Standard-Speaker from Hazleton, Pennsylvania • Page 27

lir it a Standard- Speaker EALTHI SCIENCE, TUESDAY, APRIL 18, 1989 Page 29 Surgeons mimic Mother Nature's knee design PHILADELPHIA (AP) On a chilly April Sunday, about 2,000 former orthopedic patients of the Pennsylvania Hospital's Rothman Institute walked, some with canes, into a dining room to mark the recovery of the institute's joint replacement patient. Mary Gaughn, of Hatboro, said her arthritic knees had bothered her for several months. But it took a trip last September to Yugoslavia, where she was faced with miles of walking through narrow city streets, to finally give her the courage to have her knee replaced. "Oh, it (the right knee) was in 1970, the institute has reduced its infection rate from the national average of 1 percent to 3 percent to less than 1 percent, according to Booth. If the bone or muscle surrounding a new joint becomes infected, the surgeons must go back into the joint, take out the pro-thesis and treat the infection.

"Infection in a replaced joint is very serious. If infection occurs, eradicating it can take years," Booth said. Pennsylvania Hospital othopedists are now testng a new cement called hydroxyapatite, which is similar to bone's chemical. The new fixative tricks the Side view Iran terrible shape," said Mrs. Gaughn, 73.

She hiked up her dress, just above her knees, to show another former patient what her replaced knee looks like. Her legs were so bowlegged, she said, "that they looked like a Mack Truck could drive through." A day after her Dec. 8 operation, she was walking with the aid of a walker. "When you come out of the hospital, your knee is working," Mrs. Gaughn said.

The success of joint replacement surgery once was limited to how well orthopedists re-designed the knee. But as researchers learn more about how the knee works and moves under stress, as well as how the bone gives it both elasticity and strength, the replacement parts are lasting longer, most last about a decade, and are more life-like. "In this procedure, we are mimicking Mother Nature's design, replacing what was damaged or taken away, rather than trying to re-invent the entire knee joint, which is what physicians years ago tried to do," said Dr. Robert E. Booth, the director of the Rothman Institute and chief of the orthopedics section.

More than 10,000 knees a year are replaced across the country, making the knee one of the joints most commonly replaced by artificial devices, while 130,000 Americans receive new hips. Rothman orthopedists replace about 700 knee caps a year. The majority of patients are people over age 65 suffering from osteoarthritis. The protective covering of the bones in joints is damaged or worn away and causes the bones to rub together painfully. The knee forms a hinge at the junction of the shin bone, or tibia, and the thigh bone, the femur.

When the knee is replaced, the damaged cartilage at the end of the tibia is removed and replaced by a smooth plastic surface. The end of the femur is covered by a curved metallic cap designed to ride the plastic as the patient moves. The back of the knee cap, or patella, is also replaced by plastic. In the joint replacement operation, the surgeon removes the deteriorating bone and its protective cover and replaces them. "It's not like cutting diamonds," Booth said.

Cement, mixed with antibiotics to prevent infection, holds everything in place. The results enable knee surgery patients to walk the day after they receive a new joint. "The whole goal is to keep moving," Booth said. Infection is the biggest problem, thus the treated Booth and his surgical team work inside a "greenhouse" operating room. The medical team wears head-to-toe operating gear of apace suits and helmets and body waste exhaust systems.

The suits provide them with air as well as help prevent infection. The patient is placed on the operating table, half in, half out of the greenhouse, with sliding plexiglass walls closed around the middle of the patient's stretcher. Since the Rothman Institute began using its first greenhouse in Patella Femur Muscle Bursa Tibia Femur Quadriceps femoris Lateral 1 meniscus iKnee joint Patella llUld Fibula 7 Front view Inside the knee i Lateral hamstring mubCies (Other side of legi Neurovascular bundle lartenes veins nerves) Gastrocnemius muscle i I i patient's bone into acting as though the bone were merely broken. "It acts like it's healing a fracture," Booth said. In addition to researching new antibiotics, orthopedic surgeons are learning more about what other materials, including the research-hot ceramics and titanium, can withstand the tremendous stress placed on joints and how the artificial joints can be joined to human bone.

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5 in the "Recent Acquisitions" exhibition at the Smithsonian's National Portrait Gallery. Portraits of nearly 50 distinguished Americans whose liknesses were recently acquired by the gallery are featured. Among those pictured are author Eudora Welty, actor John Barrymore, photographer Matthew Brady, writer Ezra Pound, sculptor Alexander Calder, painter John Marin and composer Igor Stravinsky. ivieaiai meniscus Ligament patellae Chicago Tribune Graphic: Source: Computer graphics more than pretty pictures pabilities of the software, you can pull out states, zoom in close, focus on just some states and more. Finished maps can be printed with a printer or plotter.

A color output device lets you use the color capabilities of the mapmaking software to the fullest. HARDWARE COMPATIBILITY Whatever graphics software you choose, make sure it works with your hardware. That's easy to do with the Macintosh; about the only thing you have to worry about is whether the graphics program requires color. For the IBM PC and clones, however, the process of matching software and hardware is much tougher. Be sure you have the proper type of graphics adapter installed in your computer and of course the right type of monitor to go with it.

Most graphics programs support several PC graph The Most Important Part Of Recovery! "Complete Guide to Sports Injuries" automate the drawing process. With these, the computer takes an active part in making the pictures. The main applications of a painting program are: To create symbols for pic-tographs. To create pictures for image underlays. To edit graphics digitized by a video digitizer or page-scanner.

To modify a chart on a dot-by-dot basis. DRAWING PROGRAMS Drawing programs are more structured than painting programs, although you can often draw the same types of images with both. Drawing packages create graphics out of a series of simple shapes, including lines, squares and circles. The way you place the shapes on the drawing pad determines the appearance of the finished graphic. Advanced drawing programs are designed for computer-aided design and are not suitable for most work with presentation graphics.

The less complex drawing programs allow you to control the exact size and placement of the objects on the screen, providing a set or rulers marked off in whatever graduations you desire. Many of the better programs let you zoom in close to make fine adjustments, then zoom back out to finish the picture. The main applications of a drawing program are: To create symbols for pic-tographs. To create pictures for image underlays. To modify a chart on an object-by-object basis.

PRESENTATION GRAPHICS PROGRAMS Business presentation graphics programs are those that turn numbers into pie, bar and other kinds of statistical charts. By far, presentation graphics programs are the most popular of the bunch, because almost everyone works with numbers they'd like to see simplified. The flexibility that a presentation graphics program provides varies from package to package. In general terms, this flexibility largely determines whether the program is for ana By GORDON MCCOMB Copley News Service Everybody, it seems, wants to make pictures with their computer, and there's no shortage of software to help achieve this goal. Having a number of worthwhile graphics programs to choose from allows you to pick the package that has the features you want.

Computer graphics embrace all users, from the draftsman who uses the power of a computer to design new circuit boards, to the businesswoman who prepares the annual budget reports, to the art student who dabbles with electronic light and color, creating a new form of high-tech expression. But the glut of graphics software also means that choosing the right one is much harder. Here, you'll learn about the myriad choices of graphics software and how to decide which of the programs is best suited for you. GRAPHICS SOFTWARE There are three general categories of computer graphics software painting, drawing and presentation graphics. Although presentation graphics packages comprise the most popular of the bunch of the IBM PC, painting and drawing programs are all the rage on the Apple Macintosh.

PAINT PROGRAMS Painting programs let you create pictures from scratch. The world of painting programs is a big one, with software costing from next to nothing to several thousand dollars. Painting programs include those that let you doodle and draw, as well as those that let you create complex electronic portraits, like the kind you see on movies and television news broadcasts. Many of the least expensive painting programs provide little more than a simple electronic easel. You're given a blank pad (the screen), a palette of shapes, patterns or color, a brush and some other artist tools.

You pick a brush, "dip" it into a color or pattern and start spreading paint over the screen. Freehand painting programs, which generate pictures out of dots, are enhanced by the addition of user-selectable options to modeling, even mapmaking. The maps show statistics such as how the population is spread across the country, areas where crime is high and the mean temperature over parts of the nation. Statistical mapmaking software is helpful for government agencies, insurance companies, advertising firms, research organizations, schools, financial institutions and others that deal with data that spans a geographic area. Most mapmaking software contains a data base, organized by state, county, city, ZIP code and general census data (for the United States and other parts of the world).

All this information for the entire country or world spans many disks, and each disk is available separately. There's no need for a disk that contains the data base for Kentucky, for example, if your business deals only with California, Oregon and Washington. Most map programs let you add to the data base, and the data base is regularly updated. Also included with the map-making software are boundary files used to draw geological features such as country, state, county and ZIP code outlines. With the data base information and the boundary files, you can construct a map that shows just about anything.

For example, consult the data base for the minimum drinking age in each state. Identify the colors for each minimum age and display the map. On the screen appears a map of the United States, color-coded to the minimum drinking ages for each state. Depending on the ca For health insurance to help pay soaring hospital and surgical bills, see me. SEE ME: Dan Eury Agent 309 Moin St.

P.O. Box 988 Conynghom, PA Phone: (717) 788-5125 'ICS like a good neighbor. State Farm is there. Star? jrr Autpmnrji Comojov St AT I (ARM INtUl AHC 1 1 lytical or presentation graphics. Analytical graphics are for use when you, and perhaps a small number of your close associates, will be looking at the charts.

The charts are simple and may or may not include titles, legends or other textual annotation. Integrated programs such as Lotus 1-2-3 produce analytical graphics. Presentation graphics are for use when you plan to show your charts to a variety of people, possibly for the purpose of selling or persuading. Presentation graphics are full of flourishes, such as text, color filling, annotations and so forth. Most all stand-alone charting programs produce presentation graphics.

If you don't have control over the labels, titles, chart position, color and other elements of the graph, the program is for analytical graphics work. The more options a program provides, the more flexible it is and, hence, the more personalized the charts can be. Presentation graphics software also varies in the number and type of charts it can produce. Almost all of them can create simple bar, line and pie charts. Better programs can create exploded pie charts, histograms (frequency distributions), scatter graphs, stock market plots and more.

A few advanced presentation graphics programs are designed to create complex statistical charts and plot such things as regression lines, modes, means, moving trends, etc. Of course, just about any charting program can create these types of line and dot graphs, but you have to do all the calculations yourself. OTHER PROGRAM TYPES Of course, there are other types of specialized graphics software, including those for statistics, 3-D By Joe Launcella, R. PH. HEART AT RISK It's heart-risky to hold your breath when you strain to push, pull, move or lift a heavy object.

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