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Im Jahr 1504 verlor der deutsche Ritter Gottfried („Götz“) von Berlichingen seine
rechte Hand. Schon während seiner Genesung dachte er daran, die Hand zu ersetzen,
und beauftragte bald darauf die erste Handprothese, die sogenannte „Eiserne Hand“.
Jahre später wurde die aufwändigere zweite „Eiserne Hand“ gebaut. Wir haben die erste
Prothese auf der Basis früherer Literaturdaten von
Quasigroch (1982) mit Hilfe von 3-D
Computer-Aided Design (CAD) rekonstruiert. Dazu mussten einige Abmessungen angepasst
und ein paar Annahmen für das CAD-Modell gemacht werden. Die historische passive
Prothese des Götz von Berlichingen ist für die moderne Neuroprothetik interessant, da sie
eine Alternative zu komplexen invasiven Brain-Machine-Interface-Konzepten darstellen
könnte, wo diese Konzepte nicht notwendig, möglich oder vom Patienten gewünscht sind.
In this study, we tested the function of a replica of the over 500-year-old original of the
famous Franconian Imperial Knight Götz von Berlichingen’s first “iron hand”, which we
reconstructed by computer-aided design (CAD) and recently printed using a multi-material
3D printer. In different everyday tasks, the artificial hand prosthesis proved to be remarkably
helpful. Thus, the hand could hold a wine glass, some grapes, or a smartphone. With a
suitable pencil, even writing was possible without any problem. Although for all these
functions the healthy other hand was necessary to assist at the beginning, the artificial hand
is an astonishing mechanical aid with many possibilities. Therefore, in certain cases, the
non-invasive approach of a passive mechanical hand replacement, which is an individual,
quick and cheap solution due to modern 3D printing, may always be worth considering
also for today’s requirements.
Auf Grundlage der Computer-Aided-Design (CAD)-rekonstruierten ersten „Eisernen Hand“ des Götz von Berlichingen wird ein umgebautes, controllergesteuertes sensomotorisches Fingersystem auf seine Funktionalität beim Greifen von unterschiedlichen Gegenständen beschrieben und geprüft. Die elektronischen Finger, die den „Pinzettengriff“ nachahmen und automatisch bei dem zuvor eingestellten Anpressdruck abschalten, bewiesen eine bemerkenswerte Alltagstauglichkeit. Das vorgestellte Grundkonzept könnte eine Alternative bei der Entwicklung einfacher und kostengünstiger, aber dennoch gut einsatzfähiger bionischer Hände sein und zeigt einmal mehr, wie historische Ideen in die Gegenwart transferiert werden können.
Knight Götz von Berlichingen (1480–1562) lost his right hand distal to the wrist due to a cannon ball splinter injury in 1504 in the Landshut War of Succession at the age of 24. Early on, Götz commissioned a gunsmith to build the first “Iron Hand,” in which the artificial thumb and two finger blocks could be moved in their basic joints by a spring mechanism and released by a push button. Some years later, probably around 1530, a second “Iron Hand” was built, in which the fingers could be moved passively in all joints. In this review, the 3D computer-aided design (CAD) reconstructions and 3D multi-material polymer replica printings of the first “Iron hand“, which were developed in the last few years at Offenburg University, are presented. Even by today’s standards, the first “Iron Hand”—as could be shown in the replicas—demonstrates sophisticated mechanics and well thought-out functionality and still offers inspiration and food for discussion when it comes to the question of an artificial prosthetic replacement for a hand. It is also outlined how some of the ideas of this mechanical passive prosthesis can be translated into a modern motorized active prosthetic hand by using simple, commercially available electronic components.
Background: This paper presents a novel approach for a hand prosthesis consisting of a flexible, anthropomorphic, 3D-printed replacement hand combined with a commercially available motorized orthosis that allows gripping.
Methods: A 3D light scanner was used to produce a personalized replacement hand. The wrist of the replacement hand was printed of rigid material; the rest of the hand was printed of flexible material. A standard arm liner was used to enable the user’s arm stump to be connected to the replacement hand. With computer-aided design, two different concepts were developed for the scanned hand model: In the first concept, the replacement hand was attached to the arm liner with a screw. The second concept involved attaching with a commercially available fastening system; furthermore, a skeleton was designed that was located within the flexible part of the replacement hand.
Results: 3D-multi-material printing of the two different hands was unproblematic and inexpensive. The printed hands had approximately the weight of the real hand. When testing the replacement hands with the orthosis it was possible to prove a convincing everyday functionality. For example, it was possible to grip and lift a 1-L water bottle. In addition, a pen could be held, making writing possible.
Conclusions: This first proof-of-concept study encourages further testing with users.
All you need is sleep
(2016)
In 21st century, the century when the humanity hopes to embark on interplanetary travel, we are yet to fully reach an understanding of our very own idiosyncratic terra incognita – the human sleep. Sleep is a highly conserved evolutionary process that constitutes approximately one third of our life, and the lack or inadequate sleep may lead to impairment across multiple cognitive domains (Tononi and Cirelli, 2014; Lim and Dinges, 2010). Sleep deprivation also leads to aberrant brain functioning, immunological and metabolic collapse, and if it is sufficiently prolonged it will ultimately lead to death (Tononi and Cirelli, 2014).
There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD). However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1) to validate previous results showing alterations of regional cerebral blood flow (rCBF) in cWAD, (2) to test if central hyperexcitability reflects changes in rCBF upon non-painful stimulation of the neck, and (3) to verify our hypothesis that the missing link in understanding the underlying pathophysiology could be the close interaction between the neck and midbrain structures. For this purpose, alterations of rCBF were explored in a case-control study using H215O positron emission tomography, where each group was exposed to four different conditions, including rest and different levels of non-painful electrical stimulation of the neck. rCBF was found to be elevated in patients with cWAD in the posterior cingulate and precuneus, and decreased in the superior temporal, parahippocampal, and inferior frontal gyri, the thalamus and the insular cortex when compared with rCBF in healthy controls. No differences in rCBF were observed between different levels of electrical stimulation. The alterations in regions directly involved with pain perception and interoceptive processing indicate that cWAD symptoms might be the consequence of a mismatch during the integration of information in brain regions involved in pain processing.
Am Buffet des Lebens
(2017)
Bach, Gas, Strom und Wasser
(2022)
Kommentar zu "Intracortical microstimulation of human somatosensory cortex" von Sharlene N. Flesher et al., veröffentlicht in Science Translational Medicine, Vol. 8, No. 361, Seite 361ra141 (DOI: 10.1126/scitranslmed.aaf8083)
Background: This paper presents a conceptual design for an anthropomorphic replacement hand made of silicone that integrates a sensory feedback system. In combination with a motorized orthosis, it allows performing movements and registering information on the flexion and the pressure of the fingers.
Methods: To create the replacement hand, a three-dimensional (3D) scanner was used to scan the hand of the test person. With computer-aided design (CAD), a mold was created from the hand, then 3D-printed. Bending and force sensors were attached to the mold before silicone casting to implement the sensory feedback system. To achieve a functional and anthropomorphic appearance of the replacement hand, a material analysis was carried out. In two different test series, the properties of the used silicones were analyzed regarding their mechanical properties and the manufacturing process.
Results: Individual fingers and an entire hand with integrated sensors were realized, which demonstrated in several tests that sensory feedback in such an anthropomorphic replacement hand can be realized. Nevertheless, the choice of silicone material remains an open challenge, as there is a trade-off between the hardness of the material and the maximum mechanical force of the orthosis.
Conclusion: Apart from manufacturing-related issues, it is possible to cost-effectively create a personalized, anthropomorphic replacement hand, including sensory feedback, by using 3D scanning and 3D printing techniques.
In this paper, a concept for an anthropomorphic replacement hand cast with silicone with an integrated sensory feedback system is presented. In order to construct the personalized replacement hand, a 3D scan of a healthy hand was used to create a 3D-printed mold using computer-aided design (CAD). To allow for movement of the index and middle fingers, a motorized orthosis was used. Information about the applied force for grasping and the degree of flexion of the fingers is registered using two pressure sensors and one bending sensor in each movable finger. To integrate the sensors and additional cavities for increased flexibility, the fingers were cast in three parts, separately from the rest of the hand. A silicone adhesive (Silpuran 4200) was examined to combine the individual parts afterwards. For this, tests with different geometries were carried out. Furthermore, different test series for the secure integration of the sensors were performed, including measurements of the registered information of the sensors. Based on these findings, skin-toned individual fingers and a replacement hand with integrated sensors were created. Using Silpuran 4200, it was possible to integrate the needed cavities and to place the sensors securely into the hand while retaining full flexion using a motorized orthosis. The measurements during different loadings and while grasping various objects proved that it is possible to realize such a sensory feedback system in a replacement hand. As a result, it can be stated that the cost-effective realization of a personalized, anthropomorphic replacement hand with an integrated sensory feedback system is possible using 3D scanning and 3D printing. By integrating smaller sensors, the risk of damaging the sensors through movement could be decreased.
In dieser Arbeit wird ein historischer Fallbericht des bis heute weit über seine Landesgrenzen bekannten italienischen Kriminalanthropologen Cesare Lombroso (1835–1909) vorgestellt. In diesem Fallbericht wird der berüchtigte und psychisch auffällige Dieb Pietro Bersone mit Hilfe eines sog. Hydrosphygmographen überführt, einem zur damaligen Zeit neuartigen technischen Gerät, das den Puls nicht-invasiv aufzeichnen konnte. Lombroso ist vermutlich einer der ersten, wenn nicht sogar der erste, der durch den Einsatz eines solchen Geräts die Idee zum „Lügendetektor“ vorweggenommen hat. Die vorgestellte Textstelle aus Lombrosos Buch „Neue Fortschritte in den Verbrecherstudien“ ist daher ein besonderes Fundstück auch für die Geschichte der Polygraphie.
(1) Background: Little is known about the baroque composer Domenico Scarlatti (1685-1757), whose life was centred behind closed doors at the royal court in Spain. There are no reports about his illnesses. From his compositions, mainly for harpsichord, an outstanding virtuosity can be read. (2) Case Presentation: In this case report, the only known oil painting of Domenico Scarlatti is presented, on which he is about 50 years old. In it one recognizes conspicuous hands with hints of watch glass nails and drumstick fingers. (3) Discussion: Whether Scarlatti had chronic hypoxia of peripheral body regions as a sign of, e.g., bronchial cancer or a severe heart disease, is not known. (4) Conclusions: The above-mentioned signs recorded in the oil painting, even if they were not interpretable at that time, are clearly represented and recorded for us and are open to diagnostic discussion from today's point of view.
Im Archiv für Kriminologie wurden bislang drei Arbeiten zur 3-D-CAD-Rekonstruktion der ersten "Eisernen Hand" des berühmten Reichsritters Gottfried ("Götz") von Berlichingen (1480-1562) vorgestellt. Mittlerweile sind einige neue Gesichtspunkte herausgearbeitet worden, die hier kurz als Ergänzung mitgeteilt werden sollen.
Die “Selbstbetrachtungen” des Marc Aurel – medizinisch-ethische Betrachtungen des Menschseins
(2013)
In the field of neuroprosthetics, the current state-of-the-art method involves controlling the prosthesis with electromyography (EMG) or electrooculography/electroencephalography (EOG/EEG). However, these systems are both expensive and time consuming to calibrate, susceptible to interference, and require a lengthy learning phase by the patient. Therefore, it is an open challenge to design more robust systems that are suitable for everyday use and meet the needs of patients. In this paper, we present a new concept of complete visual control for a prosthesis, an exoskeleton or another end effector using augmented reality (AR) glasses presented for the first time in a proof-of-concept study. By using AR glasses equipped with a monocular camera, a marker attached to the prosthesis is tracked. Minimal relative movements of the head with respect to the prosthesis are registered by tracking and used for control. Two possible control mechanisms including visual feedback are presented and implemented for both a motorized hand orthosis and a motorized hand prosthesis. Since the grasping process is mainly controlled by vision, the proposed approach appears to be natural and intuitive.
eLetter zum Artikel "How hair can reveal a history" von Hanae Armitage & Nala Rogers, veröffentlicht in Science, Vol. 351, Issue 6278, Seite 1134 (doi.org/10.1126/science.351.6278.1134)
eLetter zum Artikel "How hair can reveal a history" von Hanae Armitage & Nala Rogers, veröffentlicht in Science, Vol. 351, Issue 6278, Seite 1134 (doi.org/10.1126/science.351.6278.1134)
eLetter: "The ancient Capua leg from 300 BC and the 1941 air raid on the Royal College of Surgeons"
(2021)
eLetter zum Artikel "The College of Surgeons, London", veröffentlicht in Science, Vol. 93, Issue 2425, Seite 587 (DOI: 10.1126/science.93.2425.587).
eLetter zum Artikel "Plague Through History" von Nils Chr. Stenseth, veröffentlicht in Science, Vol. 321, Issue 5890, Seite 773-774 (doi.org/10.1126/science.1161496)
Kommentar zum Artikel "Arthur Willis Goodspeed" von Otto Glasser, veröffentlicht in Science Vol. 98, Issue 2540, Seite 219 (doi.org/10.1126/science.98.2536.125).
A survey in 2000 revealed that only about 30% of the prescriptions in the European pediatric population were on the basis of evidence-based medicine (EbM). Less for radiopharmaceuticals and principally for diagnostics, radiologists throughout Europe are referred to the pediatric guidelines of the European Association of Nuclear Medicine (EANM), as none of the frequently used tracers have been evaluated in clinical trials in the different pediatric subgroups. Following a resolution to address the lack of EbM in children, the European Commission published the Pediatric Regulation EC 1901/2006 and its amendment EC 1902/2006, effective from 2007. This regulation foresees the development of evidence-based medicine in the pediatric population. This is effected through a set of principles like the mandatory pediatric investigation plan (PIP) to be included with the market authorization application (MAA), and the pediatric use market authorization (PUMA) for off-patent pharmaceuticals, and to a very small part radiopharmaceuticals with funding possibilities for pediatric-specific research through the 7th Framework Programme (7FP) of the European Union.
This is a commentary note on the situation of functional neuroimaging in psychiatry. With this we would like to encourage psychiatrists and the journal editors of psychiatric and related journals to at least rethink the role of functional neuroimaging in this discipline and use these imaging techniques in their various aspects of clinical diagnosis and therapy regimens,respectively.
This book, now in its second, completely revised and updated edition, offers a critical approach to the challenging interpretation of the latest research data obtained using functional neuroimaging in whiplash injury. Such a comprehensive guide to recent and current international research in the field is more necessary than ever, given that the confusion regarding the condition and the medicolegal discussions surrounding it have increased further despite the publication of much literature on the subject. In recent decades especially the functional imaging methods – such as single-photon emission tomography, positron emission tomography, functional MRI, and hybrid techniques – have demonstrated a variety of significant brain alterations. Functional Neuroimaging in Whiplash Injury - New Approaches covers all aspects, including the imaging tools themselves, the various methods of image analysis, different atlas systems, and diagnostic and clinical aspects. The book will help physicians, patients and their relatives and friends, and others to understand this condition as a disease.
This book, now in its third, completely revised and updated edition, offers a critical approach to the challenging interpretation of the latest research data obtained using functional neuroimaging in whiplash injury. Such a comprehensive guide to recent and current international research in the field is more necessary than ever, given that the confusion regarding the condition and the medicolegal discussions surrounding it have increased further despite the publication of much literature on the subject. In recent decades especially the functional imaging methods – such as single-photon emission tomography, positron emission tomography, functional MRI, and hybrid techniques – have demonstrated a variety of significant brain alterations. Functional Neuroimaging in Whiplash Injury - New Approaches covers all aspects, including the imaging tools themselves and the various methods of image analysis. Details on biomechanics, including the finite element method and facts on historical whiplash experiments and crash tests have now been added to this new edition. The book will continue to help physicians, patients and their relatives and friends, and others to understand this condition as a disease.
Geleitwort
(2012)
In this entry, the 3D CAD reconstructions and 3D multi-material polymer replica printings of knight Götz von Berlichingen´s first „Iron Hand,“ which were developed in the last few years at Offenburg University, are presented. Even by today's standards, the first “Iron Hand”–as could be shown in the replicas–demonstrates sophisticated mechanics and well thought-out functionality and still offers inspiration and food for discussion when it comes to the question of an artificial prosthetic replacement for a hand.
Restoring hand motion to people experiencing amputation, paralysis, and stroke is a critical area of research and development. While electrode-based systems that use input from the brain or muscle have proven successful, these systems tend to be expensive and di¨cult to learn. One group of researchers is exploring the use of augmented reality (AR) as a new way of controlling hand prostheses. A camera mounted on eyeglasses tracks LEDs on a prosthetic to execute opening and closing commands using one of two different AR systems. One system uses a rectangular command window to control motion: crossing horizontally signals “open” along one direction and “close” in the opposite direction. The second system uses a circular command window: once control is enabled, gripping strength can be controlled by the direction of head motion. While the visual system remains to be tested with patients, its low cost, ease of use, and lack of electrodes make the device a promising solution for restoring hand motion.
Hatte Maria einen Jodmangel?
(2019)
Auch wenn sie im Internet-Zeitalter zu einer Normalität werden, bleiben Ferndiagnosen unter Medizinern umstritten. Erst recht vorsichtig sollte man sein, wenn es sich bei dem Patienten um die leibliche Mutter Gottes handelt. Doch wenn man in diesem Gemälde eine authentische Dokumentation sieht, ist der Befund eindeutig: Maria hatte zum Zeitpunkt der Geburt ihres berühmten Sohns auffällig lange und schlanke Finger sowie eine Struma des Grads II bis III.
Das 20. Jahrhundert ist geprägt von Aufsehen erregenden medizintechnischen Durchbrüchen: Von der ersten erfolgreichen Herztransplantation über die Entdeckung des Penicillins, vom Kampf gegen Infektionskrankheiten bis hin zu ersten Röntgenaufnahmen und Computer-Scans. Die Technologie und die medizinische Forschung haben in der Welt zu umwälzenden Fortschritten geführt. Krankheiten können gelindert oder sogar geheilt werden. Die Entwicklung von künstlichen Hüftgelenken, Cochlea-Implantaten sowie Herzschrittmachern sind in unserer Zeit zu alltäglichen Errungenschaften geworden. Auch die Behandlung neurologischer Bewegungsstörungen ist in den Fokus des technisch-medizinischen Fortschritts gelangt: „Hirnschrittmachersysteme“ – symptomfrei auf Knopfdruck. Ein Eingriff in das Gehirn, um gezielt elektrische Impulse abzugeben, um die Symptome beispielsweise von pharmakoresistenter Parkinsonpatienten effektiv zu behandeln. Dieses Therapieverfahren stellt für viele Patienten die letzte Möglichkeit dar, ein mehr oder weniger beschwerdefreies Leben führen zu können. Gleichzeitig ist dieses Verfahren ethisch heftig umstritten, zumal der Eingriff in das Gehirn gleichbedeutend mit einem Eingriff in den ‚Sitz des Selbst‘, der Persönlichkeit eines Patienten, verbunden ist.
Hybrid SPECT/US
(2014)
eLetter zu "Illusory movement perception improves motor control for prosthetic hands" von Paul D. Marasco et al., veröffentlicht in Science Translational Medicine, Vol. 10, No. 432 (DOI: 10.1126/scitranslmed.aao6990)
In this editorial, a topic for general discussion in the field of neuroprosthetics of the upper limb is addressed: which way—invasive or non-invasive—is the right one for the future in the development of neuroprosthetic concepts. At present, two groups of research priorities (namely the invasive versus the non-invasive approach) seem to be emerging, without taking a closer look at the wishes but also the concerns of the patients. This piece is intended to stimulate the discussion on this.
Die Namen Cormack und Hounsfield sind für den Radiologen zu einem wichtigen Synonym für die Computertomographie (CT) geworden. Der mathematische Wegbereiter für die CT, Johann Radon, kommt in der radiologischen Diskussion und den historischen Rückblicken hingegen oft zu Unrecht zu kurz. Die folgende Kurzübersicht möchte daher dem interessierten Leser die wichtigsten historischen Eckdaten zu dem in vielerlei Hinsicht bewegenden Leben und Wirken dieses großen Mathematikers näherbringen.
The Baroque composer Johann Sebastian Bach (1685–1750) has left us with many puzzles. The well-known oil painting by Elias Gottlob Haußmann is the only painting for which Bach actually posed in person. According to this portrait, Bach must have been quite obese. The cheeks and nose are flushed – possibly as signs of hypertension – and the eye lids are narrow – a sign of myopia. Furthermore, there is a thinning of the lateral third of the right eyebrow, which is known as Hertoghe’s sign, and indicated periorbital edema. Both signs are compatible with hypothyroidism. Bach might have been suffering from type-2 diabetes as the origin of his final illness, and the obituary reports two cataract surgeries by oculist John Taylor in March/April 1750, and, four months later, “apoplexy” followed by a high fever, of which Bach died. It may be speculated, however, that Bach’s entire illness was the result of his presumed obesity, possibly in combination with hypothyroidism.
In der vorliegenden Arbeit wurde die von Wilhelm His Sr. angefertigte und im Jahr 1895 publizierte Fotografie des mutmaßlichen Skeletts von Johann Sebastian Bach auf ihre Abbildungsqualität untersucht. Dies erfolgte durch direkte Messungen an einem digitalen Scan der Fotografie. Dabei wurde der von His der Fotografie beigelegte Lineal-Maßstab in mehrere 10-cm-Stücke unterteilt und die Länge dieser Abschnitte im Digitalisat mit dem Messinstrument von Adobe Acrobat ausgemessen. Darüber hinaus wurden die Längen der Femora ermittelt und mit den Maßen verglichen, die 1895 an den tatsächlichen (realen) Knochen ermittelt wurden. In dem Digitalisat entsprachen 190 cm im Lineal 244,48 mm. Der Mittelwert der 19 bestimmten 10-cm-Abschnitte betrug 100,49 mm (Median 100,49 mm, Standardabweichung 0,49 mm). Die historische Femurlänge links betrug 443,5 mm, rechts 451,0 mm. Die im Digitalisat ermittelte Femurlänge betrug links 443,8 mm, rechts 451,1 mm. Zusätzlich wurden die projizierten Centrum-Collum-Diaphysen-Winkel bestimmt. Die Daten lassen den Schluss zu, dass die Oben/unten-Verzerrung sowie die Rechts/links-Verzerrung nicht nennenswert sind und das von His angefertigte Foto mit einer hohen Genauigkeit der Abbildungsqualität und des Linsenapparats der Kamera angefertigt wurde, die es ermöglicht, bestimmte Skelettanteile aussagekräftig zu beurteilen und auszumessen.
Note: In lieu of an abstract, this is an excerpt from the first page.
Recently, we reported the three-dimensional computer-aided design (3D-CAD) reconstruction of the first “Iron Hand” of the famous Franconian knight, Götz von Berlichingen (1480–1562), who lost his right hand by a cannon ball splinter injury in 1504 in the War of the Succession of Landshut [...]
eLetter zum Artikel "Condiciones neuropsi-quiátricas y probable causa de muerte de Maurice Ravel" von Gómez-Carvajal AM, Botero-Meneses JS, Palacios-Espinosa X und Palacios-Sánchez L., veröffentlicht in Iatreia 35(3), Seite 341-8 (DOI: https://doi.org/10.17533/udea.iatreia.154).
Memento mori!
(2022)
Method for controlling a device, in particular, a prosthetic hand or a robotic arm (US20200327705A1)
(2020)
A method for controlling a device, in particular a prosthetic hand or a robotic arm, includes using an operator-mounted camera to detect at least one marker positioned on or in relation to the device. Starting from the detection of the at least one marker, a predefined movement of the operator together with the camera is detected and is used to trigger a corresponding action of the device. The predefined movement of the operator is detected in the form of a line of sight by means of camera tracking. A system for controlling a device, in particular a prosthetic hand or a robotic arm, includes a pair of AR glasses adapted to detect the at least one marker and to detect the predefined movement of the operator.