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In this study, an altered switch for rehabilitation was invented to make home training accessible for the stroke patients, by modifying a computer mouse into a foot switch. This study examined the effects of training with an adaptive foot switch and video games (VG) on walking performance and balance abilities (Centre of Pressure (CoP) sway) in people after stroke.The intervention was evaluated through a randomised controlled trial. The intervention group received 10 weeks of VG rehabilitation, for approximately 3.5 hours/week, using a pressure-activated electronic foot switch, in addition to standard rehabilitation. The control group received regular rehabilitation only. The experiment included a force platform (measuring CoP sway kinematics) and a 10-Metre Test of Walking (10MWT) to measure the standing balance and walking performance of 56 stroke patients.There were no differences between the two groups (intervention and control) at baseline in terms of the demographic or dependent variables. Multivariate tests indicated a significant interaction between the Patient Group and the Time-type variables. Subsequent analysis of the main effects revealed significant between-group differences over time in all dependent variables (10MWT, sway area, CoP sway in anterior–posterior direction (AP sway) and CoP sway in medial–lateral direction (ML sway)). Patients in the intervention group demonstrated better performance than those in the control group after the VG rehabilitation according to the post-test.This study suggests that ankle muscle training using an adaptive foot switch and VG may improve exercise compliance and enhance recovery of balance and mobility following stroke.

Background and study aims We developed a new reporting system based on structured data entry, which selectively extracts only endoscopic findings from endoscopists’ oral statements and automatically inputs them into appropriate columns in real time during endoscopic procedures. Methods We compared the time for endoscopic procedures and report preparation (ER time) by using an esophagogastroduodenoscopy simulator in three groups: one preparing reports using a mouse after endoscopic procedures (CE group); a second group preparing reports by using voice alone during endoscopic procedures (SR group); and the final group preparing reports by operating the system with a foot switch and inputting findings using voice during endoscopic procedures (SR + FS group). For the SR and SR + FS groups, we identified the recognition rates of the speech recognition system. Results Mean ER times for cases with three findings each were 162, 130 and 119 seconds in the CE, SR and SR + FS groups, respectively. The mean ER times for cases with six findings each were 220, 144 and 128 seconds, respectively. The times in the SR and SR + FS groups were significantly shorter than that in the CE group (P Conclusion Our reporting system was demonstrated to allow an endoscopist to efficiently complete the report in real time during endoscopic procedures.

We examined the behavioral characteristics of reactive turning in hemiplegic stroke patients when they were informed of the turning direction just before turning was required at an unpredictable time. Eleven stroke patients and 20 healthy elderly control people were asked to initiate a turn as soon as a visual cue to inform them of the turning direction was activated unpredictably using a foot switch. Both the segmental reorientation and stepping type when turning 90° while walking were measured. The results indicated preserved segmental reorientation of the head and pelvis in stroke patients. Stroke patients showed delays in pelvic turning but not in head turning. Their delayed pelvic movement might be due to motor dysfunction and the time taken to ensure stability when deciding when to turn.

The main objective of this study was to examine how contact pressure on the dorsal surface of the foot changes with varying shapes. Ten healthy young men (22.1 ± 0.6 years) with independent walking ability were recruited in this study. We measured the anthropometric characteristics of the foot. Shoe size for the experiment was individually decided based on the obtained anthropometric data. Subsequently, FlexiForce® sensors were attached to the dorsal side of the first metatarsophalangeal joint (P1), intermediate cuneiform (P2), and pternion (P3) to measure the contact pressure during walking. In addition, foot switch sensors were used to determine the gait cycle. At P2, some participants with a higher foot height showed a lower increase in contact pressure during the loading response or pre-swing phases than did participants with a lower foot height. The observed distribution of the contact pressure on the dorsal foot might be caused by the change in the shape of the shoes and the foot joint movement during walking.

Bronchoscopy is a commonly used minimally invasive procedure for lung-cancer staging. In standard practice, however, physicians differ greatly in their levels of performance. To address this concern, image-guided intervention (IGI) systems have been devised to improve procedure success. Current IGI bronchoscopy systems based on virtual bronchoscopic navigation (VBN), however, require involvement from the attending technician. This lessens physician control and hinders the overall acceptance of such systems. We propose a hands-free VBN system for planning and guiding bronchoscopy. The system introduces two major contributions. First, it incorporates a new procedure-planning method that automatically computes airway navigation plans conforming to the physician's bronchoscopy training and manual dexterity. Second, it incorporates a guidance strategy for bronchoscope navigation that enables user-friendly system control via a foot switch, coupled with a novel position-verification mechanism. Phantom studies verified that the system enables smooth operation under physician control, while also enabling faster navigation than an existing technician-assisted VBN system. In a clinical human study, we noted a 97% bronchoscopy navigation success rate, in line with existing VBN systems, and a mean guidance time per diagnostic site = 52 s. This represents a guidance time often nearly 3 min faster per diagnostic site than guidance times reported for other technician-assisted VBN systems. Finally, an ergonomic study further asserts the system's acceptability to the physician and long-term potential.

Purpose: Radiation exposure in invasive cardiology remains considerable. We evaluated the acceptance of radiation protective devices and the role of operator experience, team leadership, and technical equipment in radiation safety efforts in the clinical routine. Materials and Methods: Cardiologists (115 from 27 centers) answered a questionnaire and documented radiation parameters for 10 coronary angiographies (CA), before and 3.1 months after a 90-min. mini-course in radiation-reducing techniques. Results: Mini-course participants achieved significant median decreases in patient dose area products (DAP: from 26.6 to 13.0 Gy × cm2), number of radiographic frames (– 29 %) and runs (– 18 %), radiographic DAP/frame (– 32 %), fluoroscopic DAP/s (– 39 %), and fluoroscopy time (– 16 %). Multilevel analysis revealed lower DAPs with decreasing body mass index (– 1.4 Gy × cm2 per kg/m2), age (– 1.2 Gy × cm2/decade), female sex (– 5.9 Gy × cm2), participation of the team leader (– 9.4 Gy × cm2), the mini-course itself (– 16.1 Gy × cm2), experience (– 0.7 Gy × cm2/1000 CAs throughout the interventionalist’s professional life), and use of older catheterization systems (– 6.6 Gy × cm2). Lead protection included apron (100 %), glass sheet (95 %), lengthwise (94 %) and crosswise (69 %) undercouch sheet, collar (89 %), glasses (28 %), cover around the patients’ thighs (19 %), foot switch shield (7 %), gloves (3 %), and cap (1 %). Conclusion: Radiation-protection devices are employed less than optimally in the clinical routine. Cardiologists with a great variety of interventional experience profited from our radiation safety workshop – to an even greater extent if the interventional team leader also participated. Key Points: • Radiation protection devices are employed less than optimally in invasive cardiology. • The presented radiation-safety mini-course was highly efficient. • Cardiologists at all levels of experience profited from the mini-course – considerably more so if the team leader also took part. • Interventional experience was less relevant for radiation reduction. • Consequently both fellows and trainers should be encouraged to practice autonomy in radiation safety. Citation Format: • Kuon E, Weitmann K, Hoffmann W et al. Role of Experience, Leadership and Individual Protection in the Cath Lab – A Multicenter Questionnaire and Workshop on Radiation Safety. Fortschr Rontgenstr 2015; 187: 899 – 905

During microsurgical procedures, manipulations are often performed using a foot switch while the surgeon stands on one foot. This position can easily result in body axis instability and greater musculoskeletal loading. To support the surgeon's posture, we have developed a tool called the "Surgeon's Body Support Device." The objective of this study was to determine the efficacy of this device by analyzing surgeons' kinematics and musculoskeletal loading during simulated operations undertaken while standing. Fourteen surgeons volunteered to perform simulations of surgery while standing. To analyze motion kinetics and musculoskeletal loading with and without this device, a three-axis accelerometer and surface electromyography (SEMG) sensors were attached to the subjects. Compared with not using the supportive device, the axis of the surgeon's body was significantly more stable when the support device was used (P = .001). The evenness of motion also tended to be superior when the device was utilized (P = .009). Simulations performed using the device significantly reduced the musculoskeletal loading on the ventral side of the left foot by 70 % compared with simulations performed not using the device (P = .001). Data from SEMG sensor placed on the right hand, which performs the surgical manipulations, indicated that simulations performed using the device generated approximately 10 % of the musculoskeletal load generated when the device was not used (P = .001). The Surgeon's Body Support Device appears to improve maneuverability and reduce musculoskeletal loading during simulated surgical procedures undertaken while standing.

A common source of error when detecting heel-strike moments utilizing split force-plate treadmills is unwillingly stepping on contra-lateral force-plate. In this study, we quantified this error when heel-strike was detected based on such erroneous data and compared three methods to investigate how well the heel-strikes and stride-intervals were detected with erroneous data. Eleven subjects walked on a split force-plate treadmill for more than 20min. We used 20N and 50% body-weight thresholds to detect the heel-strike moments (HS20N and HS50%, respectively). Besides, we used linear approximation to estimate the unaffected force profile from affected force-plate data, and subsequently to detect the heel-strike moments (HSest). We used heel-strike moments detected by a foot-switch as a reference to compare accuracy of HS20N, HS50% and HSest. HS20N and HSest detected heel-strike moments accurately for unaffected force-plate data (median(max) errors for all subjects: 9(23) and 9(37) ms) but HS50% showed significantly larger errors (52(74) ms). Unlike HS50% and HSest, HS20N was considerably affected by the affected force-plate data (23(68) ms). The error in stride-interval measurement was relatively small using any methods for unaffected force-plate data (3(7), 6(8), and 6(12) ms), while stride-interval errors were large for some subjects when using HS20N for affected data (6(175) ms). We concluded that unwillingly stepping on contra-lateral force-plate occurred a few percent and up to 37.7% of all strides (median: 12.9%). Our proposed method (HSest) robustly showed small errors for heel-strike detection and stride-interval calculation consistently among subjects, while HS50% and HS20N showed large errors depending on subjects.

[Purpose] The purpose of this study was to investigate whether the occurrence of cardiac-locomotor synchronization (CLS) improves lower leg muscle blood perfusion during walking. [Subjects and Methods] Eleven healthy men were studied while performing two treadmill protocols. The CLS protocol involved subjects walking at the frequency of their heart rate (HR) to induce CLS. The free protocol (reference) involved subjects walking at a self-selected cadence. The treadmill load was identical in the two protocols. Electrocardiographic signals for HR, foot switch signals for step rate and near-infrared spectroscopy (NIRS) signals for total haemoglobin (total Hb) in the lower leg muscles were measured continuously for 10 min after HR reached a steady state. [Results] The mean HR and mean step rate did not differ between the CLS and free protocols. However, total Hb was significantly higher in the CLS protocol than in the free protocol. The rate of increase in total Hb positively correlated with the strength of CLS. [Conclusion] These results suggest that the occurrence of CLS enhances lower leg muscle blood perfusion by increasing the strength of CLS during walking.

In nowadays medical environment, foot switches are used in almost every operating theatre as one option to enable the interaction with medical devices. The increasing number of devices controlled by foot switches and the complexity of those devices challenge the surgeon regarding the usability and safety of human-machine-interfaces. The approach of the presented paper was to further develop and evaluate a universal foot switch and its corresponding graphical user interface for diverse medical disciplines for an open integrated operating theatre. As results of the user-centred design and evaluation process, it can be said that the fulfilment of the requirements for various medical disciplines has been challenging due to the specific required devices and tasks. Although a universal footswitch has been developed and evaluated positively, the concept of a specific universal foot switch for each discipline could be an alternative to face the identified challenge of complexity.

Purpose: Implant engine system is composed of the handpiece, micromotor, control box and foot switch. The aim of this study was to evaluate the satisfaction of the implant engine systems in terms of convenience-design and to examine the relation with the experience of implant surgery. Materials and Methods: Three implant systems were evaluated: SurgicXT/X-SG20L, INTRAsurg300/ CL3-09, XIP10/CRB26LX. For this comparative study, 30 dentists were included and the satisfaction was measured using a structured questionnaire. One-way analysis of the variance (ANOVA) and multiple regression analysis were used within and between the groups. Results: Total satisfaction differed from each other (P < 0.05). The convenience score was more associated with the total satisfaction than design score. Moreover, the implant surgery experience affected several assessments. Conclusion: Collectively, in a cross-sectional study model, the design of implant system significantly affects its total satisfaction and the surgery experience can be influential factor in the evaluation of implant engine system. (J Dent Rehabil Appl Sci 2014;30(1):9-15)

A single-ended six-transistor (6T) SRAM cell composed of a five-transistor (5T) cell and a read-assist low-[Formula: see text] PMOS as foot switch to prevent leakage damaging the data state is proposed in this work. Besides, a power–delay product (PDP) reduction circuitry design for nanoscale SRAMs is also proposed. The proposed PDP reduction circuitry design is composed of an adaptive voltage detection (AVD) circuit generating a boost-enable signal if the process variation is over a predefined range and a half-period word-line boosting (HWB) circuit responding to the enable signal. The proposed SRAM is implemented using TSMC 28-nm CMOS logic technology. PDP reduction is verified to be 41.73% according to the measurement results. The energy per access is 0.0206 pJ given the 800-mV power supply and 40-MHz system clock rate.

The article describes the development of a gait phase time-based split-belt treadmill measurement system. Conventional methods of measuring gait phase, such as the foot switch and force plate, require significant preparation and are costly. In this article, we propose a simple, cheap, and accurate gait phase measurement system that utilizes only the treadmill motor current value. Comparison of this algorithm with conventional methods reveals that the proposed algorithm is as accurate as the foot switch. Moreover, the proposed algorithm can estimate stance phase within a 0.2 s error of the measured value of the force plate in most cases (four out of five healthy subjects). This accuracy is higher than that of the foot switch which is widely used in the clinical field.

An all-solid-state green laser photocoagulator at 532 nm with output power varying from 100 mW to 1 W in a step of 10 mW and exposure time varying from 50 ms to 1000 ms in a step of 10 ms is developed for the treatment of diabetic retinopathy. The output power stability is better than ±1.5% with a nearly diffraction-limited beam quality. The system includes various safety and operational features like internal power monitoring system, safety interlock, emergency switch-off, graphical LCD display with table-top touch mode portable control panel, smart delivery device selection, aiming laser beam with controllable intensity, foot switch, patient records, service mode etc. The system has successfully passed the clinical trials and is being used on patients.

As for information system in hospital which digital hospital aims at, there are PACS(Picture Archiving and Communication System) and so on. PACS transfer and store various medical pictures which are occurring in hospital. The various medical pictures is captured by using keyboard or foot switch during a surgical operation. In this paper, foot switch USB module that can be mounted into a main foot switch case is designed and implemented, it is having a MCU circuit with a built-in micro-controller and a I/O interface having a maximum of five switch. we also developed foot switch control software program with various functions. The result of using the module in the hospital field confirms that the module operates safely.

Introduction: Laparoscopic hepatectomy has disadvantages in intraoperative diagnosis, because it offers limited visualization and palpability of the liver surface. Recently, we developed a novel fluorescent imaging technique using indocyanine green (ICG), which would enable identification of liver cancers during open hepatectomy. However, this technique has not yet been applied to laparoscopic hepatectomy. Materials and Surgical Technique: A patient with a hepatocellular carcinoma (HCC) located in Couinaud's segment II was administered ICG (0.5 mg per kg body weight) intravenous injection 5 d before surgery, as a routine liver function test. The prototype fluorescent imaging system was composed of a xenon light source and a laparoscope with a charge-coupled device camera that could filter out light with wavelengths below 810 nm. Intraoperatively, fluorescent imaging of the HCC was performed by changing color images to fluorescent images with a foot switch. Then, the fluorescing tumor was clearly identified on the visceral surface of segment II during mobilization of the left liver for resection of segments II and III. On the cut surface of the specimen, the tumor showed uniform fluorescence and was microscopically diagnosed as a well-differentiated HCC. Discussion: Laparoscopic fluorescent imaging using preoperative injection of ICG enabled real-time identification of HCC. This technique may be an easy and reliable tool to enhance the accuracy of intraoperative diagnosis during laparoscopic hepatectomy.

Fifty-one children with cerebral palsy who were candidates for surgery for equinovarus deformities of the foot had their gait evaluated by means of foot-switches and electromyography to determine the contribution of the anterior tibialis and posterior tibialis muscles to the deformity. Seven EMG patterns and five foot-switch patterns were identified, but there was no correlation between the EMG and foot-switch patterns. Foot-switch data alone could not identify the deforming muscles or their patterns, so are not adequate for planning surgical correction of varus feet of children with cerebral palsy.

金沢大学人間社会研究域人間科学系, This study aimed to examine the relationships among various stepping parameters, sex, and age in the elderly. Healthy elderly Japanese individuals 60-85 years old (50 males and 61 females) performed 4 types of stepping motions for 20 s. Stepping motions included bilateral stepping (back/forth and right/left) and unilateral stepping (back/forth and right/left). The number of steps, the average connecting time of a foot during one step, and the average time of both feet touching the floor at the same time (bilateral connecting time) were measured with a foot switch sheet. The trial-to-trial reliability was very high (above 0.86) except for the bilateral connecting time in the bilateral stepping back/forth test for 70-85 year olds (males: 0.67, females: 0.68). With age, the number of steps was significantly smaller, and the average connecting time and the bilateral connecting time were shorter in all stepping tests. There were significant sex differences in bilateral connecting time for bilateral stepping right and left and the number of steps for the bilateral stepping back and forth and the unilateral stepping right and left tests. The number of steps and average connecting time showed high correlations between bilateral stepping right/left and back/forth (r=0.71-0.94) and between unilateral stepping back/forth and right/left (r=0.87-0.99). There were significant correlations of the average connecting time between bilateral and unilateral stepping motions (r=0.51-0.83), but both stepping motions are considered to have different motion properties from the viewpoint of center of gravity sway. The correlations between the bilateral connecting time and the number of steps in bilateral stepping were relatively low (males: |r

Objectives. To test the efficacy and acceptance of a footdrop stimulator controlled by a tilt sensor. Methods. A nonrandomized, test-retest study of 26 subjects with footdrop of more than 1 year’s duration, resulting from various central nervous system disorders, was performed in 4 centers for at least 3 months. Speed of walking in a straight line, speed around a figure of 8, and physiological cost index (PCI) were measured with and without the device. Hours/day and steps/day using the device were recorded. Results.All but 2 subjects used the tilt sensor at home, rather than a foot switch. Walking speed increased by 15% after 3 months ( n = 26; P < 0.01), 32% after 6 months ( n = 16; P < 0.01), and 47% after 12 months ( n = 8; P < 0.05), while PCI decreased. The number of steps taken per day of use increased significantly over time, and increased speed was directly correlated with usage. Walking speed also increased with the stimulator off, but to a lesser extent, indicating a training effect. Subject feedback from a questionnaire indicated satisfaction with the stimulator. Conclusions. Both efficacy and acceptance of the stimulator were good in a population of subjects with chronic footdrop.

In gait research, casual walking has been considered to be walking at a casual speed. However, it is unclear that walking speed is the most stable factor in casual walking compared to other factors such as cycle duration and stride length. Although walking speed can be calculated from cycle duration and stride length, it is not necessarily the case that these parameters are "stable" in the same manner. We therefore conducted an experiment to determine which of these three parameters is most stable, regarding walking speed as cycle speed and using the coefficient of variation across gait cycles as index of stability. Ten participants were invited to walk in their own casual manner, once a week for a period of four weeks. Cycle duration was measured by means of a foot switch attached to the right heel. To measure the moving distance, participants towed a distance meter. Stride length and cycle speed were measured using this device. Over the four-week period, cycle duration and stride length were stable, whereas cycle speed was the most variable parameter. Furthermore, in the results for each single day, the cycle duration was significantly more stable than the other parameters. These results suggest that, when we walk casually, cycle duration is the dominant factor, rather than stride length or walking speed.

In rural areas of developing countries, ankle foot orthoses that can be manufactured at low cost are required. Also, systems that can be set up with readily available, low-cost materials which can easily measure their effectiveness are also required. In this paper, I report on, a low cost motion analysis system that can easily measure the effectiveness of orthoses was developed in China. In this system, a home digital video camera was used for video recording for analysis, aluminum foil for a foot switch, and freeware for analysis software. Gait analysis was performed on a healthy person and a hemiplegic patient using this system. Then a comparison was performed between the results of this simple system and those of a 3D motion analysis system. Knee joint angles obtained by both systems were essentialy the same.

For surgeons operating in the standing position, the manipulation of foot switches involves shifting of the weight to the pivoting leg and the possible loss of contact between the switch and the foot. We solved this problem by changing the position of the switch that operates bipolar forceps. Our novel device is made of aluminum plates. The base plate features a foot strap and a height-adjustable overhang over the switch-operating foot. A commercially-available disc type foot switch is attached to the underside of the overhang in upside-down position, so the switch is operable with the toe. To turn on the switch, the toe is flexed dorsally to push the switch pedal, so the action is limited to the part distal to the metatarsophalangeal joints. Our switch was used in more than 100 consecutive microsurgeries performed by surgeons operating in the standing position. The switch manipulation required no shifting of the weight and was easier and quicker than manipulation of conventionally-placed switches. The surgeons were able to change the foot position freely with the modified switch, thereby avoiding loss of contact with the switch. The modified switch placement reduced physical fatigue in the lower extremities, annoyance related to the manipulation of conventionally-placed switches, and increased the comfort of surgeons operating in the standing position.

Somatosensory event-related potential (SERP) was recorded in the blind and cerebral process of vibration pattern discrimination was examined. A large vibration pattern or a small one was delivered at a ratio of 8.5:1.5 to the left or the right index finger. Subjects were asked to push a foot switch when small-size pattern was presented at an attended side. EEG was recorded from 18 locations and SERPs due to large-size pattern to the left index finger were obtained. Regardless whether the left index finger was the attended side or the non-attended one, N80, N140 and P300 were observed in both subject groups. SERP within 200–230 ms under left-attended condition shifted toward negativity than those under right-attended one (p

A simple, fast and straightforward method was developed for automatically deriving foot-floor contact information from tracking motion analysis system markers attached to the shoes of the subjects. The method was based on an accurate calibration of the motion analysis system prior to the experiments and a trivial off-line threshold-based algorithm using dedicated foot-attached marker positions and velocities as inputs. The main purpose of the method was to obtain the results almost instantaneously. The accuracy was poorer when compared with the classic, man-assisted and time-consuming methods, but the average error was less than 0.1 s compared with the force plate or pressure insole/foot switch-based methods. The method eliminates the need for foot switches when a motion analysis system is already being used. As encumbrance is reduced for the subjects, the method is also applicable to pathological gait patterns.

Previous investigations have detailed the complexity and variability of suture knots used in arthroscopic surgery1-3. In order to improve the consistency and results, alternate means of arthroscopic knot-tying have been suggested and used4,5. In this investigation, a new, alternate method for improving the results of arthroscopic knot-tying was evaluated. An absorbable Fixation Seat, which we developed, was tested in a laboratory environment to determine whether it could be consistently welded ultrasonically to multifilament suture in a fluid-filled environment and have strength equivalent to that of standard arthroscopic knots while exhibiting less loop elongation (creep). This same Fixation Seat was then used clinically in arthroscopic rotator cuff repair as a replacement for suture knots. The Unity Ultrasonic Fixation System (Bonutti Technologies, Effingham, Illinois) was used to weld the fixation seats ultrasonically to USP-2 (United States Pharmacopoeia-2) braided polyester suture both in the laboratory and in clinical use. The Unity Ultrasonic Fixation System comprises a generator that creates the ultrasonic signal, a foot switch to activate the generator, and a hand-piece to transmit the signal to weld the Fixation Seat (Fig. 1). Fig. 1 Unity Ultrasonic Fixation System. The Fixation Seat consists of two pieces that are molded from poly-L-lactic acid. The device is 3 mm in height and has a 6-mm diameter before welding (Figs. 2 and 3). Inside the Fixation Seat, there are passages for threading the suture to be secured. Fig. 2 Fixation Seats. Fig. 3 Fixation Seat model. ### Mechanical Testing Three sample groups were constructed for testing, with each group involving a different method of securing USP-2 braided polyester suture around a 0.25-in (0.64-cm) neoprene-covered dowel. Ten samples of each of the following fixation techniques were tested: (1) ultrasonically welded Fixation Seats, (2) hand-tied Tennessee slider knots6, and (3) hand-tied Duncan loop knots6 (Fig. …

A new surgical system named ‘SonoSurg’ integrating both the ultrasonic coagulating cutter and the conventional ultrasonic aspirator has been developed for clinical use. It maintains the functions of each independent device. Various types of hand pieces can be easily exchanged at the time of surgery. Moreover, all output switches are installed in the common foot switch. Therefore, the extent of the application of this system has been extremely expanded through these additional ancillary units with different function or varieties of hand pieces that are usable in accordance with the purposes. Experience with this system used in endoscopic or open surgeries at a couple of institutions is evaluated in this paper. We believe that the integration of these two different models will be very useful in various aspects, such as the improvement of surgical safety and to simplify surgical procedures as well as functional improvement of the operating theater.

Presently, in constructing a surgical simulator, a high-performance graphics workstation (GWS) has generally been used because it is necessary that a highly faithful surgical image be generated in real time. There exist problems, however, in cost, operation, and working environment, which have prevented the widespread use of the simulator. In order to solve this problem, the authors constructed a real-time PC-based surgical simulator for the training of ophthalmologists in vitreoretinal surgery, based on the results of evaluation of a surgical simulator developed on GWS. From this study, the necessary conditions for the simulator have been identified, and a PC-based surgical simulator satisfying these conditions has been successfully constructed. The constructed system can perform the following operations. The surgical image is displayed in stereo vision, through a binocular stereo vision display. The tactile sensation of surgical tool insertion is provided by using a simulated tool device. The surgery scene can be controlled by operating a foot switch. The constructed surgical simulator provides an environment which effectively simulates real surgery. If an increased number of ophthalmologists can use the proposed simulator more easily for repetitive surgery training, surgical techniques will be improved, and new surgical procedures may be developed. © 2002 Wiley Periodicals, Inc. Syst Comp Jpn, 33(7): 11–20, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/scj.10076

We describe a newly designed syringe pump which is electrically controlled by a dual foot switch pedal. The device enables the scrubbed anaesthetist performing the regional block to aspirate, as well as to inject, the local anaesthetic without the need for any additional personnel.

A novel technique for creation of a peripheral iridectomy is presented which in our series of cases yielded a 100 % success rate. Constriction of the pupil is achieved by intracameral carbachol instillation to achieve a taut peripheral iris. A 23G vitrector on aspiration mode is first used to engage the peripheral iris with high vacuum. On pressing the foot switch to position two (in suction only mode, the peripheral iris is engaged and on pressing the foot switch to position three (in the cut mode) full thickness iridectomy is achieved. As a full thickness iris defect is made, the iris tissue flutters and the corresponding pupillary margin peaks towards the iris base due to aqueous currents through the newly created conduit; indicating that a patent iridectomy has been achieved.

Objective: To investigate the dynamic posture stability during lateral slop walking in terms of temporal distance parameters of gait cycle and the center of pressure (COP) and compare the differences between the side step and cross step. Materials & Methods: An EVaRT system with nineteen reflective markers, two force plates, and the foot switch sensors were used to measure the body movements, ground reaction forces and temporal parameters, respectively, during lateral walking on an inclined walkway with 5° tilt. Twelve normal subjects participated in this study. The subjects were instructed to walk with right leg leading from the bottom to the top of the slope at the self-selected speed using side step and cross step, respectively. The data were collected for 8 seconds for each trial. Results: Different gait pattern was found in the first and second force plate during the cross-step and the side-step walking. The result indicated that the increasing degree of inclination of the slope would cause the factor of unstable posture. The value of anterior/posterior deviation of the cross-step walking was larger than the side-step walking (P

The purpose of this study is to find out which factors are mainly responsible for the dynamic changes of the anterior arch of the foot during walking.The dynamic changes of the anterior arch were measured using an electric conductible gum, which changes its electical resistance on expanding. The dynamic changes of the anterior arch, ground reaction forces and foot switch signals were recorded simultaneously.As the results of this experiment, it was found out that the dynamic changes of the anterior arch of the foot was mainly affected by the vertical component of the ground reaction force, and also the contact point of the forefoot to the floor.

To clarify the peculiarities of gait disturbances in patients with labyrinthine, cerebellar and spinal disturbances, head movements and activity of the soleus muscles were studied during walking.The upward-downward (U-D), right-left (R-L) and forward-backward (F-B) movements of the head and activities of both soleus muscles were recorded by a polygraph with the aid of a five-channel telemeter. Head movements were recorded with three accelerometers attached to a helmet that the subject wore. Muscle activities was recorded by EMG with surface electrodes. At the same time the subject's foot-floor contact sequence was measured with electric switches in the shoes. These gait data were recorded on a pen oscillograph.1) In normal subjects, head movement recording revealed regular U-D movement and F-B inclination twice in each walking cycle and regular R-L inclination once in each walking cycle. Each soleus muscle was activated at the stance phase once in each walking cycle.2) A patient with unilateral labyrinthine disorder had head movements with irregular rhythm and ampulitude. L-R inclination of the head was not related to foot contact. The soleus muscle activities increased in the swing phase and decreased in the stance phase.3) A patient with bilateral loss of labyrinthine excitability had small, indistinct head movements with no relation to foot contact or foot raising. The record of the soleus muscle activities indicated plolongation of the active time and overlap of the activities of the two sides.4) A patient with spino-cerebellar degeneration had very irregular, unequal head movements, especially excessive F-B head movement. The active time of the soleus muscles was prolonged.5) A patient with left hemiparesis due to cervical myelopathy had small, irregular U-D and F-B head movements and large, sine wave like sway in R-Lhead movements. The soleus muscle activity of the left side in the stance phase was less than that of the right side. The record of the electric foot switch indicated that the subject often missed foot raising of her left leg.

Valleylab’s LigaSure™ vessel sealing instruments used in open surgical operations are currently operated via a foot-activated switch. Valleylab funded and mentored a senior design project at the University of Colorado at Boulder to redesign the electrosurgical device to include hand-switching. In comparison to hand-switching, a foot switch adds to the device setup complexity and increases the physical demand on the surgeon. Additional drawbacks of a foot switch include risk of inadvertent activation and need to look away from the surgical area in order to accurately activate the switch. Valleylab determined the need to redesign the LigaSure™ XTD instrument, shown in Figure 1, to use a hand-activated switch in order to provide surgeons with greater ease and precision of use.Copyright © 2007 by ASME

Background and Objectives: Endoscopic sinus surgery (ESS) has become the standard treatment modality in chronic rhinosinusitis. However there is no uniform treatment protocol regarding preoperative, intraoperative, and postoperative care. The objectives of this study are to identify and report the practice patterns of ESS in South Korea. Materials and Method: A series of eight surveys were sent to the board members of the Korean Rhinologic Society via email between August 2013 and September 2014. Responses to questions regarding detailed practice patterns were recorded anonymously. Results: The average number of replies to each survey was 41.5. Routine antibiotics were prescribed just before computed tomography by 46.9% of the respondents, and the mean duration of antibiotics treatment was 1.90 weeks. A routine preoperative olfactory test was conducted by 64.3% of respondents, and allergy tests were conducted by 82.2%. General anesthesia was preferred by 76.8%, and the mean hospitalization period was 3.12 days. The mean rotation speed used for a microdebrider was 3,054 rpm, and 3,000 rpm was selected by 51.6% of the respondents. In addition, 74.2% of respondents reported that they operate the foot switch themselves. Finally, an absorbable pack was preferred after ESS. Conclusion: The current study was the first nationwide survey on practice patterns in endoscopic sinus surgery in Korea, and the data reflects the opinions of expert sinus surgeons.

Objective To evaluate the effects of functional electrical stimulation (FES) to ankle dorsiflexor (DF) and ankle plantarflexor (PF) on kinematic and kinetic parameters of hemiplegic gait. Methods Fourteen post-stroke hemiplegic patients were considered in this study. Electrical stimulation was delivered to ankle DF during the swing phase and ankle PF during the stance phase via single foot switch. Kinematic and kinetic data were collected using a computerized motion analysis system with force plate. Data of no stimulation (NS), DF stimulation only (DS), DF and PF stimulation (DPS) group were compared among each other. Results Peak ankle dorsiflexion angle during swing phase is significantly greater in DS group (-1.55°±9.10°) and DPS group (-2.23°±9.64°), compared with NS group (-6.71°±11.73°) (p

An irrigation system which can easily be applied to the conventional high-speed air drill was developed to allow simultaneous irrigation during micro-drilling. The irrigation system is constructed with a tube of 0.8 mm outer diameter and supporting rings. Irrigation is entirely coordinated with drilling by a single foot switch. The tube of the system ejects normal saline intermittently toward the cutter bar tip. Use of this system in skull base surgery showed that effective irrigation and a clean operative field was achieved even in a narrow space under the operating microscope, saline is ejected exactly on the point of drilling and over-heating does not occur so that heat-related damage to the local nerves and blood vessels is avoided. The system can easily be applied to any type of high-speed air drill by using supporting rings of the correct size. This irrigation system is particularly useful in microneurosurgery using the high-speed air drill.

The task is to monitor walking patterns and give early warning of falls using foot switch and mercury trigger sensors. We describe a dynamic belief network model for fall diagnosis which, given evidence from sensor observations, outputs beliefs about the current walking status and makes predictions regarding future falls. The model represents possible sensor error and is parametrised to allow customisation to the individual being monitored.

BACKGROUND Observation of the surgical field from all directions is essential in microneurosurgery. A tilting operating table operated by the surgeon can satisfy this need. METHODS A tilting operating table operated by the surgeon using a foot switch was developed by modifying the Sugita table incorporating the X-Y shifter. RESULTS AND CONCLUSIONS The modified operating table allows the surgeon to move the patient in the head up or down directions, as well as the left side down or right side down directions, so the surgical field can be inspected from all aspects without changing the vertical axis of the operating microscope.

The characteristic working situation in laparoscopic surgery involves elongated instruments and limited mobility of the surgeon during the operation. These circumstances require new technical solutions to enhance the surgeon's comfort. In other surgical fields with special ergonomic situations, such as microsurgery, some surgeons prefer to operate from a seated position at the operating room table. We developed a new surgeon's chair dedicated to the ergonomic and functional requirements of laparoscopic surgery. The chair allows the surgeon to maintain a semi-standing position during the operation. Foot pedals for high frequency and suction/irrigation are integrated into the base of the chair. The pedals are purposely aligned to be comparable to foot pedals in a car. The chair is driven by electromotors, controlled with a special foot switch that operates independent of assisting personnel during surgery. Initial clinical testing of the chair could prove the theory that supporting the surgeon with a cockpit type of operating room chair helps to avoid fatigue during long endoscopic procedures. Such assistance is especially important in combination with robotic devices for use during solo surgery.

The purpose of the present investigation was to evaluate the reproducibility of probing attachment level measurements using a newly developed constant force electronic probe. The probing force was preset at 25 g (probe diameter 0.4 mm) and was connected to a computer through a variable differential transformer. The measurements were performed on 10 patients with minimal signs of periodontal disease, using individually made acrylic stents. When the probe was in place and a foot switch depressed, the measurement was stored on the computer to the nearest 0.1 mm. The measurements were performed by one periodontist and one hygienist during one visit, and were then repeated by the same periodontist and another hygienist during a second visit. The results showed high correlations between the periodontist and the hygienist during one visit, between the two visits for the periodontist, and between the two hygienists at two different visits. The subject threshold for attachment loss was calculated according to Haffajee and co-workers, and was found to average 0.84 mm for the measurements performed by the periodontist and the hygienist during the same visit. For the periodontist during two separate visits and for the two different hygienists, the average threshold was 0.99 and 1.02 mm, respectively. Duplicate measurements were also performed by one periodontist at one visit on 10 patients with advanced periodontal disease. The average subject threshold for these patients was 0.60 mm. It may be concluded that with the constant force electronic probe, loss of attachment can be detected earlier than when conventional instruments are used.

Simulation can provide a nonhazardous method for testing various equipment designs before selecting an option for implementation. A power press simulator was developed to evaluate workstation design options for foot switch and dual palm button actuation devices. Two experiments were performed with the simulator, reproducing several causal events that can result in amputations on mechanical power presses. Safety implications for workstation designers are discussed, as well as general considerations on the use of simulation for achieving a design that is as safe as possible.

A description is given of a simple comparator which allows the measurement of particle size distribution by unskilled operators. The instrument is designed to accept a 35 mm photograph of the particulate material, produced either by an optical or an electron microscope. The photograph is projected on to a translucent screen and particle sizes are compared with a superimposed spot of light projected from the other side. Adjustment of the spot diameter automatically ensures that when the particle is counted by operation of a foot switch it is also placed into the appropriate size category. The performance is illustrated by a typical size distribution determination, performed by both experienced and untrained operators. All operators were able to size particles at speeds in excess of 30 per minute.

A common problem in determining a number of important gait parameters is a convenient means for indicating foot/floor contact. Various foot switches have been used in many forms, but still an ideal, commercially available switch has yet to materialize. This note describes one method for constructing very thin, (1 mm), durable, switches that have worked well in the Gait Analysis Lab at Texas Scottish Rite Hospital.