准确地分割出来,并可以动态、实时地控制分割的效果,只要机器的内存允许,可以直接对三维图像进行三维分割。测试表明,该功能缩短和降低手术计划的时间和难度,提高导航手术的效率。     

计算机辅助微创外科的现状

随着计算机技术的不断发展，计算机技术已广泛应用于各个领域。计算机在外科手术中的应用，不但极大地降低了患者肉体上的痛苦，同时也提高了疾病的治疗效果，使外科手术水平产生了一次新的飞跃。计算机在外科手术中的应用，为现代外科医学的发展开辟了一条新的出路。     

机器人在微创外科手术中的应用

背景：微创外科手术机器人具有稳定性好、操作灵活、运动精准、手眼协调等特点,是微创手术未来发展的方向。 目的：分析微创外科手术机器人的现状,探讨微创外科手术机器人的关键技术。 方法：分别从体外手术机器人与体内手术机器人等方面,详细分析和介绍了国内外近年来的主要研究成果,并对微创外科手术机器人的力反馈、主从控制策略等关键技术进行了探讨。 结果与结论：综合国内外微创外科机器人的研究情况来看,微型体内手术机器人是手术机器人领域的研究热点,特别是微型机器人的灵巧性设计、手术机器人的定位、运动规划与控制、操作力的实时测量与力反馈等关键技术。主从操控技术是手术机器人进行遥操作和微操作的关键环节。     

计算机辅助外科手术系统技术进展和应用

计算机辅助外科手术（Ｃｏｍｐｕｔｅｒ－ａｓｓｉｓｔｅｄｓｕｒｇｅｒｙ简称ＣＡＳ）系统是一种全新的神经外科、整形外科和矫形外科手术的模拟仿真系统及术中导航系统。本文主要介绍了计算机辅助外科所需的支撑技术及其进展。利用三维坐标测量技术、体素处理技术、以及各种医学图像的伪三维显示技术，可进行术前的手术模拟、治疗计划的制订，手术中的手术路径的查找，术后的治疗控制。然后，给出了应用例子。最后，讨论了计算机辅助外科手术系统的发展趋势。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.     

A comparative study of the effects of dimebon,obsidan, finoptin,and cordaron on the functional state of ischemic focus and size of necrotic zone in experimental myocardial infarction

Dimebon, an antihistamine agent, exerts a moderate antianginal effect, improving the function of ischemic focus in the myocardium and decreasing the necrotic zone in experimental myocardial infarction. Dimebon is less active than obsidan, finoptin (except for the size of the necrotic zone), and cordaron. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 12, pp. 642–644, December, 1996     

Effects of sex steroid hormones on lipid peroxidation and glutathione antioxidant system in rat skin

Effects of estradiol and testosterone on the intensity of lipid peroxidation and contents of glutathione redox system components in the dermis and epidermis of rat skin were studied. Only estradiol induced considerable dose-dependent and tissue-specific biphasic antioxidant effects on the skin. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 12, pp. 663–666, December, 1999     

Adhesion and growth of CaCo2 cells on surface-modified PEEK substrata

A series of surface-functionalized poly(ether ether ketone) (PEEK) films has been prepared by selective wet-chemistry; they are hydroxylated polymer (PEEK-OH) obtained by reduction, aminated polymer (PEEK-[]-NH2) prepared by coupling a diisocyanate reagent to PEEKOH (PEEK-[]-NCO) followed by hydrolysis, and carboxylated and aminocarboxylated polymers (PEEK-[]-GABA and PEEK-Lysine) resulting from the coupling of aminoacids to PEEK-[]-NCO. The aminated and carboxylated substrata promoted the adhesion and growth of CaCo2 cells in the presence of serum. Fibronectin (FN), an extra-cellular matrix protein, has been covalently fixed and/or adsorbed on various PEEK substrata, in the presence or not of a polymeric surfactant (Pluronic F68). The performances of the FN-grafted substrata (PEEK-[]-FN(1) and PEEK-[]-FN(2)) were significantly higher than those of reference substrata simply coated with FN (PEEK-OH(+FN)(1) and (2), PEEK-[]-NH2(+FN)(1) and (2)), considering the adhesion and spreading of CaCo2 cells in the absence of serum. Moreover, the stability of the adherent cells on the FN-adsorbed substrata dramatically depended on the experimental conditions applied during the PEEK coating with FN.