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- 저자 : Daniel L J Morris (검색결과 2 건)
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Discovery Elbow System arthroplasty polyethylene bearing exchange: outcomes and experience
Daniel L J Morris,Katherine Walstow,Lisa Pitt,Marie Morgan,Amol A Tambe,David I Clark,Timothy Cresswell,Marius P Espag 대한견주관절학회 2024 대한견주관절의학회지 Vol.27 No.1
Background: The Discovery Elbow System (DES) utilizes a polyethylene bearing within the ulnar component. An exchange bearing requires preoperative freezing and implantation within 2 minutes of freezer removal to allow insertion. We report our outcomes and experience using this technique. Methods: This was an analysis of a two-surgeon consecutive series of DES bearing exchange. Inclusion criteria included patients in which exchange was attempted with a minimum 1-year follow-up. Clinical and radiographic review was performed 1, 2, 3, 5, 8 and 10 years postoperative. Outcome measures included range of movement, Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complications and requirement for revision surgery. Results: Eleven DESs in 10 patients were included. Indications were bearing wear encountered during humeral component revision (n=5); bearing failure (n=4); and infection treated with debridement, antibiotics and implant retention (DAIR; n=2). Bearing exchange was conducted on the first attempt in 10 cases. One case required a second attempt. One patient developed infection postoperatively managed with two-stage revision. Mean follow-up of the bearing exchange DES was 3 years. No further surgery was required, with no infection recurrence in DAIR cases. Mean elbow flexion-extension and pronosupination arcs were 107° (±22°) and 140° (±26°). Mean OES was 36/48 (±12) and MEPS was 83/100 (±19). Conclusions: Our results support the use of DES bearing exchange in cases of bearing wear with well-fixed stems or acute infection. This series provides surgeons managing DES arthroplasty with management principles, successful and reproducible surgical techniques and expected clinical outcomes in performing DES polyethylene bearing exchange. Level of evidence: IV.
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Two-photon absorption cross section of excited phthalocyanines by a femtosecond Ti-sapphire laser
Mir, Youssef,Van Lier, Johan E.,Allard, Jean-Francois,Morris, Denis,Houde, Daniel Korean Society of Photoscience 2009 Photochemical & photobiological sciences Vol.8 No.3
In the past few years, photodynamic therapy (PDT) has become a major treatment for neovascular age-related macular degeneration (AMD) in which there is abnormal growth of choroidal neovasculature (CNV) that eventually obscures central vision, leading to blindness. However, one of the main limitations of current PDT is the relatively low specificity of the photosensitizer (PS) and light for pathological tissue which may induce damage to adjacent healthy tissue. An alternative approach to circumvent the specificity limitation is to improve the irradiation process. In particular two photon (2-$\gamma$) excitation promises a more precise illumination of the target tissue. PS are activated by the simultaneous absorption of 2-$\gamma$ delivered by ultra-fast pulses of near infrared light. In order to evaluate the efficiency of phthalocyanine (Pc) dyes for 2-$\gamma$ absorption we measured 2-$\gamma$ absorption cross sections ($\sigma_2$) of a number of metalated Pc (MPc) dyes at $\lambda_{ex}$ = 800 nm using a femtosecond laser. The studied Pc molecules vary by the type of the central metal ion (Al or Zn) and the number of peripheral sulfo substituents (MPcS). Each MPc dye of our series shows an improved 2-$\gamma$ absorption $\sigma_2$ as compared to that obtained for Photofrin ($3.1{\pm}0.1\;GM$, with 1 GM = $10^{-50}\;cm^4\;s\;photon^{-1}\;mol^{-1}$), the PS currently approved for 1-$\gamma$ PDT. Our data show an 2.5-fold enhancement for AlPcCl, $AlPcS_{2adj}$ and $ZnPcS_3C_9$, up to 10-fold ($28.6{\pm}0.72\;GM$) for the ZnPcS4 dye relative to Photofrin. These findings confirm the efficiency of Pc for 2-$\gamma$ absorption processes and represent the first detailed comparison study of 2-$\gamma$ absorption $\sigma_2$ between Photofrin and Pc dyes.
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