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Sample records for anatomic subsites results

  1. Coffee consumption and the risk of colorectal cancer by anatomical subsite in Japan: Results from the HERPACC studies.

    PubMed

    Nakagawa-Senda, Hiroko; Ito, Hidemi; Hosono, Satoyo; Oze, Isao; Tanaka, Hideo; Matsuo, Keitaro

    2017-07-15

    Consumption of coffee, a popular beverage worldwide, has been associated with lower colorectal cancer (CRC) risk. Although CRC exhibits different biological characteristics by anatomical subsite, the possibly heterogeneous impact of coffee on CRC by anatomical subsite has remained unclear. Here, we conducted two case-control studies to examine the association between coffee consumption and CRC risk as well as risk by anatomic subsite among Japanese using data from the Hospital-based Epidemiological Research Program at Aichi Cancer Center I and II (HERPACC-I and II). Subjects were enrolled in HERPACC-I between 1988 and 2000 and in HERPACC-II between 2001 and 2005. Coffee consumption was measured with a self-administered questionnaire. A conditional logistic regression model was used to calculate odds ratios (ORs) of CRC with coffee consumption, adjusted for potential confounders of age, smoking, alcohol drinking, red meat intake, BMI, exercise, family history of CRC, and diabetes mellitus history. We estimated summary ORs by pooling study-specific ORs with a fixed effects model. In total, 2,696 CRC cases and 13,480 non-cancer outpatients as controls were included. Overall, compared to non-drinkers, ORs of less than 1 cup/day, 1-2 cups/day and 3 or more cups/day for CRC were 0.88 (95% CI: 0.77-1.00), 0.90 (95% CI: 0.80-1.01) and 0.78 (95% CI: 0.65-0.92), respectively (trend-p = 0.009). Subsite-specific analysis revealed a significant inverse linear trend between coffee consumption and distal colon cancer (p-trend = 0.048), and a tendency toward a lower risk of rectal cancer (p-trend = 0.068). These findings suggest that coffee consumption might impact the prevention of CRC, especially distal colon cancer. © 2017 UICC.

  2. Global gene expression profiling of oral cavity cancers suggests molecular heterogeneity within anatomic subsites

    PubMed Central

    Severino, Patricia; Alvares, Adriana M; Michaluart, Pedro; Okamoto, Oswaldo K; Nunes, Fabio D; Moreira-Filho, Carlos A; Tajara, Eloiza H

    2008-01-01

    Background Oral squamous cell carcinoma (OSCC) is a frequent neoplasm, which is usually aggressive and has unpredictable biological behavior and unfavorable prognosis. The comprehension of the molecular basis of this variability should lead to the development of targeted therapies as well as to improvements in specificity and sensitivity of diagnosis. Results Samples of primary OSCCs and their corresponding surgical margins were obtained from male patients during surgery and their gene expression profiles were screened using whole-genome microarray technology. Hierarchical clustering and Principal Components Analysis were used for data visualization and One-way Analysis of Variance was used to identify differentially expressed genes. Samples clustered mostly according to disease subsite, suggesting molecular heterogeneity within tumor stages. In order to corroborate our results, two publicly available datasets of microarray experiments were assessed. We found significant molecular differences between OSCC anatomic subsites concerning groups of genes presently or potentially important for drug development, including mRNA processing, cytoskeleton organization and biogenesis, metabolic process, cell cycle and apoptosis. Conclusion Our results corroborate literature data on molecular heterogeneity of OSCCs. Differences between disease subsites and among samples belonging to the same TNM class highlight the importance of gene expression-based classification and challenge the development of targeted therapies. PMID:19014556

  3. Disparities Between Blacks and Whites in Stage at Diagnosis, Incidence, and Anatomic Subsite of Colorectal Cancer

    PubMed Central

    Hobley, James; Lindsay II, Jerome A.; McGarrity, Thomas J.

    2006-01-01

    Background A disparity in colorectal cancer (CRC) incidence and mortality has been reported for black men and women in the United States. Objective To determine the magnitude and direction of temporal change in black/white disparity, by anatomic subsites of the colon and rectum. Design Population-based, epidemiologic study. Setting Pennsylvania, 1997–2002. Measurements Black/white ratios of the percentage of cases diagnosed at late stage and of age-adjusted incidence rates, by anatomic subsite, for four 3-year time periods. Results In 2000–2002, 54.6% of CRC cases among blacks were diagnosed at late stage, compared with 51.3% among whites. The percentage of cases in the cecum, transverse colon, splenic flexure, descending colon, sigmoid colon, rectum, and recto-sigmoid diagnosed at a late stage was larger among blacks than among whites. The disparity in the percentage of cases diagnosed at a late stage in the colon and rectum, transverse colon, and descending colon increased during the study period (P<.05). In 2000–2002, incidence was greater among blacks (64.1/100,000) than among whites (59.8/100,000). Incidence for segments of the proximal colon tended to be higher among blacks than among whites. The disparity in the incidence in the transverse colon increased during the study period (P=.021), while the increase in the disparity in the appendix approached statistical significance (P=.051). Limitations The effect of race may have been confounded by unavailable data, including socioeconomic position. Conclusions The black/white disparity in the percentage of cases diagnosed at late stage increased during the study period. The disparity in the percentage of cases diagnosed at a late stage and incidence for the transverse colon also increased. Efforts to increase screening for CRC, especially among blacks, should be enhanced.

  4. Sex disparities in colorectal cancer incidence by anatomic subsite, race and age.

    PubMed

    Murphy, Gwen; Devesa, Susan S; Cross, Amanda J; Inskip, Peter D; McGlynn, Katherine A; Cook, Michael B

    2011-04-01

    Although incidence of colorectal cancer (CRC) in the United States has declined in recent years, rates remain higher in men than in women and the male-to-female incidence rate ratio (MF IRR) increases progressively across the colon from the cecum to the rectum. Rates among races/ethnicities other than Whites or Blacks have not been frequently reported. To examine CRC rates by sex across anatomic subsite, age and racial/ethnic groups, we used the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program for cases diagnosed among residents of 13 registries during 1992-2006. Incidence rates were expressed per 100,000 person-years and age-adjusted to the 2000 US Standard Population; MF IRR and 95% confidence intervals were also calculated. Among each racial/ethnic group, the MF IRR increased fairly monotonically from close to unity for cecal cancers to 1.81 (Hispanics) for rectal cancers. MF IRRs increased with age most rapidly for distal colon cancers from <1.0 at ages <50 years to 1.4-1.9 at older ages. The MF IRR for rectal cancers also rose with age from about 1.0 to 2.0. For proximal cancer, the MF IRR was consistently <1.5; among American Indian/Alaska Natives, it was <1.0 across all ages. The MF IRRs for CRC vary markedly according to subsite and age but less by racial/ethnic group. These findings may partially reflect differences in screening experiences and access to medical care but also suggest that etiologic factors may be playing a role.

  5. Racial/ethnic variation in the anatomic subsite location of in situ and invasive cancers of the colon.

    PubMed Central

    Shavers, Vickie L.

    2007-01-01

    INTRODUCTION: Approximately 145,000 Americans were diagnosed with colorectal cancer and 56,000 died from colorectal cancer in 2006. Although colorectal screening can reduce mortality and incidence, U.S. screening rates are particularly low for racial/ethnic minorities. Racial differences in the subsite location of colon cancers could have implications for colorectal screening. This study examines the anatomic subsite distribution of tumors among African-American, Hispanic, Asian-American/Pacific-Islander and non-Hispanic white (NHW) patients with colon cancer. METHODS: Surveillance and End Results program data for 254,469 primary in situ and invasive colon cancers for patients from 1973-2002 are included in this analysis. Descriptive analyses and logistic regression are used to describe and examine variations in the proportion of colon cancers diagnosed at sites proximal to the sigmoid colon or proximal to the splenic flexure over three successive time periods. RESULTS: The proportion of colon cancers diagnosed at the sigmoid colon was 15.6-21.3% lower, while diagnoses at the descending colon were 40.5.0-45.3.0% higher for African Americans than NHWs over the three time periods. In logistic regression analyses adjusted for gender, age group and year of diagnosis, the odds of a diagnosis of cancer proximal to the sigmoid colon or proximal to the splenic flexure was significantly higher for African Americans but lower for Hispanics and Asian Americans/Pacific Islanders compared to NHWs. DISCUSSION: The higher proportion of cancers among African Americans diagnosed at sites that are generally attempted but not always reached with a sigmoidscope suggest that African Americans may benefit from screening colonoscopy. They also highlight the need for systems that collect data that would allow a direct examination of the role that the differential use of specific colon screening tests and polypectomy play in racial/ethnic variation in colon cancer incidence and in the

  6. Postoperative radiotherapy for oral cavity cancers: Impact of anatomic subsite on treatment outcome

    SciTech Connect

    Zelefsky, M.J.; Harrison, L.B.; Fass, D.E.; Armstrong, J.; Spiro, R.H.; Shah, J.P.; Strong, E.W. )

    1990-11-01

    We have retrospectively reviewed the treatment results of postoperative radiotherapy (RT) for advanced oral cavity cancers. The purpose of this study was to determine the impact of anatomic subsite on the results of treatment. Between 1975 and 1985, 51 patients with squamous cell carcinoma of the oral tongue (OT = 29 patients) and floor of mouth (FOM = 22 patients) were treated with combined surgery plus RT. All had an indication(s) for RT including advanced primary disease (T3 or T4) (29 patients), close or positive margins (34 patients), and multiple positive neck nodes and/or extracapsular extension (41 patients). With a median follow-up of 6 years, the 5-year actuarial local control rate was 74% and the rate of distant metastasis (DM) was 34%. Despite the similar T stage, margin status and median RT dose, the 5-year actuarial local failure rate was 38% for OT vs. 11% for FOM (p = 0.03). Furthermore, the median survival after recurrence was 9 months for OT and 40 months for FOM (p = 0.02). At 5 years the determinate survival for both sites was (55%), and the likelihood of developing a second malignancy was 31%. The likelihood of developing DM was 50% for FOM (N0-N1 = 3 of 12, N2-N3 = 8 of 10) and 21% for OT (N0-N1 = 4 of 21, N2-N3 = 1 of 8). This study highlights significant differences between FOM and OT cancers in response to combined surgery and RT. Future strategies should be directed at the enhancement of local control for OT and better systemic therapy for those with advanced N-stage FOM.

  7. Meat-related compounds and colorectal cancer risk by anatomical subsite.

    PubMed

    Miller, Paige E; Lazarus, Philip; Lesko, Samuel M; Cross, Amanda J; Sinha, Rashmi; Laio, Jason; Zhu, Jay; Harper, Gregory; Muscat, Joshua E; Hartman, Terryl J

    2013-01-01

    Since meat may be involved in the etiology of colorectal cancer, associations between meat-related compounds were examined to elucidate underlying mechanisms in a population-based case-control study. Participants (989 cases/1,033 healthy controls) completed a food frequency questionnaire with a meat-specific module. Multivariable logistic regression was used to examine associations between meat variables and colorectal cancer; polytomous logistic regression was used for subsite-specific analyses. The following significant positive associations were observed for meat-related compounds: 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) and colorectal, distal colon, and rectal tumors; 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and colorectal and colon cancer tumors; nitrites/nitrates and proximal colon cancer; 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) and rectal cancer; and benzo[a]pyrene and rectal cancer (P-trends < 0.05). For analyses by meat type, cooking method, and doneness preference, positive associations between red processed meat and proximal colon cancer and pan-fried red meat and colorectal cancer were found (P-trends < 0.05). Inverse associations were observed between unprocessed poultry and colorectal, colon, proximal colon, and rectal tumors; grilled/barbequed poultry and proximal colon cancer; and well-done/charred poultry and colorectal, colon, and proximal colon tumors (P-trends < 0.05). HCAs, PAHs, nitrites, and nitrates may be involved in colorectal cancer etiology. Further examination into the unexpected inverse associations between poultry and colorectal cancer is warranted.

  8. Meat-Related Compounds and Colorectal Cancer Risk by Anatomical Subsite

    PubMed Central

    Miller, Paige E.; Lazarus, Philip; Lesko, Samuel M.; Cross, Amanda J.; Sinha, Rashmi; Laio, Jason; Zhu, Jay; Harper, Gregory; Muscat, Joshua E.; Hartman, Terryl J.

    2012-01-01

    Since meat may be involved in the etiology of colorectal cancer, associations between meat-related compounds were examined to elucidate underlying mechanisms in a population-based case-control study. Participants (989 cases/1,033 healthy controls) completed a food frequency questionnaire with a meat-specific module. Multivariable logistic regression was used to examine associations between meat variables and colorectal cancer; polytomous logistic regression was used for subsite-specific analyses. The following significant positive associations were observed for meat-related compounds: 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) and colorectal, distal colon, and rectal tumors; 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and colorectal and colon cancer tumors; nitrites/nitrates and proximal colon cancer; 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) and rectal cancer; and benzo[a]pyrene and rectal cancer (P-trends < 0.05 ). For analyses by meat type, cooking method, and doneness preference, positive associations between red processed meat and proximal colon cancer and pan-fried red meat and colorectal cancer were found (P-trends < 0.05). Inverse associations were observed between unprocessed poultry and colorectal, colon, proximal colon, and rectal tumors; grilled/barbequed poultry and proximal colon cancer; and well-done/charred poultry and colorectal, colon, and proximal colon tumors (P-trends < 0.05). HCAs, PAHs, nitrites, and nitrates may be involved in colorectal cancer etiology. Further examination into the unexpected inverse associations between poultry and colorectal cancer is warranted. PMID:23441608

  9. Influence of anatomical subsite on the incidence of microsatellite instability, and KRAS and BRAF mutation rates in patients with colon carcinoma.

    PubMed

    Benedix, Frank; Meyer, Frank; Kube, Rainer; Kropf, Siegfried; Kuester, Doerthe; Lippert, Hans; Roessner, Albert; Krüger, Sabine

    2012-10-15

    There is a growing amount of data supporting the concept that cancers originating from the proximal and distal colon are distinct clinicopathological entities. The incidence of MSI and BRAF mutation is strongly associated with right sided tumor location, whereas there are conflicting results for KRAS mutation rates. However, to date, no data exist whether and to what extent defined colonic subsites influence MSI status, KRAS and BRAF mutation rates. We selected primary colon cancer from 171 patients operated on at our institution between 2007 and 2010. BRAF, KRAS mutation rates and microsatellite instability were determined and correlated with clinicopathological features and tumor location. MSI-h cancers were significantly associated with poor histological grade but a lower rate of distant metastases. KRAS-mutated tumors were linked to lower T-stage and better differentiation. Colon carcinomas with BRAF mutation were significantly associated with distant metastatic spread and poor histological grade. Furthermore, we found that MSI-h status, KRAS and BRAF mutation rates varied remarkably among the colonic subsites irrespective of right- and left-sided origin, respectively. The results of the current study provide further evidence that a simple classification into right- and left-sided colon carcinoma does not represent the complexity of this tumor entity.

  10. Tobacco smoking, alcohol drinking and risk of oral cavity cancer by subsite: results of a French population-based case-control study, the ICARE study.

    PubMed

    Radoï, Loredana; Paget-Bailly, Sophie; Cyr, Diane; Papadopoulos, Alexandra; Guida, Florence; Schmaus, Annie; Cénée, Sylvie; Menvielle, Gwenn; Carton, Matthieu; Lapôtre-Ledoux, Bénédicte; Delafosse, Patricia; Stücker, Isabelle; Luce, Danièle

    2013-05-01

    The objective was to examine the role of tobacco smoking and alcohol drinking in the incidence of oral cavity cancer by subsite in France, a high-incidence area. We analysed detailed data on lifelong tobacco smoking and alcohol drinking from 772 oral cavity cancer cases and 3555 controls included in a population-based case-control study, the ICARE study. Tobacco smoking increased the risk of oral cavity cancer even for the smaller quantities and durations, whereas alcohol drinking increased this risk only in heavy drinkers who were also ever smokers. The combined effect of smoking and drinking was greater than multiplicative. The floor of the mouth was the subsite that was the most affected by the harmful effects of tobacco and alcohol, whereas the gums were less susceptible. The risk associated with tobacco and alcohol consumption did not differ between intraoral cavity and subsites usually included in the oropharynx (soft palate and base of the tongue). Population-attributable risks for oral cavity cancer were 78.6% for tobacco smoking, 7.3% for alcohol drinking and 80.7% for tobacco and/or alcohol consumption. These results indicate that regular oral check-ups should be targeted at smokers and heavy drinkers, and that prevention efforts should be focused on smoking cessation.

  11. Mapping of barley alpha-amylases and outer subsite mutants reveals dynamic high-affinity subsites and barriers in the long substrate binding cleft.

    PubMed

    Kandra, Lili; Hachem, Maher Abou; Gyémánt, Gyöngyi; Kramhøft, Birte; Svensson, Birte

    2006-09-18

    Subsite affinity maps of long substrate binding clefts in barley alpha-amylases, obtained using a series of maltooligosaccharides of degree of polymerization of 3-12, revealed unfavorable binding energies at the internal subsites -3 and -5 and at subsites -8 and +3/+4 defining these subsites as binding barriers. Barley alpha-amylase 1 mutants Y105A and T212Y at subsite -6 and +4 resulted in release or anchoring of bound substrate, thus modifying the affinities of other high-affinity subsites (-2 and +2) and barriers. The double mutant Y105A-T212Y displayed a hybrid subsite affinity profile, converting barriers to binding areas. These findings highlight the dynamic binding energy distribution and the versatility of long maltooligosaccharide derivatives in mapping extended binding clefts in alpha-amylases.

  12. Diabetes mellitus type 2 and subsite-specific colorectal cancer risk in men and women: results from the Netherlands Cohort Study on diet and cancer.

    PubMed

    de Kort, Sander; Simons, C C J M; van den Brandt, Piet A; Goldbohm, R Alexandra Sandra; Arts, Ilja C W; de Bruine, Adriaan P; Janssen-Heijnen, Maryska L G; Sanduleanu, Silvia; Masclee, Ad A M; Weijenberg, Matty P

    2016-08-01

    Type 2 diabetes mellitus (T2DM) is associated with an increased risk of colorectal cancer (CRC); however, studies differentiating between subsites of CRC are limited. We investigated how diabetes mellitus (DM) was associated with subsite-specific CRC risk in men and women. The Netherlands Cohort Study on diet and cancer is a prospective study among 120 852 men and women aged 55-69 years old at baseline in 1986. Information on DM, anthropometric, dietary and lifestyle factors was self-reported at baseline. T2DM was defined as the diagnosis of DM after 30 years of age. Incident CRC cases were identified by record linkage with the Netherlands cancer registry and the Dutch pathology registry. After 17.3 years of follow-up, 1735 incident male CRC cases and 1321 female CRC cases were available for analyses. Subsite-specific hazard ratios (HRs) for CRC were estimated in case-cohort analyses using Cox regression. At baseline, 3.1% of subcohort members reported T2DM, of whom 80% were diagnosed after 50 years of age. Multivariable-adjusted models showed that the risk of proximal colon cancer was significantly increased in women with T2DM versus women without T2DM (HR=1.80, 95% confidence interval: 1.10-2.94). There was no association between T2DM and the risk of overall CRC, distal colon cancer and rectal cancer in women. In men, T2DM was not associated with overall CRC (HR=0.98, 95% confidence interval: 0.64-1.50), or with risk at any subsite. This prospective study showed an increased risk of proximal colon cancer in women with T2DM compared with non-T2DM women.

  13. Two subsites in the binding domain of the acetylcholine receptor: an aromatic subsite and a proline subsite.

    PubMed

    Kachalsky, S G; Jensen, B S; Barchan, D; Fuchs, S

    1995-11-07

    The ligand binding site of the nicotinic acetylcholine receptor (AcChoR) is localized in the alpha-subunit within a domain containing the tandem Cys-192 and -193. By analyzing the binding-site region of AcChoR from animal species that are resistant to alpha-neurotoxins, we have previously shown that four residues in this region, at positions 187, 189, 194, and 197, differ between animals sensitive (e.g., mouse) and resistant (e.g., mongoose and snake) to alpha-bungarotoxin (alpha-BTX). In the present study, we performed site-directed mutagenesis on a fragment of the mongoose AcChoR alpha-subunit (residues 122-205) and exchanged residues 187, 189, 194, and 197, either alone or in combination, with those present in the mouse alpha-subunit sequence. Only the mongoose fragment in which all four residues were mutated to the mouse ones exhibited alpha-BTX binding similar to that of the mouse fragment. The mongoose double mutation in which Leu-194 and His-197 were replaced with proline residues, which are present at these positions in the mouse AcChoR and in all other toxin binders, bound alpha-BTX to approximately 60% of the level of binding exhibited by the mouse fragment. In addition, replacement of either Pro-194 or -197 in the mouse fragment with serine and histidine, respectively, markedly decreased alpha-BTX binding. All other mutations resulted in no or just a small increase in alpha-BTX binding. These results have led us to propose two subsites in the binding domain for alpha-BTX: the proline subsite, which includes Pro-194 and -197 and is critical for alpha-BTX binding, and the aromatic subsite, which includes amino acid residues 187 and 189 and determines the extent of alpha-BTX binding.

  14. Two subsites in the binding domain of the acetylcholine receptor: an aromatic subsite and a proline subsite.

    PubMed Central

    Kachalsky, S G; Jensen, B S; Barchan, D; Fuchs, S

    1995-01-01

    The ligand binding site of the nicotinic acetylcholine receptor (AcChoR) is localized in the alpha-subunit within a domain containing the tandem Cys-192 and -193. By analyzing the binding-site region of AcChoR from animal species that are resistant to alpha-neurotoxins, we have previously shown that four residues in this region, at positions 187, 189, 194, and 197, differ between animals sensitive (e.g., mouse) and resistant (e.g., mongoose and snake) to alpha-bungarotoxin (alpha-BTX). In the present study, we performed site-directed mutagenesis on a fragment of the mongoose AcChoR alpha-subunit (residues 122-205) and exchanged residues 187, 189, 194, and 197, either alone or in combination, with those present in the mouse alpha-subunit sequence. Only the mongoose fragment in which all four residues were mutated to the mouse ones exhibited alpha-BTX binding similar to that of the mouse fragment. The mongoose double mutation in which Leu-194 and His-197 were replaced with proline residues, which are present at these positions in the mouse AcChoR and in all other toxin binders, bound alpha-BTX to approximately 60% of the level of binding exhibited by the mouse fragment. In addition, replacement of either Pro-194 or -197 in the mouse fragment with serine and histidine, respectively, markedly decreased alpha-BTX binding. All other mutations resulted in no or just a small increase in alpha-BTX binding. These results have led us to propose two subsites in the binding domain for alpha-BTX: the proline subsite, which includes Pro-194 and -197 and is critical for alpha-BTX binding, and the aromatic subsite, which includes amino acid residues 187 and 189 and determines the extent of alpha-BTX binding. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:7479887

  15. Differences in colorectal cancer survival between European and US populations: the importance of sub-site and morphology.

    PubMed

    Gatta, G; Ciccolallo, L; Capocaccia, R; Coleman, M P; Hakulinen, T; Møller, H; Berrino, F

    2003-10-01

    A previous study has shown a lower survival for colorectal cancer in Europe than in the United States of America (USA). It is of interest to examine the extent to which anatomical location and morphological type influence this difference in colorectal cancer survival. We analysed survival for 151,244 European and 53,884 US patients diagnosed with colorectal cancer aged 15-99 years during the period of 1985-1989, obtained from 40 cancer registries that contribute to the EUROCARE study from 17 countries, and nine Surveillance, Epidemiology and End-Results (SEER) registries in the USA. Cases included in the analysis were first primary malignant tumours (ICD-O behaviour code 3 or higher). Relative survival was estimated to correct for competing causes of mortality. The Hakulinen-Tenkanen multiple regression approach was used to examine the prognostic impact of sub-site and ICD-O histology codes. Relative excess risks (RERs) derived from this approach estimate the extent to which the hazard of death differs from that in a reference region after adjustment for mortality in the general population. In order to explore geographical variation, we defined three groups of European registries within which survival rates were known to be broadly similar. The proportion of cases with unspecified sub-site was higher in Europe than the USA (10% versus 2%), but sub-site distributions were broadly similar in the two populations. With the exception of appendix, 5-year survival was 13-22% higher in the USA than in Europe for each anatomical sub-site. The proportion of non-microscopically-verified cases was higher in Europe than the USA (16 versus 3%). Adenocarcinomas arising in a polyp (ICD-O-2 8210, 8261, 8263) were more frequent in the USA than Europe (13 versus 2%). Five-year survival was higher in the USA than Europe for each morphological group, with the exception of non-microscopically-verified cases. When age, gender and sub-site were considered, RERs ranged from 1.52 to 2

  16. Computer-aided subsite mapping of α-amylases.

    PubMed

    Mótyán, János A; Gyémánt, Gyöngyi; Harangi, János; Bagossi, Péter

    2011-02-15

    Subsite mapping is a crucial procedure in the characterization of α-amylases (EC 3.2.1.1), which are extensively used in starch-based industries and in diagnosis of pancreatic and salivary glands disorders. A computer-aided method has been developed for subsite mapping of α-amylases, which substitutes the difficult, expensive, and time-consuming experimental determination of action patterns to crystal structures based energy calculations. Interaction energies between enzymes and carbohydrate substrates were calculated after short energy minimization by a molecular mechanics program. A training set of wild type and mutant amylases with known experimental action patterns of 13 enzymes of wide range of origin was used to set up the procedure. Calculations for training set resulted in good correlation in case of subsite binding energies (r(2)=0.827-0.929) and bond cleavage frequencies (r(2)=0.727-0.835). A set of eight novel barley amylase 1 mutants was used to test our model. Subsite binding energies were predicted with r(2)=0.502 correlation coefficient, while bond cleavage frequency prediction resulted in r(2)=0.538. Our computer-aided procedure may supplement the experimental subsite mapping methods to predict and understand characteristic features of α-amylases.

  17. Interpreting and Integrating Clinical and Anatomic Pathology Results.

    PubMed

    Ramaiah, Lila; Hinrichs, Mary Jane; Skuba, Elizabeth V; Iverson, William O; Ennulat, Daniela

    2017-01-01

    The continuing education course on integrating clinical and anatomical pathology data was designed to communicate the importance of using a weight of evidence approach to interpret safety findings in toxicology studies. This approach is necessary, as neither clinical nor anatomic pathology data can be relied upon in isolation to fully understand the relationship between study findings and the test article. Basic principles for correlating anatomic pathology and clinical pathology findings and for integrating these with other study end points were reviewed. To highlight these relationships, a series of case examples, presented jointly by a clinical pathologist and an anatomic pathologist, were used to illustrate the collaborative effort required between clinical and anatomical pathologists. In addition, the diagnostic utility of traditional liver biomarkers was discussed using results from a meta-analysis of rat hepatobiliary marker and histopathology data. This discussion also included examples of traditional and novel liver and renal biomarker data implementation in nonclinical toxicology studies to illustrate the relationship between discrete changes in biochemistry and tissue morphology.

  18. [Anatomic, functional and identity results after clitoris transposition].

    PubMed

    Abramowicz, S; Oden, S; Dietrich, G; Marpeau, L; Resch, B

    2016-10-01

    Every year 3 millions of young women had undergone female genital mutilation. The psychological, identical and sexual consequences, as well as the treatment were described only recently. After a sociodemographic and cultural reminder, we analyze the anatomical, psychological, identital, and functional results of the reconstructive surgery. We conducted a retrospective monocentric study. Thirty women were included in our series. All the patients operated according to the technique of Pierre Foldes were contacted again, to estimate their motivations for this surgery and study the results on femininity, anatomy, psychology and functionality of this intervention. Twenty-six women were able to be estimated in the long term. Their main motivation was in 77% of the cases the research for a feminine identity. We compared the pre- and postoperative results, as well as different predefined under groups. The results shown a significant improvement between the pre- and the postoperative estimation for each of the items. The patients indicate an improvement: anatomical in 96% of the cases, for identity in 88% of the cases, psychological in 96% of the cases, and for sexuality in 88% of the cases. This technique allows an improvement for anatomy and functionality but also for physical image, well-being and feminity. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Effect of temperature on subsite map of Bacillus licheniformis alpha-amylase.

    PubMed

    Kandra, Lili; Remenyik, Judit; Gyémánt, Gyöngyi; Lipták, A

    2006-09-01

    To elucidate how temperature effects subsite mapping of a thermostable alpha-amylase from Bacillus licheniformis (BLA), a comparative study was performed by using 2-chloro-4-nitrophenyl (CNP) beta-maltooligosides with degree of polymerisation (DP) 4-10 as model substrates. Action patterns, cleavage frequencies and subsite binding energies were determined at 50 degrees C, 80 degrees C and 100 degrees C. Subsite map at 80 degrees C indicates more favourable bindings compared to the hydrolysis at 50 degrees C. Hydrolysis at 100 degrees C resulted in a clear shift in the product pattern and suggests significant differences in the active site architecture. Two preferred cleavage modes were seen for all substrates in which subsite (+2) and (+3) were dominant, but CNP-G1 was never formed. In the preferred binding mode of shorter oligomers, CNP-G2 serves as the leaving group (79%, 50%, 59% and 62% from CNP-G4, CNP-G5, CNP-G6 and CNP-G7, respectively), while CNP-G3 is the dominant hydrolysis product from CNP-G8, CNP-G9, and CNP-Gl0 (62%, 68% and 64%, respectively). The high binding energy value (-17.5 kJ/mol) found at subsite (+2) is consistent with the significant formation of CNP-G2. Subsite mapping at 80 degrees C and 100 degrees C confirms that there are no further binding sites despite the presence of longer products.

  20. Associations of Census-Tract Poverty with Subsite-Specific Colorectal Cancer Incidence Rates and Stage of Disease at Diagnosis in the United States

    PubMed Central

    Henry, Kevin A.; Sherman, Recinda L.; Johnson, Christopher J.; Lin, Ge; Stroup, Antoinette M.; Boscoe, Francis P.

    2014-01-01

    Background. It remains unclear whether neighborhood poverty contributes to differences in subsite-specific colorectal cancer (CRC) incidence. We examined associations between census-tract poverty and CRC incidence and stage by anatomic subsite and race/ethnicity. Methods. CRC cases diagnosed between 2005 and 2009 from 15 states and Los Angeles County (N = 278,097) were assigned to 1 of 4 groups based on census-tract poverty. Age-adjusted and stage-specific CRC incidence rates (IRs) and incidence rate ratios (IRRs) were calculated. Analyses were stratified by subsite (proximal, distal, and rectum), sex, race/ethnicity, and poverty. Results. Compared to the lowest poverty areas, CRC IRs were significantly higher in the most impoverished areas for men (IRR = 1.14 95% CI 1.12–1.17) and women (IRR = 1.06 95% CI 1.05–1.08). Rate differences between high and low poverty were strongest for distal colon (male IRR = 1.24 95% CI 1.20–1.28; female IRR = 1.14 95% CI 1.10–1.18) and weakest for proximal colon. These rate differences were significant for non-Hispanic whites and blacks and for Asian/Pacific Islander men. Inverse associations between poverty and IRs of all CRC and proximal colon were found for Hispanics. Late-to-early stage CRC IRRs increased monotonically with increasing poverty for all race/ethnicity groups. Conclusion. There are differences in subsite-specific CRC incidence by poverty, but associations were moderated by race/ethnicity. PMID:25165475

  1. Active subsite properties, subsite residues and targeting to lysosomes or midgut lumen of cathepsins L from the beetle Tenebrio molitor.

    PubMed

    Damasceno, Ticiane F; Dias, Renata O; de Oliveira, Juliana R; Salinas, Roberto K; Juliano, Maria A; Ferreira, Clelia; Terra, Walter R

    2017-10-01

    Cathepsins L are the major digestive peptidases in the beetle Tenebrio molitor. Two digestive cathepsins L (TmCAL2 and TmCAL3) from it had their 3D structures solved. The aim of this paper was to study in details TmCAL3 specificity and properties and relate them to its 3D structure. Recombinant TmCAL3 was assayed with 64 oligopeptides with different amino acid replacements in positions P2, P1, P1' and P2'. Results showed that TmCAL3 S2 specificity differs from the human enzyme and that its specificities also explain why on autoactivation two propeptide residues remain in the enzyme. Data on free energy of binding and of activation showed that S1 and S2' are mainly involved in substrate binding, S1' acts in substrate binding and catalysis, whereas S2 is implied mainly in catalysis. Enzyme subsite residues were identified by docking with the same oligopeptide used for kinetics. The subsite hydrophobicities were calculated from the efficiency of hydrolysis of different amino acid replacements in the peptide and from docking data. The results were closer for S1 and S2' than for S1' and S2, indicating that the residue subsites that were more involved in transition state binding are different from those binding the substrate seen in docking. Besides TmCAL1-3, there are nine other cathepsins L, most of them more expressed at midgut. They are supposed to be directed to lysosomes by a Drosophila-like Lerp receptor and/or motifs in their prodomains. The mannose 6-phosphate lysosomal sorting machinery is absent from T. molitor transcriptome. Cathepsin L direction to midgut contents seems to depend on overexpression. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Extended binding inhibitors of chymotrypsin that interact with leaving group subsites S1'-S3'.

    PubMed

    Imperiali, B; Abeles, R H

    1987-07-14

    We have synthesized inhibitors of chymotrypsin, based on fluoromethyl ketones, that bind at S and S' subsites. "Small" inhibitors of serine proteases, which have previously been synthesized, only interact with S subsites. The parent compound is Ac-Leu-ambo-Phe-CF2H (1) (Ki = 25 X 10(-6) M). This inhibitor was modified by successively replacing H of the -CF2H group by -CH2CH2CONHCH3, (4), -CH2CH2CONH-Leu-NHMe (5), -CH2CH2CONH-Leu-Val-OEt (6), and -CH2CH2CONH-Leu-Arg-OMe (7). Corresponding Ki values are 7.8 (4), 0.23 (5), 0.21 (6), and 0.014 (7) microM. Extending 5 to 6 by addition of Val-OEt at P3' does not decrease Ki. In contrast, extension of 5 to 7 by incorporating Arg-OMe at P3' decreases Ki approximately 15-fold, suggesting interaction between Arg and the S3' subsite but no corresponding interaction at that subsite with Val. These results are in accordance with results obtained with the homologous family of avian ovomucoid third domain proteins. Proteins with Arg at the P3' position show highly favorable interactions with the protease at the S3' subsite [Park, S. J. (1985) Ph.D. Thesis, Purdue University; M. Laskowski, Jr., personal communication]. These results establish that incorporation of residues which interact with S' subsites significantly increases the efficacy of inhibitors and that valuable information concerning the most effective amino acid composition of small inhibitors can be obtained from the amino acid sequence of protein inhibitors.

  3. Mechanism-Based Inhibitors of Serine Proteases with High Selectivity Through Optimization of S’ Subsite Binding

    PubMed Central

    Li, Yi; Dou, Dengfeng; He, Guijia; Lushington, Gerald H.; Groutas, William C.

    2009-01-01

    A series of mechanism-based inhibitors designed to interact with the S’ subsites of serine proteases was synthesized and their inhibitory activity toward the closely-related serine proteases human neutrophil elastase (HNE) and proteinase 3 (PR 3) was investigated. The compounds were found to be time-dependent inhibitors of HNE and were devoid of any inhibitory activity toward PR 3. The results suggest that highly selective inhibitors of serine proteases whose primary substrate specificity and active sites are similar can be identified by exploiting differences in their S’ subsites. The best inhibitor (compound 16) had a kinact/KI value of 4580 M−1 s−1. PMID:19394830

  4. Short-Term Results of Ultra-Short Anatomic vs Ultra-Short Non-Anatomic Proximal Loading Uncemented Femoral Stems.

    PubMed

    Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik

    2017-08-03

    Question arises as to whether rigid fixation of ultra-short anatomic or ultra-short non-anatomic proximal loading uncemented femoral stem can be obtained without diaphyseal stem fixation. The purpose of this study is to compare the short-term clinical results, radiographic results, revision and survival rates, and complication rates of ultra-short anatomic versus ultra-short non-anatomic uncemented femoral stems. This study consisted of 50 patients (56 hips) in the ultra-short anatomic uncemented stem group (mean age 61.4 ± 14.7 years) and 50 patients (56 hips) in the ultra-short non-anatomic uncemented stem group (mean age 59.5 ± 15.2 years). The mean follow-up was 3.4 years (range 3-4) in the ultra-short anatomic stem group and 3.5 years (range 3-4) in the ultra-short non-anatomic stem group. At the final follow-up, the mean Harris hip scores (92 vs 93 points), Western Ontario and McMaster Universities Osteoarthritis scores (16 vs 15 points), University of California at Los Angeles activity scores (6.5 vs 6.8 points), the incidence of thigh pain (0% vs 4%), revision rates (0% vs 4%), aseptic loosening rate (0% vs 2%), and complication rates (2% vs 4%) were not significantly different between 2 groups. Both ultra-short anatomic and ultra-short non-anatomic proximal loading uncemented femoral stems obtained rigid fixation without diaphyseal stem fixation in the short-term follow-up. This finding suggests that an ultra-short anatomic uncemented femoral stem can be replaced with an ultra-short non-anatomic uncemented stem to reduce inventory of the femoral stems, and consequently reduce manufacturing and delivery cost of these femoral stems. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Congenital middle ear anomalies: anatomical and functional results of surgery.

    PubMed

    Quesnel, Stéphanie; Benchaa, Tarik; Bernard, Sophie; Martine, François; Viala, Paul; Van Den Abbeele, Thierry; Teissier, Natacha

    2015-01-01

    The aim of this study was to describe the audiometric results following surgery in a consecutive series of pediatric patients with a congenital middle ear disorder. Retrospective chart review was performed for 29 consecutive children who underwent 33 middle ear surgeries for congenital ossicular chain anomaly between 1990 and 2012. Anomalies were classified into four groups according to the Teunissen and Cremers classification. Audiological parameters using four frequency averages (0.5, 1, 2 and 4 kHz) were assessed pre- and postoperatively. Clinical and audiometric follow-up times were, respectively, 49 ± 8 and 35 ± 5 months (mean ± SEM). Fifty-eight percent of all patients achieved an air-bone gap (ABG) ≤20 dB, 62.5% in class I, 50% in class II and 57.9% in class III. The improvement of the mean ABG was 13.6 dB, 19.2 dB for class I, 0.2 dB in class II and 15.4 dB in class III. Overall mean pure-tone averages improved 14.8 dB with 13.9 dB for class I; there was no improvement for class II and 20.2 dB for class III. The sensorineural hearing loss rate was 9%. This pediatric series showed that hearing results depend on type of anomaly. Class I and class III showed better hearing improvement than class II. © 2015 S. Karger AG, Basel.

  6. Height, weight, and body mass index associations with gastric cancer subsites.

    PubMed

    Camargo, M Constanza; Freedman, Neal D; Hollenbeck, Albert R; Abnet, Christian C; Rabkin, Charles S

    2014-01-01

    Although excess body weight has been associated with cancers of the gastric cardia, relationships with gastric cancer at other anatomic subsites are not well defined. Furthermore, subsite-specific associations with attained height have not been fully assessed. In 1995-1996, 483,700 Whites enrolling in the multi-state NIH-AARP Diet and Health Study self-reported height and weight. Gastric cancers occurring through 31 December 2006 were ascertained from regional population-based registries. We used Cox regression models to estimate cancer hazard ratios (HRs) for sex-specific tertiles of height and weight and for body mass index (BMI) categories of the World Health Organization. One thousand incident cancers (48 % localized to the cardia, 4 % fundus, 6 % corpus, 3 % greater curvature, 6 % lesser curvature, 10 % antrum, 2 % pylorus, 5 % overlapping lesion, and 16 % unspecified) occurred an average of 5.4 years after enrollment. After controlling for effects of age, sex, education, and smoking, we found an inverse association between height and total noncardia cancers (i.e., fundus, corpus, greater and lesser curvatures, antrum, and pylorus), with HRs vs. tertile 1 of 0.65 and 0.71 for tertiles 2 and 3, respectively (p trend = 0.016). Trends were consistent for individual noncardia subsites. In contrast, although weight and BMI were each associated with risk of cardia cancer, neither was associated with total noncardia cancer nor individual subsites. Noncardia gastric cancer is associated with short stature but not with high body weight or obesity. The excess risk for shorter adults would be consistent with the known association of chronic H. pylori infection with growth retardation during childhood.

  7. Subsite-Specific Dietary Risk Factors for Colorectal Cancer: A Review of Cohort Studies

    PubMed Central

    Hjartåker, Anette; Aagnes, Bjarte; Robsahm, Trude Eid; Langseth, Hilde; Bray, Freddie; Larsen, Inger Kristin

    2013-01-01

    Objective. A shift in the total incidence from left- to right-sided colon cancer has been reported and raises the question as to whether lifestyle risk factors are responsible for the changing subsite distribution of colon cancer. The present study provides a review of the subsite-specific risk estimates for the dietary components presently regarded as convincing or probable risk factors for colorectal cancer: red meat, processed meat, fiber, garlic, milk, calcium, and alcohol. Methods. Studies were identified by searching PubMed through October 8, 2012 and by reviewing reference lists. Thirty-two prospective cohort studies are included, and the estimates are compared by sex for each risk factor. Results. For alcohol, there seems to be a stronger association with rectal cancer than with colon cancer, and for meat a somewhat stronger association with distal colon and rectal cancer, relative to proximal colon cancer. For fiber, milk, and calcium, there were only minor differences in relative risk across subsites. No statement could be given regarding garlic. Overall, many of the subsite-specific risk estimates were nonsignificant, irrespective of exposure. Conclusion. For some dietary components the associations with risk of cancer of the rectum and distal colon appear stronger than for proximal colon, but not for all. PMID:23577027

  8. Radicality of Resection and Survival After Multimodality Treatment is Influenced by Subsite of Locally Recurrent Rectal Cancer

    SciTech Connect

    Kusters, Miranda; Dresen, Raphaela C.; Martijn, Hendrik; Nieuwenhuijzen, Grard A.; Velde, Cornelis J.H. van de; Berg, Hetty A. van den; Beets-Tan, Regina G.H.; Rutten, Harm J.T.

    2009-12-01

    Purpose: To analyze results of multimodality treatment in relation to subsite of locally recurrent rectal cancer (LRRC). Method and Materials: A total of 170 patients with LRRC who underwent treatment between 1994 and 2008 were studied. The basic principle of multimodality treatment was preoperative (chemo)radiotherapy, intended radical surgery, and intraoperative radiotherapy. The subsites of LRRC were classified as presacral, posterolateral, (antero)lateral, anterior, anastomotic, or perineal. Subsites were related to radicality of the resection, local re-recurrence rate, distant metastasis rate, and cancer-specific survival. Results: R0 resections were achieved in 54% of the patients, and 5-year cancer-specific survival was 40.5%. The worst outcomes were seen in presacral LRRC, with only 28% complete resections and 19% 5-year survival (p = 0.03 vs. other subsites). Anastomotic LRRC resulted in the most favorable outcomes, with 77% R0 resections and 60% 5-year survival (p = 0.04). Generally, if a complete resection was achieved, survival improved, except in posterolateral LRRC. Local re-recurrence and metastasis rate were lowest in anastomotic LRRC. Conclusions: Classification of the subsite of LRRC is a predictor of potentially resectable and consequently curable disease. Treatment of posterior LRRC imposes poor results, whereas anastomotic LRRC location shows superior results.

  9. Radicality of resection and survival after multimodality treatment is influenced by subsite of locally recurrent rectal cancer.

    PubMed

    Kusters, Miranda; Dresen, Raphaëla C; Martijn, Hendrik; Nieuwenhuijzen, Grard A; van de Velde, Cornelis J H; van den Berg, Hetty A; Beets-Tan, Regina G H; Rutten, Harm J T

    2009-12-01

    To analyze results of multimodality treatment in relation to subsite of locally recurrent rectal cancer (LRRC). A total of 170 patients with LRRC who underwent treatment between 1994 and 2008 were studied. The basic principle of multimodality treatment was preoperative (chemo)radiotherapy, intended radical surgery, and intraoperative radiotherapy. The subsites of LRRC were classified as presacral, posterolateral, (antero)lateral, anterior, anastomotic, or perineal. Subsites were related to radicality of the resection, local re-recurrence rate, distant metastasis rate, and cancer-specific survival. R0 resections were achieved in 54% of the patients, and 5-year cancer-specific survival was 40.5%. The worst outcomes were seen in presacral LRRC, with only 28% complete resections and 19% 5-year survival (p = 0.03 vs. other subsites). Anastomotic LRRC resulted in the most favorable outcomes, with 77% R0 resections and 60% 5-year survival (p = 0.04). Generally, if a complete resection was achieved, survival improved, except in posterolateral LRRC. Local re-recurrence and metastasis rate were lowest in anastomotic LRRC. Classification of the subsite of LRRC is a predictor of potentially resectable and consequently curable disease. Treatment of posterior LRRC imposes poor results, whereas anastomotic LRRC location shows superior results.

  10. A Naturally Variable Residue in the S1 Subsite of M1 Family Aminopeptidases Modulates Catalytic Properties and Promotes Functional Specialization*

    PubMed Central

    Dalal, Seema; Ragheb, Daniel R. T.; Schubot, Florian D.; Klemba, Michael

    2013-01-01

    M1 family metallo-aminopeptidases fulfill a wide range of critical and in some cases medically relevant roles in humans and human pathogens. The specificity of M1-aminopeptidases is dominated by the interaction of the well defined S1 subsite with the side chain of the first (P1) residue of the substrate and can vary widely. Extensive natural variation occurs at one of the residues that contributes to formation of the cylindrical S1 subsite. We investigated whether this natural variation contributes to diversity in S1 subsite specificity. Effects of 11 substitutions of the S1 subsite residue valine 459 in the Plasmodium falciparum aminopeptidase PfA-M1 and of three substitutions of the homologous residue methionine 260 in Escherichia coli aminopeptidase N were characterized. Many of these substitutions altered steady-state kinetic parameters for dipeptide hydrolysis and remodeled S1 subsite specificity. The most dramatic change in specificity resulted from substitution with proline, which collapsed S1 subsite specificity such that only substrates with P1-Arg, -Lys, or -Met were appreciably hydrolyzed. The structure of PfA-M1 V459P revealed that the proline substitution induced a local conformational change in the polypeptide backbone that resulted in a narrowed S1 subsite. The restricted specificity and active site backbone conformation of PfA-M1 V459P mirrored those of endoplasmic reticulum aminopeptidase 2, a human enzyme with proline in the variable S1 subsite position. Our results provide compelling evidence that changes in the variable residue in the S1 subsite of M1-aminopeptidases have facilitated the evolution of new specificities and ultimately novel functions for this important class of enzymes. PMID:23897806

  11. A naturally variable residue in the S1 subsite of M1 family aminopeptidases modulates catalytic properties and promotes functional specialization.

    PubMed

    Dalal, Seema; Ragheb, Daniel R T; Schubot, Florian D; Klemba, Michael

    2013-09-06

    M1 family metallo-aminopeptidases fulfill a wide range of critical and in some cases medically relevant roles in humans and human pathogens. The specificity of M1-aminopeptidases is dominated by the interaction of the well defined S1 subsite with the side chain of the first (P1) residue of the substrate and can vary widely. Extensive natural variation occurs at one of the residues that contributes to formation of the cylindrical S1 subsite. We investigated whether this natural variation contributes to diversity in S1 subsite specificity. Effects of 11 substitutions of the S1 subsite residue valine 459 in the Plasmodium falciparum aminopeptidase PfA-M1 and of three substitutions of the homologous residue methionine 260 in Escherichia coli aminopeptidase N were characterized. Many of these substitutions altered steady-state kinetic parameters for dipeptide hydrolysis and remodeled S1 subsite specificity. The most dramatic change in specificity resulted from substitution with proline, which collapsed S1 subsite specificity such that only substrates with P1-Arg, -Lys, or -Met were appreciably hydrolyzed. The structure of PfA-M1 V459P revealed that the proline substitution induced a local conformational change in the polypeptide backbone that resulted in a narrowed S1 subsite. The restricted specificity and active site backbone conformation of PfA-M1 V459P mirrored those of endoplasmic reticulum aminopeptidase 2, a human enzyme with proline in the variable S1 subsite position. Our results provide compelling evidence that changes in the variable residue in the S1 subsite of M1-aminopeptidases have facilitated the evolution of new specificities and ultimately novel functions for this important class of enzymes.

  12. CD14 and IL18 gene polymorphisms associated with colorectal cancer subsite risks among atomic bomb survivors.

    PubMed

    Hu, Yiqun; Yoshida, Kengo; Cologne, John B; Maki, Mayumi; Morishita, Yukari; Sasaki, Keiko; Hayashi, Ikue; Ohishi, Waka; Hida, Ayumi; Kyoizumi, Seishi; Kusunoki, Yoichiro; Tokunaga, Katsushi; Nakachi, Kei; Hayashi, Tomonori

    2015-01-01

    Colorectal cancer (CRC) is a common malignancy worldwide, and chronic inflammation is a risk factor for CRC. In this study, we carried out a cohort study among the Japanese atomic bomb (A-bomb) survivor population to investigate any association between immune- and inflammation-related gene polymorphisms and CRC. We examined the effects of six single-nucleotide polymorphisms of CD14 and IL18 on relative risks (RRs) of CRC. Results showed that RRs of CRC, overall and by anatomic subsite, significantly increased with increasing radiation dose. The CD14-911A/A genotype showed statistically significant higher risks for all CRC and distal CRC compared with the other two genotypes. In addition, the IL18-137 G/G genotype showed statistically significant higher risks for proximal colon cancer compared with the other two genotypes. In phenotype-genotype analyses, the CD14-911A/A genotype presented significantly higher levels of membrane and soluble CD14 compared with the other two genotypes, and the IL18-137 G/G genotype tended to be lower levels of plasma interleukin (IL)-18 compared with the other two genotypes. These results suggest the potential involvement of a CD14-mediated inflammatory response in the development of distal CRC and an IL18-mediated inflammatory response in the development of proximal colon cancer among A-bomb survivors.

  13. CD14 and IL18 gene polymorphisms associated with colorectal cancer subsite risks among atomic bomb survivors

    PubMed Central

    Hu, Yiqun; Yoshida, Kengo; Cologne, John B; Maki, Mayumi; Morishita, Yukari; Sasaki, Keiko; Hayashi, Ikue; Ohishi, Waka; Hida, Ayumi; Kyoizumi, Seishi; Kusunoki, Yoichiro; Tokunaga, Katsushi; Nakachi, Kei; Hayashi, Tomonori

    2015-01-01

    Colorectal cancer (CRC) is a common malignancy worldwide, and chronic inflammation is a risk factor for CRC. In this study, we carried out a cohort study among the Japanese atomic bomb (A-bomb) survivor population to investigate any association between immune- and inflammation-related gene polymorphisms and CRC. We examined the effects of six single-nucleotide polymorphisms of CD14 and IL18 on relative risks (RRs) of CRC. Results showed that RRs of CRC, overall and by anatomic subsite, significantly increased with increasing radiation dose. The CD14–911A/A genotype showed statistically significant higher risks for all CRC and distal CRC compared with the other two genotypes. In addition, the IL18–137 G/G genotype showed statistically significant higher risks for proximal colon cancer compared with the other two genotypes. In phenotype–genotype analyses, the CD14–911A/A genotype presented significantly higher levels of membrane and soluble CD14 compared with the other two genotypes, and the IL18–137 G/G genotype tended to be lower levels of plasma interleukin (IL)-18 compared with the other two genotypes. These results suggest the potential involvement of a CD14-mediated inflammatory response in the development of distal CRC and an IL18-mediated inflammatory response in the development of proximal colon cancer among A-bomb survivors. PMID:27081544

  14. Endovascular treatment of intracranial aneurysms with Barricade coils: Feasibility, procedural safety, and immediate postoperative anatomical results.

    PubMed

    Zidan, Mohamed; Gawlitza, Matthias; Metaxas, Georgios; Foussier, Cédric; Soize, Sébastien; Pierot, Laurent

    2016-10-01

    The safety of bare platinum coils has been widely described in the literature. This study aimed to report the first series of intracranial aneurysms treated with Barricade bare platinum coils with a comprehensive evaluation of their procedural safety and postprocedural anatomical results. Patients with intracranial aneurysms treated between October 2013 and December 2015 by simple coiling or balloon-assisted coiling with Barricade coils (Blockade Medical, Irvine, California, USA) were prospectively included in a database and retrospectively studied. For all included patients, the patient and aneurysm characteristics, procedural complications, technical issues, postoperative anatomical results, and one-month clinical outcome (modified Rankin Scale) were evaluated by an independent interventional neuroradiologist. Eighty-eight patients harboring 97 aneurysms were included. Procedural complications and technical issues were encountered in 17 and 5 patients (19.3 and 5.7%, respectively), but clinical worsening in only 2 patients (2.2%). There was no treatment-related mortality. After one month, morbidity (mRS≥1) was observed in 19 patients (21.8%), 17 related to subarachnoid hemorrhage (SAH) in patients with ruptured aneurysms (19.4%) and 2 related to thromboembolic events in patients with unruptured aneurysms (2.3%). Nine patients initially presenting with a ruptured aneurysm were deceased at 1 month as a consequence of SAH (10.2%). Adequate occlusion was observed postoperatively in 94.8% of the aneurysms (complete occlusion in 81.4% and residual neck in 13.4%). Endovascular treatment of intracranial aneurysms with Barricade coils is feasible and the demonstrated overall safety results are within the ranges found in the literature for other coils. Immediate anatomical results are satisfying. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Subsite-specific contributions of different aromatic residues in the active site architecture of glycoside hydrolase family 12

    PubMed Central

    Zhang, Xiaomei; Wang, Shuai; Wu, Xiuyun; Liu, Shijia; Li, Dandan; Xu, Hao; Gao, Peiji; Chen, Guanjun; Wang, Lushan

    2015-01-01

    The active site architecture of glycoside hydrolase (GH) is a contiguous subregion of the enzyme constituted by residues clustered in the three-dimensional space, recognizing the monomeric unit of ligand through hydrogen bonds and hydrophobic interactions. Mutations of the key residues in the active site architecture of the GH12 family exerted different impacts on catalytic efficiency. Binding affinities between the aromatic amino acids and carbohydrate rings were quantitatively determined by isothermal titration calorimetry (ITC) and the quantum mechanical (QM) method, showing that the binding capacity order of Tyr>Trp>His (and Phe) was determined by their side-chain properties. The results also revealed that the binding constant of a certain residue remained unchanged when altering its location, while the catalytic efficiency changed dramatically. Increased binding affinity at a relatively distant subsite, such as the mutant of W7Y at the −4 subsite, resulted in a marked increase in the intermediate product of cellotetraose and enhanced the reactivity of endoglucanase by 144%; while tighter binding near the catalytic center, i.e. W22Y at the −2 subsite, enabled the enzyme to bind and hydrolyze smaller oligosaccharides. Clarification of the specific roles of the aromatics at different subsites may pave the way for a more rational design of GHs. PMID:26670009

  16. Veneered anatomically designed zirconia FDPs resulting from digital intraoral scans: Preliminary results of a prospective clinical study.

    PubMed

    Selz, Christian F; Bogler, Jan; Vach, Kirstin; Strub, Joerg R; Guess, Petra C

    2015-12-01

    The aim of this prospective clinical study was to evaluate the clinical performance of veneered anatomically designed zirconia fixed dental prostheses (FDPs) resulting from intraoral digital impressions. 24 patients requiring treatment were provided with all-ceramic FDPs. Intraoral scans (iTero) were performed and veneered anatomically designed CAD/CAM-zirconia FDPs (Zerion/VitaVM9) were fabricated. A feldspar veneering ceramic following a slow cooling firing protocol was applied. A self-curing resin based luting material was used for adhesive cementation. Clinical evaluations were performed at baseline and 6, 12, and 18 months recalls according to the modified USPHS-criteria. Intraoral digital surface scans (iTero) were performed at each recall examination and were digitally superimposed (Geomagic) to evaluate potential veneer cohesive fractures. Kaplan-Meier survival analysis comprised secondary caries, clinically unacceptable fractures, root canal treatment and debonding. Kaplan-Meier success rate included restorations with minimal crevices, tolerable color deviations and clinically acceptable fractures. Data were statistically analyzed. The Kaplan-Meier survival rate and success rate of the FDPs were 100% and 91.7%, respectively. Clinically acceptable veneer cohesive fractures and crevices at the restoration margin were observed in two patients. These shallow veneer fractures were only detected by overlapping baseline and recall scans. Ceramic surface roughness increased significantly over time (p<0.0001). Veneered zirconia FDPs fabricated from digital intraoral scans showed a favorable clinical performance over an observation period of 18 months. Anatomical zirconia core design and slow cooling firing protocol of the veneering ceramic reduced the incidence of chip fractures to a level that could not be detected clinically. The digital workflow on the basis of intraoral digital impressions resulted in clinically satisfying outcomes for veneered zirconia FDPs

  17. [Long-term results of anatomic repair of transposition of great vessels].

    PubMed

    Guilhot, M; Godart, F; Foucher, C; Francart, C; Libersa, C; Pladys, A; Vaksmann, G; Brevière, G M; Rey, C

    2000-05-01

    The long-term complications after anatomical repair of transposition of the great arteries (TGA) were analysed in a prospective study of 30 successive patients, from August 1996 to October 1999, who were presumed asymptomatic and investigated 10 years after surgery. All underwent clinical examination, ECG, stress Thallium 201 myocardial scintigraphy, Doppler echocardiography, Holter ECG, pulmonary perfusion scintigraphy, right and left cardiac catheterization with selective coronary angiography. Five patients had coronary lesions (4 thromboses and 1 coronary-pulmonary artery fistula). The other abnormalities observed were mild bilateral stenosis of the two pulmonary arteries (1 case), grade 1 aortic regurgitation (6 cases), including 1 case of aortic root dilatation. Type B to E coronary circulations (Yacoub classification) were not significantly correlated with coronary artery disease in this series (p = 0.06). For the diagnosis of these lesions, myocardial scintigraphy and Doppler echocardiographic detection of wall motion abnormalities had a sensitivity of 50% and respective specificities of 88% and 35%. Long-term results after anatomical repair of TGA are satisfactory. However, the high incidence of coronary lesions makes regular follow-up and systematic coronary angiography necessary in all children.

  18. [Surgery for posterior segment intraocular foreign bodies -- anatomical and functional results].

    PubMed

    Brănişteanu, Daniel; Moraru, Andreea

    2013-01-01

    To assess the anatomical and visual outcome and also the retinal complications following vitreoretinal surgery for posterior segment intraocular foreign bodies (IOFBs). Retrospective analysis of 59 IOFBs, with different locations within posterior segment,removed during pars plana vitrectomy (PPV) between January 1999 and January 2011, by the same surgeon, in Eye Clinic 1 Iasi. 47 out of 59 IOFBs (79.66%) were removed immediately after primary wound closure and 12 with a delay ranging from 48 hours to 5 years. All IOFBs were metallic. Total 20G pars plana vitrectomy with IOFB removal by forceps or intraocular magnet, careful membrane peeling and laser photocoagulation around the retinal injury (if present) was performed. Relaxing retinotomy was necessary in 3 cases of retinal incarceration. Endotamponade with SF6 (26 cases) or silicone oil (8 cases) were performed, if needed, at the end of surgery. The average follow-up period after surgery was 17.9 month (ranging 6 - 36 months). 18 out of 59 IOFBs (30.5%) were intraretinal. 39 out of 59 eyes (66.10%) showed signs of endophthalmitis at the time of surgery. Preoperative visual acuity ranged from light perception to 0.6. The mean visual acuity significantly increased after surgery from 0.16 preoperatively to 0.5 at the end of follow-up (range hand movements--1). 51 out of 59 cases (86.44%) had stable anatomical result. A final visual acuity equal or better than 0.1 was obtained in 45 cases (76.27%). Mild retinal folding could be noticed in some cases around the laser-treated retinal injury. In 8 out of 59 cases (13.56%) visual acuity remained low or decreased due to macular injury or PVR associated retinal detachment requiring additional surgery. IOFBs, and especially those intraretinal, require an early, complex and customized approach during PPV. Functional results do not match anatomical restoration if macula or optic nerve are impacted. Main postoperative complications were represented by retinal folds and PVR

  19. Creation of a Neovagina by Laparoscopic Modified Vecchietti Technique: Anatomic and Functional Results.

    PubMed

    Baptista, Eduardo; Carvalho, Giselda; Nobre, Carlos; Dias, Isabel; Torgal, Isabel

    2016-09-01

    Purpose To evaluate the anatomic and functional results of a laparoscopic modified Vecchietti technique for the creation of a neovagina in patients with congenital vaginal aplasia. Methods Retrospective study of nine patients with congenital vaginal aplasia submitted to the laparoscopic Vecchietti procedure, in our department, between 2006 and 2013. The anatomical results were evaluated by assessing the length, width and epithelialization of the neovagina at the postoperative visits. The functional outcome was evaluated using the Rosen Female Sexual Function Index (FSFI) questionnaire and comparing the patients' results to those of a control group of 20 healthy women. The statistical analysis was performed using SPSS Statistics version 19.0 (IBM, Armonk, NY, USA), Student t-test, Mann-Whitney U test and Fisher exact test. Results The condition underlying the vaginal aplasia was Mayer-Rokitansky-Küster-Hauser syndrome in eight cases, and androgen insensitivity syndrome in one case. The average preoperative vaginal length was 2.9 cm. At surgery, the mean age of the patients was 22.2 years. The surgery was performed successfully in all patients and no intra or postoperative complications were recorded. At the first postoperative visit (6 to 8 weeks after surgery), the mean vaginal length was 8.1 cm. In all cases, the neovagina was epithelialized and had an appropriate width. The mean FSFI total and single domain scores did not differ significantly from those of the control group: 27.5 vs. 30.6 (total); 4.0 vs. 4.2 (desire); 4.4 vs. 5.2 (arousal); 5.2 vs. 5.3 (lubrication); 4.2 vs. 5.0 (orgasm); 5.3 vs. 5.5 (satisfaction) and 4.4 vs. 5.4 (comfort). Conclusions This modified laparoscopic Vecchietti technique is a simple, safe and effective procedure, which allows patients with congenital vaginal aplasia to have a satisfactory sexual activity, comparable to that of normal controls.

  20. Anatomic Results and Complications of Stent-Assisted Coil Embolization of Intracranial Aneurysms

    PubMed Central

    Kim, S.-R.; Vora, N.; Jovin, T.G.; Gupta, R.; Thomas, A.; Kassam, A.; Lee, K.; Gologorsky, Y.; Jankowitz, B.; Panapitiya, N.; Aleu, A.; Sandhu, E.; Crago, E.; Hricik, A.; Gallek, M.; Horowitz, M.B.

    2008-01-01

    Summary The purpose of this study was to evaluate and report our anatomic results and complications associated with stent-assisted coil embolization of intracranial aneurysms using the Neuroform stent. From September 2003 to August 2007, 127 consecutive patients (ruptured 50, 39.4%; unruptured 77, 60.6%) underwent 129 stent-assisted coil embolization procedures to treat 136 aneurysms at our institution. Anatomic results at follow-up, procedure-related complications, and morbidity/mortality were retrospectively reviewed. Stent deployment was successful in 128 out of 129 procedures (99.2%). Forty-seven patients presented with 53 procedure-related complications (37.0%, 47/127). Thromboembolic events (n=17, 13.4%) were the most common complications, followed by intraoperative rupture (n=8, 6.3%), coil herniation (n=5, 3.9%), and postoperative rupture (n=4, 3.1%). For thromboembolic events, acute intra-procedural in-stent thromboses were observed in two patients and subacute or delayed in-stent thromboses in three patients. Overall mortality rate was 16.5% (21/127) and procedure-related morbidity and mortality rates were 5.5% (7/127) and 8.7% (11/127) retrospectively. Patients with poor grade subarachnoid hemorrhage (Hunt and Hess grade IV or V; 25/127, 19.7%) exhibited 56% (14/25) overall mortality rate and 24% (6/25) procedure-related mortality rate. Immediate angiographic results showed complete occlusion in 31.7% of aneurysms, near-complete occlusion in 45.5%, and partial occlusion in 22.8%. Sixty nine patients in 70 procedures with 77 aneurysms underwent angiographic follow-up at six months or later. Mean follow-up period was 13.7 months (6 to 45 months). Complete occlusion was observed in 57 aneurysms (74.0%) and significant in-stent stenosis was not found. Thromboembolism and intra/postoperative aneurysm ruptures were the most common complications and the main causes of procedure-related morbidity and mortality. Patients with poor grade subarachnoid hemorrhage

  1. [Bilateral cleft lip and palate. Anatomic and clinical characteristics and therapeutic results].

    PubMed

    Morand, B; Raphaël, B

    2004-09-01

    Treatment teams that conceive and nourish their ideas in a multi-disciplinary environment are best suited to elaborate therapeutic protocols. Their concepts should be based on consistent evaluation of their treatment results as documented by precise and reproducible records. In the wide array of maxillo-facial anatomical deformities presented clinically, bilateral cleft lips and palates are the rarest (20%), but they are also the most serious because of the inherent disconnection of maxillary structures that accompanies them and because of the grave disturbances they inflict on the development of the middle third of the face. Surgeons have devised an extraordinary gamut of protocols to correct these disorders and then abandoned them because of the problematical and ephemeral results they provided. The authors, after evaluating their own results, modified their therapeutic approach in 1994. They present their current protocol, which calls for an orthopedic phase carried out when the patient is 2 months old and two surgical phases when the patient is 3 and then 7 months old.

  2. Preliminary results of anatomic lung resection using energy-based tissue and vessel coagulative fusion technology.

    PubMed

    Schuchert, Matthew J; Abbas, Ghulam; Pettiford, Brian L; Luketich, James D; Landreneau, Rodney J

    2010-11-01

    Mechanical stapling devices have been established as the mainstay of therapy in the selective isolation and division of bronchial and vascular structures during anatomic lung resection. Few data are available regarding the application of energy-based tissue fusion technology during anatomic lung resection. In the present study, we evaluated the use of energy-based instruments for the division of the pulmonary arterial and venous branches during anatomic lung resection. Anatomic lung resection (segmentectomy or lobectomy) was performed using energy-based coagulative fusion technology. A low-profile jaw can be used to facilitate dissection in both open and video-assisted thoracic surgery cases, applying a seal 6 mm wide by 22 mm in length. Two energy applications were applied to the arterial and venous branches before vessel division. The bipolar tissue fusion system was used in 211 patients between 2008 and 2010 (104 lobectomies and 107 anatomic segmentectomies). Initially, we used a device with a smaller, curved jaw (n = 12), producing a 3.3- to 4.7-cm seal. No arterial dehiscences and 2 partial venous dehiscences that were recognized and controlled intraoperatively occurred. For the remaining cases, we used a new device with a larger jaw that applied a seal 6 mm wide by 22 mm in length. No arterial or venous dehiscences (vessel size range, 0.4-1.2 cm) occurred. The bipolar tissue fusion system provided safe and reliable control of pulmonary arterial and venous branches during anatomic lung resection. The use of energy-based tissue fusion technology represents a reasonable alternative to mechanical stapling devices during anatomic lung resection. Copyright © 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  3. The mechanism of salivary amylase hydrolysis: role of residues at subsite S2'.

    PubMed

    Mishra, Prasunkumar J; Ragunath, Chandran; Ramasubbu, Narayanan

    2002-03-29

    Hydrolysis of starch or oligosaccharides by mammalian amylases, in general, results in maltose as the leaving group. The active site of these amylases harbors three aromatic residues Trp59, Tyr62, and Tyr151, which provide stacking interactions to the bound glucose moieties. We hypothesized that Tyr151, located at the S2' subsite, may influence the size of the leaving group. Therefore, using a baculovirus expression system, we generated a mutant Y151M in which the tyrosine at position 151 of human salivary amylase is replaced by a methionine. The specific activity, K(m), rate of hydrolysis, and the product distribution for Y151M were distinctly different from those of the wild-type enzyme using starch and oligosaccharides as substrates. The mutant enzyme Y151M consistently produced glucose as the minimal leaving group and exhibited a twofold increase in K(m). These results suggest that the stacking interaction at subsite S2' in the wild type plays a role in hydrolysis. (c)2002 Elsevier Science (USA).

  4. [Use of the anatomical cemented femoral stem SAS I: mid-term results].

    PubMed

    Mikláš, M; Pink, M; Valoušek, T

    2015-01-01

    PURPOSE OF THE STUDY In view of increasing interest in a relationship between the surface of an implant and its behaviour and longevity in total hip arthroplasty (THA), the aim of this study is to present the clinical and radiographic results, as well as complications, of hip replacement surgery using the cemented femoral stem SAS I. MATERIAL AND METHODS A total of 298 cemented femoral stems SAS I were implanted in 275 patients at our department between 1996 and 2005. The patient average age was 72.1 years, with the range from 64 to 92 years. The pre-operative diagnoses were as follows: primary osteoarthritis in 179 (30.1%); post-dysplastic osteoarthritis in 41 (13.7%); femoral neck fracture in 44 (14.8%); avascular necrosis of the femoral head in 23 (7.7%); rheumatoid arthritis in nine (3%) and other causes in two (0.7%) patients. Of the 275 patients who had the surgery, 186 (204 THAs) underwent clinical and X-ray examination at an average follow-up of 11.5 years (range, 8 to 17 years). The clinical results were used to calculate the Harris hip score and radiographic evaluation was based on antero-posterior views. RESULTS The group of 186 assessed patients (204 THAs) comprised 106 women and 80 men, who were on average 85.4 years old on evaluation (range, 72 to 92 years). Of the remaining patients, 62 patients (64 THAs) died from causes unrelated to the surgery and 27 patients (30 THAs) were lost to follow-up. The functional outcome of surgery assessed by the Harris hip score was excellent in 61 (32.8%), good in 94 (50.5%), satisfactory in 26 (14%) and poor in five (2.7%) patients. The 93.1% SAS I stem longevity was recorded in relation to aseptic loosening; reimplantation for this indication was performed in 14 THAs. No revision surgery for failure due to valgus/varus deviations of the stem was carried out. Of the 204 hips, 188 had femoral stems aligned in neutral, 12 (5.9%) in valgus and four (2%) in varus positions. DISCUSSION The anatomical femoral stem SAS I

  5. Brainstem arteriovenous malformations: anatomical subtypes, assessment of “occlusion in situ” technique, and microsurgical results

    PubMed Central

    Han, Seunggu J.; Englot, Dario J.; Kim, Helen; Lawton, Michael T.

    2017-01-01

    OBJECT The surgical management of brainstem arteriovenous malformations (AVMs) might benefit from the definition of anatomical subtypes and refinements of resection techniques. Many brainstem AVMs sit extrinsically on pia mater rather than intrinsically in the parenchyma, allowing treatment by occluding feeding arteries circumferentially, interrupting draining veins after arteriovenous shunting is eliminated, and leaving the obliterated nidus behind. The authors report here the largest series of brainstem AVMs to define 6 subtypes, assess this “occlusion in situ” technique, and analyze the microsurgical results. METHODS Brainstem AVMs were categorized as 1 of 6 types: anterior midbrain, posterior midbrain, anterior pontine, lateral pontine, anterior medullary, and lateral medullary AVMs. Data from a prospectively maintained AVM registry were reviewed to evaluate multidisciplinary treatment results. RESULTS During a 15-year period, the authors treated 29 patients with brainstem AVMs located in the midbrain (1 anterior and 6 posterior), pons (6 anterior and 7 lateral), and medulla (1 anterior and 8 lateral). The nidus was pial in 26 cases and parenchymal in 3 cases. Twenty-three patients (79%) presented with hemorrhage. Brainstem AVMs were either resected (18 patients, 62%) or occluded in situ (11 patients, 38%). All lateral pontine AVMs were resected, and the occlusion in situ rate was highest with anterior pontine AVMs (83%). Angiography confirmed complete obliteration in 26 patients (89.6%). The surgical mortality rate was 6.9%, and the rate of permanent neurological deterioration was 13.8%. At follow-up (mean 1.3 years), good outcomes (modified Rankin Scale [mRS] score ≤ 2) were observed in 18 patients (66.7%) and poor outcomes (mRS score of 3–5) were observed in 9 patients (33.3%). The mRS scores in 21 patients (77.8%) were unchanged or improved. The best outcomes were observed with lateral pontine (100%) and lateral medullary (75%) AVMs, and the rate of

  6. Cerebellar Arteriovenous Malformations: Anatomical Subtypes, Surgical Results, and Increased Predictive Accuracy of the Supplementary Grading System

    PubMed Central

    Rodríguez-Hernández, Ana; Kim, Helen; Pourmohamad, Tony; Young, William L.; Lawton, Michael T.

    2013-01-01

    Background Anatomical diversity amongst cerebellar AVMs calls for a classification that is intuitive and surgically informative. Selection tools like the Spetzler-Martin grading system are designed to work best with cerebral AVMs, but have shortcomings with cerebellar AVMs. Objective To define subtypes of cerebellar AVMs that clarify anatomy and surgical management, determine results according to subtypes, and compare predictive accuracies of Spetzler-Martin and supplementary systems. Methods From a consecutive surgical series of 500 patients, 60 had cerebellar AVMs, 39 had brain stem AVMs and were excluded, and 401 had cerebral AVMs. Results Cerebellar AVM subtypes were: 18 vermian, 13 suboccipital, 12 tentorial, 12 petrosal, and 5 tonsillar. Patients with tonsillar and tentorial AVMs fared best. Cerebellar AVMs presented with hemorrhage more than cerebral AVMs (p<0.001). Cerebellar AVMs were more likely to drain deep (p=0.036) and less likely eloquent (p<0.001). The predictive accuracy of supplementary grade was better than that of Spetzler-Martin grade with cerebellar AVMs (areas under the ROC curve 0.74 and 0.59, respectively). The predictive accuracy of the supplementary system was consistent for cerebral and cerebellar AVMs, whereas that of the Spetzler-Martin system was greater with cerebral AVMs. Conclusion Patients with cerebellar AVMs present with hemorrhage more than patients with cerebral AVMs, justifying an aggressive treatment posture. The supplementary system is better than the Spetzler-Martin system at predicting outcomes after cerebellar AVM resection. Key components of the Spetzler-Martin system, like venous drainage and eloquence, are distorted by cerebellar anatomy in ways that components of the supplementary system are not. PMID:22986595

  7. Does learning in clinical context in anatomical sciences improve examination results, learning motivation, or learning orientation?

    PubMed

    Böckers, Anja; Mayer, Christian; Böckers, Tobias Maria

    2014-01-01

    The preclinical compulsory elective course "Ready for the Operating Room (OR)!?" [in German]: "Fit für den OP (FOP)"] was implemented for students in their second year, who were simultaneously enrolled in the gross anatomy course. The objective of the study was to determine whether the direct practical application of anatomical knowledge within the surgical context of the course led to any improvement in learning motivation, learning orientation, and ultimately examination results in the gross anatomy course, as compared with a control group. Within the scope of five teaching sessions, the students learned surgical hand disinfection, suturing techniques, and the identification of commonly used surgical instruments. In addition, the students attended five surgical demonstrations performed by surgical colleagues on cadavers. Successful learning of these basic skills was then assessed based on an Objectively Structured Practical Examination. Learning motivation and learning orientation in both subgroups was determined using the SELLMO-ST motivation test and the Approaches and Study Skills Inventory test. While a significant increase in work avoidance was identified in the control group, this was not the case for FOP participants. Similarly, an increase in the "deep approach" to learning, as well as a decrease in the "surface approach," was able to be documented among the FOP participants following completion of the course. The results suggest that students enrolled in the gross anatomy course, who were simultaneously provided with the opportunity to learn in clinical context, were more likely to be successful at maintaining learning motivation and learning orientation required for the learning process, than students who attended the gross anatomy course alone.

  8. Brainstem arteriovenous malformations: anatomical subtypes, assessment of "occlusion in situ" technique, and microsurgical results.

    PubMed

    Han, Seunggu J; Englot, Dario J; Kim, Helen; Lawton, Michael T

    2015-01-01

    The surgical management of brainstem arteriovenous malformations (AVMs) might benefit from the definition of anatomical subtypes and refinements of resection techniques. Many brainstem AVMs sit extrinsically on pia mater rather than intrinsically in the parenchyma, allowing treatment by occluding feeding arteries circumferentially, interrupting draining veins after arteriovenous shunting is eliminated, and leaving the obliterated nidus behind. The authors report here the largest series of brainstem AVMs to define 6 subtypes, assess this "occlusion in situ" technique, and analyze the microsurgical results. Brainstem AVMs were categorized as 1 of 6 types: anterior midbrain, posterior midbrain, anterior pontine, lateral pontine, anterior medullary, and lateral medullary AVMs. Data from a prospectively maintained AVM registry were reviewed to evaluate multidisciplinary treatment results. During a 15-year period, the authors treated 29 patients with brainstem AVMs located in the midbrain (1 anterior and 6 posterior), pons (6 anterior and 7 lateral), and medulla (1 anterior and 8 lateral). The nidus was pial in 26 cases and parenchymal in 3 cases. Twenty-three patients (79%) presented with hemorrhage. Brainstem AVMs were either resected (18 patients, 62%) or occluded in situ (11 patients, 38%). All lateral pontine AVMs were resected, and the occlusion in situ rate was highest with anterior pontine AVMs (83%). Angiography confirmed complete obliteration in 26 patients (89.6%). The surgical mortality rate was 6.9%, and the rate of permanent neurological deterioration was 13.8%. At follow-up (mean 1.3 years), good outcomes (modified Rankin Scale [mRS] score ≤ 2) were observed in 18 patients (66.7%) and poor outcomes (mRS score of 3-5) were observed in 9 patients (33.3%). The mRS scores in 21 patients (77.8%) were unchanged or improved. The best outcomes were observed with lateral pontine (100%) and lateral medullary (75%) AVMs, and the rate of worsening/death was greatest

  9. Mathematical model for preoperative identification of obstructed nasal subsites.

    PubMed

    Gamerra, M; Cantone, E; Sorrentino, G; De Luca, R; Russo, M B; De Corso, E; Bossa, F; De Vivo, A; Iengo, M

    2017-05-22

    The planning of experimental studies for evaluation of nasal airflow is particularly challenging given the difficulty in obtaining objective measurements in vivo. Although standard rhinomanometry and acoustic rhinometry are the most widely used diagnostic tools for evaluation of nasal airflow, they provide only a global measurement of nasal dynamics, without temporal or spatial details. Furthermore, the numerical simulation of nasal airflow as computational fluid dynamics technology is not validated. Unfortunately, to date, there are no available diagnostic tools to objectively evaluate the geometry of the nasal cavities and to measure nasal resistance and the degree of nasal obstruction, which is of utmost importance for surgical planning. To overcame these limitations, we developed a mathematical model based on Bernoulli's equation, which allows clinicians to obtain, with the use of a particular direct digital manometry, pressure measurements over time to identify which nasal subsite is obstructed. To the best of our knowledge, this is the first study to identify two limiting curves, one below and one above an average representative curve, describing the time dependence of the gauge pressure inside a single nostril. These upper and lower curves enclosed an area into which the airflow pattern of healthy individuals falls. In our opinion, this model may be useful to study each nasal subsite and to objectively evaluate the geometry and resistances of the nasal cavities, particularly in preoperative planning and follow-up. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  10. Mapping glycoside hydrolase substrate subsites by isothermal titration calorimetry

    PubMed Central

    Zolotnitsky, Gennady; Cogan, Uri; Adir, Noam; Solomon, Vered; Shoham, Gil; Shoham, Yuval

    2004-01-01

    Relating thermodynamic parameters to structural and biochemical data allows a better understanding of substrate binding and its contribution to catalysis. The analysis of the binding of carbohydrates to proteins or enzymes is a special challenge because of the multiple interactions and forces involved. Isothermal titration calorimetry (ITC) provides a direct measure of binding enthalpy (ΔHa) and allows the determination of the binding constant (free energy), entropy, and stoichiometry. In this study, we used ITC to elucidate the binding thermodynamics of xylosaccharides for two xylanases of family 10 isolated from Geobacillus stearothermophilus T-6. The change in the heat capacity of binding (ΔCp = ΔH/ΔT) for xylosaccharides differing in one sugar unit was determined by using ITC measurements at different temperatures. Because hydrophobic stacking interactions are associated with negative ΔCp, the data allow us to predict the substrate binding preference in the binding subsites based on the crystal structure of the enzyme. The proposed positional binding preference was consistent with mutants lacking aromatic binding residues at different subsites and was also supported by tryptophan fluorescence analysis. PMID:15277671

  11. Cerebellar arteriovenous malformations: anatomic subtypes, surgical results, and increased predictive accuracy of the supplementary grading system.

    PubMed

    Rodríguez-Hernández, Ana; Kim, Helen; Pourmohamad, Tony; Young, William L; Lawton, Michael T

    2012-12-01

    Anatomic diversity among cerebellar arteriovenous malformations (AVMs) calls for a classification that is intuitive and surgically informative. Selection tools like the Spetzler-Martin grading system are designed to work best with cerebral AVMs but have shortcomings with cerebellar AVMs. To define subtypes of cerebellar AVMs that clarify anatomy and surgical management, to determine results according to subtypes, and to compare predictive accuracies of the Spetzler-Martin and supplementary systems. From a consecutive surgical series of 500 patients, 60 had cerebellar AVMs, 39 had brainstem AVMs and were excluded, and 401 had cerebral AVMs. Cerebellar AVM subtypes were as follows: 18 vermian, 13 suboccipital, 12 tentorial, 12 petrosal, and 5 tonsillar. Patients with tonsillar and tentorial AVMs fared best. Cerebellar AVMs presented with hemorrhage more than cerebral AVMs (P < .001). Cerebellar AVMs were more likely to drain deep (P = .04) and less likely to be eloquent (P < .001). The predictive accuracy of the supplementary grade was better than that of the Spetzler-Martin grade with cerebellar AVMs (areas under the receiver-operating characteristic curve, 0.74 and 0.59, respectively). The predictive accuracy of the supplementary system was consistent for cerebral and cerebellar AVMs, whereas that of the Spetzler-Martin system was greater with cerebral AVMs. Patients with cerebellar AVMs present with hemorrhage more often than patients with cerebral AVMs, justifying an aggressive treatment posture. The supplementary system is better than the Spetzler-Martin system at predicting outcomes after cerebellar AVM resection. Key components of the Spetzler-Martin system such as venous drainage and eloquence are distorted by cerebellar anatomy in ways that components of the supplementary system are not.

  12. Importance of independent evaluation of initial anatomic results after endovascular coiling for ruptured cerebral aneurysms.

    PubMed

    Taki, Waro; Sakai, Nobuyuki; Suzuki, Hidenori

    2013-04-01

    Initial incomplete occlusion is been an important predictor of aneurysm recurrence, rebleeding or retreatment after endovascular coiling. In 129 patients in the Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) cohort, ruptured aneurysms were coiled within 14days of onset, and initial post-coiling and 1-year follow-up aneurysm-occlusion status were evaluated by both local investigators and independent reviewers. The aim of this study was to investigate whether self-reported evaluations of initial aneurysm occlusion by treating physicians predicted incomplete aneurysm occlusion at 1year after coiling for ruptured cerebral aneurysms as well as that done by independent evaluations. The relationships between self-reported or independent evaluations of initial anatomic results and 1-year incomplete aneurysm occlusion (retreatment within 1year, or residual aneurysms at 1year) were determined. Both initial and 1-year aneurysm-occlusion status were judged significantly worse by independent reviewers than by local investigators (p<0.001). One-year incomplete aneurysm occlusion was identified in 59 patients: 10 patients, including two patients with re-ruptured aneurysms, were retreated and 49 other patients were judged to have residual aneurysms by independent reviewers. On immediate post-coiling angiograms, both residual neck or aneurysm judged by local investigators, and residual aneurysm judged by independent reviewers, were predictive for 1-year incomplete aneurysm occlusion on univariate analyses. However, multivariate analyses found that the initial aneurysm occlusion status judged by independent reviewers (p=0.02, odds ratio=2.83, 95% confidence interval=1.15-6.95), but not by local investigators, was a significant predictor for 1-year incomplete aneurysm occlusion. This study demonstrates the importance of independent evaluations of aneurysm occlusion status for management of coiled aneurysms.

  13. Etiology of Sudden Death in the Community: Results of Anatomic, Metabolic and Genetic Evaluation

    PubMed Central

    Adabag, A. Selcuk; Peterson, Gary; Apple, Fred S.; Titus, Jack; King, Richard; Luepker, Russell V.

    2009-01-01

    Background Identifying persons at risk for sudden cardiac death (SCD) is challenging. A comprehensive evaluation may reveal clues about the clinical, anatomic, genetic and metabolic risk factors for SCD. Methods Seventy-one SCD victims (25–60 years-old) without an initially apparent cause of death were evaluated at the Hennepin County Medical Examiner’s office from August, 2001 to July, 2004. We reviewed their clinic records conducted next-of-kin interviews and performed autopsy, laboratory testing and genetic analysis for mutations in genes associated with the long-QT syndrome. Results Mean age was 49.5±7 years, 86% were male and 2 subjects had history of coronary heart disease (CHD). Coronary risk factors were highly prevalent in comparison to individuals of the same age group in this community (e.g. smoking 61%; hypertension 27%; hyperlipidemia 25%) but inadequately treated. On autopsy, 80% of the subjects had high-grade coronary stenoses. Acute coronary lesions and previous silent myocardial infarction (MI) were found in 27% and 34%, respectively. Further, 32% of the subjects had recently smoked cigarettes and 50% had ingested analgesics. Possible deleterious mutations of the ion channel genes were detected in 5 (7%) subjects. Of these, 4 were in the sodium channel gene SCN5A. Conclusions Overwhelming majority of the SCD victims in the community had severe subclinical CHD, including undetected previous MI. Traditional coronary risk factors were prevalent and under-treated. Mutations in the long-QT syndrome genes were detected in a few subjects. These findings imply that improvements in the detection and treatment of subclinical CHD in the community are needed to prevent SCD. PMID:20102864

  14. Aminoalcohols as Probes of the Two-subsite Active Site of Beta-D-xylosidase from Selenomonas ruminantium

    USDA-ARS?s Scientific Manuscript database

    Catalysis and inhibitor binding by the GH43 beta-xylosidase are governed by the protonation state of catalytic base (D14, pKa 5.0) and catalytic acid (E186, pKa 7.2) which reside in subsite -1 of the two-subsite active site. Cationic aminoalcohols are shown to bind exclusively to subsite -1 of the ...

  15. Arthroscopic procedures and therapeutic results of anatomical reconstruction of the coracoclavicular ligaments for acromioclavicular Joint dislocation.

    PubMed

    Takase, K; Yamamoto, K

    2016-09-01

    Surgical treatment is recommended for type 5 acromioclavicular joint dislocation on Rockwood's classification. We believe that anatomic repair of the coracoclavicular ligaments best restores the function of the acromioclavicular joint. We attempted to correctly reconstruct the anatomy of the coracoclavicular ligaments under arthroscopy, and describe the minimally invasive arthroscopic procedure. There were 22 patients; mean age at surgery, 38.1 years. Mean time to surgery was 13.2 days. Mean follow-up was 3 years 2 months. The palmaris longus tendon was excised from the ipsilateral side to replace the conoid ligament, while artificial ligament was used for reconstructing the trapezoid ligament. Both ligament reconstructions were performed arthroscopically. No temporary fixation of the acromioclavicular joint was performed. On postoperative radiographic evaluation, 4 patients showed subluxation and 2 showed dislocation of the acromioclavicular joint; the other 16 patients had maintained reduction at the final consultation. MR images 1year after surgery clearly revealed the reconstructed ligaments in 19 patients. Only 1 patient showed osteoarthritis of the acromioclavicular joint. Although it requires resection of the ipsilateral palmaris longus for grafting, we believe that anatomic reconstruction of both coracoclavicular ligaments best restores the function of the acromioclavicular joint. 4. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. Effects of Remnant Tissue Preservation on Clinical and Arthroscopic Results After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction.

    PubMed

    Kondo, Eiji; Yasuda, Kazunori; Onodera, Jun; Kawaguchi, Yasuyuki; Kitamura, Nobuto

    2015-08-01

    Clinical utility of remnant tissue preservation after single-bundle anterior cruciate ligament (ACL) reconstruction has not been established. In addition, no studies have evaluated the clinical utility of remnant preservation after anatomic double-bundle ACL reconstruction. The study hypotheses were as follows: (1) Subjective and functional clinical results may be comparable between anatomic double-bundle reconstructions that preserve the remnant tissue and those that resect the remnant tissue, (2) postoperative knee stability and the second-look arthroscopic evaluation may be significantly more favorable with the remnant-preserving reconstruction, and (3) the degree of the initial graft coverage may significantly affect postoperative knee stability. Cohort study; Level of evidence, 2. A total of 179 patients underwent anatomic double-bundle ACL reconstruction. Based on the Crain classification of ACL remnant tissue, 81 patients underwent the remnant-preserving procedure (group P) and the remaining 98 patients underwent the remnant-resecting procedure (group R). There were no differences between the 2 groups concerning all background factors, including preoperative knee instability and intraoperative tunnel positions. The patients were followed for 2 years or more. The subjective and functional clinical results were comparable between the 2 reconstruction procedures. Side-to-side anterior laxity was significantly less (P = .0277) in group P (0.9 mm) than in group R (1.5 mm). The pivot-shift test was negative in 89% of group P and 78% of group R patients; the result for group R was significantly lower (P = .0460). In the arthroscopic observations, results for group P were significantly better than for group R concerning postoperative laceration and fibrous tissue coverage of the grafts (P = .0479). Remnant preservation in anatomic double-bundle ACL reconstruction did not significantly improve subjective and functional results in the short-term evaluation, but it

  17. Can intestinal innervation be preserved in pancreatoduodenectomy for cancer? Results of an anatomical study.

    PubMed

    Nano, M; Dal Corso, H; Ferronato, M; Solej, M; Hornung, J P

    2003-04-01

    Twenty dissections were carried out, in all of which the splanchnic nerves, celiac plexuses, capital pancreatic plexus and superior mesenteric plexus were identified and traced. The capital pancreatic plexus was formed from two bundles, the first taking its origin from the right celiac plexus, the second from the superior mesenteric plexus. These two bundles joined together just behind the head of the pancreas. Two preganglionic bundles, a ganglion and two postganglionic bundles composed the superior mesenteric plexus. Postganglionic bundles received fibers from both right and left celiac plexuses. In small cancers a thin layer of nervous tissue around the superior mesenteric artery might be spared in order to avoid diarrhea from intestinal denervation. This study has provided anatomical evidence that a part of the mesenteric plexus, which receives fibers from both left and right celiac plexuses, maintains a sufficient intestinal innervation.

  18. Computational docking, molecular dynamics simulation and subsite structure analysis of a maltogenic amylase from Bacillus lehensis G1 provide insights into substrate and product specificity.

    PubMed

    Manas, Nor Hasmaliana Abdul; Bakar, Farah Diba Abu; Illias, Rosli Md

    2016-06-01

    Maltogenic amylase (MAG1) from Bacillus lehensis G1 displayed the highest hydrolysis activity on β-cyclodextrin (β-CD) to produce maltose as a main product and exhibited high transglycosylation activity on malto-oligosaccharides with polymerization degree of three and above. These substrate and product specificities of MAG1 were elucidated from structural point of view in this study. A three-dimensional structure of MAG1 was constructed using homology modeling. Docking of β-CD and malto-oligosaccharides was then performed in the MAG1 active site. An aromatic platform in the active site was identified which is responsible in substrate recognition especially in determining the enzyme's preference toward β-CD. Molecular dynamics (MD) simulation showed MAG1 structure is most stable when docked with β-CD and least stable when docked with maltose. The docking analysis and MD simulation showed that the main subsites for substrate stabilization in the active site are -2, -1, +1 and +2. A bulky residue, Trp359 at the +2 subsite was identified to cause steric interference to the bound linear malto-oligosaccharides thus prevented it to occupy subsite +3, which can only be reached by a highly bent glucose molecule such as β-CD. The resulted modes of binding from docking simulation show a good correlation with the experimentally determined hydrolysis pattern. The subsite structure generated from this study led to a possible mode of action that revealed how maltose was mainly produced during hydrolysis. Furthermore, maltose only occupies subsite +1 and +2, therefore could not be hydrolyzed or transglycosylated by the enzyme. This important knowledge has paved the way for a novel structure-based molecular design for modulation of its catalytic activities.

  19. Location, number and morphology of parathyroid glands: results from a large anatomical series.

    PubMed

    Lappas, Dimitrios; Noussios, George; Anagnostis, Panagiotis; Adamidou, Fotini; Chatzigeorgiou, Antonios; Skandalakis, Panagiotis

    2012-09-01

    Surgical management of parathyroid gland disease may sometimes be difficult, due mainly to the surgeon's failure to successfully detect parathyroids in unusual locations. The records of 942 cadavers (574 men and 368 women) who underwent autopsy in the Department of Forensic Medicine in Athens during the period 1988-2009 were reviewed. In total, 3,796 parathyroid glands were resected and histologically verified. Parathyroid glands varied in number. In 47 cases (5 %), one supernumerary (fifth) parathyroid was found, while in 19 cases (2 %) three parathyroid glands found. Superior glands were larger than inferior ones. However, there was no significant difference between the genders with respect to gland size. In 324 (8.5 %) out of 3,796, the glands were detected in an ectopic location: 7 (0.2 %) in the thyroid parenchyma, 79 (2 %) in different sites in the neck and 238 (6.3 %) in the mediastinum, 152 (4.1 %) of which were found in the upper and 86 (2.2 %) in the lower mediastinum. Significant anatomical variations of normal parathyroid glands may exist regarding number and location-knowledge that is essential for their successful identification and surgical management.

  20. Subsite mapping of enzymes. Application of the depolymerase computer model to two alpha-amylases.

    PubMed Central

    Allen, J D; Thoma, J A

    1976-01-01

    In the preceding paper (Allen and Thoma, 1976) we developed a depolymerase computer model, which uses a minimization routine to establish a subsite map for a depolymerase. In the present paper we show how the model is applied to experimental data for two alpha-amylases. Michaelis parameters and bond-cleavage frequencies for substrates of chain lengths up to twelve glucosyl units have been reported for Bacillus amyloliquefaciens, and a subsite map has been proposed for this enzyme [Thoma et al. (1971) J. Biol. Chem. 246, 5621-5635]. By applying the computer model to the experimental data, we have arrived at a ten-subsite map. We find that a significant improvement in this map is achieved by allowing the hydrolytic rate coefficient to vary as a function of the number of occupied subsites comprising the enzyme-binding region. The bond-cleavage frequencies, the enzyme is found to have eight subsites. A partial subsite map is arrived at, but the entire binding region cannot be mapped because Michaelis parameters are complicated by transglycosylation reactions. The hydrolytic rate coefficients for this enzyme are not constant. PMID:999630

  1. Challenging Breast Augmentations: The Influence of Preoperative Anatomical Features on the Final Result

    PubMed Central

    Bayram, Yalcin; Zor, Fatih; Karagoz, Huseyin; Kulahci, Yalcin; Afifi, Ahmed M.; Ozturk, Serdar

    2016-01-01

    Background Achieving satisfactory results may be difficult in augmentation mammaplasty patients in the presence of breast, chest wall, or vertebral deformities. These deformities have not been classified previously, and the impact of each deformity or combination of deformities has not been defined. Objectives The aims of this study are to determine the complicating factors in augmentation mammaplasty, to classify these factors according to their influence on surgical outcome, and to develop an identification system for simplifying the recognition of challenging cases. Methods We retrospectively analyzed photographs and records of 100 consecutive patients who underwent augmentation mammaplasty. We observed suboptimal results in 18 cases. Preoperative deformities of the breast, chest wall, and vertebra were recorded in order to determine which factor or factors had complicated the surgeries. Eventually, the relationship between suboptimal surgical results and complicating factors was evaluated. Results We observed that some deformities alone caused suboptimal results, whereas others did not. Deformities that caused suboptimal results alone were called major complicating factors, and any others were called minor complicating factors. We observed that suboptimal results were also obtained in patients who had four minor complicating factors. Patients who had suboptimal results because of major or minor complicating factors were considered challenging cases. Conclusions In this study, complicating factors for augmentation mammaplasty were defined and classified as major or minor depending on their effect on the surgical outcome. We suggest an identification system that simplifies the recognition of challenging cases in breast augmentation. Level of Evidence: 4 Therapeutic PMID:26420774

  2. Eligibility for Renal Denervation: Anatomical Classification and Results in Essential Resistant Hypertension

    SciTech Connect

    Okada, Takuya Pellerin, Olivier; Savard, Sébastien; Curis, Emmanuel; Monge, Matthieu; Frank, Michael; Bobrie, Guillaume; Yamaguchi, Masato; Sugimoto, Koji; Plouin, Pierre-François; Azizi, Michel; Sapoval, Marc

    2015-02-15

    PurposeTo classify the renal artery (RA) anatomy based on specific requirements for endovascular renal artery denervation (RDN) in patients with drug-resistant hypertension (RH).Materials and MethodsThe RA anatomy of 122 consecutive RH patients was evaluated by computed tomography angiography and classified as two types: A (main RA ≥20 mm in length and ≥4.0 mm in diameter) or B (main RA <20 mm in length or main RA <4.0 mm in diameter). The A type included three subtypes: A1 (without accessory RAs), A2 (with accessory RAs <3.0 mm in diameter), and A3 (with accessory RAs ≥3.0 mm in diameter]. A1 and A2 types were eligible for RDN with the Simplicity Flex catheter. Type B included twi subtypes based on the main RA length and diameter. Patients were accordingly classified into three eligibility categories: complete (CE; both RAs were eligible), partial (PE; one eligible RA), and noneligibility (NE; no eligible RA).ResultsBilateral A1 type was the most prevalent and was observed in 48.4 % of the patients followed by the A1/A2 type (18 %). CE, PE, and NE were observed in 69.7, 22.9, and 7.4 % of patients, respectively. The prevalence of accessory RAs was 41 %.ConclusionsOf RH patients, 30.3 % were not eligible for bilateral RDN with the current Simplicity Flex catheter. This classification provides the basis for standardized reporting to allow for pooling of results of larger patient cohorts in the future.

  3. Uterine preservation for advanced pelvic organ prolapse repair: Anatomical results and patient satisfaction

    PubMed Central

    Fink, Keshet; Shachar, Inbar Ben; Braun, Naama Marcus

    2016-01-01

    ABSTRACT Objective: The aims of the current study were to evaluate outcomes and patient satisfaction in cases of uterine prolapse treated with vaginal mesh, while preserving the uterus. Materials and Methods: This is a retrospective cohort study that included all patients operated for prolapse repair with trocar-less vaginal mesh while preserving the uterus between October 2010 and March 2013. Data included: patients pre-and post-operative symptoms, POP-Q and operative complications. Success was defined as prolapse < than stage 2. A telephone survey questionnaire was used to evaluate patient's satisfaction. Results: Sixty-six patients with pelvic organ prolapse stage 3, including uterine pro-lapse of at least stage 2 (mean point C at+1.4 (range+8-(-1)) were included. Mean follow-up was 22 months. Success rate of the vaginal mesh procedure aimed to repair uterine prolapse was 92% (61/66), with mean point C at −6.7 (range (-1) - (-9)). No major intra-or post-operative complication occurred. A telephone survey questionnaire was conducted post-operatively 28 months on average. Ninety-eight percent of women were satisfied with the decision to preserve their uterus. Eighteen patients (34%) received prior consultation elsewhere for hysterectomy due to their prolapse, and decided to have the operation at our center in order to preserve the uterus. Conclusions: Uterine preservation with vaginal mesh was found to be a safe and effective treatment, even in cases with advanced uterine prolapse. Most patients prefer to keep their uterus. Uterus preservation options should be discussed with every patient before surgery for pelvic organ prolapse. PMID:27564289

  4. Musculoskeletal pain at various anatomical sites and socioeconomic position: Results of a national survey.

    PubMed

    Leclerc, A; Chastang, J-F; Taiba, R; Pascal, P; Cyr, D; Plouvier, S; Descatha, A

    2016-10-01

    Prevalence of musculoskeletal pain according to sites of pain and associated factors in the community has not been thoroughly documented. The association between pain and socioeconomic position has been studied by several authors, but without details in most studies regarding sites of pain, whereas the relations with social position could differ according to the site of pain. The objective of this study was to explore these differences in the community in France. The national Health and Occupational History survey was conducted in France in 2006 in subjects aged 20-74 years. Self-assessment of pain at various sites in the previous year was recorded. Five sites were considered here: back, neck, shoulder, upper limb, and lower limb. After a description of prevalence according to gender and age, the associations with socioeconomic position at the beginning of the subjects' working life, in seven categories, were studied with logistic models adjusted for age. The analyses were limited to those aged 30-74 years and were conducted separately for men and women. Of the 5520 males and 6643 females studied, prevalence was the highest for back pain (35% for males, 37% for females). Pain was globally more frequent for women. For all sites of pain an increase with age was significant for women. This was not observed in men for back pain (highest prevalence in the 40- to 49-year-old age group) or neck pain. Overall, prevalence of pain was the lowest for professionals (reference category in the analyses). For males, the first occupation as a farmer or blue-collar worker was associated with an increased prevalence for most sites of pain, with odds ratios close to 2. For females, prevalence was increased for more socioeconomic categories, as compared to professionals. Among the five sites, neck pain was an exception: for both men and women, no association was observed between neck pain and socioeconomic position. Although exploratory, these results are consistent with the

  5. The bZIP dimer localizes at DNA full-sites where each basic region can alternately translocate and bind to subsites at the half-site

    PubMed Central

    Chan, I-San; Al-Sarraj, Taufik; Shahravan, S. Hesam; Fedorova, Anna V.; Shin, Jumi A.

    2012-01-01

    Crystal structures of the GCN4 bZIP (basic region/leucine zipper) with the AP-1 or CRE site show how each GCN4 basic region binds to a 4-bp cognate half-site as a single DNA target; however, this may not always fully describe how bZIP proteins interact with their target sites. Previously, we showed that the GCN4 basic region interacts with all 5 bp in half-site TTGCG (termed 5H-LR), and that 5H-LR comprises two 4-bp subsites, TTGC and TGCG, which individually are also target sites of the basic region. In this work, we explored how the basic region interacts with 5H-LR when the bZIP dimer localizes to full-sites. Using AMBER molecular modeling, we simulated GCN4 bZIP complexes with full-sites containing 5H-LR to investigate in silico the interface between the basic region and 5H-LR. We also performed in vitro investigation of bZIP–DNA interactions at a number of full-sites that contain 5H-LR vs. either subsite: we analyzed results from DNase I footprinting and electrophoretic mobility shift assay (EMSA) and from EMSA titrations to quantify binding affinities. Our computational and experimental results together support a highly dynamic DNA-binding model: when a bZIP dimer localizes to its target full-site, the basic region can alternately recognize either subsite as a distinct target at 5H-LR and translocate between the subsites, potentially by sliding and hopping. This model provides added insights into how α-helical DNA-binding domains of transcription factors can localize to their gene regulatory sequences in vivo. PMID:22856882

  6. Subsite, T Class, and N Class Cannot be Used to Exclude the Retropharyngeal Nodes From Treatment De-Intensification in Advanced Oropharyngeal Squamous Cell Carcinoma

    PubMed Central

    Spector, Matthew E.; Chinn, Steven B.; Bellile, Emily; Gallagher, K. Kelly; Kang, Stephen Y.; Moyer, Jeffrey S.; Prince, Mark E.; Wolf, Gregory T.; Bradford, Carol R.; McHugh, Jonathan B.; Carey, Thomas E.; Worden, Francis P.; Eisbruch, Avraham; Ibrahim, Mohannad; Chepeha, Douglas B.

    2016-01-01

    Importance Understanding the drainage patterns to the retropharyngeal nodes is an important consideration in oropharyngeal squamous cell carcinoma (OPSCC) because treatment of these nodes is related to increased morbidity. Prediction of these drainage patterns could not only help minimize treatment morbidity, but could also prevent failures in at-risk patients, as de-escalation trials are underway for this disease. Objective To evaluate the prevalence of pathologic retropharyngeal adenopathy (RPA) in OPSCC relative to involvement of the oropharyngeal subsite, number of neck nodes, T classification and N classification. Design Retrospective review from 2003–2010 Setting Academic Referral Center Participants 205 previously untreated, advanced stage (III, IV), pathologically confirmed patients with OPSCC Exposure: Concurrent chemoradiation Main Outcome Measures Radiologic evidence of pathologic RPA was tabulated and related to involvement of the oropharyngeal subsite, number of neck nodes, T classification and N classification. Results Pathologic RPA was identified in 18% of patients. There were pathologic retropharyngeal lymph nodes in 12/89 (13%) base of tongue cancers, 24/109 (22%) tonsil cancers, and 1/7 (14%) other oropharyngeal subsite cancers. Increasing prevalence of RPA was positively correlated with closer proximity to the posterior tonsillar pillar. A multivariate predictive regression model using the oropharyngeal subsite, involvement of the posterior tonsillar pillar, number of metastatic nodes, T classification, and N classification, showed that the number of metastatic nodes was statistically significant with an odds ratio of 1.436 (p=0.0001, 95% confidence interval: 1.203 – 1.714). Conclusions and Relevance The prevalence of pathologic RPA in this cohort was 18% and patients with multiple nodes had the highest risk for pathologic RPA, followed by involvement of the posterior tonsillar pillar. However, this data suggests that there is no clear

  7. Signal-CF: a subsite-coupled and window-fusing approach for predicting signal peptides.

    PubMed

    Chou, Kuo-Chen; Shen, Hong-Bin

    2007-06-08

    We have developed an automated method for predicting signal peptide sequences and their cleavage sites in eukaryotic and bacterial protein sequences. It is a 2-layer predictor: the 1st-layer prediction engine is to identify a query protein as secretory or non-secretory; if it is secretory, the process will be automatically continued with the 2nd-layer prediction engine to further identify the cleavage site of its signal peptide. The new predictor is called Signal-CF, where C stands for "coupling" and F for "fusion", meaning that Signal-CF is formed by incorporating the subsite coupling effects along a protein sequence and by fusing the results derived from many width-different scaled windows through a voting system. Signal-CF is featured by high success prediction rates with short computational time, and hence is particularly useful for the analysis of large-scale datasets. Signal-CF is freely available as a web-server at http://chou.med.harvard.edu/bioinf/Signal-CF/ or http://202.120.37.186/bioinf/Signal-CF/.

  8. Long-term results following an anatomically based surgical technique for resection of colon cancer: a comparison with results from complete mesocolic excision.

    PubMed

    Bokey, L; Chapuis, P H; Chan, C; Stewart, P; Rickard, M J F X; Keshava, A; Dent, O F

    2016-07-01

    Complete mesocolic excision (CME) has been advocated as likely to improve the long-term oncological outcome of colon cancer resection, although there is a paucity of long-term results in the literature. The aim of this study was to supplement our previously published results on colon cancer resection based on a standardized technique of precise dissection along anatomical planes with high vascular ligation and to compare our long-term results with those of recent European studies of CME. Data were drawn from a prospective hospital registry of consecutive resections for colon cancer between 1996 and 2007, including follow-up to the end of 2012. The principal outcomes from potentially curative resections were 5-year Kaplan-Meier rates of local recurrence, systemic recurrence, overall survival and cancer-specific survival. Secondary outcomes for all resections were postoperative complications, number of lymph nodes retrieved and R0 status. For 779 potentially curative resections the local recurrence rate was 2.1% (95% CI 1.3-3.4), the systemic recurrence rate was 10.2% (95% CI 8.1-12.7), the 5-year overall survival rate was 76.2% (95% CI 73.0-79.0) and the cancer-specific survival rate was 89.8% (95% CI 87.3-91.9). For all 905 resections, rates of 14 surgical complications were low and not dissimilar to those in a comparable study. The median lymph node count was 15 (range 0-113). R0 status was confirmed in 883/905 patients (97.6%; 95% CI 96.4-98.5). For colon cancer, meticulous dissection along anatomical planes together with high vascular ligation results in few complications, a high R0 rate, low recurrence and high survival. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  9. Printed Three-dimensional Anatomic Templates for Virtual Preoperative Planning Before Reconstruction of Old Pelvic Injuries: Initial Results

    PubMed Central

    Wu, Xin-Bao; Wang, Jun-Qiang; Zhao, Chun-Peng; Sun, Xu; Shi, Yin; Zhang, Zi-An; Li, Yu-Neng; Wang, Man-Yi

    2015-01-01

    Background: Old pelvis fractures are among the most challenging fractures to treat because of their complex anatomy, difficult-to-access surgical sites, and the relatively low incidence of such cases. Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture. The goal of this study was to assess the use of three-dimensional (3D) printing techniques for surgical management of old pelvic fractures. Methods: First, 16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data. Next, nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models. The pelvic injuries were all type C, and the average time from injury to reconstruction was 11 weeks (range: 8–17 weeks). The workflow consisted of: (1) Printing patient-specific bone models based on preoperative computed tomography (CT) scans, (2) virtual fracture reduction using the printed 3D anatomic template, (3) virtual fracture fixation using Kirschner wires, and (4) preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation. These models aided communication between surgical team members during the procedure. This technique was validated by comparing the preoperative planning to the intraoperative procedure. Results: The accuracy of the 3D printed models was within specification. Production of a model from standard CT DICOM data took 7 hours (range: 6–9 hours). Preoperative planning using the 3D printed models was feasible in all cases. Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases. The patients were followed for 3–29 months (median: 5 months). The fracture healing time was 9–17 weeks (mean: 10 weeks). No delayed incision healing, wound infection, or nonunions occurred. The

  10. Acid-suppressing therapies and subsite-specific risk of stomach cancer.

    PubMed

    Wennerström, E Christina M; Simonsen, Jacob; Camargo, M Constanza; Rabkin, Charles S

    2017-04-25

    Associations of stomach cancer risk with histamine type-2 receptor antagonists (H2RA) and proton-pump inhibitors (PPI) are controversial. We hypothesised that proximal extension of Helicobacter pylori infection from acid suppression would disproportionately increase cancers at proximal subsites. A total of 1 563 860 individuals in the Danish Prescription Drug Registry first prescribed acid-suppressive drugs 1995-2011 were matched to unexposed population-based controls. Hazard ratios (HR) were calculated by Cox proportional hazard regression for stomach cancers diagnosed more than one year after first prescription. There were 703 stomach cancers among H2RA-exposed individuals and 1347 among PPI-exposed. Restricted to individuals with five or more prescriptions, subsite-specific HRs for H2RA and PPI were 4.1 and 6.4 for proximal subsites vs 8.0 and 10.3 for distal subsites, respectively. Moderate exposures to acid-suppressive drugs did not favour proximal tumour localisation. Given confounding by indication, these findings do not resolve potential contribution to gastric carcinogenesis overall.

  11. Neoadjuvant and adjuvant chemotherapy combined with anatomical resection of feline injection-site sarcoma: results in 21 cats.

    PubMed

    Bray, J; Polton, G

    2016-06-01

    This study assesses the outcome of two combined treatment strategies for the treatment of feline injection-site sarcoma (FISS). Twenty-one cats with primary or recurrent FISS received 3 cycles of neoadjuvant chemotherapy with epirubicin (25 mg m(-2) ), then an anatomical resection of the entire muscle compartment containing the tumour was performed based on the findings of co-axial imaging. Cats then received a further 3 cycles of adjuvant chemotherapy. Follow-up was performed by telephone contact with a median follow-up time of 1072 days. Three cats (14%) developed local tumour recurrence at days 264, 664 and 1573 after surgery. A median survival time could not be calculated as over 80% of the study population remained alive or were censored due to death from other causes. When compared to historical controls, the results of this study demonstrate superior rates of tumour-free survival and disease-free interval.

  12. The Munich Anatomical Institute under National Socialism. First results and prospective tasks of an ongoing research project.

    PubMed

    Schütz, Mathias; Waschke, Jens; Marckmann, Georg; Steger, Florian

    2013-07-01

    While research into the history of German anatomy under National Socialist rule has increased during the last decade, the story of one of the most important anatomical institutes of the time, the Anatomische Anstalt Munich, has not yet been explored. This study presents the results of an ongoing, cooperative research project at the universities of Halle and Munich and focuses on the history of the institution, its personnel and organization, and its interactions with the National Socialist regime. It reveals continuity and disruption within the institute following Munich anatomists' involvement with the regime's policies and ideology as well as their becoming victims to these policies. Also documented is the manner in which the Munich anatomy benefited from the massive increase in executions, especially during the Second World War, by receiving and using the bodies of prisoners executed at the Stadelheim prison in Munich for scientific purposes. Finally, an outlook is presented regarding planned research aiming to fully understand the history of the Anatomische Anstalt during National Socialism. Copyright © 2013 Elsevier GmbH. All rights reserved.

  13. Cartilage graft or fascia in tympanoplasty in patients with low middle ear risk index (anatomical and audological results).

    PubMed

    Callioglu, Elif Ersoy; Ceylan, B Tijen; Kuran, Gokhan; Demirci, Sule; Tulaci, Kamil Gokce; Caylan, Refik

    2013-11-01

    The aim of this study was to compare anatomic and audiological results of cartilage graft with temporal fascia graft in type 1 tympanoplasty patients with low middle ear risk index (MERI). In this retrospective study, 63 patients that underwent type 1 tympanoplasty with chondroperichondrial island graft between July 2009 and November 2010 were compared with 45 patients in whom temporal muscle fascia was used. Patients in both groups had low MERI values varying between 1 and 3. Five and nine patients underwent masteidectomy in cartilage and fascia group, respectively. Mean duration of follow-up was 11.9 ± 3.7 (5-17) months. Mean value was calculated at pre-operative and post-operative hearing threshold 0.5, 1, 2, 4 kHz, and air bone gap (ABG) gain was compared in both cartilage and fascia groups. when pre-operative and post-operative ABG gain were compared, significant decrease was seen in ABG levels (p < 0.001). However, no significant difference was seen in ABG gain values (p = 0.608), which was 10.1 ± 7.00 dB in cartilage group and 10.8 ± 5.38 dB in fascia group. In both groups, age, sex, and the addition of mastoidectomy procedure had no significant effect on ABG gain and success. Cartilage is a graft material that may be preferred without concern about the effects on hearing results, especially, in patients with low MERI values. The addition of mastoidectomy had no impact on the outcome of operation and audiological results. However, further studies with larger case series may be carried out to further clarify the issue.

  14. [Anatomical and functional results of macular hole surgery with internal limiting membrane peeling after 10-year follow-up].

    PubMed

    Foveau, P; Conart, J-B; Hubert, I; Selton, J; Berrod, J-P

    2016-09-01

    To evaluate the anatomical and functional results of macular hole surgery with internal limiting membrane (ILM) peeling after 10 years follow-up. Monocentric retrospective study of patients who had undergone macular hole surgery between 2003 and 2005 in the Nancy University Medical Center and still followed in the department in 2014. All patients underwent pars plana vitrectomy and ILM peeling without staining. Clinical examination at ten years including determination of best-corrected visual acuity (BCVA), evaluation of quality of life and spectral domain optical coherence tomography was performed. Four men and six women with mean age of 64±8 years were included. The mean diameter of the MH was 395±133μm. The mean best corrected visual acuity improved significantly from 0.90±0.22 logMAR to 0.14±0.14 logMAR after 10 years with a satisfactory quality of life in 90 % of patients. The integrity of the IS/OS layer was preserved in 9 eyes. Inner retinal dimples located in the temporal quadrant related to ILM peeling initiation were observed in 8 eyes. No significant RNFL or ganglion cell complex changes were found compared to the contralateral eye. Macular hole surgery with ILM peeling in this series resulted in a visual acuity gain of 8 ETDRS lines and persistent improvement in quality of life after a 10-year follow-up. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Variations in the predominant cultivable microflora of dental plaque at defined subsites on approximal tooth surfaces in children.

    PubMed

    Babaahmady, K G; Marsh, P D; Challacombe, S J; Newman, H N

    1997-02-01

    The distribution and composition of the resident microflora were determined in approximal gingival margin plaque from 21 premolars extracted from schoolchildren (mean age 12.0 +/- 1.8 yr). Indigo carmine (5% w v) was used to visualize plaque to facilitate sampling. About 1 mm2 of plaque was removed from sites away from (A), to the side of (S), and below (B) the contact area. Plaque samples were dispersed, serially diluted, and cultured on selective and non-selective agar media. An average of seven to nine species was found at each subsite. Streptococcus and Actinomyces were subdivided on the basis of a range of biochemical tests. The predominant Actinomyces and streptococcal species at most subsites were A. naeslundii and Strep. mitis biovar I. A. naeslundii and A. odontolyticus were isolated more often at subsite B (90.5 and 57.1%, respectively), and A. israelii at subsite S (66.7%) Strep. mitis 1 and Strep. sanguis were found more frequently at subsite S (76.2 and 66.7% respectively), whereas Strep mutans, Strep. sobrinus, Strep. gordonii and Veillonella spp. were recovered most commonly from subsite B (85.7, 33.3, 38.1 and 76.2%, respectively). The isolation frequencies of Strep. mutans and Strep. sobrinus were significantly higher at subsite B (A B p < 0.01 and p < 0.05, respectively). Veillonella spp. were significantly higher at subsites B and S (A < B, p > 0.01; B > S, p < 0.05), while Neisseria spp. were most common at subsite A (A > B. p > 0.03). IgAl protease-producing species were found at each subsite, but they formed only a small proportion of the total Streptococcus population. This study has shown that local variations were evident at different subsites, both with respect to species prevalence and to proportions of each species within each subsite. The population shifts in gingival margin plaque appear to relate to the location of plaque in relation to the most caries-prone site below the contact area B.

  16. Exploration of subsite binding specificity of human cathepsin D through kinetics and rule-based molecular modeling.

    PubMed Central

    Scarborough, P. E.; Guruprasad, K.; Topham, C.; Richo, G. R.; Conner, G. E.; Blundell, T. L.; Dunn, B. M.

    1993-01-01

    The family of aspartic proteinases includes several human enzymes that may play roles in both physiological and pathophysiological processes. The human lysosomal aspartic proteinase cathepsin D is thought to function in the normal degradation of intracellular and endocytosed proteins but has also emerged as a prognostic indicator of breast tumor invasiveness. Presented here are results from a continuing effort to elucidate the factors that contribute to specificity of ligand binding at individual subsites within the cathepsin D active site. The synthetic peptide Lys-Pro-Ile-Glu-Phe*Nph-Arg-Leu has proven to be an excellent chromogenic substrate for cathepsin D yielding a value of kcat/Km = 0.92 x 10(-6) s-1 M-1 for enzyme isolated from human placenta. In contrast, the peptide Lys-Pro-Ala-Lys-Phe*Nph-Arg-Leu and all derivatives with Ala-Lys in the P3-P2 positions are either not cleaved at all or cleaved with extremely poor efficiency. To explore the binding requirements of the S3 and S2 subsites of cathepsin D, a series of synthetic peptides was prepared with systematic replacements at the P2 position fixing either Ile or Ala in P3. Kinetic parameters were determined using both human placenta cathepsin D and recombinant human fibroblast cathepsin D expressed in Escherichia coli. A rule-based structural model of human cathepsin D, constructed on the basis of known three-dimensional structures of other aspartic proteinases, was utilized in an effort to rationalize the observed substrate selectivity. PMID:8443603

  17. Effects of guanidine hydrochloride and high pressure on subsite flexibility of beta-amylase.

    PubMed

    Tanaka, Naoki; Kajimoto, Sachie; Mitani, Daisuke; Kunugi, Shigeru

    2002-04-29

    We investigated the effects of guanidine hydrochloride (GuHCl) and high pressure on the conformational flexibility of the active site of sweet potato beta-amylase by monitoring the sulfhydryl reaction and the enzymatic activity. The reactivity of Cys345 at the active site, one of six inert half cystine residues of this enzyme, was enhanced by GuHCl at concentrations below 0.5 M. A GuHCl-induced change of the active site was also observed through an intensity change in the near-UV circular dichroism (CD) spectrum. On the other hand, the native conformation of sweet potato beta-amylase observed through fluorescence polarization, far-UV CD spectrum and intrinsic fluorescence was not influenced by GuHCl at concentrations below 0.5 M. Therefore, Cys345 reaction caused by GuHCl was due to an alteration of the local conformation of the active site. GuHCl-induced reaction of Cys345, located in the vicinity of subsites 3 and 4, is attributed to enhanced subsite flexibility, which is responsible for substrate slipping in a single-chain attack mechanism. Due to the flexible conformation, the local region of the subsite is more susceptible to GuHCl perturbation than the molecule overall. The enzymatic activity of sweet potato beta-amylase was reversibly inhibited by GuHCl at concentrations below 0.5 M, and kinetic analysis of the enzymatic mechanism showed that GuHCl decreases the kcat value. High pressure below 400 MPa also inactivated sweet potato beta-amylase with an increase in Cys345 reactivity. These findings indicated that excessively enhanced subsite flexibility reduced the enzymatic activity of sweet potato beta-amylase.

  18. Modified metaphyseal-loading anterolaterally flared anatomic femoral stem: five- to nine-year prospective follow-up evaluation and results of three-dimensional finite element analysis.

    PubMed

    Kokubo, Yasuo; Uchida, Kenzo; Oki, Hisashi; Negoro, Kohei; Nagamune, Kouki; Kawaguchi, Shogo; Takeno, Kenichi; Yayama, Takafumi; Nakajima, Hideaki; Sugita, Daisuke; Yoshida, Ai; Baba, Hisatoshi

    2013-02-01

    We have designed a proximal-fitting, anterolaterally flared, arc-deposit hydroxyapatite-coated anatomical femoral stem (FMS-anatomic stem; KYOCERA Medical, Osaka, Japan) for cementless total hip arthroplasty (THA) for Japanese patients with dysplastic hip osteoarthritis, using a nonlinear three-dimensional finite element analysis simulating loading conditions. The Anatomic Fit stem was modified in the region of the arc-sprayed surface, to allow more proximal appearance of spot welds. The aim of the present study was to analyze the clinical and radiographic outcomes of patients who underwent THA using this stem. We reviewed 73 consecutive patients (79 hips; 13 men 16 hips; 60 women 63 hips; age at surgery, 57.6 years, range, 35-78) who underwent cementless THA using the Anatomic Fit stem, at a follow-up period of 7.1 years (range, 5.1-9.4). Harris Hip score improved from 40.7 ± 17.1 before surgery to 91.0 ± 5.2 points at follow-up. The 7.1-year stem survival rate was 100%. Radiographs at follow-up confirmed the stability of the femoral stems within the femoral canal in all cases, with sufficient bone ingrowth. None of the patients had subsidence of the stem exceeding 2.0 mm within the femoral canal or changes in varus or valgus position of more than 2.0°. The Anatomic Fit stem provided excellent results. The nonlinear three-dimensional finite element analysis demonstrated that the stem-bone relative motion was 10 µm at the proximal end of the stem and proximal load transfer. Our analysis confirmed reduced radiolucency around the stem, minimal subsidence, appropriate stress shielding, and promising medium-term stability within the femoral canal.

  19. Obesity and positive surgical margins by anatomic location after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital database

    PubMed Central

    Jayachandran, Jayakrishnan; Aronson, William J.; Terris, Martha K.; Presti, Joseph C.; Amling, Christopher L.; Kane, Christopher J.; Freedland, Stephen J.

    2011-01-01

    OBJECTIVES To determine if there is predilection for any specific anatomical location of positive surgical margins (PSMs) after radical prostatectomy (RP) for prostate cancer in obese men, as previous studies found that obesity was associated with an increased risk of PSMs. PATIENTS AND METHODS We analysed retrospectively 1434 men treated with RP between 1989 and 2007 within the Shared Equal Access Regional Cancer Hospital database. The association between increased body mass index (BMI) and overall and site-specific PSMs was assessed using multivariate logistic regression. RESULTS After adjusting for several preoperative clinical and pathological characteristics, a higher BMI was associated with an increased risk of PSMs both overall and at all specific anatomical locations (all P ≤ 0.007). For mildly obese men, this risk was very similar across all anatomical sites (44–78% increased risk relative to men of normal weight). When BMI was coded as a continuous variable, the odds ratio for the risk of overall PSMs or at any specific locations was nearly identical at 1.05–1.06. Among men with a BMI of ≥35 kg/m2, there was more variation, with the highest excess risk of PSMs at the bladder neck and apex. CONCLUSIONS Obesity was associated with an increased risk of overall PSMs and at all anatomical locations. Although the excess risk of PSMs was similar across all anatomical locations, there was a suggestion of a higher risk of apical margins among the most obese men, which if validated, further supports the importance of the apical dissection in all men and suggests added difficulty in obese patients. PMID:18691176

  20. Is the supply of continuing education in the anatomical sciences keeping up with the demand? Results of a national survey.

    PubMed

    Wilson, Adam B; Barger, J Bradley; Perez, Patricia; Brooks, William S

    2017-09-14

    Continuing education (CE) is an essential element in the life-long learning of health care providers and educators. Despite the importance of the anatomical sciences in the training and practice of clinicians, no studies have examined the need/state of anatomy-related CE nationally. This study assessed the current landscape of CE in the anatomical sciences to contextualize preferences for CE, identify factors that influence the perceived need for CE, and examine the association between supply and demand. Surveys were distributed to educators in the anatomical sciences, practicing physical therapists (PTs), and anatomy training programs across the United States. Twenty-five percent (9 of 36) of training programs surveyed offered CE, certificates, or summer series programs related to anatomy. The majority of PTs (92%) and anatomy educators (81%) felt they had a potential or actual need for anatomy related CE with the most popular formats being online videos/learning modules and intensive, hands-on workshops. The most commonly perceived barriers to participating in CE for both groups were program location, cost, and duration, while educators also perceived time of year as a significant factor. Logistic regression analyses revealed that no investigated factor influenced the need or desire for PTs to engage in anatomy related CE (P ≤ 0.124), while teaching experience and the highest level of learner taught significantly influenced the perceived need among anatomy educators (P < 0.001). Overall, quantitative and qualitative analyses revealed a robust need for CE that strategically integrates anatomy with areas of clinical practice and education. Anat Sci Educ. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

  1. Iterative Saturation Mutagenesis of −6 Subsite Residues in Cyclodextrin Glycosyltransferase from Paenibacillus macerans To Improve Maltodextrin Specificity for 2-O-d-Glucopyranosyl-l-Ascorbic Acid Synthesis

    PubMed Central

    Han, Ruizhi; Shin, Hyun-dong; Chen, Rachel R.; Li, Jianghua; Chen, Jian

    2013-01-01

    2-O-d-Glucopyranosyl-l-ascorbic acid (AA-2G), a stable l-ascorbic acid derivative, is usually synthesized by cyclodextrin glycosyltransferase (CGTase), which contains nine substrate-binding subsites (from +2 to −7). In this study, iterative saturation mutagenesis (ISM) was performed on the −6 subsite residues (Y167, G179, G180, and N193) in the CGTase from Paenibacillus macerans to improve its specificity for maltodextrin, which is a cheap and easily soluble glycosyl donor for AA-2G synthesis. Site saturation mutagenesis of four sites—Y167, G179, G180, and N193—was first performed and revealed that four mutants—Y167S, G179R, N193R, and G180R—produced AA-2G yields higher than those of other mutant and wild-type CGTases. ISM was then conducted with the best positive mutant as a template. Under optimal conditions, mutant Y167S/G179K/N193R/G180R produced the highest AA-2G titer of 2.12 g/liter, which was 84% higher than that (1.15 g/liter) produced by the wild-type CGTase. Kinetics analysis of AA-2G synthesis using mutant CGTases confirmed the enhanced maltodextrin specificity and showed that compared to the wild-type CGTase, the mutants had no cyclization activity but high hydrolysis and disproportionation activities. A possible mechanism for the enhanced substrate specificity was also analyzed through structure modeling of the mutant and wild-type CGTases. These results indicated that the −6 subsite played crucial roles in the substrate binding and catalytic reactions of CGTase and that the obtained CGTase mutants, especially Y167S/G179K/N193R/G180R, are promising starting points for further development through protein engineering. PMID:24077706

  2. Iterative saturation mutagenesis of -6 subsite residues in cyclodextrin glycosyltransferase from Paenibacillus macerans to improve maltodextrin specificity for 2-O-D-glucopyranosyl-L-ascorbic acid synthesis.

    PubMed

    Han, Ruizhi; Liu, Long; Shin, Hyun-Dong; Chen, Rachel R; Li, Jianghua; Du, Guocheng; Chen, Jian

    2013-12-01

    2-O-d-Glucopyranosyl-l-ascorbic acid (AA-2G), a stable l-ascorbic acid derivative, is usually synthesized by cyclodextrin glycosyltransferase (CGTase), which contains nine substrate-binding subsites (from +2 to -7). In this study, iterative saturation mutagenesis (ISM) was performed on the -6 subsite residues (Y167, G179, G180, and N193) in the CGTase from Paenibacillus macerans to improve its specificity for maltodextrin, which is a cheap and easily soluble glycosyl donor for AA-2G synthesis. Site saturation mutagenesis of four sites-Y167, G179, G180, and N193-was first performed and revealed that four mutants-Y167S, G179R, N193R, and G180R-produced AA-2G yields higher than those of other mutant and wild-type CGTases. ISM was then conducted with the best positive mutant as a template. Under optimal conditions, mutant Y167S/G179K/N193R/G180R produced the highest AA-2G titer of 2.12 g/liter, which was 84% higher than that (1.15 g/liter) produced by the wild-type CGTase. Kinetics analysis of AA-2G synthesis using mutant CGTases confirmed the enhanced maltodextrin specificity and showed that compared to the wild-type CGTase, the mutants had no cyclization activity but high hydrolysis and disproportionation activities. A possible mechanism for the enhanced substrate specificity was also analyzed through structure modeling of the mutant and wild-type CGTases. These results indicated that the -6 subsite played crucial roles in the substrate binding and catalytic reactions of CGTase and that the obtained CGTase mutants, especially Y167S/G179K/N193R/G180R, are promising starting points for further development through protein engineering.

  3. Are Anatomic Results Influenced by WEB Shape Modification? Analysis in a Prospective, Single-Center Series of 39 Patients with Aneurysms Treated with the WEB.

    PubMed

    Herbreteau, D; Bibi, R; Narata, A P; Janot, K; Papagiannaki, C; Soize, S; Pierot, L

    2016-12-01

    Endovascular treatment with the flow-disrupter Woven EndoBridge aneurysm embolization system (WEB) is an innovative treatment for wide-neck bifurcation aneurysms. Prospective, multicenter studies have shown the high safety of this technique. Stability of aneurysm occlusion in long-term follow-up has been rarely studied. Moreover the "compression" phenomenon has been reported and seems to be associated with poor anatomic results. This prospective, single-center series analyzes the safety and efficacy of the WEB device in long-term follow-up in relation to WEB shape modification. All patients with aneurysms treated with the WEB were prospectively included in a data base. Demographics, aneurysm characteristics, adverse events, and anatomic results were retrospectively analyzed. Anatomic results and modification of the WEB shape on the follow-up examinations were independently evaluated by a core laboratory. Thirty-nine patients were included. We observed few complications: intraoperative rupture in no patients (0.0%) and thromboembolic events in 3 patients (7.7%) with a permanent deficit in 1 (2.6%). At short-term, midterm, and long-term follow-up, adequate occlusion was obtained in 86.8%, 83.3%, and 87.5%, respectively. Retreatment rates were low (5.1%). At 6 months, WEB shape modification (compression/retraction) was observed in 31.6% of patients but was not associated with a lower rate of adequate occlusion. This prospective, single-center series with WEB devices used in 39 patients during 3.5 years confirms data from previous multicenter studies. Treatment can be accomplished with good safety and efficacy, with a high rate of adequate occlusion. Anatomic results were not worse in case of WEB shape modification. © 2016 by American Journal of Neuroradiology.

  4. Prediction of Signal Peptide Cleavage Sites with Subsite-Coupled and Template Matching Fusion Algorithm.

    PubMed

    Zhang, Shao-Wu; Zhang, Ting-He; Zhang, Jun-Nan; Huang, Yufei

    2014-03-01

    Fast and effective prediction of signal peptides (SP) and their cleavage sites is of great importance in computational biology. The approaches developed to predict signal peptide can be roughly divided into machine learning based, and sliding windows based. In order to further increase the prediction accuracy and coverage of organism for SP cleavage sites, we propose a novel method for predicting SP cleavage sites called Signal-CTF that utilizes machine learning and sliding windows, and is designed for N-termial secretory proteins in a large variety of organisms including human, animal, plant, virus, bacteria, fungi and archaea. Signal-CTF consists of three distinct elements: (1) a subsite-coupled and regularization function with a scaled window of fixed width that selects a set of candidates of possible secretion-cleavable segment for a query secretory protein; (2) a sum fusion system that integrates the outcomes from aligning the cleavage site template sequence with each of the aforementioned candidates in a scaled window of fixed width to determine the best candidate cleavage sites for the query secretory protein; (3) a voting system that identifies the ultimate signal peptide cleavage site among all possible results derived from using scaled windows of different width. When compared with Signal-3L and SignalP 4.0 predictors, the prediction accuracy of Signal-CTF is 4-12 %, 10-25 % higher than that of Signal-3L for human, animal and eukaryote, and SignalP 4.0 for eukaryota, Gram-positive bacteria and Gram-negative bacteria, respectively. Comparing with PRED-SIGNAL and SignalP 4.0 predictors on the 32 archaea secretory proteins of used in Bagos's paper, the prediction accuracy of Signal-CTF is 12.5 %, 25 % higher than that of PRED-SIGNAL and SignalP 4.0, respectively. The predicting results of several long signal peptides show that the Signal-CTF can better predict cleavage sites for long signal peptides than SignalP, Phobius, Philius, SPOCTOPUS, Signal

  5. Internally quenched fluorescent peptide substrates disclose the subsite preferences of human caspases 1, 3, 6, 7 and 8.

    PubMed Central

    Stennicke, H R; Renatus, M; Meldal, M; Salvesen, G S

    2000-01-01

    Subsite interactions are considered to define the stringent specificity of proteases for their natural substrates. To probe this issue in the proteolytic pathways leading to apoptosis we have examined the P(4), P(1) and P(1)' subsite preferences of human caspases 1, 3, 6, 7 and 8, using internally quenched fluorescent peptide substrates containing o-aminobenzoyl (also known as anthranilic acid) and 3-nitro-tyrosine. Previous work has demonstrated the importance of the S(4) subsite in directing specificity within the caspase family. Here we demonstrate the influence of the S(1) and S(1)' subsites that flank the scissile peptide bond. The S(1) subsite, the major specificity-determining site of the caspases, demonstrates tremendous selectivity, with a 20000-fold preference for cleaving substrates containing aspartic acid over glutamic acid at this position. Thus caspases are among the most selective of known endopeptidases. We find that the caspases show an unexpected degree of discrimination in the P(1)' position, with a general preference for small amino acid residues such as alanine, glycine and serine, with glycine being the preferred substituent. Large aromatic residues are also surprisingly well-tolerated, but charged residues are prohibited. While this describes the general order of P(1)' subsite preferences within the caspase family, there are some differences in individual profiles, with caspase-3 being particularly promiscuous. Overall, the subsite preferences can be used to predict natural substrates, but in certain cases the cleavage site within a presumed natural substrate cannot be predicted by looking for the preferred peptide cleavage sites. In the latter case we conclude that second-site interactions may overcome otherwise sub-optimal cleavage sequences. PMID:10947972

  6. Thulium laser versus staplers for anatomic pulmonary resections with incomplete fissures: negative results of a randomized trial.

    PubMed

    Scanagatta, Paolo; Furia, Simone; Billè, Andrea; Duranti, Leonardo; Girelli, Lara; Tavecchio, Luca Domenico; Leo, Francesco; Giovannetti, Riccardo; Pelosi, Giuseppe; Porcu, Luca; Pastorino, Ugo

    2014-01-01

    This randomized trial evaluated the feasibility and safety of thulium 2010-nm laser to perform anatomic lung resections in patients with incomplete fissures, as compared to mechanical staplers with or without sealants. Seventy-two patients scheduled for segmentectomy or lobectomy were enrolled. After intraoperative confirmation of the extent of resection and incomplete fissures (Craig type 2, 3 or 4), they were randomized and allocated to one of the following arms: laser resection by thulium (group A) or standard resection with mechanical staplers with or without sealants (group B). The primary endpoints of the study included analysis of intraoperative and postoperative course, and costs. Thirty-eight patients were assigned to group A (32 lobectomies, 6 segmentectomies) and 34 to group B (31 lobectomies, 3 segmentectomies). No 30-day mortality was observed. Median operative times were 145.0 minutes (group A) and 142.5 minutes (group B, P = 0.83). The median time to drainage removal was 5 days (group A) and 4 days (group B), while the median length of hospital stay was the same (7 days). Prolonged air leaks >7 days were observed in 12 patients of group A (32%) and 10 patients of group B (29%, P = 0.46). Unpredictable late pneumothorax occurred in 3 patients of group A (2 readmissions, need for 1 repeat thoracotomy). Cost analysis demonstrated an intraoperative advantage for group A (mean 807 ± 212 euro) versus group B (mean 1,047+/-276 euro, P <0.0001), but the differences in total costs could be due to chance (P = 0.83). The use of laser to complete fissures can lead to late pneumothorax, even in the absence of postoperative air leaks. Moreover, the use of laser to complete fissures did not prove to reduce overall costs. Trial Registration Identification Number: 41/10 (IRB00001457 - FWA00001798 - IORG0001063).

  7. [Ranibizumab and exudative age-related macular degeneration: 5-year multicentric functional and anatomical results in real-life practice].

    PubMed

    Boulanger-Scemama, E; Sayag, D; Ha Chau Tran, T; Quaranta-El Maftouhi, M; Rumen, F; Creuzot-Garcher, C; Blanco Garavito, R; Jung, C; Souied, E

    2016-10-01

    The goal of this study was to evaluate five year functional and anatomical outcomes of wet AMD patients treated with ranibizumab according to a pro re nata (PRN) regimen in real-life practice. A retrospective, multicentric chart review of 201 eyes of 201 patients who underwent their first ranibizumab intravitreal injection (IVT) between January 1, 2007 and December 31, 2008 was performed. Best-corrected visual acuity (BCVA), central macular thickness (CMT) on SD-OCT, number of IVT and follow-up visits were collected at baseline and during the entire follow-up period of 5 years. Mean BCVA at baseline was 52.3±16.5 letters. Mean BCVA change from baseline was respectively +2.8, +2.5, +1.8, -0.6 at 1, 2, 3, 4 years of follow-up. At year 5, 43% of eyes had a stable or improved letter score (≥0 letter gain), whereas 29% declined by 15 letters or more, with an overall significant mean decline of 2.8 letters (P<0.05). No correlation was observed between final visual outcome and age, baseline BCVA, type of neovascularization, naive status, number of IVT or number of follow-up visits. On SD-OCT, mean CMT was 293±96μm at baseline and was significantly reduced compared to baseline at each year end-point (P<0.005). The mean number of IVT was 15±10.4 at year 5, with 55% of eyes still being under active treatment. PRN ranibizumab in real-life practice improved or stabilized visual acuity over 4 years. During the 5th year, progressive decline of visual acuity was observed. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Probing the S2' Subsite of the Anthrax Toxin Lethal Factor Using Novel N-Alkylated Hydroxamates.

    PubMed

    Kurbanov, Elbek K; Chiu, Ting-Lan; Solberg, Jonathan; Francis, Subhashree; Maize, Kimberly M; Fernandez, Jenna; Johnson, Rodney L; Hawkinson, Jon E; Walters, Michael A; Finzel, Barry C; Amin, Elizabeth Ambrose

    2015-11-12

    The lethal factor (LF) enzyme secreted by Bacillus anthracis is a zinc hydrolase that is chiefly responsible for anthrax-related cell death. Although many studies of the design of small molecule LF inhibitors have been conducted, no LF inhibitor is yet available as a therapeutic agent. Inhibitors with considerable chemical diversity have been developed and investigated; however, the LF S2' subsite has not yet been systematically explored as a potential target for lead optimization. Here we present synthesis, experimental evaluation, modeling, and structural biology for a novel series of sulfonamide hydroxamate LF inhibitor analogues specifically designed to extend into, and probe chemical preferences of, this S2' subsite. We discovered that this region accommodates a wide variety of chemical functionalities and that a broad selection of ligand structural modifications directed to this area can be incorporated without significant deleterious alterations in biological activity. We also identified key residues in this subsite that can potentially be targeted to improve inhibitor binding.

  9. Activity of a peptidase secreted by Phanerochaete chrysosporium depends on lysine to subsite S'1.

    PubMed

    da Silva, Ronivaldo Rodrigues; de Oliveira, Lilian Caroline Gonçalves; Juliano, Maria Aparecida; Juliano, Luiz; Rosa, Jose C; Cabral, Hamilton

    2017-01-01

    Peptidases are enzymes that catalyze the rupture of peptide bonds. Catalytic specificity studies of these enzymes have illuminated their modes of action and preferred hydrolysis targets. We describe the biochemical characteristics and catalytic specificity of a lysine-dependent peptidase secreted by the basidiomycete fungus Phanerochaete chrysosporium. We attained 5.7-fold purification of a ∼23-kDa neutral peptidase using size-exclusion (Sephadex G-50 resin) and ion-exchange (Source 15S resin) chromatography. Using the Fluorescence Resonance Energy Transfer substrate Abz-KLRSSKQ-EDDnp, we detected maximal activity at pH 7.0 and 45-55°C. The peptidase retained ∼80% of its enzymatic activity for a wide range of conditions (pH 4-9; temperatures up to 50°C for 1h). The peptidase activity was lowered by the ionic surfactants, sodium dodecyl sulfate and cetyltrimethylammonium bromide; the reducing agent, dithiothreitol; the chaotrope, guanidine; copper (II) ion; and the cysteine peptidase-specific inhibitors, iodoacetic acid and N-ethylmaleimide. The peptidase preferred the basic amino acids K and R and high selectivity on S'1 subsite, exhibiting a condition of lysine-dependence to catalysis on anchoring of this subsite. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Treatment of osteonecrosis of the femoral head with focal anatomic-resurfacing implantation (HemiCAP): preliminary results of an alternative option.

    PubMed

    Bilge, Onur; Doral, Mahmut Nedim; Yel, Mustafa; Karalezli, Nazim; Miniaci, Anthony

    2015-04-28

    The optimal treatment of osteonecrosis of the femoral head has not been established yet. The aim of this study was to report preliminary clinical results of focal anatomic-resurfacing implantation for the treatment of osteonecrosis of the femoral head. Five patients (four male, one female) with seven surgical procedures, ages between 37 and 52 with an average age of 45.2 (+/- 7.2), diagnosed as femoral head avascular necrosis and who were unresponsive to conservative management or had failed previous surgical treatments were treated with a focal anatomic femoral head resurfacing between the years 2011-2012 and were retrospectively reviewed. Five patients with at least two years of follow-up, one left hip, two right hips, and two patients with bilateral hip surgery were included in this review. After safe surgical dislocation of the hip, full exposure of the femoral head was established. A focal-resurfacing implant matching patient anatomy and femoral head curvature was performed accordingly. Neither intraoperative or postoperative complications nor revision ensued. Visual analogue scores and Harris Hip Scores were recorded both preoperatively and at postoperative 2 years for all seven surgeries. The mean follow-up period was 26.6 +/- 3.8 months, with a range between 24-33 months. The mean visual analogue scores were 8.9 +/- 0.9 preoperatively and 2.3 +/- 1.0 postoperatively at year two (p = 0.017). Harris Hip Scores at postoperative follow-up were found to improve significantly from good to excellent scores (86.0 +/- 7.9), compared with preoperative poor scores (26.7 +/- 11.8) (p = 0.018). The clinical improvements in visual analogue scores (VAS) and Harris Hip Scores were also found to correlate with each other (p < 0.05). In the present study, the alternative technique of focal anatomic hip resurfacing with HemiCAP® yielded preliminary successful results for the treatment of osteonecrosis of the femoral head. To the best of our knowledge, this is

  11. A veterinary digital anatomical database.

    PubMed

    Snell, J R; Green, R; Stott, G; Van Baerle, S

    1991-01-01

    This paper describes the Veterinary Digital Anatomical Database Project. The purpose of the project is to investigate the construction and use of digitally stored anatomical models. We will be discussing the overall project goals and the results to date. Digital anatomical models are 3 dimensional, solid model representations of normal anatomy. The digital representations are electronically stored and can be manipulated and displayed on a computer graphics workstation. A digital database of anatomical structures can be used in conjunction with gross dissection in teaching normal anatomy to first year students in the professional curriculum. The computer model gives students the opportunity to "discover" relationships between anatomical structures that may have been destroyed or may not be obvious in the gross dissection. By using a digital database, the student will have the ability to view and manipulate anatomical structures in ways that are not available through interactive video disk (IVD). IVD constrains the student to preselected views and sections stored on the disk.

  12. Preliminary results by flow-sensitive magnetic resonance imaging after Tiron David I procedure with an anatomically shaped ascending aortic graft.

    PubMed

    Frydrychowicz, Alex; Berger, Alexander; Stalder, Aurélien F; Markl, Michael

    2009-08-01

    We present preliminary data of the vascular hemodynamics in a novel, anatomically shaped ascending aortic graft in comparison to non-operated individuals by use of 3D magnetic resonance (MR) flow measurements. We examined a 72-year-old male patient after Tiron David I valve sparing aortic root reconstruction and replacement of the ascending aorta (AAo) with an anatomically curved prosthesis. Results from flow-sensitive MR at 3T were compared to 12 age-matched individuals with comparable diameters of the AAo. For 3D flow visualization, streamlines and time-resolved particle traces were applied. A visual analysis of hemodynamic properties including blood flow helicity, vorticity and retrograde flow was performed. In contrast to reported highly disturbed flow of straight aortic grafts in the literature, the patient analysis revealed smooth blood flow through the graft which gave rise to a right-handed helical flow in the reconstructed aorta. In comparison to non-operated volunteers, blood flow helicity was more pronounced. Flow jets or vortices were not encountered. While physiological retrograde flow was seen in the volunteers, it was absent in the patient which may be explained by the altered aortic compliance and thus reduced Windkessel effect. This promising finding will have to prove its validity in further comparative studies.

  13. Long-term administration of cocaine or serotonin reuptake inhibitors results in anatomical and neurochemical changes in noradrenergic, dopaminergic, and serotonin pathways.

    PubMed

    Horne, Malcolm K; Lee, Joohyung; Chen, Feng; Lanning, Katherine; Tomas, Doris; Lawrence, Andrew J

    2008-08-01

    The catechol and indole pathways are important components underlying plasticity in the frontal cortex and basal ganglia. This study demonstrates that administering rats either cocaine or a selective serotonin (or 5-hydroxytryptamine; 5-HT) reuptake inhibitor (SSRI) for 16 weeks results in reduced density of dopaminergic and noradrenergic terminals in the striatum and olfactory bulb, respectively, reflecting pruning of the terminal arbor of ventral midbrain dopaminergic and locus coeruleus noradrenergic neurones. In the striatum of cocaine-treated animals, basal dopamine levels, as well as cocaine-induced dopamine release, is diminished compared with controls. In contrast, serotonergic fibers, projecting from the raphe, sprout and have increased terminal density in the lateral septal nucleus and frontal cortex, following long-term cocaine or SSRI treatment. This is associated with elevated basal 5-HT and enhanced cocaine-induced 5-HT release in the frontal cortex. The anatomical and neurochemical changes in serotonergic fibers following cocaine or SSRI treatment may be explained by attenuated 5-HT(1A) autoreceptor function in the raphe. This study demonstrates extensive plasticity in the morphology and neurochemistry of the catechol and indole pathways that contribute to drug-induced plasticity of the corticostriatal (and other) projections. Moreover, our data suggest that drug-induced plastic adaptation is anatomically widespread and consequently, likely to have multiple and complex consequences.

  14. Outcome after internal fixation of intraarticular distal humerus (AO type B & C) fractures: Preliminary results with anatomical distal humerus LCP system.

    PubMed

    Patel, Jwalant; Motwani, Girish; Shah, Himanshu; Daveshwar, Rajeev

    2017-01-01

    The treatment of intraarticular fractures of the distal humerus is challenging and involves the risk of complications and bad functional results. Anatomical and stable internal fixation with early postoperative mobilization is expected to improve the functional outcomes. The objective of this study was to evaluate the functional and radiological results, along with the complications associated, of open reduction and internal fixation using precontoured anatomical locking LCP plate system for intraarticular distal humerus fractures in adult patients. This prospective study consist of 31 patients with a mean age of 41.2 years (range 19-62) were treated with open reduction and angular stable internal fixation. All underwent posterior transolecranon surgical approach. Mean follow-up to the final interview was 10 months (from 6 to 20 months). All operated patients were available at the time of last followup. AO classification showed 26 C-fractures (9*13C 1, 12*13C2,5* 13C3) and 5 B-fracture (1* 13B1,1* 13B2,3* 13B3). There were 25 closed fractures and 6 open grade 1 fractures. The clinical followup using Mayo elbow performance score (MEPS) and radiographic follow up with elbow anterior-posterior and lateral view X-rays were performed postoperatively. The mean MEPS was 87.9 points out of 100 (range 55-100) with 61% Excellent, 29% good and 10% fair and poor scores. Mean elbow flexion of 115.8° (range 85°-150°). The mean deficit in extension was 19° (range 5°-35°). All olecranon osteotomy were united .Nonunion of distal humerus fracture occurred in 2 cases. Other complications were hardware prominence in 3 cases, superficial infection in 4 cases and Ulnar nerve neuropraxia in 1 case which was recovered uneventfully. Revision surgery was not required in any complication. Open reduction and internal fixation with precontoured distal humerus anatomical locking plate system is a good method of treatment for complex Supra- intercondylar fracture of distal humerus with

  15. Good vs Poor Results After Total Hip Arthroplasty: An Analysis Method Using Implant and Anatomic Parameters With the EOS Imaging System.

    PubMed

    Bendaya, Samy; Anglin, Carolyn; Lazennec, Jean-Yves; Allena, Rachele; Thoumie, Philippe; Skalli, Wafa

    2016-09-01

    Existing imaging techniques and single-parameter analyses, in nonfunctional positions, fail to detect the differences between patients with good vs poor results after total hip arthroplasty. The present study developed an analysis method using the EOS full-body, low-dose, biplanar, weightbearing imaging system to compare good vs poor patients after total hip arthroplasty and to report on our preliminary experiences (17 good, 18 poor). All revision cases were found to have at least 4 high or low implant or anatomic parameters relative to the good group. These included acetabular cup orientation, sagittal pelvic tilt, sacral slope, femoral offset, and neck-shaft angle. Acetabular cup orientation differed significantly between groups. With the EOS system, a large cohort can be studied relatively quickly and at low dose, which could lead to patient-specific guidelines. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Crystal structure of a new benzoic acid inhibitor of influenza neuraminidase bound with a new tilt induced by overpacking subsite C6

    PubMed Central

    2012-01-01

    Background Influenza neuraminidase (NA) is an important target for antiviral inhibitors since its active site is highly conserved such that inhibitors can be cross-reactive against multiple types and subtypes of influenza. Here, we discuss the crystal structure of neuraminidase subtype N9 complexed with a new benzoic acid based inhibitor (2) that was designed to add contacts by overpacking one side of the active site pocket. Inhibitor 2 uses benzoic acid to mimic the pyranose ring, a bis-(hydroxymethyl)-substituted 2-pyrrolidinone ring in place of the N-acetyl group of the sialic acid, and a branched aliphatic structure to fill the sialic acid C6 subsite. Results Inhibitor 2 {4-[2,2-bis(hydroxymethyl)-5-oxo-pyrrolidin-1-yl]-3-[(dipropylamino)methyl)]benzoic acid} was soaked into crystals of neuraminidase of A/tern/Australia/G70c/75 (N9), and the structure refined with 1.55 Å X-ray data. The benzene ring of the inhibitor tilted 8.9° compared to the previous compound (1), and the number of contacts, including hydrogen bonds, increased. However, the IC50 for compound 2 remained in the low micromolar range, likely because one propyl group was disordered. In this high-resolution structure of NA isolated from virus grown in chicken eggs, we found electron density for additional sugar units on the N-linked glycans compared to previous neuraminidase structures. In particular, seven mannoses and two N-acetylglucosamines are visible in the glycan attached to Asn200. This long, branched high-mannose glycan makes significant contacts with the neighboring subunit. Conclusions We designed inhibitor 2 with an extended substituent at C4-corresponding to C6 of sialic acid-to increase the contact surface in the C6-subsite and to force the benzene ring to tilt to maximize these interactions while retaining the interactions of the carboxylate and the pyrolidinone substituents. The crystal structure at 1.55 Å showed that we partially succeeded in that the ring in 2 is tilted

  17. The use of a modular system to convert an anatomical total shoulder arthroplasty to a reverse shoulder arthroplasty: Clinical and radiological results.

    PubMed

    Weber-Spickschen, T S; Alfke, D; Agneskirchner, J D

    2015-12-01

    If a modular convertible total shoulder system is used as a primary implant for an anatomical total shoulder arthroplasty, failure of the prosthesis or the rotator cuff can be addressed by converting it to a reverse shoulder arthroplasty (RSA), with retention of the humeral stem and glenoid baseplate. This has the potential to reduce morbidity and improve the results. In a retrospective study of 14 patients (15 shoulders) with a mean age of 70 years (47 to 83) we reviewed the clinical and radiological outcome of converting an anatomical shoulder arthroplasty (ASA) to a RSA using a convertible prosthetic system (SMR system, Lima, San Daniele, Italy). The mean operating time was 64 minutes (45 to 75). All humeral stems and glenoid baseplates were found to be well-fixed and could be retained. There were no intra-operative or early post-operative complications and no post-operative infection. The mean follow-up was 43 months (21 to 83), by which time the mean visual analogue scale for pain had decreased from 8 pre-operatively to 1, the mean American Shoulder and Elbow Surgeons Score from 12 to 76, the mean Oxford shoulder score from 3 to 39, the mean Western Ontario Osteoarthritis of the Shoulder Score from 1618 to 418 and the mean Subjective shoulder value from 15 to 61. On radiological review, one patient had a lucency around the humeral stem, two had stress shielding. There were no fatigue fractures of the acromion but four cases of grade 1 scapular notching. The use of a convertible prosthetic system to revise a failed ASA reduces morbidity and minimises the rate of complications. The mid-term clinical and radiological results of this technique are promising.

  18. Anatomic single-bundle anterior cruciate ligament reconstruction using the outside-in femoral tunnel drilling technique: a prospective study and short- to mid-term results.

    PubMed

    Abdelkafy, Ashraf

    2015-03-01

    Anatomic positioning of the femoral and tibial tunnels in the native ACL femoral and tibial footprints requires an independent drilling either via an accessory medial portal (trans-portal drilling) or using an outside-in drilling technique. Conventional trans-tibial drilling (dependant drilling) was found to lack the ability to accurately position the femoral tunnel in the native ACL footprint. The purpose of the current study was to evaluate the functional outcome results of anatomic single-bundle ACLR using the OI femoral tunnel drilling technique. Single surgeon single center prospective case series study. 64 patients having complete ACL tears were included in the current study. Average follow-up was 15.8 months (range 8-25). Objective and subjective IKDC scores, Lysholm knee score, SF-36 score, VAS for patients' satisfaction, VAS for pain and Kellgren and Lawrence (K/L) classification of osteoarthritis were used for follow-up evaluation. Objective IKDC score revealed that 60 patients had grade ''A'' and 4 had grade ''B'', while no single patient had neither grade ''C'' nor ''D''. The average Lysholm Score was 92.4, average subjective IKDC was 91.5. Average SF-36 score was 96.7. The average VAS for operation satisfaction was 9.7. Average VAS for pain was 0.3. Forty-nine patients were classified as normal K/L classification, 7 were grade ''1'', 8 were grade ''2''. Comparing pre-operative and follow-up Objective IKDC, Subjective IKDC, Lysholm, SF-36 and VAS for pain scores revealed statistically significant differences (P value <0.05). Arthroscopic-assisted ACL reconstruction using the outside-in femoral tunnel drilling technique shows a good and satisfactory functional outcome results at short- to mid-term follow-up. Level IV.

  19. Laparoscopic anatomic liver resection

    PubMed Central

    Vibert, Eric; Kouider, Ali

    2004-01-01

    Background Liver resection is reputed to be one of the most difficult procedures embraced in laparoscopy. This report shows that with adequate training, anatomical liver resection including major hepatectomies can be performed. Methods This is a retrospective study. Results From 1995 to 2004, among 84 laparoscopic liver resections, 46 (54%) anatomical laparoscopic hepatectomies were performed in our institution by laparoscopy. Nine (20%) patients had benign disease while 37 (80%) had malignant lesions. Among those with malignant lesions, 14 patients had hepatocellular carcinoma (HCC), 18 had colorectal metastasis (CRM), while 5 had miscellaneous tumours. For benign disease, minor (two Couinaud's segments or less) and major anatomic hepatectomies were performed in five and four patients, respectively. For malignant lesions, minor and major anatomic hepatectomies were performed in 15 and 22 patients, respectively. Overall, conversion to laparotomy was necessary in 7 (15%) patients. Blood transfusion was required in five (10%) patients. One patient died of cerebral infarction 8 days after a massive peroperative haemorrhage. The overall morbidity rate was 34% whatever the type of resection. Three patients required reoperation, either for haemorrhage (n=1) and/or biliary leak (n=2). For CRM (n=18), overall and disease-free survival at 24 months (mean follow-up of 17 months) were 100% and 56%, respectively. For HCC (n=14), overall and disease-free survival at 36 months (mean follow-up of 29 months) were 91% and 65%, respectively. No port site metastasis occurred in patients with malignancy. Conclusions After a long training with limited liver resection in superficial segments, laparoscopic anatomical minor and major resections are feasible. Short-term carcinological results seem to be similar to those obtained with laparotomy. PMID:18333079

  20. The complexity of anatomical systems

    PubMed Central

    Grizzi, Fabio; Chiriva-Internati, Maurizio

    2005-01-01

    Background The conception of anatomical entities as a hierarchy of infinitely graduated forms and the increase in the number of observed anatomical sub-entities and structural variables has generated a growing complexity, thus highlighting new properties of organised biological matter. Results (1) Complexity is so pervasive in the anatomical world that it has come to be considered as a primary characteristic of anatomical systems. (2) Anatomical entities, when viewed at microscopic as well as macroscopic level of observation, show a different degree of complexity. (3) Complexity can reside in the structure of the anatomical system (having many diverse parts with varying interactions or an intricate architecture) or in its behaviour. Often complexity in structure and behaviour go together. (4) Complex systems admit many descriptions (ways of looking at the system) each of which is only partially true. Each way of looking at a complex system requires its own description, its own mode of analysis and its own breaking down of the system in different parts; (5) Almost all the anatomical entities display hierarchical forms: their component structures at different spatial scales or their process at different time scales are related to each other. Conclusion The need to find a new way of observing and measuring anatomical entities, and objectively quantifying their different structural changes, prompted us to investigate the non-Euclidean geometries and the theories of complexity, and to apply their concepts to human anatomy. This attempt has led us to reflect upon the complex significance of the shape of an observed anatomical entity. Its changes have been defined in relation to variations in its status: from a normal (i.e. natural) to a pathological or altered state introducing the concepts of kinematics and dynamics of anatomical forms, speed of their changes, and that of scale of their observation. PMID:16029490

  1. Recognition of chitooligosaccharides and their N-acetyl groups by putative subsites of chitin deacetylase from a deuteromycete, Colletotrichum lindemuthianum.

    PubMed

    Tokuyasu, K; Mitsutomi, M; Yamaguchi, I; Hayashi, K; Mori, Y

    2000-08-01

    The reaction pattern of an extracellular chitin deacetylase from a Deuteromycete, Colletotrichum lindemuthianum ATCC 56676, was investigated by use of chitooligosaccharides [(GlcNAc)(n)(), n = 3-6] and partially N-deacetylated chitooligosaccharides as substrates. When 0.5% of (GlcNAc)(n)() was deacetylated, the corresponding monodeacetylated products were initially detected without any processivity, suggesting the involvement of a multiple-chain mechanism for the deacetylation reaction. The structural analysis of these first-step products indicated that the chitin deacetylase strongly recognizes a sequence of four N-acetyl-D-glucosamine (GlcNAc) residues of the substrate (the subsites for the four GlcNAc residues are defined as -2, -1, 0, and +1, respectively, from the nonreducing end to the reducing end), and the N-acetyl group in the GlcNAc residue positioned at subsite 0 is exclusively deacetylated. When substrates of a low concentration (100 microM) were deacetylated, the initial deacetylation rate for (GlcNAc)(4) was comparable to that of (GlcNAc)(5), while deacetylation of (GlcNAc)(3) could not be detected. Reaction rate analyses of partially N-deacetylated chitooligosaccharides suggested that subsite -2 strongly recognizes the N-acetyl group of the GlcNAc residue of the substrate, while the deacetylation rate was not affected when either subsite -1 or +1 was occupied with a D-glucosamine residue instead of GlcNAc residue. Thus, the reaction pattern of the chitin deacetylase is completely distinct from that of a Zygomycete, Mucor rouxii, which produces a chitin deacetylase for accumulation of chitosan in its cell wall.

  2. Tyrosine sulfation of human trypsin steers S2' subsite selectivity towards basic amino acids.

    PubMed

    Szabó, András; Salameh, Moh'd A; Ludwig, Maren; Radisky, Evette S; Sahin-Tóth, Miklós

    2014-01-01

    Human cationic and anionic trypsins are sulfated on Tyr154, a residue which helps to shape the prime side substrate-binding subsites. Here, we used phage display technology to assess the significance of tyrosine sulfation for the specificity of human trypsins. The prime side residues P1'-P4' in the binding loop of bovine pancreatic trypsin inhibitor (BPTI) were fully randomized and tight binding inhibitor phages were selected against non-sulfated and sulfated human cationic trypsin. The selection pattern for the two targets differed mostly at the P2' position, where variants selected against non-sulfated trypsin contained primarily aliphatic residues (Leu, Ile, Met), while variants selected against sulfated trypsin were enriched also for Arg. BPTI variants carrying Arg, Lys, Ile, Leu or Ala at the P2' position of the binding loop were purified and equilibrium dissociation constants were determined against non-sulfated and sulfated cationic and anionic human trypsins. BPTI variants harboring apolar residues at P2' exhibited 3-12-fold lower affinity to sulfated trypsin relative to the non-sulfated enzyme, whereas BPTI variants containing basic residues at P2' had comparable affinity to both trypsin forms. Taken together, the observations demonstrate that the tyrosyl sulfate in human trypsins interacts with the P2' position of the substrate-like inhibitor and this modification increases P2' selectivity towards basic side chains.

  3. Tumour thickness as a predictor of nodal metastases in oral cancer: comparison between tongue and floor of mouth subsites.

    PubMed

    Balasubramanian, Deepak; Ebrahimi, Ardalan; Gupta, Ruta; Gao, Kan; Elliott, Michael; Palme, Carsten E; Clark, Jonathan R

    2014-12-01

    To identify whether tumour thickness as a predictor of nodal metastases in oral squamous cell carcinoma differs between tongue and floor of mouth (FOM) subsites. Retrospective review of 343 patients treated between 1987 and 2012. The neck was considered positive in the presence of pathologically proven nodal metastases on neck dissection or during follow-up. There were 222 oral tongue and 121 FOM tumours. In patients with FOM tumours 2.1-4mm thick, the rate of nodal metastases was 41.7%. In contrast, for tongue cancers of a similar thickness the rate was only 11.2%. This increased to 38.5% in patients with tongue cancers that were 4.1-6mm thick. Comparing these two subsites, FOM cancers cross the critical 20% threshold of probability for nodal metastases between 1 and 2mm whereas tongue cancers cross the 20% threshold just under 4mm thickness. On logistic regression adjusting for relevant covariates, there was a significant difference in the propensity for nodal metastases based on tumour thickness according to subsite (p=0.028). Thin FOM tumours (2.1-4mm) have a high rate of nodal metastases. Elective neck dissection is appropriate in FOM tumours ⩾2mm thick and in tongue tumours ⩾4mm thick. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. [Comparison of anatomic and functional results between Z6 femtosecond laser assisted and manual trephination in deep anterior lamellar keratoplasty for advanced keratoconus [French version

    PubMed

    Blériot, A; Martin, E; Lebranchu, P; Zimmerman, K; Libeau, L; Weber, M; Vabres, B; Orignac, I

    2017-09-01

    The management of severe keratoconus requires corneal transplantation, for which the gold standard is deep anterior lamellar keratoplasty (DALK), preserving the healthy Descemet's membrane and endothelium. The safety and reproducibility of corneal cuts have been improved by the evolution of femtosecond lasers in refractive surgery, and femtosecond laser in DALK would seem to provide the same advantages over the manual method. In our retrospective study, we compare functional and anatomical results of femtosecond assisted DALK versus manual trephination DALK in patients with keratoconus in stage 4 of the Krumeich classification. It is a retrospective study including all patients with stage 4 keratoconus who underwent femtosecond laser assisted DALK between November 2012 and November 2015 in Nantes hospital. We compared those patients to a group of patients who underwent manual DALK in the same period, paired by age and maximal keratometry. We assessed visual acuity, pachymetry, endothelial cell density (specular microscopy), and keratometry before surgery and at 4, 8 and 12 months of follow-up. Laser settings and intraoperative complications were recorded. Nineteen patients underwent surgery by femtosecond assisted DALK, 6 women and 12 men with average age 30.2±10.8 years at transplantation. They were paired with a group of 17 patients who underwent manual DALK in order to compare results. Before surgery, mean visual acuity in the femtosecond group was 0.90 logMAR versus 0.89 logMAR in the manual group, showing no statistically significant difference (P=0.96). Both groups were similar in terms of preoperative age, mean keratometry, pachymetry and endothelial cell density. Average visual acuity post-surgery was 0.27, 0.26; and 0.14 logMAR for femtosecond DALK versus 0.27, 0.17 et 0.25 for manual DALK at 4, 8 and 12 months follow-up, respectively showing no statistically significant difference. After surgery, at 4, 8 and 12 months, mean pachymetry

  5. Comparison of 12-month anatomic and functional results between Z6 femtosecond laser-assisted and manual trephination in deep anterior lamellar keratoplasty for advanced keratoconus.

    PubMed

    Blériot, A; Martin, E; Lebranchu, P; Zimmerman, K; Libeau, L; Weber, M; Vabres, B; Orignac, I

    2017-06-01

    The management of severe keratoconus requires corneal transplantation, for which the gold standard is deep anterior lamellar keratoplasty (DALK), preserving the healthy Descemet's membrane and endothelium. The safety and reproducibility of corneal cuts have been improved by the evolution of femtosecond lasers in refractive surgery, and femtosecond laser in DALK would seem to provide the same advantages over the manual method. In our retrospective study, we compare functional and anatomical results of femtosecond-assisted DALK versus manual trephination DALK in patients with keratoconus in stage 4 of the Krumeich classification. It is a retrospective study including all patients with stage 4 keratoconus who underwent femtosecond laser-assisted DALK between November 2012 and November 2015 in Nantes university medical center. We compared those patients to a group of patients who underwent manual DALK in the same period, paired by age and maximal keratometry. We assessed visual acuity, pachymetry, endothelial cell density (specular microscopy), and keratometry before surgery and at 4, 8 and 12 months of follow-up. Laser settings and intraoperative complications were recorded. Nineteen patients underwent surgery by femtosecond-assisted DALK, 6 women and 12 men with average age 30.2±10.8 years at transplantation. They were paired with a group of 17 patients who underwent manual DALK in order to compare results. Before surgery, mean visual acuity in the femtosecond group was 0.90 logMAR versus 0.89 logMAR in the manual group, showing no statistically significant difference (P=0.96). Both groups were similar in terms of preoperative age, mean keratometry, pachymetry and endothelial cell density. Average visual acuity post-surgery was 0.27; 0.26; and 0.14 logMAR for femtosecond DALK versus 0.27; 0.17 et 0.25 for manual DALK at 4, 8 and 12 months follow-up respectively, showing no statistically significant difference. After surgery, at 4, 8 and 12 months, mean

  6. Evaluation of anatomical and functional results of overlapping anal sphincter repair with or without the injection of bone marrow aspirate concentrate: a case-control study.

    PubMed

    Khafagy, W W; El-Said, M M; Thabet, W M; Aref, S E-S; Omar, W; Emile, S H; Elfeki, H; El-Ghonemy, M S; El-Shobaky, M T

    2017-01-01

    Overlapping anal sphincter repair (OASR) is used for treatment of faecal incontinence due to an external anal sphincter (EAS) defect; however, it is not the optimal treatment as its functional results tend to deteriorate significantly with time. The present study aimed to evaluate the effect of local injection of bone marrow aspirate concentrate (BMAC) on the outcome of OASR. We compared a prospective group of 20 patients with EAS defect who were managed with OASR and BMAC injection (group I) with a historical control group of an equal number of patients managed with OASR alone (group II). Patients were assessed preoperatively and during follow-up by the Wexner continence score and endoanal ultrasound. The primary end-points were the improvement of the continence level measured by the Wexner score and the residual EAS defect size measured by endoanal ultrasound. At the end of follow-up, group I had significantly lower mean postoperative Wexner score (5.4 ± 7.6 vs 10.6 ± 7.4; P = 0.03) and smaller EAS defect percentage (12.2 ± 17.5 vs 18.3 ± 18.9). These findings were statistically significant in patients with a small preoperative EAS defect equal to or less than one-third of the anal circumference. Patients with larger preoperative EAS did not show a significant improvement of the continence level after repair in either group. Augmenting OASR with local injection of BMAC in patients with faecal incontinence caused by an EAS defect, particularly a smaller defect, can improve both functional and anatomical outcomes of OASR. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  7. The results of percutaneous release of trigger digits by using full handle knife 15 degrees: an anatomical hand surface landmark and clinical study.

    PubMed

    Jongjirasiri, Yolchai

    2007-07-01

    Know the results of percutaneous release of trigger digits by using full handle knife 15 degrees. The author identified 510 cadaveric digits to find the anatomical landmark of Al pulley that relates to the knuckle and measurements of A1 pulley lengths. The proximal margin of the Al pulleys on the perpendicular line from the knuckle to the palm was in the same line in 327 (64.1%) digits, while 464 (91.0%) digits were < or =1 mm and 509 (99.8%) were < or =2 mm. The average lengths of A1 pulleys in each digit were as follows: thumb; 5.30, index finger; 6.32, middle finger; 6.58, ring finger; 6.32, and little finger 5.30 mm. The average lengths of all fingers were 6.13 mm. A further 338 digits of trigger digit in 248 patients were treated by percutaneous release by using full handle knife 15 degrees with these landmarks. Three hundred and thirty-eight trigger digits were treated. There was a complete resolution of symptoms in 314 digits (92.90%) when followed up 6 weeks after operation. One digit, an index finger had residual grade 1 after 3 weeks and complete resolution in 8 weeks. Three digits (0.89%), which were one thumb and two index fingers, underwent local steroid injection because of painful scar. Nineteen digits (5.62%) were stiff at proximal interphalangeal joint because of grade 4 triggering and osteoarthritis of the proximal interphalangeal joint but they increased the range of motion after 6 months. A case (0.30%) had numbness of the radial tip of the thumb, which may have been caused by injury to the radial digital nerve ofthe thumb. No one had open release of A1 pulley. This technique was a safe and effective out patient procedure on 248 patients and had a complete resolution of symptoms 92.90%.

  8. The degree of intratumor mutational heterogeneity varies by primary tumor sub-site

    PubMed Central

    Eterovic, Agda Karina; Wick, Jo; Chen, Ken; Zhao, Hao; Tazi, Loubna; Manna, Pradip; Kerley, Spencer; Joshi, Radhika; Wang, Lin; Chiosea, Simion I.; Garnett, James David; Tsue, Terance Ted; Chien, Jeremy; Mills, Gordon B.; Grandis, Jennifer Rubin; Thomas, Sufi Mary

    2016-01-01

    In an era where mutational profiles inform treatment options, it is critical to know the extent to which tumor biopsies represent the molecular profile of the primary and metastatic tumor. Head and neck squamous cell carcinoma (HNSCC) arise primarily in the mucosal lining of oral cavity and oropharynx. Despite aggressive therapy the 5-year survival rate is at 50%. The primary objective of this study is to characterize the degree of intratumor mutational heterogeneity in HNSCC. We used multi-region sequencing of paired primary and metastatic tumor DNA of 24 spatially distinct samples from seven patients with HNSCC of larynx, floor of the mouth (FOM) or oral tongue. Full length, in-depth sequencing of 202 genes implicated in cancer was carried out. Larynx and FOM tumors had more than 69.2% unique SNVs between the paired primary and metastatic lesions. In contrast, the oral tongue HNSCC had only 33.3% unique SNVs across multiple sites. In addition, HNSCC of the oral tongue had fewer mutations than larynx and FOM tumors. These findings were validated on the Affymetrix whole genome 6.0 array platform and were consistent with data from The Cancer Genome Atlas (TCGA). This is the first report demonstrating differences in mutational heterogeneity varying by subsite in HNSCC. The heterogeneity within laryngeal tumor specimens may lead to an underestimation of the genetic abnormalities within tumors and may foster resistance to standard treatment protocols. These findings are relevant to investigators and clinicians developing personalized cancer treatments based on identification of specific mutations in tumor biopsies. PMID:27034009

  9. Conformational dynamics of threonine 195 and the S1 subsite in functional trypsin variants.

    PubMed

    Gokey, Trevor; Baird, Teaster T; Guliaev, Anton B

    2012-11-01

    Replacing the catalytic serine in trypsin with threonine (S195T variant) leads to a nearly complete loss of catalytic activity, which can be partially restored by eliminating the C42-C58 disulfide bond. The 0.69 μs of combined explicit solvent molecular dynamics (MD) simulations revealed continuous rearrangement of T195 with different conformational preferences between five trypsin variants tested. Among three conformational families observed for the T195 residue, one showed the T195 hydroxyl in a conformation analogous to that of the serine residue in wild-type trypsin, positioning the hydroxyl oxygen atom for attack on the carbonyl carbon of the peptide substrate. MD simulations demonstrated that this conformation was more populated for the C42A/C58V/S195T and C42A/C58A/S195T triple variants than for the catalytically inactive S195T variant and correlated with restored enzymatic activities for triple variants. In addition, observation of the increased motion of the S214-G219 segment in the S195T substituted variants suggested an existence of open and closed conformations for the substrate binding pocket. The closed conformation precludes access to the S1 binding site and could further reduce enzymatic activities for triple variants. Double variants with intact serine residues (C42A/C58A/S195 and C42A/C58V/S195) also showed interchange between closed and open conformations for the S214-G219 segment, but to a lesser extent than the triple variants. The increased conformational flexibility of the S1 subsite, which was not observed for the wild-type, correlated with reduced enzymatic activities and suggested a possible mode of substrate regulation for the trypsin variants tested.

  10. [Guepar anatomical trapeziometacarpal prosthesis].

    PubMed

    Masmejean, E; Alnot, J Y; Chantelot, C; Beccari, R

    2003-02-01

    A choice of surgical techniques of treatment for trapeziometacarpal (TMC) Osteo-Arthritis (OA) have been described. Total arthroplasty is often used, especially in France. Many papers have been published, presenting various prostheses. In English literature, this device is not thoroughly used. [corrected] Guepar total arthroplasty is a cemented ball-in-socket prosthesis in metal-polyethylene. It includes an anatomical stem available in 4 sizes. After failure of the conservative treatment, total arthroplasty must be reserved to elderly patients, painful, with OA Dell stage III or IV aligned or not. The trapezial height must be sufficient. The authors reports the preliminary results of 64 Guepar prostheses, anatomical new design, implanted since 1995. Results of 63 prostheses are presented. One removal had been necessary at 9 months for metacarpal loosening (failure). Mean follow-up was 29 months. Clinical results were judged excellent or good in all cases. Regarding the radiological results, no modifications has been observed in 56 cases. Six radiolucent lines without displacement of the implants has been noted, with no incidence on clinical results. In one case, a metacarpal stem penetrated into the medullary canal in the bone axis but without any clinical modifications. Clinically, in addition to pain relief, trapeziometacarpal prosthesis allows to preserve the first column length and to obtain a better opposition of the thumb as well of a better thumb-digits pinch, compared after trapeziectomy. Radiologically, as for total hip arthroplasty, the exact adaptation of an anatomical stem (new design) to the canal has probably a better prognosis at long term follow-up.

  11. Autologous in vitro cultured vaginal tissue for vaginoplasty in women with Mayer-Rokitansky-Küster-Hauser syndrome: anatomic and functional results.

    PubMed

    Benedetti Panici, Pierluigi; Maffucci, Diana; Ceccarelli, Simona; Vescarelli, Enrica; Perniola, Giorgia; Muzii, Ludovico; Marchese, Cinzia

    2015-02-01

    To present the procedure and the results of a technique in which in vitro autologous cell cultures were used for the canal lining in patients with Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) subjected to vaginoplasty with a modified Abbè-McIndoe technique. MRKHS is a rare anomaly characterized by vaginal agenesis with variable müllerian duct abnormalities. The Abbè-McIndoe procedure is 1 of the most frequent surgical treatments adopted in these women. In the last decades, several modifications have been introduced by different authors, mostly changing the lining material, but no consensus has been reached on what material should be used for the neovagina canal wall lining. A pilot study (Canadian Task Force classification II-1). Policlinico Umberto I, "Sapienza" University of Rome. A consecutive series of 23 women with MRKHS underwent neovaginoplasty with autologous vaginal tissue as the graft material between 2006 and 2013. Each patient with MRKHS was subjected to a full-thickness mucosal biopsy from the vaginal vestibule. After enzymatic dissociation, cells were inoculated onto collagen IV-coated plates and cultured for 2 to 3 weeks. The patients were subjected to vaginoplasty with a modified Abbè-McIndoe technique with autologous in vitro cultured vaginal tissue. Patients underwent clinical follow-up visits at 1, 3, 6, and 12 months after surgery and every year thereafter. Anatomic, functional, and sexual results were assessed. In all cases, the vagina appeared normal in length and depth. A vaginal cytology and a vaginal biopsy obtained at the 3-month follow-up visit revealed physiological vaginal tissue. All 23 patients completed the Female Sexual Function Index questionnaire at 12 months after surgery. The results showed a total score of 27.2. These results indicate a satisfactory quality of sexual life. The modified Abbè-McIndoe technique with autologous vaginal tissue appears to be safe and feasible. This technique allows normal and

  12. A veterinary digital anatomical database.

    PubMed Central

    Snell, J. R.; Green, R.; Stott, G.; Van Baerle, S.

    1991-01-01

    This paper describes the Veterinary Digital Anatomical Database Project. The purpose of the project is to investigate the construction and use of digitally stored anatomical models. We will be discussing the overall project goals and the results to date. Digital anatomical models are 3 dimensional, solid model representations of normal anatomy. The digital representations are electronically stored and can be manipulated and displayed on a computer graphics workstation. A digital database of anatomical structures can be used in conjunction with gross dissection in teaching normal anatomy to first year students in the professional curriculum. The computer model gives students the opportunity to "discover" relationships between anatomical structures that may have been destroyed or may not be obvious in the gross dissection. By using a digital database, the student will have the ability to view and manipulate anatomical structures in ways that are not available through interactive video disk (IVD). IVD constrains the student to preselected views and sections stored on the disk. Images Figure 1 PMID:1807707

  13. Surgery for Type III-IV hiatal hernia: anatomical recurrence and global results after elective treatment of short oesophagus with open and minimally invasive surgery.

    PubMed

    Lugaresi, Marialuisa; Mattioli, Benedetta; Daddi, Niccolò; Di Simone, Massimo Pierluigi; Perrone, Ottorino; Mattioli, Sandro

    2016-04-01

    Type III-IV hiatal hernia (HH) is associated with a true short oesophagus in more than 50% of cases; dedicated treatment of this condition might be appropriate to reduce the recurrence rate after surgery. A case series of patients receiving surgery for Type III-IV hernia was examined for short oesophagus, and the results were analysed. From 1980 to 1994, 60 patients underwent an open surgical approach, and the position of the oesophago-gastric junction was visually localized; from 1995 to 2013, 48 patients underwent a minimally invasive approach, and the oesophago-gastric junction was objectively localized using a laparoscopic-endoscopic method. The patients underwent a timed clinical-instrumental follow-up that included symptoms assessment, barium swallow and endoscopy. The results were considered to be excellent in the absence of symptoms and oesophagitis; good, if symptoms occurred two to four times a month in the absence of oesophagitis; fair, if symptoms occurred two to four times a week in the presence of hyperaemia, oedema and/or microscopic oesophagitis; and poor, if symptoms occurred on a daily basis in the presence of any grade of endoscopic oesophagitis, HH of any size or type, or the need for antireflux medical therapy. The follow-up time was calculated from the time of surgery to the last complete follow-up. Among the open surgery patients, 78% underwent abdominal fundoplication, 10% the Belsey Mark IV procedure, 8% laparotomic Collis-Nissen fundoplication and 3% the Pearson operation. Among the minimally invasive surgery patients, 44% underwent a laparoscopic floppy Nissen procedure and 56% a left thoracoscopic Collis-laparoscopic Nissen procedure. The postoperative mortality and complication rates were 1.6% (1/60) and 15% for open surgery and 4.1% (2/48) and 12.5% for minimally invasive surgery. A total of 105 patients were followed up for a median period of 96 months. Five relapses occurred after open surgery (5/59, 8%) and two after minimally

  14. The exo- or endonucleolytic preference of bovine pancreatic ribonuclease A depends on its subsites structure and on the substrate size

    PubMed Central

    Cuchillo, Claudi M.; Moussaoui, Mohamed; Barman, Tom; Travers, Franck; Nogués, M. Victòria

    2002-01-01

    The cleavage pattern of oligocytidylic acid substrates by bovine pancreatic ribonuclease A (RNase A) was studied by means of reversed-phase HPLC. Oligocytidylic acids, ranging from dinucleotides to heptanucleotides, were obtained by RNase A digestion of poly(C). They were identified by MALDI-TOF mass spectrometry; it was confirmed that all of them corresponded to the general structure (Cp)nC>p, in which C>p indicates a 2`,3`-cyclic phosphate. This is a confirmation of the proposed mechanism for RNase A, wherein the so-called hydrolytic (or second) step is in fact a special case of the reverse of transphosphorylation (first step). The patterns of cleavage for the oligonucleotide substrates show that the native enzyme has no special preference for endonucleolytic or exonucleolytic cleavage, whereas a mutant of the enzyme (K7Q/R10Q-RNase A) lacking p2 (a phosphate binding subsite adjacent, on the 3` side, to the main phosphate binding site p1) shows a clear exonucleolytic pattern; a mutant (K66Q-RNase A) lacking p0 (a phosphate binding subsite adjacent, on the 5` side, to the main phosphate binding site p1) shows a more endonucleolytic pattern. This indicates the important role played by the subsites on the preference for the bond cleaved. Molecular modeling shows that, in the case of the p2 mutant, the amide group of glutamine can form a hydrogen bond with the 2`,3`-cyclic terminal phosphate, whereas the distance to a 3`,5`-phosphodiester bond is too long to form such a hydrogen bond. This could explain the preference for exonucleolytic cleavage shown by the p2 mutant. PMID:11742128

  15. SARS-CoV 3CL protease cleaves its C-terminal autoprocessing site by novel subsite cooperativity

    PubMed Central

    Muramatsu, Tomonari; Takemoto, Chie; Kim, Yong-Tae; Wang, Hongfei; Nishii, Wataru; Terada, Takaho; Shirouzu, Mikako

    2016-01-01

    The 3C-like protease (3CLpro) of severe acute respiratory syndrome coronavirus (SARS-CoV) cleaves 11 sites in the polyproteins, including its own N- and C-terminal autoprocessing sites, by recognizing P4–P1 and P1′. In this study, we determined the crystal structure of 3CLpro with the C-terminal prosequence and the catalytic-site C145A mutation, in which the enzyme binds the C-terminal prosequence of another molecule. Surprisingly, Phe at the P3′ position [Phe(P3′)] is snugly accommodated in the S3′ pocket. Mutations of Phe(P3′) impaired the C-terminal autoprocessing, but did not affect N-terminal autoprocessing. This difference was ascribed to the P2 residue, Phe(P2) and Leu(P2), in the C- and N-terminal sites, as follows. The S3′ subsite is formed by Phe(P2)-induced conformational changes of 3CLpro and the direct involvement of Phe(P2) itself. In contrast, the N-terminal prosequence with Leu(P2) does not cause such conformational changes for the S3′ subsite formation. In fact, the mutation of Phe(P2) to Leu in the C-terminal autoprocessing site abolishes the dependence on Phe(P3′). These mechanisms explain why Phe is required at the P3' position when the P2 position is occupied by Phe rather than Leu, which reveals a type of subsite cooperativity. Moreover, the peptide consisting of P4–P1 with Leu(P2) inhibits protease activity, whereas that with Phe(P2) exhibits a much smaller inhibitory effect, because Phe(P3′) is missing. Thus, this subsite cooperativity likely exists to avoid the autoinhibition of the enzyme by its mature C-terminal sequence, and to retain the efficient C-terminal autoprocessing by the use of Phe(P2). PMID:27799534

  16. Anatomic Anterolateral Ligament Reconstruction Improves Postoperative Clinical Outcomes Combined with Anatomic Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Qiu, Man; Zhou, Aiguo; Zhang, Jian; Jiang, Dianming

    2016-01-01

    A significant cohort of patients is plagued by postoperative rotational instability after the anatomic anterior cruciate ligament (ACL) reconstruction surgery. Anatomic anterolateral ligament (ALL) reconstruction was performed in this study with the aim to assess the clinical role of ALL in knee’s stability and joint functions. Sixty patients were recruited and divided into three groups to perform the operations of anatomic single-bundle ACL reconstruction, anatomic double-bundle ACL reconstruction, and anatomic single-bundle ACL reconstruction + anterolateral ligament reconstruction, respectively. And then postoperative knee’s stability and joint functions were evaluated to compare the clinical outcomes among the three different kind of operations. The postoperative knee’s stability and joint functions of the anatomic double-bundle ACL reconstruction group and the anatomic single-bundle ACL reconstruction + ALL reconstruction group were better than the anatomic single-bundle ACL reconstruction group. No significant difference was observed between the anatomic double-bundle ACL reconstruction group and the anatomic single-bundle ACL reconstruction + ALL reconstruction group. The anatomic anterolateral ligament reconstruction could improve the clinical outcomes after patients performed the anatomic single-bundle anterior cruciate ligament reconstruction. This indicates that the anterolateral ligament plays a crucial role in knee’s stability and joint function, especially the rotational stability. Key points Anatomic anterolateral ligament reconstruction combined with anatomic anterior cruciate ligament reconstruction was performed to treat the patients with ACL rupture. Compared to the anatomic single-bundle ACL reconstruction group, the anatomic single-bundle ACL reconstruction + ALL reconstruction group achieve a better clinical outcomes. The results suggest that the anterolateral ligament plays a crucial role in knee’s stability and joint function

  17. Gene-environment interactions in determining differences in genetic susceptibility to cancer in subsites of the head and neck.

    PubMed

    Maurya, Shailendra S; Katiyar, Tridiv; Dhawan, Ankur; Singh, Sudhir; Jain, Swatantra K; Pant, Mohan C; Parmar, Devendra

    2015-04-01

    Genetic differences in susceptibility to cancer in subsites of the head and neck were investigated in a case-control study involving 750 cases of cancers of the oral cavity, larynx, or pharynx, and an equal number of healthy controls. The prevalence of variant genotypes of cytochrome P450 (CYP) 1A1, 1B1, 2E1, or glutathione-S-transferase M1 (null) in cases suggests that polymorphisms in drug metabolizing enzymes (DMEs) modify cancer risk within subsites of the head and neck. Tobacco or alcohol use was found to increase the risk in cases of laryngeal, pharyngeal, or oral cavity cancers. Interaction between genetic variation in DMEs and tobacco smoke (or smoking) exposures conferred significant risk for laryngeal cancer. Likewise, strong associations of the polymorphic genotypes of DMEs with cases of pharyngeal and oral cavity cancer who were tobacco chewers or alcohol users demonstrate that gene-environment interactions may explain differences in genetic susceptibility for cancers of the oral cavity, larynx, and pharynx. © 2014 Wiley Periodicals, Inc.

  18. [Improving maltodextrin specificity by site-saturation engineering of subsite +1 in cyclodextrin glycosyltransferase from Paenibacillus macerans].

    PubMed

    Xu, Qiaoyan; Han, Ruizhi; Li, Jianghua; Du, Guocheng; Liu, Long; Chen, Jian

    2014-01-01

    By engineering the subsite +1 of cyclodextrin glycosyltransferase (CGTase) from Paenibacillus macerans, we improved its maltodextrin specificity for 2-O-D-glucopyranosyl-L-ascorbic acid (AA-2G) synthesis. Specifically, we conducted site-saturation mutagenesis on Leu194, Ala230, and His233 in subsite +1 separately and gained 3 mutants L194N (leucine --> asparagine), A230D (alanine --> aspartic acid), and H233E (histidine --> glutamic acid) produced higher AA-2G yield than the wild-type and the other mutant CGTases. Therefore, the 3 mutants L194N, A230D, and H233E were further used to construct the double and triple mutations. Among the 7 obtained combinational mutants, the triple mutant L194N/A230D/H233E produced the highest AA-2G titer of 1.95 g/L, which was increased by 62.5% compared with that produced by the wild-type CGTase. Then, we modeled the reaction kinetics of all the mutants and found a substrate inhibition by high titer of L-AA for the mutants. The optimal temperature, pH, and reaction time of all the mutants were also determined. The structure modeling indicated that the enhanced maltodextrin specificity may be related with the changes of hydrogen bonding interactions between the side chain of residue at the three positions (194, 230 and 233) and the substrate sugars.

  19. SU-D-17A-04: The Impact of Audiovisual Biofeedback On Image Quality During 4D Functional and Anatomic Imaging: Results of a Prospective Clinical Trial

    SciTech Connect

    Keall, P; Pollock, S; Yang, J; Diehn, M; Berger, J; Graves, E; Loo, B; Yamamoto, T

    2014-06-01

    Purpose: The ability of audiovisual (AV) biofeedback to improve breathing regularity has not previously been investigated for functional imaging studies. The purpose of this study was to investigate the impact of AV biofeedback on 4D-PET and 4D-CT image quality in a prospective clinical trial. We hypothesized that motion blurring in 4D-PET images and the number of artifacts in 4D-CT images are reduced using AV biofeedback. Methods: AV biofeedback is a real-time, interactive and personalized system designed to help a patient self-regulate his/her breathing using a patient-specific representative waveform and musical guides. In an IRB-approved prospective clinical trial, 4D-PET and 4D-CT images of 10 lung cancer patients were acquired with AV biofeedback (AV) and free breathing (FB). The 4D-PET images in 6 respiratory bins were analyzed for motion blurring by: (1) decrease of GTVPET and (2) increase of SUVmax in 4-DPET compared to 3D-PET. The 4D-CT images were analyzed for artifacts by: (1) comparing normalized cross correlation-based scores (NCCS); and (2) quantifying a visual assessment score (VAS). A two-tailed paired t-test was used to test the hypotheses. Results: The impact of AV biofeedback on 4D-PET and 4D-CT images varied widely between patients, suggesting inconsistent patient comprehension and capability. Overall, the 4D-PET decrease of GTVPET was 2.0±3.0cm3 with AV and 2.3±3.9cm{sup 3} for FB (p=0.61). The 4D-PET increase of SUVmax was 1.6±1.0 with AV and 1.1±0.8 with FB (p=0.002). The 4D-CT NCCS were 0.65±0.27 with AV and 0.60±0.32 for FB (p=0.32). The 4D-CT VAS was 0.0±2.7 (p=ns). Conclusion: A 10-patient study demonstrated a statistically significant reduction of motion blurring of AV over FB for 1/2 functional 4D-PET imaging metrics. No difference between AV and FB was found for 2 anatomic 4D-CT imaging metrics. Future studies will focus on optimizing the human-computer interface and including patient training sessions for improved

  20. Gantzer muscle. An anatomical study

    PubMed Central

    Caetano, Edie Benedito; Sabongi, João José; Vieira, Luiz Ângelo; Caetano, Maurício Ferreira; Moraes, Daniel Vinhais

    2015-01-01

    OBJECTIVE: The relationship of Gantzer muscle to the median and anterior interosseous nerve is debated. METHODS: Ìn an anatomical study with 80 limbs from 40 cadavers the incidence, origin, insertion, nerve supply and relations of Gantzer muscle have been documented. RESULTS: The muscle was found in 54 forearms (68% of limbs) and was supplied by the anterior interosseous nerve. It arose from the deep surface of the flexor digitorum superficialis muscle, (42 limbs), coronoid process (eight limbs) and medial epicondyle (seven limbs). Its insertion was to the ulnar part of flexor pollicis longus muscle. The Gantzer muscle always lay posterior to both the median and anterior interosseous nerve. CONCLUSION: The Gantzer muscle may contribute to the median nerve and anterior interosseous nerve compression. The muscle was found in 68% of limbs and should be considered a normal anatomical pattern rather than an anatomical variation. Level of Evidence IV, Case Series . PMID:27069404

  1. Peptide vaccine against canine parvovirus: identification of two neutralization subsites in the N terminus of VP2 and optimization of the amino acid sequence.

    PubMed

    Casal, J I; Langeveld, J P; Cortés, E; Schaaper, W W; van Dijk, E; Vela, C; Kamstrup, S; Meloen, R H

    1995-11-01

    The N-terminal domain of the major capsid protein VP2 of canine parvovirus was shown to be an excellent target for development of a synthetic peptide vaccine, but detailed information about number of epitopes, optimal length, sequence choice, and site of coupling to the carrier protein was lacking. Therefore, several overlapping peptides based on this N terminus were synthesized to establish conditions for optimal and reproducible induction of neutralizing antibodies in rabbits. The specificity and neutralizing ability of the antibody response for these peptides were determined. Within the N-terminal 23 residues of VP2, two subsites able to induce neutralizing antibodies and which overlapped by only two glycine residues at positions 10 and 11 could be discriminated. The shortest sequence sufficient for neutralization induction was nine residues. Peptides longer than 13 residues consistently induced neutralization, provided that their N termini were located between positions 1 and 11 of VP2. The orientation of the peptides at the carrier protein was also of importance, being more effective when coupled through the N terminus than through the C terminus to keyhole limpet hemocyanin. The results suggest that the presence of amino acid residues 2 to 21 (and probably 3 to 17) of VP2 in a single peptide is preferable for a synthetic peptide vaccine.

  2. Biochemical and milk-clotting properties and mapping of catalytic subsites of an extracellular aspartic peptidase from basidiomycete fungus Phanerochaete chrysosporium.

    PubMed

    da Silva, Ronivaldo Rodrigues; de Oliveira, Lilian Caroline Gonçalves; Juliano, Maria Aparecida; Juliano, Luiz; de Oliveira, Arthur H C; Rosa, Jose C; Cabral, Hamilton

    2017-06-15

    For a long time, proteolytic enzymes have been employed as key tools of industrial processes, especially in the dairy industry. In the present work, we used Phanerochaete chrysosporium for biochemical characterization and analysis of catalytic specificity of an aspartic peptidase. Our results revealed an aspartic peptidase with molecular mass ∼38kDa, maximal activity at pH 4.5 and 50°C, and stability above 80% in the pH range of 3-8 and temperature up to 55°C for 1h. In a milk-clotting assay, this peptidase showed maximal milk clotting activity at 60-65°C and maintenance of enzymatic activity above 80% in the presence of 20mM CaCl2. In a specificity assay, we observed stronger restriction of catalysis at the S1 subsite, with a preference for lysine, arginine, leucine, tyrosine, and phenylalanine residues. The restricted proteolysis and milk-clotting potential are attractive properties for the use in cheese production. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Peptide vaccine against canine parvovirus: identification of two neutralization subsites in the N terminus of VP2 and optimization of the amino acid sequence.

    PubMed Central

    Casal, J I; Langeveld, J P; Cortés, E; Schaaper, W W; van Dijk, E; Vela, C; Kamstrup, S; Meloen, R H

    1995-01-01

    The N-terminal domain of the major capsid protein VP2 of canine parvovirus was shown to be an excellent target for development of a synthetic peptide vaccine, but detailed information about number of epitopes, optimal length, sequence choice, and site of coupling to the carrier protein was lacking. Therefore, several overlapping peptides based on this N terminus were synthesized to establish conditions for optimal and reproducible induction of neutralizing antibodies in rabbits. The specificity and neutralizing ability of the antibody response for these peptides were determined. Within the N-terminal 23 residues of VP2, two subsites able to induce neutralizing antibodies and which overlapped by only two glycine residues at positions 10 and 11 could be discriminated. The shortest sequence sufficient for neutralization induction was nine residues. Peptides longer than 13 residues consistently induced neutralization, provided that their N termini were located between positions 1 and 11 of VP2. The orientation of the peptides at the carrier protein was also of importance, being more effective when coupled through the N terminus than through the C terminus to keyhole limpet hemocyanin. The results suggest that the presence of amino acid residues 2 to 21 (and probably 3 to 17) of VP2 in a single peptide is preferable for a synthetic peptide vaccine. PMID:7474152

  4. Functional and anatomical results after a single intravitreal Ozurdex injection in retinal vein occlusion: a 6-month follow-up -- the SOLO study.

    PubMed

    Bezatis, Athanasios; Spital, Georg; Höhn, Fabian; Maier, Mathias; Clemens, Christoph R; Wachtlin, Joachim; Lehmann, Florian; Hattenbach, Lars Olof; Feltgen, Nicolas; Meyer, Carsten H

    2013-08-01

    .6 logMAR (Snellen equivalent of 0.25) after 12 weeks, 0.6 logMAR (Snellen equivalent of 0.25) after 16 weeks, 0.5 logMAR (Snellen equivalent of 0.32) after 20 weeks and 0.52 logMAR (Snellen equivalent of 0.30) after 24 weeks. The mean CRT at baseline was 740 ± 351 μm and it decreased to 419 ± 315 μm after 4 weeks, 352 ± 261 μm after 8 weeks, 455 ± 251 μm after 12 weeks, 497 ± 280 μm after 16 weeks, 468 ± 301 μm after 20 weeks and 395 ± 234 μm after 24 weeks. The BCVA improvement was statistically significantly better (p < 0.05) compared with baseline in both groups at every follow-up visit. The mean CRT maintained significantly better when compared with baseline in both groups at all follow-up visits. Early reinjection was indicated in BRVO in 40.7% after 17.5 ± 4.2 weeks and in CRVO in 50% after 17.68 ± 4.2. Six eyes (11%) with BRVO received a sectorial laser photocoagulation at a mean interval of 22 ± 5.0 weeks. Seven eyes (15%) with CRVO received a panretinal laser photocoagulation after a mean interval of 18 ± 7.0 weeks. The BCVA improvement and the mean CRT reduction were statistically significant (p < 0.05) compared with baseline in both groups at every follow-up visit. Dexamethasone intravitreal implant resulted in a significant improvement of the BCVA and reduction of CME in patients with BRVO or CRVO. Early retreatment after 16 weeks instead of 24 weeks, like in the GENEVA study, was indicated in 50% to stabilize the improved functional and anatomical results. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by Blackwell Publishing Ltd.

  5. Anatomical Abnormalities in Autism?

    PubMed

    Haar, Shlomi; Berman, Sigal; Behrmann, Marlene; Dinstein, Ilan

    2016-04-01

    Substantial controversy exists regarding the presence and significance of anatomical abnormalities in autism spectrum disorders (ASD). The release of the Autism Brain Imaging Data Exchange (∼1000 participants, age 6-65 years) offers an unprecedented opportunity to conduct large-scale comparisons of anatomical MRI scans across groups and to resolve many of the outstanding questions. Comprehensive univariate analyses using volumetric, thickness, and surface area measures of over 180 anatomically defined brain areas, revealed significantly larger ventricular volumes, smaller corpus callosum volume (central segment only), and several cortical areas with increased thickness in the ASD group. Previously reported anatomical abnormalities in ASD including larger intracranial volumes, smaller cerebellar volumes, and larger amygdala volumes were not substantiated by the current study. In addition, multivariate classification analyses yielded modest decoding accuracies of individuals' group identity (<60%), suggesting that the examined anatomical measures are of limited diagnostic utility for ASD. While anatomical abnormalities may be present in distinct subgroups of ASD individuals, the current findings show that many previously reported anatomical measures are likely to be of low clinical and scientific significance for understanding ASD neuropathology as a whole in individuals 6-35 years old.

  6. A synthetic model of the Mn₃Ca subsite of the oxygen-evolving complex in photosystem II.

    PubMed

    Kanady, Jacob S; Tsui, Emily Y; Day, Michael W; Agapie, Theodor

    2011-08-05

    Within photosynthetic organisms, the oxygen-evolving complex (OEC) of photosystem II generates dioxygen from water using a catalytic Mn(4)CaO(n) cluster (n varies with the mechanism and nature of the intermediate). We report here the rational synthesis of a [Mn(3)CaO(4)](6+) cubane that structurally models the trimanganese-calcium-cubane subsite of the OEC. Structural and electrochemical comparison between Mn(3)CaO(4) and a related Mn(4)O(4) cubane alongside characterization of an intermediate calcium-manganese multinuclear complex reveals potential roles of calcium in facilitating high oxidation states at manganese and in the assembly of the biological cluster.

  7. Subsite structure of the endo-type chitin deacetylase from a deuteromycete, Colletotrichum lindemuthianum: an investigation using steady-state kinetic analysis and MS.

    PubMed Central

    Hekmat, Omid; Tokuyasu, Ken; Withers, Stephen G

    2003-01-01

    The endo-type chitin deacetylase (EC 3.5.1.41) from a deuteromycete, Colletotrichum lindemuthianum (ATCC 56676), catalyses the hydrolysis of the acetamido group of GlcNAc (2-acetamido-2-deoxy-D-glucose) residues in chitin or chito-oligosaccharides with a degree of polymerization (n) equal to or greater than 2. The steady-state kinetic parameters for the initial deacetylation reactions of (GlcNAc)(2-6) were determined using a direct, continuous spectrophotometric assay in combination with ESI-MS (electrospray ionization MS) analysis of the products. The dependence of the observed K(m) and k(cat)/K(m) on n suggests the presence of four enzyme subsites (-2, -1, 0 and +1) that interact with GlcNAc residues from the non-reducing end to the reducing end of the substrate. The turnover number (k (cat), 7 s(-1)) is independent of n and represents the intrinsic rate constant (k(int)) for the hydrolysis of the acetamido group in subsite 0. The subsite affinities for the GlcNAc residues were calculated from the observed k(cat)/K(m) values (A (-2), -11.0; A (-1), -1.5; A (0), -7.7; A (+1), -12.5 kJ x mol(-1)). The increments in the subsite affinities due to the recognition of the acetamido groups were calculated [DeltaDelta G ((N-acetyl))=3.3, 0, 4.0 and 0 kJ x mol(-1) for subsites -2, -1, 0 and +1 respectively]. The steady-state kinetic parameters for the second deacetylation reaction of (GlcNAc)(4) were also determined using (GlcNAcGlcNAcGlcNGlcNAc) as the substrate. The comparison of the experimental and theoretical values (calculated using the subsite affinities) suggests that the mono-deacetylated substrate binds strongly in a non-productive mode occupying all four subsites, thereby inhibiting the second deacetylation reaction. PMID:12775215

  8. Subsite structure of the endo-type chitin deacetylase from a deuteromycete, Colletotrichum lindemuthianum: an investigation using steady-state kinetic analysis and MS.

    PubMed

    Hekmat, Omid; Tokuyasu, Ken; Withers, Stephen G

    2003-09-01

    The endo-type chitin deacetylase (EC 3.5.1.41) from a deuteromycete, Colletotrichum lindemuthianum (ATCC 56676), catalyses the hydrolysis of the acetamido group of GlcNAc (2-acetamido-2-deoxy-D-glucose) residues in chitin or chito-oligosaccharides with a degree of polymerization (n) equal to or greater than 2. The steady-state kinetic parameters for the initial deacetylation reactions of (GlcNAc)(2-6) were determined using a direct, continuous spectrophotometric assay in combination with ESI-MS (electrospray ionization MS) analysis of the products. The dependence of the observed K(m) and k(cat)/K(m) on n suggests the presence of four enzyme subsites (-2, -1, 0 and +1) that interact with GlcNAc residues from the non-reducing end to the reducing end of the substrate. The turnover number (k (cat), 7 s(-1)) is independent of n and represents the intrinsic rate constant (k(int)) for the hydrolysis of the acetamido group in subsite 0. The subsite affinities for the GlcNAc residues were calculated from the observed k(cat)/K(m) values (A (-2), -11.0; A (-1), -1.5; A (0), -7.7; A (+1), -12.5 kJ x mol(-1)). The increments in the subsite affinities due to the recognition of the acetamido groups were calculated [DeltaDelta G ((N-acetyl))=3.3, 0, 4.0 and 0 kJ x mol(-1) for subsites -2, -1, 0 and +1 respectively]. The steady-state kinetic parameters for the second deacetylation reaction of (GlcNAc)(4) were also determined using (GlcNAcGlcNAcGlcNGlcNAc) as the substrate. The comparison of the experimental and theoretical values (calculated using the subsite affinities) suggests that the mono-deacetylated substrate binds strongly in a non-productive mode occupying all four subsites, thereby inhibiting the second deacetylation reaction.

  9. Meat, fish and fat intake in relation to subsite-specific risk of colorectal cancer: The Fukuoka Colorectal Cancer Study.

    PubMed

    Kimura, Yasumi; Kono, Suminori; Toyomura, Kengo; Nagano, Jun; Mizoue, Tetsuya; Moore, Malcolm A; Mibu, Ryuichi; Tanaka, Masao; Kakeji, Yoshihiro; Maehara, Yoshihiko; Okamura, Takeshi; Ikejiri, Koji; Futami, Kitaroh; Yasunami, Yohichi; Maekawa, Takafumi; Takenaka, Kenji; Ichimiya, Hitoshi; Imaizumi, Nobutoshi

    2007-04-01

    High intake of red meat has been associated with increased risk of colorectal cancer in Western countries. There has been much interest in the role of n-3 polyunsaturated fatty acids (PUFA) in colorectal cancer prevention, but epidemiological findings are limited and inconsistent. The objective of our study was to examine associations of meat, fish and fat intake with risk of colorectal cancer, paying particular attention to the subsite within the colorectum. Data were from the Fukuoka Colorectal Cancer Study, a population-based case-control study, covering 782 cases and 793 controls. Diet was assessed by interview, using newly developed personal-computer software for registering semiquantitative food frequencies. The intake of beef/pork, processed meat, total fat, saturated fat or n-6 PUFA showed no clear association with the overall or subsite-specific risk of colorectal cancer. There was an almost significant inverse association between n-3 PUFA and the risk of colorectal cancer; the covariate-adjusted odds ratio for the highest (median 3.94 g/day) versus lowest (median 1.99 g/day) quintile of energy-adjusted intake was 0.74 (95% confidence interval 0.52-1.06, trend P=0.050). The consumption of fish and fish products was similarly inversely related to the risk although the association was not statistically significant. These associations were more evident for distal colon cancer; adjusted odds ratio for the highest versus lowest quintile of n-3 PUFA intake was 0.56 (95% confidence interval 0.34-0.92, trend P=0.02). Our findings do not support the hypothesis that consumption of red meat increases colorectal cancer risk but do suggest that high intake of fish may decrease the risk, particularly of distal colon cancer.

  10. Bilateral hip imaging at 7 Tesla using a multi-channel transmit technology: initial results presenting anatomical detail in healthy volunteers and pathological changes in patients with avascular necrosis of the femoral head.

    PubMed

    Theysohn, J M; Kraff, O; Orzada, S; Theysohn, N; Classen, T; Landgraeber, S; Ladd, M E; Lauenstein, T C

    2013-11-01

    To evaluate 7-T MRI of both hips using a multi-channel transmit technology to compensate for inherent B1 inhomogeneities in volunteers and patients with avascular necrosis of the femoral head. A self-built, eight-channel transmit-receive coil was utilized for B1 modification at 7 T. Two shim modes (individual shim vs. CP2+ mode) were initially compared and the best shim result was used for all further imaging. Robustness of sequences against B1 inhomogeneities, appearance of anatomic and pathologic changes of the femoral heads of MEDIC, DESS, PD/T2w TSE, T1w TSE, and STIR sequences at 7 T were evaluated in 12 subjects on a four-point scale (1-4): four male volunteers and eight patients (seven males, one female) suffering from avascular necrosis treated by advanced core decompression. Successful MRI of both femoral heads was achieved in all 12 subjects. CP2+ mode proved superior in ten of 12 cases. DESS proved most robust against B1 inhomogeneity. Anatomical details (labrum, articular cartilage) were best depicted in PDw, MEDIC, and DESS, while for depiction of pathological changes PDw, DESS (0.76 mm(3)) and T1w were superior. Our initial results of ultra-high-field hip joint imaging demonstrate high-resolution, high-contrast images with a good depiction of anatomic and pathologic changes. However, shifting areas of signal dropout from the femoral heads to the center of the pelvis makes these areas not assessable. For clinical workflow CP2+ mode is most practical. Seven-Tesla MRI of the hip joints may become a valuable complement to clinical field strengths.

  11. Non-combinatorial library screening reveals subsite cooperativity and identifies new high-efficiency substrates for kallikrein-related peptidase 14.

    PubMed

    de Veer, Simon J; Swedberg, Joakim E; Parker, Edward A; Harris, Jonathan M

    2012-04-01

    An array of substrates link the tryptic serine protease, kallikrein-related peptidase 14 (KLK14), to physiological functions including desquamation and activation of signaling molecules associated with inflammation and cancer. Recognition of protease cleavage sequences is driven by complementarity between exposed substrate motifs and the physicochemical signature of an enzyme's active site cleft. However, conventional substrate screening methods have generated conflicting subsite profiles for KLK14. This study utilizes a recently developed screening technique, the sparse matrix library, to identify five novel high-efficiency sequences for KLK14. The optimal sequence, YASR, was cleaved with higher efficiency (k(cat)/K(m)=3.81 ± 0.4 × 10(6) M(-1) s(-1)) than favored substrates from positional scanning and phage display by 2- and 10-fold, respectively. Binding site cooperativity was prominent among preferred sequences, which enabled optimal interaction at all subsites as indicated by predictive modeling of KLK14/substrate complexes. These simulations constitute the first molecular dynamics analysis of KLK14 and offer a structural rationale for the divergent subsite preferences evident between KLK14 and closely related KLKs, KLK4 and KLK5. Collectively, these findings highlight the importance of binding site cooperativity in protease substrate recognition, which has implications for discovery of optimal substrates and engineering highly effective protease inhibitors.

  12. Reference Man anatomical model

    SciTech Connect

    Cristy, M.

    1994-10-01

    The 70-kg Standard Man or Reference Man has been used in physiological models since at least the 1920s to represent adult males. It came into use in radiation protection in the late 1940s and was developed extensively during the 1950s and used by the International Commission on Radiological Protection (ICRP) in its Publication 2 in 1959. The current Reference Man for Purposes of Radiation Protection is a monumental book published in 1975 by the ICRP as ICRP Publication 23. It has a wealth of information useful for radiation dosimetry, including anatomical and physiological data, gross and elemental composition of the body and organs and tissues of the body. The anatomical data includes specified reference values for an adult male and an adult female. Other reference values are primarily for the adult male. The anatomical data include much data on fetuses and children, although reference values are not established. There is an ICRP task group currently working on revising selected parts of the Reference Man document.

  13. Utilization management in anatomic pathology.

    PubMed

    Lewandrowski, Kent; Black-Schaffer, Steven

    2014-01-01

    There is relatively little published literature concerning utilization management in anatomic pathology. Nonetheless there are many utilization management opportunities that currently exist and are well recognized. Some of these impact only the cost structure within the pathology department itself whereas others reduce charges for third party payers. Utilization management may result in medical legal liabilities for breaching the standard of care. For this reason it will be important for pathology professional societies to develop national utilization guidelines to assist individual practices in implementing a medically sound approach to utilization management. © 2013.

  14. Crystal structure of papain-E64-c complex. Binding diversity of E64-c to papain S2 and S3 subsites.

    PubMed

    Kim, M J; Yamamoto, D; Matsumoto, K; Inoue, M; Ishida, T; Mizuno, H; Sumiya, S; Kitamura, K

    1992-11-01

    In order to investigate the binding mode of E64-c (a synthetic cysteine proteinase inhibitor) to papain at the atomic level, the crystal structure of the complex was analysed by X-ray diffraction at 1.9 A (1 A is expressed in SI units as 0.1 nm) resolution. The crystal has a space group P2(1)2(1)2(1) with a = 43.37, b = 102.34 and c = 49.95 A. A total of 21,135 observed reflections were collected from the same crystal, and 14811 unique reflections of up to 1.9 A resolution [Fo > 3 sigma(Fo)] were used for the structure solution and refinement. The papain structure was determined by means of the molecular replacement method, and then the inhibitor was observed on a (2 magnitude of Fo-magnitude of Fc) difference Fourier map. The complex structure was finally refined to R = 19.4% including 207 solvent molecules. Although this complex crystal (Form II) was polymorphous as compared with the previously analysed one (Form I), the binding modes of leucine and isoamylamide moieties of E64-c were significantly different from each other. By the calculation of accessible surface area for each complex atom, these two different binding modes were both shown to be tight enough to prevent the access of solvent molecules to the papain active site. With respect to the E64-c-papain binding mode, molecular-dynamics simulations proposed two kinds of stationary states which were derived from the crystal structures of Forms I and II. One of these, which corresponds to the binding mode simulated from Form I, was essentially the same as that observed in the crystal structure, and the other was somewhat different from the crystal structure of Form II, especially with respect to the binding of the isoamylamide moiety with the papain S subsites. The substrate specificity for the papain active site is discussed on the basis of the present results.

  15. Anatomic hemispherectomy: historical perspective.

    PubMed

    Bahuleyan, Biji; Robinson, Shenandoah; Nair, Ajith Rajappan; Sivanandapanicker, Jyothish L; Cohen, Alan R

    2013-01-01

    The history of surgical treatment for hemispheric epilepsy is rich with colorful twists and turns. The authors trace the evolution of the surgical treatment of hemispheric epilepsy from radical anatomic resections to current less invasive disconnection procedures. Anatomic hemispherectomy (AH) was first described by Dandy in 1928 as a treatment for gliomas. The first report of this technique to control seizures was by McKenzie in 1938. AH gained wide popularity but began to fall out of favor after the description of superficial cerebral hemosiderosis in 1966. To reduce the morbidity and mortality associated with AH, Rasmussen introduced functional hemispherectomy in 1974. The technique of hemispherotomy was introduced in the 1990 s to minimize the extent of brain removal while maximizing the white matter disconnections. Thus, surgery for hemispheric epilepsy has undergone dramatic transformation since the technique was first introduced. Less invasive techniques have been developed to reduce surgical morbidity. Although optimal seizure control is best achieved with radical AH, the newer less invasive disconnection techniques appear to achieve near-comparable postoperative seizure control with a significantly lower rate of complications.

  16. Anatomical and technical factors associated with stroke or death during carotid angioplasty and stenting: results from the endarterectomy versus angioplasty in patients with symptomatic severe carotid stenosis (EVA-3S) trial and systematic review.

    PubMed

    Naggara, Olivier; Touzé, Emmanuel; Beyssen, Bernard; Trinquart, Ludovic; Chatellier, Gilles; Meder, Jean-François; Mas, Jean-Louis

    2011-02-01

    was associated with a lower risk of stroke or death (RR, 0.55; 0.41 to 0.73). Risk was not related with stent or cerebral protection device type. Our results strongly suggest that some technical and anatomic factors, especially extreme angulation of the carotid artery, have an impact on the risks of carotid angioplasty and stenting.

  17. Occipital neuralgia: anatomic considerations.

    PubMed

    Cesmebasi, Alper; Muhleman, Mitchel A; Hulsberg, Paul; Gielecki, Jerzy; Matusz, Petru; Tubbs, R Shane; Loukas, Marios

    2015-01-01

    Occipital neuralgia is a debilitating disorder first described in 1821 as recurrent headaches localized in the occipital region. Other symptoms that have been associated with this condition include paroxysmal burning and aching pain in the distribution of the greater, lesser, or third occipital nerves. Several etiologies have been identified in the cause of occipital neuralgia and include, but are not limited to, trauma, fibrositis, myositis, fracture of the atlas, and compression of the C-2 nerve root, C1-2 arthrosis syndrome, atlantoaxial lateral mass osteoarthritis, hypertrophic cervical pachymeningitis, cervical cord tumor, Chiari malformation, and neurosyphilis. The management of occipital neuralgia can include conservative approaches and/or surgical interventions. Occipital neuralgia is a multifactorial problem where multiple anatomic areas/structures may be involved with this pathology. A review of these etiologies may provide guidance in better understanding occipital neuralgia. © 2014 Wiley Periodicals, Inc.

  18. Pediatric Thoracic Anatomic Variants: What Radiologists Need to Know.

    PubMed

    Winant, Abbey J; Cho, Joo; Alyafei, Tahiya Salem; Lee, Edward Y

    2017-07-01

    Anatomic variants are common incidental findings in pediatric chest imaging and can be mistaken for true underlying pathology, sometimes resulting in unnecessary additional imaging evaluation or invasive procedures. Clear understanding of the imaging characteristics and clinical significance of anatomic thoracic variants is important for accurate diagnosis and avoidance of unnecessary intervention. This article provides an up-to-date review of anatomic variants in the pediatric chest to increase knowledge and aide in timely, correct diagnosis. Published by Elsevier Inc.

  19. Subsite specificity (S3, S2, S1', S2' and S3') of oligopeptidase B from Trypanosoma cruzi and Trypanosoma brucei using fluorescent quenched peptides: comparative study and identification of specific carboxypeptidase activity.

    PubMed Central

    Hemerly, Jefferson P; Oliveira, Vitor; Del Nery, Elaine; Morty, Rory E; Andrews, Norma W; Juliano, Maria A; Juliano, Luiz

    2003-01-01

    We characterized the extended substrate binding site of recombinant oligopeptidase B enzymes from Trypanosoma cruzi (Tc-OP) and Trypanosoma brucei (Tb-OP), evaluating the specificity of their S3, S2, S1', S2' and S3' subsites. Five series of internally quenched fluorescent peptides based on the substrate Abz-AGGRGAQ-EDDnp [where Abz is o -aminobenzoic acid and EDDnp is N -(2,4-dinitrophenyl)ethylenediamine] were designed to contain amino acid residues with side chains of a minimum size, and each residue position of this substrate was modified. Synthetic peptides of different lengths derived from the human kininogen sequence were also examined, and peptides of up to 17 amino acids were found to be hydrolysed by Tc-OP and Tb-OP. These two oligopeptidases were essentially arginyl hydrolases, since for all peptides examined the only cleavage site was the Arg-Xaa bond. We also demonstrated that Tc-OP and Tb-OP have a very specific carboxypeptidase activity for basic amino acids, which depends on the presence of at least of a pair of basic amino acids at the C-terminal end of the substrate. The peptide with triple Arg residues (Abz-AGRRRAQ-EDDnp) was an efficient substrate for Tc-OP and Tb-OP: the Arg-Ala peptide bond was cleaved first and then two C-terminal Arg residues were successively removed. The S1' subsite seems to be an important determinant of the specificity of both enzymes, showing a preference for Tyr, Ser, Thr and Gln as hydrogen donors. The presence of these amino acids at P1' resulted in substrates that were hydrolysed with K (m) values in the sub-micromolar range. Taken together, this work supports the view that oligopeptidase B is a specialized protein-processing enzyme with a specific carboxypeptidase activity. Excellent substrates were obtained for Tb-OP and Tc-OP (Abz-AMRRTISQ-EDDnp and Abz-AHKRYSHQ-EDDnp respectively), which were hydrolysed with remarkably high k (cat) and low K (m) values. PMID:12737623

  20. An investigation of anatomical competence in junior medical doctors.

    PubMed

    Vorstenbosch, Marc A T M; Kooloos, Jan G M; Bolhuis, Sanneke M; Laan, Roland F J M

    2016-01-01

    Because of a decrease of the time available for anatomy education, decisions need to be made to reduce the relevant content of the anatomy curriculum. Several expert consensus initiatives resulted in lists of structures, lacking analysis of anatomical competence. This study aims to explore the use of anatomical knowledge by medical doctors in an attempt to delineate the nature of anatomical competence. The research question is: what kind of anatomical knowledge do junior medical doctors use during a consultation with a patient presenting with a shoulder complaint? Ten junior medical doctors participated in this stimulated recall study. Each of them was videotaped while performing a consultation with a standardized patient with a complex shoulder complaint. The recording was viewed immediately after. Participants were videotaped again while verbalizing the thoughts they remembered having during the consultation. Verbatim transcriptions were coded by two coders using the qualitative data analysis ATLAS.ti software. Results were that these junior medical doctors used anatomical knowledge in all phases of the consultation, especially during physical examination. The use of anatomical terms was strongly associated with clinical reasoning and it was apparent that every subject visualized relevant anatomical information. Conclusion is that young medical doctors actively use their anatomical knowledge and it seems that the relevant anatomy consists largely of adequate visual representations in memory. Anatomy teachers should focus the students' learning activity on building an adequate visual representation of anatomical structures. This should be supported by assessments that test the quality of the students' visual representations.

  1. [Graphic reconstruction of anatomic surfaces].

    PubMed

    Ciobanu, O

    2004-01-01

    The paper deals with the graphic reconstruction of anatomic surfaces in a virtual 3D setting. Scanning technologies and soft provides a greater flexibility in the digitization of surfaces and a higher resolution and accuracy. An alternative cheap method for the reconstruction of 3D anatomic surfaces is presented in connection with some studies and international projects developed by Medical Design research team.

  2. Defining error in anatomic pathology.

    PubMed

    Sirota, Ronald L

    2006-05-01

    Although much has been said and written about medical error and about error in pathology since the publication of the Institute of Medicine's report on medical error in 1999, precise definitions of what constitutes error in anatomic pathology do not exist for the specialty. Without better definitions, it is impossible to accurately judge errors in pathology. The lack of standardized definitions has implications for patient care and for the legal judgment of malpractice. To review the goals of anatomic pathology, to discuss the problems inherent in applying these goals to the judgment of error in pathology, to offer definitions of major and minor errors in pathology, and to discuss error in anatomic pathology in relation to the classic laboratory test cycle. Existing literature. Definitions for major and minor error in anatomic pathology are proffered, and anatomic pathology error is characterized in the classic test cycle.

  3. Acute and long-term results of PVI at antrum using a novel high-density mapping catheter without help of 3D electro-anatomic mapping in patients with paroxysmal and chronic atrial fibrillation.

    PubMed

    Neumann, Thomas; Kuniss, Malte; Erkapic, Damir; Zaltsberg, Sergey; Berkowitsch, Alexander; Pajitnev, Dimitri; Wojcik, Maciej; Janin, Sebastien; Hamm, Christian W; Pitschner, Heinz F

    2010-03-01

    Multi-electrode circumferential mapping catheters have been developed by several manufacturers to facilitate catheter ablation procedures for atrial fibrillation (AF). We tested the effectiveness and safety of a conventional, fully endocardial electrogram-guided circumferential antrum isolation (PVI) with a novel mapping device. The study enrolled 250 consecutive patients with paroxysmal or chronic AF. High-density (HD) mapping of the pulmonary veins was performed with the HD Mesh Mapper (HDMM; Bard Electrophysiology, Lowell, MA, USA). The device was not constructed for radiofrequency energy delivery. Antral PVI was performed by irrigated radiofrequency application around the HDMM. Entry and exit conduction block, as well as decreased local electrode amplitude, were endpoints for acute successful ablation. Primary endpoint of the study was the AF free event probability during follow-up. As secondary endpoints, the acute results and related complications were determined. In 984 of 1,002 pulmonary vein (PV, 98.2%), signals were characterized as PV potentials by mapping the proximal part of the PV and the antrum. We achieved a complete antrum ablation in front of the 25-mm ring of the MESH Mapper in 95% of the PV in all patients. In difficult anatomic relationships, the repositioning of the mapping catheter could be necessary. The median follow-up time was 20.8 and 15.6 months in patients with paroxysmal and chronic AF, respectively. Log Rang test revealed a probability to be free from AF episodes of 71.2% and 49.4% after one ablation procedure and improved in chronic AF after a second procedure (71.1%). Our study demonstrates satisfactory success rate regarding the safety and long-term results in patients both with paroxysmal and persistent AF when a 3D mapping system is not being implemented. The study underlines the importance of a continuous signal analysis during the ablation procedure even with a conventional mapping system.

  4. Motivation and Organizational Principles for Anatomical Knowledge Representation

    PubMed Central

    Rosse, Cornelius; Mejino, José L.; Modayur, Bharath R.; Jakobovits, Rex; Hinshaw, Kevin P.; Brinkley, James F.

    1998-01-01

    Abstract Objective: Conceptualization of the physical objects and spaces that constitute the human body at the macroscopic level of organization, specified as a machine-parseable ontology that, in its human-readable form, is comprehensible to both expert and novice users of anatomical information. Design: Conceived as an anatomical enhancement of the UMLS Semantic Network and Metathesaurus, the anatomical ontology was formulated by specifying defining attributes and differentia for classes and subclasses of physical anatomical entities based on their partitive and spatial relationships. The validity of the classification was assessed by instantiating the ontology for the thorax. Several transitive relationships were used for symbolically modeling aspects of the physical organization of the thorax. Results: By declaring Organ as the macroscopic organizational unit of the body, and defining the entities that constitute organs and higher level entities constituted by organs, all anatomical entities could be assigned to one of three top level classes (Anatomical structure, Anatomical spatial entity and Body substance). The ontology accommodates both the systemic and regional (topographical) views of anatomy, as well as diverse clinical naming conventions of anatomical entities. Conclusions: The ontology formulated for the thorax is extendible to microscopic and cellular levels, as well as to other body parts, in that its classes subsume essentially all anatomical entities that constitute the body. Explicit definitions of these entities and their relationships provide the first requirement for standards in anatomical concept representation. Conceived from an anatomical viewpoint, the ontology can be generalized and mapped to other biomedical domains and problem solving tasks that require anatomical knowledge. PMID:9452983

  5. Tracking in anatomic pathology.

    PubMed

    Pantanowitz, Liron; Mackinnon, Alexander C; Sinard, John H

    2013-12-01

    Bar code-based tracking solutions, long present in clinical pathology laboratories, have recently made an appearance in anatomic pathology (AP) laboratories. Tracking of AP "assets" (specimens, blocks, slides) can enhance laboratory efficiency, promote patient safety, and improve patient care. Routing of excess clinical material into research laboratories and biorepositories are other avenues that can benefit from tracking of AP assets. Implementing tracking is not as simple as installing software and turning it on. Not all tracking solutions are alike. Careful analysis of laboratory workflow is needed before implementing tracking to assure that this solution will meet the needs of the laboratory. Such analysis will likely uncover practices that may need to be modified before a tracking system can be deployed. Costs that go beyond simply that of purchasing software will be incurred and need to be considered in the budgeting process. Finally, people, not technology, are the key to assuring quality. Tracking will require significant changes in workflow and an overall change in the culture of the laboratory. Preparation, training, buy-in, and accountability of the people involved are crucial to the success of this process. This article reviews the benefits, available technology, underlying principles, and implementation of tracking solutions for the AP and research laboratory.

  6. Standardized anatomic space for abdominal fat quantification

    NASA Astrophysics Data System (ADS)

    Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.

    2014-03-01

    The ability to accurately measure subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) from images is important for improved assessment and management of patients with various conditions such as obesity, diabetes mellitus, obstructive sleep apnea, cardiovascular disease, kidney disease, and degenerative disease. Although imaging and analysis methods to measure the volume of these tissue components have been developed [1, 2], in clinical practice, an estimate of the amount of fat is obtained from just one transverse abdominal CT slice typically acquired at the level of the L4-L5 vertebrae for various reasons including decreased radiation exposure and cost [3-5]. It is generally assumed that such an estimate reliably depicts the burden of fat in the body. This paper sets out to answer two questions related to this issue which have not been addressed in the literature. How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? At what anatomic location do the volumes of SAT and VAT correlate maximally with the corresponding single-slice area measures? To answer these questions, we propose two approaches for slice localization: linear mapping and non-linear mapping which is a novel learning based strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. We then study the volume-to-area correlations and determine where they become maximal. We demonstrate on 50 abdominal CT data sets that this mapping achieves significantly improved consistency of anatomic localization compared to current practice. Our results also indicate that maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized.

  7. Modeling the active site of [NiFe] hydrogenases and the [NiFeu] subsite of the C-cluster of carbon monoxide dehydrogenases: low-spin iron(II) versus high-spin iron(II).

    PubMed

    Weber, Katharina; Erdem, Özlen F; Bill, Eckhard; Weyhermüller, Thomas; Lubitz, Wolfgang

    2014-06-16

    A series of four [S2Ni(μ-S)2FeCp*Cl] compounds with different tetradentate thiolate/thioether ligands bound to the Ni(II) ion is reported (Cp* = C5Me5). The {S2Ni(μ-S)2Fe} core of these compounds resembles structural features of the active site of [NiFe] hydrogenases. Detailed analyses of the electronic structures of these compounds by Mössbauer and electron paramagnetic resonance spectroscopy, magnetic measurements, and density functional theory calculations reveal the oxidation states Ni(II) low spin and Fe(II) high spin for the metal ions. The same electronic configurations have been suggested for the Cred1 state of the C-cluster [NiFeu] subsite in carbon monoxide dehydrogenases (CODH). The Ni-Fe distance of ∼3 Å excludes a metal-metal bond between nickel and iron, which is in agreement with the computational results. Electrochemical experiments show that iron is the redox active site in these complexes, performing a reversible one-electron oxidation. The four complexes are discussed with regard to their similarities and differences both to the [NiFe] hydrogenases and the C-cluster of Ni-containing CODH.

  8. Anatomical entity mention recognition at literature scale

    PubMed Central

    Pyysalo, Sampo; Ananiadou, Sophia

    2014-01-01

    Motivation: Anatomical entities ranging from subcellular structures to organ systems are central to biomedical science, and mentions of these entities are essential to understanding the scientific literature. Despite extensive efforts to automatically analyze various aspects of biomedical text, there have been only few studies focusing on anatomical entities, and no dedicated methods for learning to automatically recognize anatomical entity mentions in free-form text have been introduced. Results: We present AnatomyTagger, a machine learning-based system for anatomical entity mention recognition. The system incorporates a broad array of approaches proposed to benefit tagging, including the use of Unified Medical Language System (UMLS)- and Open Biomedical Ontologies (OBO)-based lexical resources, word representations induced from unlabeled text, statistical truecasing and non-local features. We train and evaluate the system on a newly introduced corpus that substantially extends on previously available resources, and apply the resulting tagger to automatically annotate the entire open access scientific domain literature. The resulting analyses have been applied to extend services provided by the Europe PubMed Central literature database. Availability and implementation: All tools and resources introduced in this work are available from http://nactem.ac.uk/anatomytagger. Contact: sophia.ananiadou@manchester.ac.uk Supplementary Information: Supplementary data are available at Bioinformatics online. PMID:24162468

  9. Anatomical adaptations of aquatic mammals.

    PubMed

    Reidenberg, Joy S

    2007-06-01

    This special issue of the Anatomical Record explores many of the anatomical adaptations exhibited by aquatic mammals that enable life in the water. Anatomical observations on a range of fossil and living marine and freshwater mammals are presented, including sirenians (manatees and dugongs), cetaceans (both baleen whales and toothed whales, including dolphins and porpoises), pinnipeds (seals, sea lions, and walruses), the sea otter, and the pygmy hippopotamus. A range of anatomical systems are covered in this issue, including the external form (integument, tail shape), nervous system (eye, ear, brain), musculoskeletal systems (cranium, mandible, hyoid, vertebral column, flipper/forelimb), digestive tract (teeth/tusks/baleen, tongue, stomach), and respiratory tract (larynx). Emphasis is placed on exploring anatomical function in the context of aquatic life. The following topics are addressed: evolution, sound production, sound reception, feeding, locomotion, buoyancy control, thermoregulation, cognition, and behavior. A variety of approaches and techniques are used to examine and characterize these adaptations, ranging from dissection, to histology, to electron microscopy, to two-dimensional (2D) and 3D computerized tomography, to experimental field tests of function. The articles in this issue are a blend of literature review and new, hypothesis-driven anatomical research, which highlight the special nature of anatomical form and function in aquatic mammals that enables their exquisite adaptation for life in such a challenging environment. 2007 Wiley-Liss, Inc.

  10. An Investigation of Anatomical Competence in Junior Medical Doctors

    ERIC Educational Resources Information Center

    Vorstenbosch, Marc A. T. M.; Kooloos, Jan G. M.; Bolhuis, Sanneke M.; Laan, Roland F. J. M.

    2016-01-01

    Because of a decrease of the time available for anatomy education, decisions need to be made to reduce the relevant content of the anatomy curriculum. Several expert consensus initiatives resulted in lists of structures, lacking analysis of anatomical competence. This study aims to explore the use of anatomical knowledge by medical doctors in an…

  11. An Investigation of Anatomical Competence in Junior Medical Doctors

    ERIC Educational Resources Information Center

    Vorstenbosch, Marc A. T. M.; Kooloos, Jan G. M.; Bolhuis, Sanneke M.; Laan, Roland F. J. M.

    2016-01-01

    Because of a decrease of the time available for anatomy education, decisions need to be made to reduce the relevant content of the anatomy curriculum. Several expert consensus initiatives resulted in lists of structures, lacking analysis of anatomical competence. This study aims to explore the use of anatomical knowledge by medical doctors in an…

  12. Crystal structure of a new benzoic acid inhibitor of influenza neuraminidase bound with a new tilt induced by overpacking subsite C6.

    PubMed

    Venkatramani, Lalitha; Johnson, Eric S; Kolavi, Gundurao; Air, Gillian M; Brouillette, Wayne J; Mooers, Blaine H M

    2012-05-06

    Influenza neuraminidase (NA) is an important target for antiviral inhibitors since its active site is highly conserved such that inhibitors can be cross-reactive against multiple types and subtypes of influenza. Here, we discuss the crystal structure of neuraminidase subtype N9 complexed with a new benzoic acid based inhibitor (2) that was designed to add contacts by overpacking one side of the active site pocket. Inhibitor 2 uses benzoic acid to mimic the pyranose ring, a bis-(hydroxymethyl)-substituted 2-pyrrolidinone ring in place of the N-acetyl group of the sialic acid, and a branched aliphatic structure to fill the sialic acid C6 subsite. Inhibitor 2 {4-[2,2-bis(hydroxymethyl)-5-oxo-pyrrolidin-1-yl]-3-[(dipropylamino)methyl)]benzoic acid} was soaked into crystals of neuraminidase of A/tern/Australia/G70c/75 (N9), and the structure refined with 1.55 Å X-ray data. The benzene ring of the inhibitor tilted 8.9° compared to the previous compound (1), and the number of contacts, including hydrogen bonds, increased. However, the IC50 for compound 2 remained in the low micromolar range, likely because one propyl group was disordered. In this high-resolution structure of NA isolated from virus grown in chicken eggs, we found electron density for additional sugar units on the N-linked glycans compared to previous neuraminidase structures. In particular, seven mannoses and two N-acetylglucosamines are visible in the glycan attached to Asn200. This long, branched high-mannose glycan makes significant contacts with the neighboring subunit. We designed inhibitor 2 with an extended substituent at C4-corresponding to C6 of sialic acid-to increase the contact surface in the C6-subsite and to force the benzene ring to tilt to maximize these interactions while retaining the interactions of the carboxylate and the pyrolidinone substituents. The crystal structure at 1.55 Å showed that we partially succeeded in that the ring in 2 is tilted relative to 1 and the number of

  13. Recent advances in standards for collaborative Digital Anatomic Pathology

    PubMed Central

    2011-01-01

    Context Collaborative Digital Anatomic Pathology refers to the use of information technology that supports the creation and sharing or exchange of information, including data and images, during the complex workflow performed in an Anatomic Pathology department from specimen reception to report transmission and exploitation. Collaborative Digital Anatomic Pathology can only be fully achieved using medical informatics standards. The goal of the international integrating the Healthcare Enterprise (IHE) initiative is precisely specifying how medical informatics standards should be implemented to meet specific health care needs and making systems integration more efficient and less expensive. Objective To define the best use of medical informatics standards in order to share and exchange machine-readable structured reports and their evidences (including whole slide images) within hospitals and across healthcare facilities. Methods Specific working groups dedicated to Anatomy Pathology within multiple standards organizations defined standard-based data structures for Anatomic Pathology reports and images as well as informatic transactions in order to integrate Anatomic Pathology information into the electronic healthcare enterprise. Results The DICOM supplements 122 and 145 provide flexible object information definitions dedicated respectively to specimen description and Whole Slide Image acquisition, storage and display. The content profile “Anatomic Pathology Structured Report” (APSR) provides standard templates for structured reports in which textual observations may be bound to digital images or regions of interest. Anatomic Pathology observations are encoded using an international controlled vocabulary defined by the IHE Anatomic Pathology domain that is currently being mapped to SNOMED CT concepts. Conclusion Recent advances in standards for Collaborative Digital Anatomic Pathology are a unique opportunity to share or exchange Anatomic Pathology structured

  14. Developmental Dyslexia: Current Anatomical Research.

    ERIC Educational Resources Information Center

    Galaburda, Albert

    1983-01-01

    Findings from anatomical research are highlighted in a discussion of the role of anomalous lateralization and asymmetry in the dyslexic brain. Studies of animal asymmetry are cited along with studies of humans. (CL)

  15. Incidence of gliomas by anatomic location

    PubMed Central

    Larjavaara, Suvi; Mäntylä, Riitta; Salminen, Tiina; Haapasalo, Hannu; Raitanen, Jani; Jääskeläinen, Juha; Auvinen, Anssi

    2007-01-01

    The anatomic location of a glioma influences prognosis and treatment options. The aim of our study was to describe the distribution of gliomas in different anatomic areas of the brain. A representative population-based sample of 331 adults with glioma was used for preliminary analyses. The anatomic locations for 89 patients from a single center were analyzed in more detail from radiologic imaging and recorded on a three-dimensional 1 × 1 × 1– cm grid. The age-standardized incidence rate of gliomas was 4.7 per 100,000 person-years. The most frequent subtypes were glioblastoma (47%) and grade II–III astrocytoma (23%), followed by oligodendroglioma and mixed glioma. The gliomas were located in the frontal lobe in 40% of the cases, temporal in 29%, parietal in 14%, and occipital lobe in 3%, with 14% in the deeper structures. The difference in distribution between lobes remained after adjustment for their tissue volume: the tumor:volume ratio was 4.5 for frontal, 4.8 for temporal, and 2.3 for parietal relative to the occipital lobe. The area with the densest occurrence was the anterior subcortical brain. Statistically significant spatial clustering was found in the three-dimensional analysis. No differences in location were found among glioblastoma, diffuse astrocytoma, and oligodendroglioma. Our results demonstrate considerable heterogeneity in the anatomic distribution of gliomas within the brain. PMID:17522333

  16. Subsite Awareness in Neuropathology Evaluation of National Toxicology Program (NTP) Studies: A Review of Select Neuroanatomical Structures with their Functional Significance in Rodents

    PubMed Central

    Rao, Deepa B.; Little, Peter B.; Sills, Robert

    2013-01-01

    This review manuscript is designed to serve as an introductory guide in neuroanatomy for toxicologic pathologists evaluating general toxicity studies. The manuscript provides an overview of approximately 50 neuroanatomical subsites and their functional significance across seven coronal sections of the brain. Also reviewed are three sections of the spinal cord, cranial and peripheral nerves (trigeminal and sciatic respectively), and intestinal autonomic ganglia. The review is limited to the evaluation of hematoxylin and eosin (H&E) stained tissue sections, as light microscopic evaluation of these sections is an integral part of the first-tier toxicity screening of environmental chemicals, drugs, and other agents. Prominent neuroanatomical sites associated with major neurological disorders are noted. This guide, when used in conjunction with detailed neuroanatomic atlases may aid in an understanding of the significance of functional neuroanatomy, thereby improving the characterization of neurotoxicity in general toxicity and safety evaluation studies. PMID:24135464

  17. Two functionally distinct subsites for the binding of internal blockers to the pore of voltage-activated K+ channels

    PubMed Central

    Baukrowitz, Thomas; Yellen, Gary

    1996-01-01

    Many blockers of Na+ and K+ channels act by blocking the pore from the intracellular side. For Shaker K+ channels, such intracellular blockers vary in their functional effect on slow (C-type) inactivation: Some blockers interfere with C-type inactivation, whereas others do not. These functional differences can be explained by supposing that there are two overlapping “subsites” for blocker binding, only one of which inhibits C-type inactivation through an allosteric effect. We find that the ability to bind to these subsites depends on specific structural characteristics of the blockers, and correlates with the effect of mutations in two distinct regions of the channel protein. These interactions are important because they affect the ability of blockers to produce use-dependent inhibition. PMID:8917595

  18. Incorporating anatomical side information into PET reconstruction using nonlocal regularization.

    PubMed

    Nguyen, Van-Giang; Lee, Soo-Jin

    2013-10-01

    With the introduction of combined positron emission tomography (PET)/computed tomography (CT) or PET/magnetic resonance imaging (MRI) scanners, there is an increasing emphasis on reconstructing PET images with the aid of the anatomical side information obtained from X-ray CT or MRI scanners. In this paper, we propose a new approach to incorporating prior anatomical information into PET reconstruction using the nonlocal regularization method. The nonlocal regularizer developed for this application is designed to selectively consider the anatomical information only when it is reliable. As our proposed nonlocal regularization method does not directly use anatomical edges or boundaries which are often used in conventional methods, it is not only free from additional processes to extract anatomical boundaries or segmented regions, but also more robust to the signal mismatch problem that is caused by the indirect relationship between the PET image and the anatomical image. We perform simulations with digital phantoms. According to our experimental results, compared to the conventional method based on the traditional local regularization method, our nonlocal regularization method performs well even with the imperfect prior anatomical information or in the presence of signal mismatch between the PET image and the anatomical image.

  19. Anatomic pathology databases and patient safety.

    PubMed

    Raab, Stephen S; Grzybicki, Dana M; Zarbo, Richard J; Meier, Frederick A; Geyer, Stanley J; Jensen, Chris

    2005-10-01

    The utility of anatomic pathology discrepancies has not been rigorously studied. To outline how databases may be used to study anatomic pathology patient safety. The Agency for Healthcare Research and Quality funded the creation of a national anatomic pathology errors database to establish benchmarks for error frequency. The database is used to track more frequent errors and errors that result in more serious harm, in order to design quality improvement interventions intended to reduce these types of errors. In the first year of funding, 4 institutions (University of Pittsburgh, Henry Ford Hospital, University of Iowa, and Western Pennsylvania Hospital) reported cytologic-histologic correlation error data after standardizing correlation methods. Root cause analysis was performed to determine sources of error, and error reduction plans were implemented. Four institutions self-reported anatomic pathology error data. Frequency of cytologic-histologic correlation error, case type, cause of error (sampling or interpretation), and effect of error on patient outcome (ie, no harm, near miss, and harm). The institutional gynecologic cytologic-histologic correlation error frequency ranged from 0.17% to 0.63%, using the denominator of all Papanicolaou tests. Based on the nongynecologic cytologic-histologic correlation data, the specimen sites with the highest discrepancy frequency (by project site) were lung (ranging from 16.5% to 62.3% of all errors) and urinary bladder (ranging from 4.4% to 25.0%). Most errors detected by the gynecologic cytologic-histologic correlation process were no-harm events (ranging from 10.7% to 43.2% by project site). Root cause analysis identified sources of error on both the clinical and pathology sides of the process, and error intervention programs are currently being implemented to improve patient safety. A multi-institutional anatomic pathology error database may be used to benchmark practices and target specific high-frequency errors or

  20. Anatomical pathology is dead? Long live anatomical pathology.

    PubMed

    Nicholls, John M; Francis, Glenn D

    2011-10-01

    The standard diagnostic instrument used for over 150 years by anatomical pathologists has been the optical microscope and glass slide. The advent of immunohistochemistry in the routine laboratory in the 1980s, followed by in situ hybridisation in the 1990s, has increased the armamentaria available to the diagnostic pathologist, and this technology has led to changed patient management in a limited number of neoplastic diseases. The first decade of the 21 century has seen an increasing number of publications using proteomic technologies that promise to change disease diagnosis and management, the traditional role of an anatomical pathologist. Despite the plethora of publications on proteomics and pathology, to date there are actually limited data where proteomic technologies do appear to be of greater diagnostic value than the standard histological slide. Though proteomic techniques will become more prevalent in the future, it will need the expertise of an anatomical pathologist to dissect out and validate this added information.

  1. Anatomical Atlas of the Quail's Ear (Coturnix coturnix).

    PubMed

    Bonsmann, A; Stoffel, M H; Burkhart, M; Hatt, J-M

    2016-10-01

    This study aims to enhance the anatomical knowledge of the ear of the adult quail (Coturnix coturnix) through the creation of a scaled 3D model utilizing data from micro-CT images. In addition, 17 annotated histological sections of the quail's ear are aligned to their 3D position in the model. The resulting anatomical atlas provides an intuitive insight into the 3D anatomy and can be used for medical education. The model also allows measuring anatomical structures and can thus serve as reference for the quail's auricular anatomy and as a basis to evaluate clinical diagnostic imaging results. © 2015 Blackwell Verlag GmbH.

  2. Anatomical and functional imaging in endocrine hypertension

    PubMed Central

    Chaudhary, Vikas; Bano, Shahina

    2012-01-01

    In endocrine hypertension, hormonal excess results in clinically significant hypertension. The functional imaging (such as radionuclide imaging) complements anatomy-based imaging (such as ultrasound, computed tomography, and magnetic resonance imaging) to facilitate diagnostic localization of a lesion causing endocrine hypertension. The aim of this review article is to familiarize general radiologists, endocrinologists, and clinicians with various anatomical and functional imaging techniques used in patients with endocrine hypertension. PMID:23087854

  3. In vivo posterior cruciate ligament elongation in running activity after anatomic and non-anatomic anterior cruciate ligament reconstruction.

    PubMed

    Tang, Jing; Thorhauer, Eric; Bowman, Karl; Fu, Freddie H; Tashman, Scott

    2017-04-01

    The goals of this study were to (1) investigate the in vivo elongation behaviour of the posterior cruciate ligament (PCL) during running in the uninjured knee and (2) evaluate changes in PCL elongation during running after anatomic or non-anatomic anterior cruciate ligament (ACL) reconstruction. Seventeen unilateral ACL-injured subjects were recruited after undergoing anatomic (n = 9) or non-anatomic (n = 8) ACL reconstruction. Bilateral high-resolution CT scans were obtained to produce 3D models. Anterolateral (AL) and posteromedial (PM) bundles insertion sites of the PCL were identified on the 3D CT scan reconstructions. Dynamic knee function was assessed during running using a dynamic stereo X-ray (DSX) system. The lengths of the AL and PM bundles were estimated from late swing through mid-stance. The contralateral knees served as normal controls. Control knees demonstrated a slight decrease in AL bundle and a significant decrease in PM bundle length following foot strike. Length and elongation patterns of the both bundles of the PCL in the anatomic ACL reconstruction group were similar to the controls. However, the change in dynamic PCL length was significantly greater in the non-anatomic group than in the anatomic reconstruction group after foot strike (p < 0.05). The AL bundle length decreased slightly, and the PM bundle length significantly decreased after foot strike during running in uninjured knees. Anatomic ACL reconstruction maintained normal PCL elongation patterns more effectively than non-anatomic ACL reconstruction during high-demand, functional loading. These results support the use of anatomic ACL reconstruction to achieve normal knee function in high-demand activities. Case-control study, Level III.

  4. The Computerized Anatomical Man (CAM) model

    NASA Technical Reports Server (NTRS)

    Billings, M. P.; Yucker, W. R.

    1973-01-01

    A computerized anatomical man (CAM) model, representing the most detailed and anatomically correct geometrical model of the human body yet prepared, has been developed for use in analyzing radiation dose distribution in man. This model of a 50-percentile standing USAF man comprises some 1100 unique geometric surfaces and some 2450 solid regions. Internal body geometry such as organs, voids, bones, and bone marrow are explicitly modeled. A computer program called CAMERA has also been developed for performing analyses with the model. Such analyses include tracing rays through the CAM geometry, placing results on magnetic tape in various forms, collapsing areal density data from ray tracing information to areal density distributions, preparing cross section views, etc. Numerous computer drawn cross sections through the CAM model are presented.

  5. Statistical Analyses of Femur Parameters for Designing Anatomical Plates.

    PubMed

    Wang, Lin; He, Kunjin; Chen, Zhengming

    2016-01-01

    Femur parameters are key prerequisites for scientifically designing anatomical plates. Meanwhile, individual differences in femurs present a challenge to design well-fitting anatomical plates. Therefore, to design anatomical plates more scientifically, analyses of femur parameters with statistical methods were performed in this study. The specific steps were as follows. First, taking eight anatomical femur parameters as variables, 100 femur samples were classified into three classes with factor analysis and Q-type cluster analysis. Second, based on the mean parameter values of the three classes of femurs, three sizes of average anatomical plates corresponding to the three classes of femurs were designed. Finally, based on Bayes discriminant analysis, a new femur could be assigned to the proper class. Thereafter, the average anatomical plate suitable for that new femur was selected from the three available sizes of plates. Experimental results showed that the classification of femurs was quite reasonable based on the anatomical aspects of the femurs. For instance, three sizes of condylar buttress plates were designed. Meanwhile, 20 new femurs are judged to which classes the femurs belong. Thereafter, suitable condylar buttress plates were determined and selected.

  6. Statistical Analyses of Femur Parameters for Designing Anatomical Plates

    PubMed Central

    2016-01-01

    Femur parameters are key prerequisites for scientifically designing anatomical plates. Meanwhile, individual differences in femurs present a challenge to design well-fitting anatomical plates. Therefore, to design anatomical plates more scientifically, analyses of femur parameters with statistical methods were performed in this study. The specific steps were as follows. First, taking eight anatomical femur parameters as variables, 100 femur samples were classified into three classes with factor analysis and Q-type cluster analysis. Second, based on the mean parameter values of the three classes of femurs, three sizes of average anatomical plates corresponding to the three classes of femurs were designed. Finally, based on Bayes discriminant analysis, a new femur could be assigned to the proper class. Thereafter, the average anatomical plate suitable for that new femur was selected from the three available sizes of plates. Experimental results showed that the classification of femurs was quite reasonable based on the anatomical aspects of the femurs. For instance, three sizes of condylar buttress plates were designed. Meanwhile, 20 new femurs are judged to which classes the femurs belong. Thereafter, suitable condylar buttress plates were determined and selected. PMID:28044087

  7. [Anatomical limits of endonasal ethmoidectomy].

    PubMed

    Prades, J M; Veyret, C; Martin, C

    1992-01-01

    Constant anatomic boundaries of the lateral mass of the ethnoid are described, based on data from microdissections, endoscopic examinations, computed tomography imaging and histology in 12 subjects. As with surgical progression, identification of these boundaries follows the lateral orbital and superior craniofrontal surfaces. The "starred groove formation", ethmoidal roof lamina and ethmoidosphenoidal recesses are the safety beacons for endonasal ethmoidectomy under endoscopic control.

  8. Variations in target volume definition and dose to normal tissue using anatomic versus biological imaging ((18) F-FDG-PET) in the treatment of bone metastases: results from a 3-arm randomized phase II trial.

    PubMed

    Berwouts, Dieter; De Wolf, Katrien; De Neve, Wilfried; Olteanu, Luiza Am; Lambert, Bieke; Speleers, Bruno; Goethals, Ingeborg; Madani, Indira; Ost, Piet

    2017-02-01

    To report the impact on target volume delineation and dose to normal tissue using anatomic versus biological imaging ((18) F-FDG-PET) for bone metastases. Patients with uncomplicated painful bone metastases were randomized (1:1:1) and blinded to receive either 8 Gy in a single fraction with conventionally planned radiotherapy (ConvRT-8 Gy) or 8 Gy in a single fraction with dose-painting-by-numbers (DPBN) dose range between 6 and 10 Gy) (DPBN-8 Gy) or 16 Gy in a single fraction with DPBN (dose range between 14 and 18 Gy) (DPBN-16 Gy). The primary endpoint was overall pain response at 1 month. Volumes of the gross tumour volume (GTV) - both biological (GTVPET ) and anatomical (GTVCT ) -, planning target volume (PTV), dose to the normal tissue and maximum standardized-uptake values (SUVMAX ) were analysed (secondary endpoint). Sixty-three percent of the GTVCT volume did not show (18) F-FDG-uptake. On average, 20% of the GTVPET volume was outside GTVCT . The volume of normal tissue receiving 4 Gy, 6 Gy and 8 Gy was at least 3×, 6× and 13× smaller in DPBN-8 Gy compared to ConvRT-8 Gy and DPBN-16 Gy (P < 0.05). Positron emitting tomography-information potentially changes the target volume for bone metastases. DPBN between 6 and 10 Gy significantly decreases dose to the normal tissue compared to conventional radiotherapy. © 2016 The Royal Australian and New Zealand College of Radiologists.

  9. Error detection in anatomic pathology.

    PubMed

    Zarbo, Richard J; Meier, Frederick A; Raab, Stephen S

    2005-10-01

    To define the magnitude of error occurring in anatomic pathology, to propose a scheme to classify such errors so their influence on clinical outcomes can be evaluated, and to identify quality assurance procedures able to reduce the frequency of errors. (a) Peer-reviewed literature search via PubMed for studies from single institutions and multi-institutional College of American Pathologists Q-Probes studies of anatomic pathology error detection and prevention practices; (b) structured evaluation of defects in surgical pathology reports uncovered in the Department of Pathology and Laboratory Medicine of the Henry Ford Health System in 2001-2003, using a newly validated error taxonomy scheme; and (c) comparative review of anatomic pathology quality assurance procedures proposed to reduce error. Marked differences in both definitions of error and pathology practice make comparison of error detection and prevention procedures among publications from individual institutions impossible. Q-Probes studies further suggest that observer redundancy reduces diagnostic variation and interpretive error, which ranges from 1.2 to 50 errors per 1000 cases; however, it is unclear which forms of such redundancy are the most efficient in uncovering diagnostic error. The proposed error taxonomy tested has shown a very good interobserver agreement of 91.4% (kappa = 0.8780; 95% confidence limit, 0.8416-0.9144), when applied to amended reports, and suggests a distribution of errors among identification, specimen, interpretation, and reporting variables. Presently, there are no standardized tools for defining error in anatomic pathology, so it cannot be reliably measured nor can its clinical impact be assessed. The authors propose a standardized error classification that would permit measurement of error frequencies, clinical impact of errors, and the effect of error reduction and prevention efforts. In particular, the value of double-reading, case conferences, and consultations (the

  10. Matching and anatomical labeling of human airway tree

    PubMed Central

    Tschirren, Juerg; McLennan, Geoffrey; Palágyi, Kálmán; Hoffman, Eric A.; Sonka, Milan

    2005-01-01

    Matching of corresponding branchpoints between two human airway trees, as well as assigning anatomical names to the segments and branchpoints of the human airway tree, are of significant interest for clinical applications and physiological studies. In the past these tasks were often performed manually due to the lack of automated algorithms that can tolerate false branches and anatomical variability typical for in vivo trees. In this paper we present algorithms that perform both matching of branchpoints and anatomical labeling of in vivo trees without any human intervention and within a short computing time. No hand-pruning of false branches is required. The results from the automated methods show a high degree of accuracy when validated against reference data provided by human experts. 92.9% of the verifiable branchpoint matches found by the computer agree with experts’ results. For anatomical labeling, 97.1% of the automatically assigned segment labels were found to be correct. PMID:16353371

  11. Anatomical correlates of blepharospasm

    PubMed Central

    2012-01-01

    Background Focal dystonia is a neurological disorder characterized by unwanted muscle spasms. Blepharospasm is a focal dystonia producing an involuntary closure of the eyelid. Its etiology is unknown. Objective To investigate if there are structural changes in the white and grey matter of blepharospasm patients, and if the changes are related to disease features. Methods T1 and diffusion-weighted magnetic resonance imaging scans were collected from 14 female blepharospasm patients and 14 healthy matched controls. Grey matter volumes, fractional anisotropy (FA), and mean diffusivity maps were compared between the groups. Based on grey matter differences within the facial portion of the primary motor cortex, the corticobulbar tract was traced and compared between groups. Results Changes in grey matter in patients included the facial portion of the sensorimotor area and anterior cingulate gyrus. These changes did not correlate with disease duration. Corticobulbar tract volume and peak tract connectivity were decreased in patients compared with controls. There were no significant differences in FA or mean diffusivity between groups. Conclusions Grey matter changes within the primary sensorimotor and the anterior cingulate cortices in blepharospasm patients may help explain involuntary eyelid closure and the abnormal sensations often reported in this condition. PMID:23210426

  12. [Lymphoscintigrams with anatomical landmarks obtained with vector graphics].

    PubMed

    Rubini, Giuseppe; Antonica, Filippo; Renna, Maria Antonia; Ferrari, Cristina; Iuele, Francesca; Stabile Ianora, Antonio Amato; Losco, Matteo; Niccoli Asabella, Artor

    2012-11-01

    Nuclear medicine images are difficult to interpret because they do not include anatomical details. The aim of this study was to obtain lymphoscintigrams with anatomical landmarks that could be easily interpreted by General Physicians. Traditional lymphoscintigrams were processed with Adobe© Photoshop® CS6 and converted into vector images created by Illustrator®. The combination with a silhouette vector improved image interpretation, without resulting in longer radiation exposure or acquisition times.

  13. Anatomically-aided PET reconstruction using the kernel method

    NASA Astrophysics Data System (ADS)

    Hutchcroft, Will; Wang, Guobao; Chen, Kevin T.; Catana, Ciprian; Qi, Jinyi

    2016-09-01

    This paper extends the kernel method that was proposed previously for dynamic PET reconstruction, to incorporate anatomical side information into the PET reconstruction model. In contrast to existing methods that incorporate anatomical information using a penalized likelihood framework, the proposed method incorporates this information in the simpler maximum likelihood (ML) formulation and is amenable to ordered subsets. The new method also does not require any segmentation of the anatomical image to obtain edge information. We compare the kernel method with the Bowsher method for anatomically-aided PET image reconstruction through a simulated data set. Computer simulations demonstrate that the kernel method offers advantages over the Bowsher method in region of interest quantification. Additionally the kernel method is applied to a 3D patient data set. The kernel method results in reduced noise at a matched contrast level compared with the conventional ML expectation maximization algorithm.

  14. Evidence-based Peer Review for Radiation Therapy - Updated Review of the Literature with a Focus on Tumour Subsite and Treatment Modality.

    PubMed

    Huo, M; Gorayski, P; Poulsen, M; Thompson, K; Pinkham, M B

    2017-10-01

    Technological advances in radiation therapy permit steep dose gradients from the target to spare normal tissue, but increase the risk of geographic miss. Suboptimal target delineation adversely affects clinical outcomes. Prospective peer review is a method for quality assurance of oncologists' radiotherapy plans. Published surveys suggest it is widely implemented. However, it may not be feasible to review every case before commencement of radiation therapy in all departments. The rate of plan changes following peer review of cases without a specific subsite or modality is typically around 10%. Stereotactic body radiation therapy, head and neck, gynaecological, gastrointestinal, haematological and lung cases are associated with higher rates of change of around 25%. These cases could thus be prioritised for peer review. Other factors may limit peer review efficacy including organisational culture, time constraints and the physical environment in which sessions are held. Recommendations for peer review endorsed by the American Society for Radiation Oncology were made available in 2013, but a number of relevant studies have been published since. Here we review and update the literature, and provide an updated suggestion for the implementation of peer review to serve as an adjunct to published guidelines. This may help practitioners evaluate their current processes and maximise the utility and effectiveness of peer review sessions. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  15. [Anatomical basis for rejuvenation surgery].

    PubMed

    Sinna, R; Herlin, C; Garson, S; Dast, S; Delay, E

    2017-09-20

    The understanding of the face anatomy is mandatory before to be able to appreciate the different surgical techniques of face lifting. Despite numerous controversies and anatomical variations, we can find in the literature several keystone works that allows us to understand that the soft tissues of the face are not only a superposition of layers but also a tridimensionnal structure with a fibrous system that links the different layers. This structures creates a mix loose spaces, fat and retaining ligament that can be describe in a quite systematic manner. This systematisation can help the surgeon during the surgical procedure to search and find the area where there is no danger and alert him around the retaining for example, which is where we can often find a vessel or a branch of the facial nerve that we want to avoid. This article summarizes these anatomical knowledge. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Partial ACL tears: anatomic reconstruction versus nonanatomic augmentation surgery.

    PubMed

    Buda, Roberto; Ruffilli, Alberto; Parma, Alessandro; Pagliazzi, Gherardo; Luciani, Deianira; Ramponi, Laura; Castagnini, Francesco; Giannini, Sandro

    2013-09-01

    Treatment of partial anterior cruciate ligament (ACL) tears requires ACL remnant preservation. The goal of this study was to compare the outcome of anatomic reconstruction of the torn bundle with nonanatomic augmentation using the over-the-top femoral route. Fifty-two athletes (mean age, 23.3 years) with partial ACL lesions underwent anatomic reconstruction (n=26) or nonanatomic augmentation (n=26). Intraoperative damage of the healthy bundle that required a standard ACL reconstruction occurred in 2 patients in the anatomic reconstruction group. International Knee Documentation Committee (IKDC) score, Tegner score, and arthrometer evaluation were used pre-operatively and at follow-up for up to 5 years postoperatively. One failure occurred in the anatomic reconstruction group. Mean IKDC subjective score at follow-up was 88.2 ± 5.7 in the anatomic reconstruction group and 90.2 ± 4.7 in the nonanatomic augmentation group. According to the IKDC objective score at final follow-up, 96% of knees in the nonanatomic augmentation group were normal vs 87.5% in the anatomic reconstruction group. No significative differences were observed between the 2 groups at final follow-up. Anteromedial bundle reconstruction showed significantly lower IKDC subjective and objective scores and higher residual instability values as evaluated with the arthrometer compared with posterolateral bundle reconstruction (P=.017). The surgical treatment of ACL partial tears is demanding. Adapted portals, perfect control of the tunnel drilling process, and intercondylar space management are required in anatomic reconstruction. The nonanatomic augmentation technique is simpler, providing excellent durable results over time with a lower complication rate. Anteromedial bundle reconstruction is associated with a poorer outcome, especially when performed with anatomic reconstruction.

  17. Steps towards automatic building of anatomical atlases

    NASA Astrophysics Data System (ADS)

    Subsol, Gerard; Thirion, Jean-Philippe; Ayache, Nicholas

    1994-09-01

    This paper presents a general scheme for the building of anatomical atlases. We propose to use specific and stable features, the crest lines (or ridge lines) which are automatically extracted from 3D images by differential geometry operators. We have developed non-rigid registration techniques based on polynomial transformations to find correspondences between lines. We got encouraging results for the building of atlases of the crest lines of the skull and of the brain based on several CT-Scan and MRI images of different patients.

  18. Bronchopulmonary segments approximation using anatomical atlas

    NASA Astrophysics Data System (ADS)

    Busayarat, Sata; Zrimec, Tatjana

    2007-03-01

    Bronchopulmonary segments are valuable as they give more accurate localization than lung lobes. Traditionally, determining the segments requires segmentation and identification of segmental bronchi, which, in turn, require volumetric imaging data. In this paper, we present a method for approximating the bronchopulmonary segments for sparse data by effectively using an anatomical atlas. The atlas is constructed from a volumetric data and contains accurate information about bronchopulmonary segments. A new ray-tracing based image registration is used for transferring the information from the atlas to a query image. Results show that the method is able to approximate the segments on sparse HRCT data with slice gap up to 25 millimeters.

  19. Effects of anatomical constraints on tumor growth

    NASA Astrophysics Data System (ADS)

    Capogrosso Sansone, B.; Delsanto, P. P.; Magnano, M.; Scalerandi, M.

    2001-08-01

    Competition for available nutrients and the presence of anatomical barriers are major determinants of tumor growth in vivo. We extend a model recently proposed to simulate the growth of neoplasms in real tissues to include geometrical constraints mimicking pressure effects on the tumor surface induced by the presence of rigid or semirigid structures. Different tissues have different diffusivities for nutrients and cells. Despite the simplicity of the approach, based on a few inherently local mechanisms, the numerical results agree qualitatively with clinical data (computed tomography scans of neoplasms) for the larynx and the oral cavity.

  20. Two-year functional and anatomical results after converting treatment resistant eyes with exudative age-related macular degeneration to aflibercept in accordance with a treat and extend protocol.

    PubMed

    Jørstad, Øystein Kalsnes; Faber, Rowan Thomas; Moe, Morten Carstens

    2017-08-01

    To study the effects of converting to aflibercept in accordance with a treat and extend (T&E) strategy in eyes with treatment resistant exudative age-related macular degeneration (AMD). Two-year prospective study of eyes with exudative AMD and persistent macular fluid despite monthly treatment with ranibizumab or bevacizumab. Eyes were converted to 2.0 mg aflibercept in accordance with a T&E protocol. Fifty eyes from 47 patients were included. At baseline, the mean central retinal thickness (CRT) was 273 μm and mean best-corrected visual acuity (BCVA) 0.25 logarithm of the minimal angle of resolution (logMAR). The mean number of aflibercept injections the first year was 9.2. After 1 year, there was a reduction in mean CRT to 228 μm (p < 0.001); 22 eyes (44%) had a dry macula; and the mean BCVA was 0.24 logMAR (p = 0.531). The mean number of aflibercept injections the second year was 8.0 (p = 0.013 compared to first year). After 2 years, 24 eyes (48%) received treatment more frequently than every eighth week. The mean CRT was 225 μm (p < 0.001 compared to baseline); 31 eyes (62%) had a dry macula; and mean BCVA was 0.32 logMAR (p = 0.005 compared to baseline). Five eyes did not complete 2 years of aflibercept treatment after failing to improve. A majority of eyes showed improved anatomic outcomes. There was a small decrease in mean BCVA after the second year of treatment. About half of the eyes required treatment more frequently than the recommended aflibercept label of an 8-week interval. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  1. Results.

    ERIC Educational Resources Information Center

    Zemsky, Robert; Shaman, Susan; Shapiro, Daniel B.

    2001-01-01

    Describes the Collegiate Results Instrument (CRI), which measures a range of collegiate outcomes for alumni 6 years after graduation. The CRI was designed to target alumni from institutions across market segments and assess their values, abilities, work skills, occupations, and pursuit of lifelong learning. (EV)

  2. Chronic ankle instability: Arthroscopic anatomical repair.

    PubMed

    Arroyo-Hernández, M; Mellado-Romero, M; Páramo-Díaz, P; García-Lamas, L; Vilà-Rico, J

    Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. A retrospective observational study was conducted on 21 patients surgically treated for chronic ankle instability by means of an arthroscopic anatomical repair, between May 2012 and January 2013. There were 15 men and 6 women, with a mean age of 30.43 years (range 18-48). The mean follow-up was 29 months (range 25-33). All patients were treated by arthroscopic anatomical repair of anterior talofibular ligament. Four (19%) patients were found to have varus hindfoot deformity. Associated injuries were present in 13 (62%) patients. There were 6 cases of osteochondral lesions, 3 cases of posterior ankle impingement syndrome, and 6 cases of peroneal pathology. All these injuries were surgically treated in the same surgical time. A clinical-functional study was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. The mean score before surgery was 66.12 (range 60-71), and after surgery it increased up to a mean of 96.95 (range 90-100). All patients were able to return to their previous sport activity within a mean of 21.5 weeks (range 17-28). Complications were found in 3 (14%) patients. Arthroscopic anatomical ligament repair technique has excellent clinical-functional results with a low percentage of complications, and enables patients to return to their previous sport activity within a short period of time. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Haemodynamic and anatomic progression of aortic stenosis.

    PubMed

    Nguyen, Virginia; Cimadevilla, Claire; Estellat, Candice; Codogno, Isabelle; Huart, Virginie; Benessiano, Joelle; Duval, Xavier; Pibarot, Philippe; Clavel, Marie Annick; Enriquez-Sarano, Maurice; Vahanian, Alec; Messika-Zeitoun, David

    2015-06-01

    Aortic valve stenosis (AS) is a progressive disease, but the impact of baseline AS haemodynamic or anatomic severity on AS progression remains unclear. In 149 patients (104 mild AS, 36 moderate AS and 9 severe AS) enrolled in 2 ongoing prospective cohorts (COFRASA/GENERAC), we evaluated AS haemodynamic severity at baseline and yearly, thereafter, using echocardiography (mean pressure gradient (MPG)) and AS anatomic severity using CT (degree of aortic valve calcification (AVC)). After a mean follow-up of 2.9±1.0 years, mean MGP increased from 22±11 to 30±16 mm Hg (+3±3 mm Hg/year), and mean AVC from 1108±891 to 1640±1251 AU (arbitrary units) (+188±176 AU/year). Progression of AS was strongly related to baseline haemodynamic severity (+2±3 mm Hg/year in mild AS, +4±3 mm Hg/year in moderate AS and +5±5 mm Hg/year in severe AS (p=0.01)), and baseline haemodynamic severity was an independent predictor of haemodynamic progression (p=0.0003). Annualised haemodynamic and anatomic progression rates were significantly correlated (r=0.55, p<0.0001), but AVC progression rate was also significantly associated with baseline haemodynamic severity (+141±133 AU/year in mild AS, +279±189 AU/year in moderate AS and +361±293 AU/year in severe AS, p<0.0001), and both baseline MPG and baseline AVC were independent determinants of AVC progression (p<0.0001). AS progressed faster with increasing haemodynamic or anatomic severity. Our results suggest that a medical strategy aimed at preventing AVC progression may be useful in all subsets of patients with AS including those with severe AS and support the recommended closer follow-up of patients with AS as AS severity increases. COFRASA (clinicalTrial.gov number NCT 00338676) and GENERAC (clinicalTrial.gov number NCT00647088). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. CT following US for possible appendicitis: anatomic coverage.

    PubMed

    O'Malley, Martin E; Alharbi, Fawaz; Chawla, Tanya P; Moshonov, Hadas

    2016-02-01

    To determine superior-inferior anatomic borders for CT following inconclusive/nondiagnostic US for possible appendicitis. Ninety-nine patients with possible appendicitis and inconclusive/nondiagnostic US followed by CT were included in this retrospective study. Two radiologists reviewed CT images and determined superior-inferior anatomic borders required to diagnose or exclude appendicitis and diagnose alternative causes. This "targeted" coverage was used to estimate potential reduction in anatomic coverage compared to standard abdominal/pelvic CT. The study group included 83 women and 16 men; mean age 32 (median, 29; range 18-73) years. Final diagnoses were: nonspecific abdominal pain 50/99 (51%), appendicitis 26/99 (26%), gynaecological 12/99 (12%), gastrointestinal 9/99 (10%), and musculoskeletal 2/99 (2%). Median dose-length product for standard CT was 890.0 (range, 306.3 - 2493.9) mGy.cm. To confidently diagnose/exclude appendicitis or identify alternative diagnoses, maximum superior-inferior anatomic CT coverage was the superior border of L2-superior border of pubic symphysis, for both reviewers. Targeted CT would reduce anatomic coverage by 30-55% (mean 39%, median 40%) compared to standard CT. When CT is performed for appendicitis following inconclusive/nondiagnostic US, targeted CT from the superior border of L2-superior border of pubic symphysis can be used resulting in significant reduction in exposure to ionizing radiation compared to standard CT. • When CT is used following inconclusive/ nondiagnostic ultrasound, anatomic coverage can be reduced. • CT from L2 to pubic symphysis can be used to diagnose/exclude appendicitis. • Reduced anatomic coverage for CT results in reduced exposure to ionizing radiation.

  5. Anatomical modeling of the bronchial tree

    NASA Astrophysics Data System (ADS)

    Hentschel, Gerrit; Klinder, Tobias; Blaffert, Thomas; Bülow, Thomas; Wiemker, Rafael; Lorenz, Cristian

    2010-02-01

    The bronchial tree is of direct clinical importance in the context of respective diseases, such as chronic obstructive pulmonary disease (COPD). It furthermore constitutes a reference structure for object localization in the lungs and it finally provides access to lung tissue in, e.g., bronchoscope based procedures for diagnosis and therapy. This paper presents a comprehensive anatomical model for the bronchial tree, including statistics of position, relative and absolute orientation, length, and radius of 34 bronchial segments, going beyond previously published results. The model has been built from 16 manually annotated CT scans, covering several branching variants. The model is represented as a centerline/tree structure but can also be converted in a surface representation. Possible model applications are either to anatomically label extracted bronchial trees or to improve the tree extraction itself by identifying missing segments or sub-trees, e.g., if located beyond a bronchial stenosis. Bronchial tree labeling is achieved using a naïve Bayesian classifier based on the segment properties contained in the model in combination with tree matching. The tree matching step makes use of branching variations covered by the model. An evaluation of the model has been performed in a leaveone- out manner. In total, 87% of the branches resulting from preceding airway tree segmentation could be correctly labeled. The individualized model enables the detection of missing branches, allowing a targeted search, e.g., a local rerun of the tree-segmentation segmentation.

  6. Trigger Points: An Anatomical Substratum

    PubMed Central

    Akamatsu, Flávia Emi; Ayres, Bernardo Rodrigues; Saleh, Samir Omar; Hojaij, Flávio; Andrade, Mauro; Hsing, Wu Tu; Jacomo, Alfredo Luiz

    2015-01-01

    This study aimed to bring the trapezius muscle knowledge of the locations where the accessory nerve branches enter the muscle belly to reach the motor endplates and find myofascial trigger points (MTrPs). Although anatomoclinical correlations represent a major feature of MTrP, no previous reports describing the distribution of the accessory nerve branches and their anatomical relationship with MTrP are found in the literature. Both trapezius muscles from twelve adult cadavers were carefully dissected by the authors (anatomy professors and medical graduate students) to observe the exact point where the branches of the spinal accessory nerve entered the muscle belly. Dissection was performed through stratigraphic layers to preserve the motor innervation of the trapezius muscle, which is located deep in the muscle. Seven points are described, four of which are motor points: in all cases, these locations corresponded to clinically described MTrPs. The four points were common in these twelve cadavers. This type of clinical correlation between spinal accessory nerve branching and MTrP is useful to achieve a better understanding of the anatomical correlation of MTrP and the physiopathology of these disorders and may provide a scientific basis for their treatment, rendering useful additional information to therapists to achieve better diagnoses and improve therapeutic approaches. PMID:25811029

  7. The anatomical diaspora: evidence of early American anatomical traditions in North Dakota.

    PubMed

    Stubblefield, Phoebe R

    2011-09-01

    The current focus in forensic anthropology on increasing scientific certainty in ancestry determination reinforces the need to examine the ancestry of skeletal remains used for osteology instruction. Human skeletal remains were discovered on the University of North Dakota campus in 2007. After recovery, the osteological examination resulted in a profile for a 33- to 46-year-old woman of African descent with stature ranging from 56.3 to 61.0 in. The pattern of postmortem damage indicated that the remains had been prepared for use as an anatomical teaching specimen. Review of the American history of anatomical teaching revealed a preference for Black subjects, which apparently extended to states like North Dakota despite extremely low resident populations of people of African descent. This study emphasizes the need to examine the ancestry of older teaching specimens that lack provenience, rather than assuming they are derived from typical (i.e., Indian) sources of anatomical material. © 2011 American Academy of Forensic Sciences.

  8. Retinal vascular tree reconstruction with anatomical realism.

    PubMed

    Lin, Kai-Shun; Tsai, Chia-Ling; Tsai, Chih-Hsiangng; Sofka, Michal; Chen, Shih-Jen; Lin, Wei-Yang

    2012-12-01

    Motivated by the goals of automatically extracting vessel segments and constructing retinal vascular trees with anatomical realism, this paper presents and analyses an algorithm that combines vessel segmentation and grouping of the extracted vessel segments. The proposed method aims to restore the topology of the vascular trees with anatomical realism for clinical studies and diagnosis of retinal vascular diseases, which manifest abnormalities in either venous and/or arterial vascular systems. Vessel segments are grouped using extended Kalman filter which takes into account continuities in curvature, width, and intensity changes at the bifurcation or crossover point. At a junction, the proposed method applies the minimum-cost matching algorithm to resolve the conflict in grouping due to error in tracing. The system was trained with 20 images from the DRIVE dataset, and tested using the remaining 20 images. The dataset contained a mixture of normal and pathological images. In addition, six pathological fluorescein angiogram sequences were also included in this study. The results were compared against the groundtruth images provided by a physician, achieving average success rates of 88.79% and 90.09%, respectively.

  9. Anatomic Landmarks for the First Dorsal Compartment

    PubMed Central

    Hazani, Ron; Engineer, Nitin J.; Cooney, Damon; Wilhelmi, Bradon J.

    2008-01-01

    Objective: Knowledge of anatomic landmarks for the first dorsal compartment can assist clinicians with management of de Quervain's disease. The radial styloid, the scaphoid tubercle, and Lister's tubercle can be used as superficial landmarks for the first dorsal compartment. Methods: Thirty-two cadaveric wrists were dissected, and measurements were taken from the predetermined landmarks to the extensor retinaculum. The compartments were also inspected for variability of the abductor pollicis longus tendon and intracompartmental septations. Results: The average length of the extensor retinaculum from its proximal to distal extent measured approximately 2.2 cm. The distal aspect of the radial styloid was 0.3 cm distal to the distal aspect of the extensor retinaculum, and the distance between the distal aspect of the extensor retinaculum and the APL-Lister's-Scaphoid juncture was approximately 0.5 cm. A separate compartment for the extensor pollicis brevis was noted in 35% of the specimens. The abductor pollicis longus tendon demonstrated great variability with 1, 2, 3, or 4 slips in 9%, 30%, 43%, or 26% of the specimens, respectively. Conclusion: The superficial bony prominences of the radial wrist can be used reliably as anatomic landmarks for the first dorsal compartment. PMID:19092992

  10. Combining multiple anatomical MRI measures improves Alzheimer's disease classification.

    PubMed

    de Vos, Frank; Schouten, Tijn M; Hafkemeijer, Anne; Dopper, Elise G P; van Swieten, John C; de Rooij, Mark; van der Grond, Jeroen; Rombouts, Serge A R B

    2016-05-01

    Several anatomical MRI markers for Alzheimer's disease (AD) have been identified. Hippocampal volume, cortical thickness, and grey matter density have been used successfully to discriminate AD patients from controls. These anatomical MRI measures have so far mainly been used separately. The full potential of anatomical MRI scans for AD diagnosis might thus not yet have been used optimally. In this study, we therefore combined multiple anatomical MRI measures to improve diagnostic classification of AD. For 21 clinically diagnosed AD patients and 21 cognitively normal controls, we calculated (i) cortical thickness, (ii) cortical area, (iii) cortical curvature, (iv) grey matter density, (v) subcortical volumes, and (vi) hippocampal shape. These six measures were used separately and combined as predictors in an elastic net logistic regression. We made receiver operating curve plots and calculated the area under the curve (AUC) to determine classification performance. AUC values for the single measures ranged from 0.67 (cortical thickness) to 0.94 (grey matter density). The combination of all six measures resulted in an AUC of 0.98. Our results demonstrate that the different anatomical MRI measures contain complementary information. A combination of these measures may therefore improve accuracy of AD diagnosis in clinical practice. Hum Brain Mapp 37:1920-1929, 2016. © 2016 Wiley Periodicals, Inc.

  11. Anatomical assessment of congenital heart disease.

    PubMed

    Wood, John C

    2006-01-01

    Cardiac MRI (CMR) is replacing diagnostic cardiac catheterization as the modality of choice for anatomic and functional characterization of congenital heart disease (CHD) when echocardiographic imaging is insufficient. In this manuscript, we discuss the principles of anatomic imaging of CHD, placing emphasis on the appropriate choice and modification of pulse sequences necessary to evaluate infants and small children. Clinical examples are provided to illustrate the relative strengths and shortcomings of different CMR imaging techniques. Although cardiovascular function and flow techniques are not described, their role in evaluating the severity of anatomic defects is emphasized. Anatomic characterization represents the first component of a carefully-planned, integrated CMR assessment of CHD.

  12. Accuracy of distal radius positioning using an anatomical plate.

    PubMed

    Vroemen, Joy C; Dobbe, Johannes G G; Sierevelt, Inger N; Strackee, Simon D; Streekstra, Geert J

    2013-04-01

    Over the past decade, several anatomical plates have been introduced to improve the result of open reduction and internal fixation of the distal radius. Using 3-dimensional imaging techniques, the authors studied the accuracy and reproducibility of distal radius positioning using anatomical plates.Distal radius fractures and the correction of these fractures were simulated with plastic bone models of radii. The authors simulated a defect by removing an arbitrary wedge shape from the artificial radii. Two surgeons corrected these fractures by placing 2 anatomical plate types according to the plate manufacturers' instructions. The residual positioning errors of the distal segment in relation to the unaffected radii were determined using 3-dimensional imaging and were compared with naturally occurring bilateral radius differences in healthy individuals. In many cases, positioning does not agree with differences based on bilateral asymmetry in healthy patients.This study indicated the accuracy of anatomical plates. Positioning an anatomical plate may lead to considerable residual errors in individual patients. Volar distal radius plate shapes differ among plate manufacturers. Therefore, one plate may perform better than another in an individual.

  13. Gaussian kernel based anatomically-aided diffuse optical tomography reconstruction

    NASA Astrophysics Data System (ADS)

    Baikejiang, Reheman; Zhang, Wei; Li, Changqing

    2017-02-01

    Image reconstruction in diffuse optical tomography (DOT) is challenging because its inverse problem is nonlinear, ill-posed and ill-conditioned. Anatomical guidance from high spatial resolution imaging modalities can substantially improve the quality of reconstructed DOT images. In this paper, inspired by the kernel methods in machine learning, we propose the kernel method to introduce anatomical information into the DOT image reconstruction algorithm. In this kernel method, optical absorption coefficient at each finite element node is represented as a function of a set of features obtained from anatomical images such as computed tomography (CT). The kernel based image model is directly incorporated into the forward model of DOT, which exploits the sparseness of the image in the feature space. Compared with Laplacian approaches to include structural priors, the proposed method does not require the image segmentation of distinct regions. The proposed kernel method is validated with numerical simulations of 3D DOT reconstruction using synthetic CT data. We added 15% Gaussian noise onto both the numerical DOT measurements and the simulated CT image. We have also validated the proposed method by agar phantom experiment with anatomical guidance from a CT scan. We have studied the effects of voxel size and number of nearest neighborhood size in kernel method on the reconstructed DOT images. Our results indicate that the spatial resolution and the accuracy of the reconstructed DOT images have been improved substantially after applying the anatomical guidance with the proposed kernel method.

  14. Presentation of Anatomical Variations Using the Aurasma Mobile App.

    PubMed

    Hong, Trudy; Bézard, Georg; Lozanoff, Beth K; Labrash, Steven; Lozanoff, Scott

    2015-09-01

    Knowledge of anatomical variations is critical to avoid clinical complications and it enables an understanding of morphogenetic mechanisms. Depictions are comprised of photographs or illustrations often limiting appreciation of three-dimensional (3D) spatial relationships. The purpose of this study is to describe an approach for presenting anatomical variations utilizing video clips emphasizing 3D anatomical relationships delivered on personal electronic devices. An aberrant right subclavian artery (ARSA) was an incidental finding in a routine dissection of an 89-year-old man cadaver during a medical student instructional laboratory. The specimen was photographed and physical measurements were recorded. Three-dimensional models were lofted and rendered with Maya software and converted as Quicktime animations. Photographs of the first frame of the animations were recorded and registered with Aurasma Mobile App software (www.aurasma.com). Resulting animations were viewed on mobile devices. The ARSA model can be manipulated on the mobile device enabling the student to view and appreciate spatial relationships. Model elements can be de-constructed to provide even greater spatial resolution of anatomical relationships. Animations provide a useful approach for visualizing anatomical variations. Future work will be directed at creating a library of variants and underlying mechanism of formation for presentation through the Aurasma application.

  15. Presentation of Anatomical Variations Using the Aurasma Mobile App

    PubMed Central

    Bézard, Georg; Lozanoff, Beth K; Labrash, Steven; Lozanoff, Scott

    2015-01-01

    Knowledge of anatomical variations is critical to avoid clinical complications and it enables an understanding of morphogenetic mechanisms. Depictions are comprised of photographs or illustrations often limiting appreciation of three-dimensional (3D) spatial relationships. The purpose of this study is to describe an approach for presenting anatomical variations utilizing video clips emphasizing 3D anatomical relationships delivered on personal electronic devices. An aberrant right subclavian artery (ARSA) was an incidental finding in a routine dissection of an 89-year-old man cadaver during a medical student instructional laboratory. The specimen was photographed and physical measurements were recorded. Three-dimensional models were lofted and rendered with Maya software and converted as Quicktime animations. Photographs of the first frame of the animations were recorded and registered with Aurasma Mobile App software (www.aurasma.com). Resulting animations were viewed on mobile devices. The ARSA model can be manipulated on the mobile device enabling the student to view and appreciate spatial relationships. Model elements can be de-constructed to provide even greater spatial resolution of anatomical relationships. Animations provide a useful approach for visualizing anatomical variations. Future work will be directed at creating a library of variants and underlying mechanism of formation for presentation through the Aurasma application. PMID:26793410

  16. Are All Manikins Created Equal? A Pilot Study of Simulator Upper Airway Anatomic Fidelity.

    PubMed

    Woo, Jennifer A; Malekzadeh, Sonya; Malloy, Kelly M; Deutsch, Ellen S

    2017-06-01

    This study evaluates the anatomic fidelity of several commercially available pediatric and adult manikins, including airway task trainers, which could be used in aerodigestive procedure training. Twenty-three experienced otolaryngologists assessed the aerodigestive anatomy of 5 adult and 5 pediatric manikins in a passive state, using rigid and flexible endoscopy. Anatomic fidelity was rated on a 5-point scale for the following: nasal cavity, nasopharynx, oral cavity, oropharynx, larynx, trachea, esophagus, and neck. Mean scores and standard deviations were tabulated for each manikin at each anatomic site. Ratings by survey participants demonstrated variation in the anatomic fidelity of the aerodigestive tract in a range of manikins. Radar chart display of the results allows comparison of manikin fidelity by anatomic site. Differences in scores may allow instructors to select manikins with the best anatomic fidelity for specific educational purposes, and they may contribute to recommendations to improve future manikin design.

  17. Anatomist on the dissecting table? Dutch anatomical professionals' views on body donation.

    PubMed

    Bolt, Sophie; Venbrux, Eric; Eisinga, Rob; Gerrits, Peter O

    2012-03-01

    Anatomical professionals know better than anyone else that donated bodies are a valuable asset to anatomical science and medical education. They highly value voluntary donations, since a dearth of bodies negatively affects their profession. With this in mind, we conducted a survey (n = 54) at the 171st scientific meeting of the Dutch Anatomical Society in 2009 to see to what extent anatomical professionals are willing to donate their own body. The results reveal that none of the survey participants are registered as a whole body donor and that only a quarter of them would consider the possibility of body donation. We argue that the two main constraints preventing Dutch anatomical professionals from donating their own body are their professional and their social environments. In contrast to the absence of registered body donors, half of the anatomical professionals are registered as an organ donor. This figure far exceeds the proportion of registered organ donors among the general Dutch population.

  18. Sulfur oxygenates of biomimetics of the diiron subsite of the [FeFe]-hydrogenase active site: properties and oxygen damage repair possibilities.

    PubMed

    Liu, Tianbiao; Li, Bin; Singleton, Michael L; Hall, Michael B; Darensbourg, Marcetta Y

    2009-06-17

    This study explores the site specificity (sulfur vs the Fe-Fe bond) of oxygenation of diiron (Fe(I)Fe(I) and Fe(II)Fe(II)) organometallics that model the 2-iron subsite in the active site of [FeFe]-hydrogenase: (mu-pdt)[Fe(CO)(2)L][Fe(CO)(2)L'] (L = L' = CO (1); L = PPh(3), L' = CO (2); L = L' = PMe(3) (4)) and (mu-pdt)(mu-H)[Fe(CO)(2)PMe(3)](2) (5). DFT computations find that the Fe-Fe bond in the Fe(I)Fe(I) diiron models is thermodynamically favored to produce the mu-oxo or oxidative addition product, Fe(II)-O-Fe(II); nevertheless, the sulfur-based HOMO-1 accounts for the experimentally observed mono- and bis-O-atom adducts at sulfur, i.e., (mu-pst)[Fe(CO)(2)L][Fe(CO)(2)L'] (pst = -S(CH(2))(3)S(O)-, 1,3-propanesulfenatothiolate; L = L' = CO (1-O); L = PPh(3), L' = CO (2-O); L = L' = PMe(3) (4-O)) and (mu-pds)[Fe(CO)(2)L][Fe(CO)(2)L'] (pds = -(O)S(CH(2))(3)S(O)-, 1,3-propanedisulfenato; L = PPh(3), L' = CO (2-O(2))). The Fe(II)(mu-H)Fe(II) diiron model (5), for which the HOMO is largely of sulfur character, exclusively yields S-oxygenation. The depressing effect of such bridging ligand modification on the dynamic NMR properties arising from rotation of the Fe(CO)(3) correlates with higher barriers to the CO/PMe(3) exchange of (mu-pst)[Fe(CO)(3)](2) as compared to (mu-pdt)[Fe(CO)(3)](2). Five molecular structures are confirmed by X-ray diffraction: 1-O, 2-O, 2-O(2), 4-O, and 6. Deoxygenation with reclamation of the mu-pdt parent complex occurs in a proton/electron-coupled process. The possible biological relevance of oxygenation and deoxygenation studies is discussed.

  19. Restoring the seal of an anatomical face mask.

    PubMed

    Singhal, Suresh; Lal, Jatin

    2011-07-01

    The face mask is a device to facilitate the delivery of gases from a breathing system to a patient by creating an airtight seal around the face. Of the many types of face masks available, the anatomical face mask is most commonly used for anaesthesia. With repeated usage, the seal of the anatomical face mask becomes flattened due to the loss of air in the cushion, leading to a poor fit on the patient's face. This results in air dilution during spontaneous respiration and inadequate gas exchange during controlled ventilation. A simple solution to restore this seal has been provided.

  20. Brain Morphometry Using Anatomical Magnetic Resonance Imaging

    ERIC Educational Resources Information Center

    Bansal, Ravi; Gerber, Andrew J.; Peterson, Bradley S.

    2008-01-01

    The efficacy of anatomical magnetic resonance imaging (MRI) in studying the morphological features of various regions of the brain is described, also providing the steps used in the processing and studying of the images. The ability to correlate these features with several clinical and psychological measures can help in using anatomical MRI to…

  1. Brain Morphometry Using Anatomical Magnetic Resonance Imaging

    ERIC Educational Resources Information Center

    Bansal, Ravi; Gerber, Andrew J.; Peterson, Bradley S.

    2008-01-01

    The efficacy of anatomical magnetic resonance imaging (MRI) in studying the morphological features of various regions of the brain is described, also providing the steps used in the processing and studying of the images. The ability to correlate these features with several clinical and psychological measures can help in using anatomical MRI to…

  2. Detection of breast asymmetry using anatomical features

    NASA Astrophysics Data System (ADS)

    Miller, Peter; Astley, Susan M.

    1993-07-01

    We present a new approach to the detection of breast asymmetry, an important radiological sign of cancer. The conventional approach to this problem is to search for brightness or texture differences between corresponding locations on left and right breast images. Due to the difficulty in accurately identifying corresponding locations, asymmetry cues generated in this way are insufficiently specific to be used as prompts for small and subtle abnormalities in a computer-aided diagnosis system. We have undertaken studies to discover more about the visual cues utilized by radiologists. We propose a new automatic method for detecting asymmetry based on the comparison of corresponding anatomical structures, which are identified by an automatic segmentation of breast tissue types. We describe a number of methods for comparing the shape and grey-level distribution of these regions, and we have achieved promising results by combining evidence for asymmetry.

  3. Visualizing the spine using anatomical knowledge

    NASA Astrophysics Data System (ADS)

    Cornelius, Craig W.; Fellingham, Linda L.

    1990-08-01

    In vivo anatomy is now routinely displayed as 2-D and 3-D images obtained from Computed X-ray Tomograpy (CT), Magnetic Resonance Imaging (MRI), and other diagnostic modalities. Most current medical visualization methods rely on pixel intensities to segment the data into tissues. However, structural features must be differentiated by a human operator, and geometric measurements of the anatomy are tedious and error prone to compute. This paper describes processing and imaging methods to aid the interpretation of CT studies of the spine. These procedures incorporate knowledge of the symmetry, shapes, and spatial relationships of vertebrae to locate the spinal cord and major components of vertebral bone from CT slices of the spine and automatically compute anatomical measurements. Results of these methods are shown as applied to the cervical (neck) and lumbar (lower back) regions of the spine.

  4. Critical diagnoses (critical values) in anatomic pathology.

    PubMed

    Silverman, Jan F; Fletcher, Christopher D M; Frable, William J; Goldblum, John R; Pereira, Telma C; Swanson, Paul E

    2006-08-01

    Similar to critical values in clinical pathology, occasional diagnoses in surgical pathology and cytology may require urgent contact of the physician to facilitate rapid intervention or treatment. However, there are no established critical value (critical diagnosis) guidelines in anatomic pathology. As discussed herein, the Association of Directors of Anatomic and Surgical Pathology (ADASP) believes that establishing anatomic pathology critical diagnosis guidelines represents a practice improvement and patient safety initiative. The ADASP also recognizes that a generic anatomic pathology critical diagnosis guideline such as this should only be used as a template because the list needs to be customized at each individual hospital after consultation with relevant clinical services. Based on surveys of the membership of the ADASP, this document provides examples of possible critical diagnoses in anatomic pathology.

  5. Critical diagnoses (critical values) in anatomic pathology.

    PubMed

    Silverman, Jan F

    2006-06-01

    Similar to critical values in clinical pathology, occasional diagnoses in surgical pathology and cytology may require urgent contact of the physician to facilitate rapid intervention or treatment. However, there are no established critical value (critical diagnosis) guidelines in anatomic pathology. As discussed herein, the Association of Directors of Anatomic and Surgical Pathology (ADASP) believes that establishing anatomic pathology critical diagnosis guidelines represents a practice improvement and patient safety initiative. ADASP also recognizes that a generic anatomic pathology critical diagnosis guideline such as this should be used only as a template because the list needs to be customized at each individual hospital following consultation with relevant clinical services. Based on surveys of the membership of the ADASP, this document provides examples of possible critical diagnoses in anatomic pathology.

  6. Critical diagnoses (critical values) in anatomic pathology.

    PubMed

    2006-07-01

    Similar to critical values in clinical pathology, occasional diagnoses in surgical pathology and cytology may require urgent contact of the physician to facilitate rapid intervention or treatment. However, there are no established critical value (critical diagnosis) guidelines in anatomic pathology. As discussed herein, the Association of Directors of Anatomic and Surgical Pathology (ADASP) believes that establishing anatomic pathology critical diagnosis guidelines represents a practice improvement and patient safety initiative. ADASP also recognizes that a generic anatomic pathology critical diagnosis guideline such as this should only be used as a template, because the list needs to be customized at each individual hospital after consultation with relevant clinical services. Based on surveys of the membership of the ADASP, this document provides examples of possible critical diagnoses in anatomic pathology.

  7. [Videothoracoscopic anatomic pulmonary segmentary: an initial single-center experience].

    PubMed

    Reis, João Eurico; Bravio, Ivan; Baptista, Pedro; Martelo, Fernando Palma

    2012-01-01

    The use of minimally invasive surgery for the treatment of lung cancer has been growing worldwide. Between May 2008 and November 2012, we performed 24 videothoracoscopic anatomical lung resections in our department. This includes 22 lobectomies and 2 anatomic segmentectomies, which is known to be a more complex surgery, since it demands a finer dissection of sub-lobar structures. We report the clinical cases of two patients who underwent anatomic segmentectomies. The first one was a 63 year old woman, smoker and with a history of breast cancer 20 years earlier. An incidental 9 mm node was found in the lingula. The patient underwent an anatomic lingulectomy and the frozen section was suggestive of a primary lung cancer. Therefore, we proceeded to a full lymphadenectomy. The final pathology evaluation showed a typical carcinoid tumour (pT1aN0). The second patient was a 50 year old woman, a smoker and with a heavy family history of lung cancer. In a screening CT scan a 8 mm ground glass opacity was identified in the left lower lobe (segment VI). After a VATS wedge resection of the node the frozen section evaluation was compatible with adenocarcinoma. We then proceeded to an anatomic segmentectomy with lymphadenectomy. The definitive pathology evaluation confirmed that it was a pT1a N0 bronchioloalveolar adenocarcinoma. The patients now have 5 and 2 months of follow up respectivelly and neither of them has signs of recurrence and the surgical incision showed a good aesthetic result. Anatomic segmentectomy is the indicated surgery especially in patients with low grade tumours, in early stage lung cancers or in patients without pulmonary function for a lobar resection, and it can be done safely using VATS.

  8. Sequencing human ribs into anatomical order by quantitative multivariate methods.

    PubMed

    Cirillo, John; Henneberg, Maciej

    2012-06-01

    Little research has focussed on methods to anatomically sequence ribs. Correct anatomical sequencing of ribs assists in determining the location and distribution of regional trauma, age estimation, number of puncture wounds, number of individuals, and personal identification. The aim of the current study is to develop a method for placing fragmented and incomplete rib sets into correct anatomical position. Ribs 2-10 were used from eleven cadavers of an Australian population. Seven variables were measured from anatomical locations on the rib. General descriptive statistics were calculated for each variable along with an analysis of variance (ANOVA) and ANOVA with Bonferroni statistics. Considerable overlap was observed between ribs for univariate methods. Bivariate and multivariate methods were then applied. Results of the ANOVA with post hoc Bonferroni statistics show that ratios of various dimensions of a single rib could be used to sequence it within adjacent ribs. Using multiple regression formulae, the most accurate estimation of the anatomical rib number occurs when the entire rib is found in isolation. This however, is not always possible. Even when only the head and neck of the rib are preserved, a modified multivariate regression formula assigned 91.95% of ribs into correct anatomical position or as an adjacent rib. Using multivariate methods it is possible to sequence a single human rib with a high level of accuracy and they are superior to univariate methods. Left and right ribs were found to be highly symmetrical. Some rib dimensions were greater in males than in females, but overall the level of sexual dimorphism was low.

  9. Effect of anatomical backgrounds on detectability in volumetric cone beam CT images

    NASA Astrophysics Data System (ADS)

    Han, Minah; Park, Subok; Baek, Jongduk

    2016-03-01

    As anatomical noise is often a dominating factor affecting signal detection in medical imaging, we investigate the effects of anatomical backgrounds on signal detection in volumetric cone beam CT images. Signal detection performances are compared between transverse and longitudinal planes with either uniform or anatomical backgrounds. Sphere objects with diameters of 1mm, 5mm, 8mm, and 11mm are used as the signals. Three-dimensional (3D) anatomical backgrounds are generated using an anatomical noise power spectrum, 1/fβ, with β=3, equivalent to mammographic background [1]. The mean voxel value of the 3D anatomical backgrounds is used as an attenuation coefficient of the uniform background. Noisy projection data are acquired by the forward projection of the uniform and anatomical 3D backgrounds with/without sphere lesions and by the addition of quantum noise. Then, images are reconstructed by an FDK algorithm [2]. For each signal size, signal detection performances in transverse and longitudinal planes are measured by calculating the task SNR of a channelized Hotelling observer with Laguerre-Gauss channels. In the uniform background case, transverse planes yield higher task SNR values for all sphere diameters but 1mm. In the anatomical background case, longitudinal planes yield higher task SNR values for all signal diameters. The results indicate that it is beneficial to use longitudinal planes to detect spherical signals in anatomical backgrounds.

  10. An analysis of knee anatomic imaging factors associated with primary lateral patellar dislocations.

    PubMed

    Arendt, Elizabeth A; England, Kristin; Agel, Julie; Tompkins, Marc A

    2016-05-04

    Various knee anatomic imaging factors have been historically associated with lateral patellar dislocation. The characterization of these anatomic factors in a primary lateral patellar dislocation population has not been well described. Our purpose was to characterize the spectrum of anatomic factors from slice imaging measurements specific to a population of primary lateral patellar dislocation. A secondary purpose was to stratify these data by sex/skeletal maturity to better detail potential dimorphic characteristics. Patients with a history of primary lateral patellar dislocation between 2008 and 2012 were prospectively identified. Ten MRI measurements were analysed with results stratified by sex/skeletal maturity. A '4-factor' analysis was performed to detail the number of 'excessive' anatomic factors within a single individual. This study involved 157 knees (79 M/78 F), and 107 patients were skeletally mature. The measurements demonstrate more anatomic risk factors in this population than historical controls. Patella height and trochlear measurements are the most common 'dysplastic' anatomic factors in this population. There were differences based on sex for some patellar height measurements and for TT-TG; there were no differences based on skeletal maturity. Primary lateral patellar dislocation patients have MRI measurements of knee anatomic factors that are generally more dysplastic than the normal population; however, there is a broad spectrum of anatomic features with no pattern predominating. Characterizing knee anatomic imaging factors in the patient with a primary lateral patellar dislocation is a necessary first step in characterizing the (potential) differences between the primary and recurrent patellar dislocation patient. IV.

  11. Beyond Anatomical Dolls: Professionals' Use of Other Play Therapy Techniques.

    ERIC Educational Resources Information Center

    Kendall-Tackett, Kathleen A.

    1992-01-01

    Telephone interviews were conducted with 201 Boston-area professionals who work with child victims of sexual abuse. Questions concerned use of anatomical dolls and other techniques and behavioral indicators of sexual abuse. Results indicated that mental health professionals used significantly more techniques than did law enforcement professionals.…

  12. Improving maltodextrin specificity for enzymatic synthesis of 2-O-d-glucopyranosyl-l-ascorbic acid by site-saturation engineering of subsite-3 in cyclodextrin glycosyltransferase from Paenibacillus macerans.

    PubMed

    Liu, Long; Xu, Qiaoyan; Han, Ruizhi; Shin, Hyun-dong; Chen, Rachel R; Li, Jianghua; Du, Guocheng; Chen, Jian

    2013-07-20

    In this work, the subsite-3 of cyclodextrin glycosyltransferase (CGTase) from Paenibacillus macerans was engineered to improve maltodextrin specificity for 2-O-d-glucopyranosyl-l-ascorbic acid (AA-2G) synthesis. Specifically, the site-saturation mutagenesis of tyrosine 89, asparagine 94, aspartic acid 196, and aspartic acid 372 in subsite-3 was separately performed, and three mutants Y89F (tyrosine→phenylalanine), N94P (asparagine→proline), and D196Y (aspartic acid→tyrosine) produced higher AA-2G titer than the wild-type and the other mutants. Previously, we found the mutant K47L (lysine→leucine) also had a higher maltodextrin specificity. Therefore, the four mutants K47L, Y89F, N94P, and D196Y were further used to construct the double, triple, and quadruple mutations. Among the 11 combinational mutants, the quadruple mutant K47L/Y89F/N94P/D196Y produced the highest AA-2G titer of 2.23g/L, which was increased by 85.8% compared to that produced by the wild-type CGTase. The reaction kinetics of all the mutants were modeled, and the pH and thermal stabilities of all the mutants were analyzed. The structure modeling indicated that the enhanced maltodextrin specificity may be related with the changes of hydrogen bonding interactions between the side chain of residue at the four positions (47, 89, 94, and 196) and the substrate sugars.

  13. Anatomic concepts for brow lift procedures.

    PubMed

    Knize, David M

    2009-12-01

    Brow lifting became a component of the facialplasty procedure 45 years ago, and the original brow-lifting technique incorporating a coronal incision approach is still practiced by many surgeons today. Over the past 15 years, however, the endoscope-assisted procedure and the limited incision, nonendoscopic techniques have evolved as alternate procedures for brow lifting. The level of artistry in performing any brow lift technique is raised when the surgeon acquires knowledge of upper facial anatomy and integrates that knowledge into a working concept of the aging process of the upper face. This article presents one surgeon's concepts of the process that culminate in the typical appearance of the aged upper face. The same understanding of upper facial anatomy that can be called upon to explain the steps in this aging process can also be applied to the technical steps of any foreheadplasty procedure. Those anatomic structures that play a role in this process are examined here. The typical appearance of the aged upper face is the product of muscle action and gravitational forces acting on the unique anatomy of the human face. Interestingly, the appearance of the typical aged upper face exhibits much the same characteristics as one might observe in the face of an individual experiencing the emotions of sadness or grief. It is an inappropriate facial expression of sadness or grief that most often motivates the patient to schedule a consultation with the plastic surgeon. Any of the brow lift procedures used in current clinical practice can provide a successful cosmetic result in selected patients if the procedure incorporates technical steps based on sound anatomic principles.

  14. Detectability of radiological images: the influence of anatomical noise

    NASA Astrophysics Data System (ADS)

    Bochud, Francois O.; Verdun, Francis R.; Hessler, Christian; Valley, Jean-Francois

    1995-04-01

    Radiological image quality can be objectively quantified by the statistical decision theory. This theory is commonly applied with the noise of the imaging system alone (quantum, screen and film noises) whereas the actual noise present on the image is the 'anatomical noise' (sum of the system noise and the anatomical texture). This anatomical texture should play a role in the detection task. This paper compares these two kinds of noises by performing 2AFC experiments and computing the area under the ROC-curve. It is shown that the 'anatomical noise' cannot be considered as a noise in the sense of Wiener spectrum approach and that the detectability performance is the same as the one obtained with the system noise alone in the case of a small object to be detected. Furthermore, the statistical decision theory and the non- prewhitening observer does not match the experimental results. This is especially the case in the low contrast values for which the theory predicts an increase of the detectability as soon as the contrast is different from zero whereas the experimental result demonstrates an offset of the contrast value below which the detectability is purely random. The theory therefore needs to be improved in order to take this result into account.

  15. An anatomical signature for literacy.

    PubMed

    Carreiras, Manuel; Seghier, Mohamed L; Baquero, Silvia; Estévez, Adelina; Lozano, Alfonso; Devlin, Joseph T; Price, Cathy J

    2009-10-15

    Language is a uniquely human ability that evolved at some point in the roughly 6,000,000 years since human and chimpanzee lines diverged. Even in the most linguistically impoverished environments, children naturally develop sophisticated language systems. In contrast, reading is a learnt skill that does not develop without intensive tuition and practice. Learning to read is likely to involve ontogenic structural brain changes, but these are nearly impossible to isolate in children owing to concurrent biological, environmental and social maturational changes. In Colombia, guerrillas are re-integrating into mainstream society and learning to read for the first time as adults. This presents a unique opportunity to investigate how literacy changes the brain, without the maturational complications present in children. Here we compare structural brain scans from those who learnt to read as adults (late-literates) with those from a carefully matched set of illiterates. Late-literates had more white matter in the splenium of the corpus callosum and more grey matter in bilateral angular, dorsal occipital, middle temporal, left supramarginal and superior temporal gyri. The importance of these brain regions for skilled reading was investigated in early literates, who learnt to read as children. We found anatomical connections linking the left and right angular and dorsal occipital gyri through the area of the corpus callosum where white matter was higher in late-literates than in illiterates; that reading, relative to object naming, increased the interhemispheric functional connectivity between the left and right angular gyri; and that activation in the left angular gyrus exerts top-down modulation on information flow from the left dorsal occipital gyrus to the left supramarginal gyrus. These findings demonstrate how the regions identified in late-literates interact during reading, relative to object naming, in early literates.

  16. Iridium-192 interstitial brachytherapy for equine periocular tumours: treatment results and prognostic factors in 115 horses.

    PubMed

    Théon, A P; Pascoe, J R

    1995-03-01

    One hundred and fifteen horses with periocular tumours were treated with iridium-192 interstitial brachytherapy. Tumours included squamous cell carcinomas (n = 52) and sarcoids (n = 63). All horses were scheduled to receive 60 Gy (minimal tumour dose) given at a low dose rate (0.034 +/- 0.010 Gy/h). The mean and median follow-up times to last contact or death were 24 and 16 months, respectively. Chronic radiation reactions included palpebral fibrosis (10.4%), cataract (7.8%), keratitis and corneal ulceration (6.9%). Cosmetic changes included permanent epilation (21.7%) and hair dyspigmentation (78.3%). The one year progression-free survival (PFS) rates for sarcoids and carcinomas were 86.6% and 81.8% and the 5 year PFS rates were 74.0% and 63.5%, respectively. The horse age and sex, histopathological type, anatomical subsite and classification (WHO T1-3) were included in the analysis of prognostic factors. The only significant prognostic factor that independently affected PFS time was the WHO T-classification (P = 0.009, relative risk = 0.85). When compared to horses with T1 lesions, horses with T2 and T3 lesions had 1.8-fold and 3.4-fold increased risks, respectively, for tumour recurrence (relative excess risk). The one year PFS rates for T1, T2 and T3 lesions were 95.2%, 89.5% and 66.2%, respectively. The 5 year PFS rates were 72.2%, 74.0% and 53.1%, respectively. The results of this study indicate that irradiation is an effective treatment option for horses with T1-2 lesions and should be part of a combined treatment modality for horses with T3 lesions.

  17. EUROCARE-3: survival of cancer patients diagnosed 1990-94--results and commentary.

    PubMed

    Sant, M; Aareleid, T; Berrino, F; Bielska Lasota, M; Carli, P M; Faivre, J; Grosclaude, P; Hédelin, G; Matsuda, T; Møller, H; Möller, T; Verdecchia, A; Capocaccia, R; Gatta, G; Micheli, A; Santaquilani, M; Roazzi, P; Lisi, D

    2003-01-01

    EUROCARE-3 analysed the survival of 1815584 adult cancer patients diagnosed from 1990 to 1994 in 22 European countries. The results are reported in tables, one per cancer site, coded according to the International Classification of Diseases (ICD)-9 classification. The main findings of the tables are summarised and commented on in this article. For most solid cancers, wide differences in survival between different European populations were found, as also reported by EUROCARE-1 and EUROCARE-2, despite a remarkable (10%) overall increase in cancer survival from 1985 to 1994. Survival was highest in northern Europe (Sweden, Norway, Finland and Iceland), and fairly good in central-southern Europe (France, Switzerland, Austria and Spain). Survival was particularly low in eastern Europe, low in Denmark and the UK, and fairly low in Portugal and Malta. The mix of tumour stage at diagnosis explains much of the survival differences for cancers of the digestive tract, female reproductive system, breast, thyroid, and also skin melanoma. For tumours of the urinary tract and prostate, the differences were explained mainly by differences in diagnostic criteria and procedures. The case mix by anatomic subsite largely explains differences in survival for head and neck cancers. For oesophagus, pancreas, liver and brain cancer, with poor prognoses, survival differences were limited. Tumours, for which highly effective treatments are available, such as testicular cancer, Hodgkin's lymphoma and some haematological malignancies, had fairly uniform survival across Europe. Survival for all tumours combined (an indicator of the overall cancer care performance of a nation's health system) was better in young than old patients, and better in women than men. The affluence of countries influenced overall cancer survival through the availability of adequate diagnostic and treatment procedures, and screening programmes.

  18. Validation and detection of vessel landmarks by using anatomical knowledge

    NASA Astrophysics Data System (ADS)

    Beck, Thomas; Bernhardt, Dominik; Biermann, Christina; Dillmann, Rüdiger

    2010-03-01

    The detection of anatomical landmarks is an important prerequisite to analyze medical images fully automatically. Several machine learning approaches have been proposed to parse 3D CT datasets and to determine the location of landmarks with associated uncertainty. However, it is a challenging task to incorporate high-level anatomical knowledge to improve these classification results. We propose a new approach to validate candidates for vessel bifurcation landmarks which is also applied to systematically search missed and to validate ambiguous landmarks. A knowledge base is trained providing human-readable geometric information of the vascular system, mainly vessel lengths, radii and curvature information, for validation of landmarks and to guide the search process. To analyze the bifurcation area surrounding a vessel landmark of interest, a new approach is proposed which is based on Fast Marching and incorporates anatomical information from the knowledge base. Using the proposed algorithms, an anatomical knowledge base has been generated based on 90 manually annotated CT images containing different parts of the body. To evaluate the landmark validation a set of 50 carotid datasets has been tested in combination with a state of the art landmark detector with excellent results. Beside the carotid bifurcation the algorithm is designed to handle a wide range of vascular landmarks, e.g. celiac, superior mesenteric, renal, aortic, iliac and femoral bifurcation.

  19. Additive Manufacturing of Anatomical Models from Computed Tomography Scan Data.

    PubMed

    Gür, Y

    2014-12-01

    The purpose of the study presented here was to investigate the manufacturability of human anatomical models from Computed Tomography (CT) scan data via a 3D desktop printer which uses fused deposition modelling (FDM) technology. First, Digital Imaging and Communications in Medicine (DICOM) CT scan data were converted to 3D Standard Triangle Language (STL) format by using In Vaselius digital imaging program. Once this STL file is obtained, a 3D physical version of the anatomical model can be fabricated by a desktop 3D FDM printer. As a case study, a patient's skull CT scan data was considered, and a tangible version of the skull was manufactured by a 3D FDM desktop printer. During the 3D printing process, the skull was built using acrylonitrile-butadiene-styrene (ABS) co-polymer plastic. The printed model showed that the 3D FDM printing technology is able to fabricate anatomical models with high accuracy. As a result, the skull model can be used for preoperative surgical planning, medical training activities, implant design and simulation to show the potential of the FDM technology in medical field. It will also improve communication between medical stuff and patients. Current result indicates that a 3D desktop printer which uses FDM technology can be used to obtain accurate anatomical models.

  20. Functional and anatomic results after creation of a neovagina according to Wharton-Sheares-George in patients with Mayer-Rokitansky-Küster-Hauser syndrome-long-term follow-up.

    PubMed

    Walch, Katharina; Kowarik, Eleen; Leithner, Katharina; Schätz, Theresa; Dörfler, Daniela; Wenzl, René

    2011-08-01

    To evaluate the long-term outcomes and degree of satisfaction after neovaginoplasty according to Wharton-Sheares-George in women with Mayer-Rokitansky-Küster-Hauser syndrome. Open, monocentric follow-up study. University hospital and referral center for pediatric and adolescent gynecology. Ten patients with Mayer-Rokitansky-Küster-Hauser syndrome with neovaginas created according to Wharton-Sheares-George 3 to 77 months ago. Gynecologic follow-up examination, including vaginal swab, bacterial culture, Papanicolaou smear, hybrid capture test for human papillomavirus typing, biopsy, pelvic ultrasound, and 2 questionnaires concerning global quality of life and degree of sexual satisfaction. Satisfaction with sexual function, quality of life, length and width of neovagina, structure of vaginal epithelium, and type of bacterial colonization. Functional long-term follow-up results showed a high subjective degree of general well-being and sexual satisfaction in affected women. A satisfactory neovaginal length (mean, 8.3 ± 1.06 cm; range, 7-10 cm) and width (mean, 3.3 ± 0.5 cm; range, 2.5-4 cm) was obtained. As revealed by smears and biopsy, the neovagina resembled a natural vagina with regard to type of bacterial colonization and structure of epithelium. The goal of any method of creating a neovagina is to provide the patient the possibility to have satisfactory sexual intercourse and to enhance well-being and quality of life. These aims can be achieved by creating a neovagina according to Wharton-Sheares-George. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Anatomic versus non-anatomic liver resection for hepatocellular carcinoma: a systematic review.

    PubMed

    Tang, Yun-Hao; Wen, Tian-Fu; Chen, Xi

    2013-01-01

    To evaluate the feasibility and therapeutic effects of anatomic liver resection versus non-anatomic liver resection for hepatocellular carcinoma. Randomized controlled trials and non-randomized trials comparing the clinical effectiveness between anatomic and non-anatomic liver resection for hepatocellular carcinoma were identified by using a predefined search strategy. A meta-analysis was performed to estimate pooled survival and recurrence rate. No Randomized controlled trial was identified. Twelve non-randomized comparative trials (10 in English and 2 in Chinese) including total 1,829 cases, 1,005 cases in anatomic resection group and 824 cases in non-anatomic resection group, were included in this review. Meta-analysis showed that there was no significant difference between anatomic and non-anatomic liver resection in 1-year survival rate (p = 0.98), 3-year survival rate (p = 0.75), 5-year survival rate (p = 0.38) and recurrence rate (p = 0.44). The differences in post-operative morbidity (p = 0.32) and blood loss during operation (p = 0.11) were also not statistically significant. Anatomic liver resection for HCC does not provide significant benefit in 1-year/3-year/5-year survival rate, recurrence rate, post-operative morbidity and blood loss during operation compared with non-anatomic resection.

  2. Absence of Flexor Carpi Radialis during an Elective Carpometacarpal Arthroplasty of the Thumb: A Rare Anatomical Variation.

    PubMed

    Sofos, Stratos S; Riaz, Muhammad

    2016-01-01

    Purpose. We present an extremely rare anatomical variation of unilateral flexor carpi radialis (FCR) absence. This rare anatomical variation posed a clinical dilemma to us and we highlight the importance of the surgeon being aware of this anatomical variation of an important structure both as a reconstruction tool and as an anatomical landmark. Methods. This anatomical variation of the unilaterally absent FCR was found upon dissection during a carpometacarpal arthroplasty of the thumb. Results. Upon the discovery of an absent FCR tendon, we proceeded with a simple trapeziectomy. Conclusions. We present an extremely rare anatomical variation of unilateral FCR absence. This rare anatomical variation may pose clinical dilemmas to the operating surgeon who aims to utilise the FCR either for tendon transfer, for tendon graft, or, as seen in our case, in the reconstruction of a carpometacarpal excision at the thumb. We highlight this diagnosis of suspicion, which may influence the clinical procedure.

  3. Sensitivity of Noninvasive Cardiac Electrophysiological Imaging to Variations in Personalized Anatomical Modeling

    PubMed Central

    Wang, Linwei

    2015-01-01

    Objective Noninvasive cardiac electrophysiological (EP) imaging techniques rely on anatomically-detailed heart-torso models derived from high-quality tomographic images of individual subjects. However, anatomical modeling involves variations that lead to unresolved uncertainties in the outcome of EP imaging, bringing questions to the robustness of these methods in clinical practice. In this study, we design a systematic statistical approach to assess the sensitivity of EP imaging methods to the variations in personalized anatomical modeling. Methods We first quantify the variations in personalized anatomical models by a novel application of statistical shape modeling. Given the statistical distribution of the variation in personalized anatomical models, we then employ unscented transform to determine the sensitivity of EP imaging outputs to the variation in input personalized anatomical modeling. Results We test the feasibility of our proposed approach using two of the existing EP imaging methods: epicardial-based electrocardiographic imaging and transmural electrophysiological imaging. Both phantom and real-data experiments show that variations in personalized anatomical models have negligible impact on the outcome of EP imaging. Conclusion This study verifies the robustness of EP imaging methods to the errors in personalized anatomical modeling and suggests the possibility to simplify the process of anatomical modeling in future clinical practice. Significance This study proposes a systematic statistical approach to quantify anatomical modeling variations and assess their impact on EP imaging, which can be extended to find a balance between the quality of personalized anatomical models and the accuracy of EP imaging that may improve the clinical feasibility of EP imaging. PMID:25615906

  4. Anatomical Basis for the Cardiac Interventional Electrophysiologist

    PubMed Central

    Sánchez-Quintana, Damián; Doblado-Calatrava, Manuel; Cabrera, José Angel; Macías, Yolanda; Saremi, Farhood

    2015-01-01

    The establishment of radiofrequency catheter ablation techniques as the mainstay in the treatment of tachycardia has renewed new interest in cardiac anatomy. The interventional arrhythmologist has drawn attention not only to the gross anatomic details of the heart but also to architectural and histological characteristics of various cardiac regions that are relevant to the development or recurrence of tachyarrhythmias and procedural related complications of catheter ablation. In this review, therefore, we discuss some anatomic landmarks commonly used in catheter ablations including the terminal crest, sinus node region, Koch's triangle, cavotricuspid isthmus, Eustachian ridge and valve, pulmonary venous orifices, venoatrial junctions, and ventricular outflow tracts. We also discuss the anatomical features of important structures in the vicinity of the atria and pulmonary veins, such as the esophagus and phrenic nerves. This paper provides basic anatomic information to improve understanding of the mapping and ablative procedures for cardiac interventional electrophysiologists. PMID:26665006

  5. Effect of lengthening along the anatomical axis of the femur and its clinical impact.

    PubMed

    Emara, Khaled M; Mahmoud, Ahmed Nageeb; Emara, Ahmed K; Emara, Mariam K

    2017-05-18

    To review and study the effect of lengthening along the anatomical axis of long bones and its relation to the mechanical axis deviation. We try in this review to calculate and discuss the exact clinical impact of lengthening along the anatomical axis of the femur on affecting the limb alignment. Also we used a trigonometric formula to predict the change of the femoral distal anatomical mechanical angle (AMA) after lengthening along the anatomical axis. Lengthening along the anatomical axis of the femur by 10% of its original length results in reduction in the distal femoral AMA by 0.57 degrees. There is no objective experimental scientific data to prove that the Mechanical axis is passing via the center of the hip to the center of the knee. There is wide variation in normal anatomical axis for different populations. In deformity correction, surgeons try to reproduce the normal usual bone shape to regain normal function, which is mainly anatomical axis. Lengthening of the femur along its anatomical axis results in mild reduction of the distal femoral AMA. This may partially compensate for the expected mechanical axis lateralisation and hence justify its minimal clinical impact.

  6. Anatomical reasoning in the informatics age: Principles, ontologies, and agendas.

    PubMed

    Trelease, Robert B

    2006-03-01

    Reasoning about anatomy shares historical scientific roots with formal logic and artificial intelligence. With advances in computer-based intelligent programming, high-level biological structural knowledge may be exploited directly for biomedical research, clinical tasks, and educational applications. We consider the special nature of anatomical domain knowledge, emphasizing the complex concepts and semantics that must be represented in the development of ontologies, formally structured databases of biological information. We review the evolution of the fundamental scientific principles of logic and artificial intelligence needed for building machines that can make use of anatomical knowledge. We look at methods for compiling ontologies and compare the structural designs of the Foundational Model of Anatomy and Open GALEN ontologies. We further consider issues related to mapping developing anatomy resources with other biological ontologies in genomics, proteomics, and physiology. Although early results are promising, considerable resources and continuing effort must be committed to completing and extending anatomical ontologies for the ultimate success of computer-based anatomical reasoning. Anat Rec (Part B: New Anat) 289B:72-84, 2006. (c) 2006 Wiley-Liss, Inc.

  7. Multiple variations of the tendons of the anatomical snuffbox

    PubMed Central

    Thwin, San San; Zaini, Fazlin; Than, Myo

    2014-01-01

    INTRODUCTION Multiple tendons of the abductor pollicis longus (APL) in the anatomical snuffbox of the wrist can lead to the development of de Quervain's syndrome, which is caused by stenosing tenosynovitis. A cadaveric study was performed to establish the variations present in the tendons of the anatomical snuffbox in a Malaysian population, in the hope that this knowledge would aid clinical investigation and surgical treatment of de Quervain's tenosynovitis. METHODS Routine dissection of ten upper limbs was performed to determine the variations in the tendons of the anatomical snuffbox of the wrist. RESULTS In all the dissected upper limbs, the APL tendon of the first extensor compartment was found to have several (3–14) tendon slips. The insertion of the APL tendon slips in all upper limbs were at the base of the first metacarpal bone, trapezium and fascia of the opponens pollicis muscle; however, in seven specimens, they were also found to be attached to the fleshy belly of the abductor pollicis brevis muscle. In two specimens, double tendons of the extensor pollicis longus located in the third extensor compartment were inserted into the capsule of the proximal interphalangeal joints before being joined to the extensor expansion. In two other specimens, the first extensor compartment had two osseofibrous tunnels divided by a septum that separated the APL tendon from the extensor pollicis brevis tendon. CONCLUSION Multiple variations were found in the anatomical snuffbox region of the dissected upper limbs. Knowledge of these variations would be useful in interventional radiology and orthopaedic surgery. PMID:24452976

  8. Anatomic considerations for abdominally placed permanent left ventricular assist devices.

    PubMed

    Parnis, S M; McGee, M G; Igo, S R; Dasse, K; Frazier, O H

    1989-01-01

    To determine anatomic parameters for a permanent, electrically actuated left ventricular assist device (LVAD), the effects of abdominal placement of pneumatic LVADs used as temporary support for patients awaiting heart transplantation was studied. Understanding the anatomic constraints imposed by the abdominal viscera in LVAD placement is crucial, because improper placement can result in compression or obstruction of adjacent structures. Anatomic compatibility was assessed in four men (age 22-48 years) who were supported by the LVAD for over 1 month (range 35-132 days). The pump was intraperitoneally placed in the left upper quadrant. Radiographic techniques were employed, including CT scanning (with patients supine) and contrast imaging (patients in anatomical position), and the pump and conduits appeared to be properly positioned, with minimal compression of the body of the stomach, and no obstruction of adjacent organs. Three patients returned to a solid food diet and exercised daily by stationary cycling and walking. No signs of migration or erosion of the pump were present at the time of LVAD removal and cardiac transplantation. Successful clinical experience with short-term use of the LVAD suggests that the electrically actuated device can be well tolerated in patients requiring permanent left ventricular assistance.

  9. Handedness and cerebral anatomical asymmetries in young adult males.

    PubMed

    Hervé, Pierre-Yves; Crivello, Fabrice; Perchey, Guy; Mazoyer, Bernard; Tzourio-Mazoyer, Nathalie

    2006-02-15

    Using voxel-based morphometry, we measured the cerebral anatomical asymmetries in a sample of 56 young right-handed males and then compared voxelwise asymmetry indices of these subjects to those of 56 young left-handed males. In the right-handed, the clusters of grey matter asymmetry corresponding to the leftward occipital petalia and planum temporale asymmetries were retrieved. Strong rightward temporo-parietal asymmetries were also observed, but the rightward grey matter asymmetry in the frontal lobe was less massive than previously described. Group comparisons of left- and right-handed subjects' asymmetry maps, performed at a statistical threshold not corrected for multiple comparisons, revealed significant effects of handedness on this pattern of anatomical asymmetry in frontal regions, notably in the lower central and precentral sulci, and also in the planum temporale, with right-handed subjects being more leftward asymmetric. Concerning white matter, although almost no focal differences between left- and right-handed subjects were detected, volumetric analyses at the hemispheric level revealed a leftward asymmetry, which happened to be significantly less marked in the left-handed. This latter result, together with the pattern of leftward white matter asymmetries, suggested that anatomical correlates of the left hemispheric specialization for language would exist in white matter. In the population we studied, differences in anatomical asymmetry between left- and right-handed subjects provided structural arguments for a greater functional ambilaterality in left-handed subjects.

  10. Giving ourselves: the ethics of anatomical donation.

    PubMed

    Gunderman, Richard B

    2008-01-01

    In some European countries, such as Italy, medical education is threatened by a dearth of anatomical specimens. Such a shortage could spread to other nations, including the United States. This article addresses two ethical questions in body donation. Why might people choose to donate their bodies to education and science? What sorts of ethical appeals might anatomists, physicians, and other health professionals make to patients and family members for anatomical donation? Two models of giving, egoistic and liberal, merit close examination.

  11. [Establishment of anatomical terminology in Japan].

    PubMed

    Shimada, Kazuyuki

    2008-12-01

    The history of anatomical terminology in Japan began with the publication of Waran Naikei Ihan-teimŏ in 1805 and Chŏtei Kaitai Shinsho in 1826. Although the establishment of Japanese anatomical terminology became necessary during the Meiji era when many western anatomy books imported into Janan were translated, such terminology was not unified during this period and varied among translators. In 1871, Tsukumo Ono's Kaibŏgaku Gosen was published by the Ministry of Education. Although this book is considered to be the first anatomical glossary terms in Japan, its contents were incomplete. Overseas, the German Anatomical Society established a unified anatomical terminology in 1895 called the Basle Nomina Anatomica (B.N.A.). Based on this development, Kaibŏgaku Meishŭ which follows the BNA, by Buntarŏ Suzuki was published in 1905. With the subsequent establishment in 1935 of Jena Nomina Anatomica (J.N.A.), the unification of anatomical terminology was also accelerated in Japan, leading to the further development of terminology.

  12. Anatomical entity recognition with a hierarchical framework augmented by external resources.

    PubMed

    Xu, Yan; Hua, Ji; Ni, Zhaoheng; Chen, Qinlang; Fan, Yubo; Ananiadou, Sophia; Chang, Eric I-Chao; Tsujii, Junichi

    2014-01-01

    References to anatomical entities in medical records consist not only of explicit references to anatomical locations, but also other diverse types of expressions, such as specific diseases, clinical tests, clinical treatments, which constitute implicit references to anatomical entities. In order to identify these implicit anatomical entities, we propose a hierarchical framework, in which two layers of named entity recognizers (NERs) work in a cooperative manner. Each of the NERs is implemented using the Conditional Random Fields (CRF) model, which use a range of external resources to generate features. We constructed a dictionary of anatomical entity expressions by exploiting four existing resources, i.e., UMLS, MeSH, RadLex and BodyPart3D, and supplemented information from two external knowledge bases, i.e., Wikipedia and WordNet, to improve inference of anatomical entities from implicit expressions. Experiments conducted on 300 discharge summaries showed a micro-averaged performance of 0.8509 Precision, 0.7796 Recall and 0.8137 F1 for explicit anatomical entity recognition, and 0.8695 Precision, 0.6893 Recall and 0.7690 F1 for implicit anatomical entity recognition. The use of the hierarchical framework, which combines the recognition of named entities of various types (diseases, clinical tests, treatments) with information embedded in external knowledge bases, resulted in a 5.08% increment in F1. The resources constructed for this research will be made publicly available.

  13. Altered anatomical network in early blindness revealed by diffusion tensor tractography.

    PubMed

    Shu, Ni; Liu, Yong; Li, Jun; Li, Yonghui; Yu, Chunshui; Jiang, Tianzi

    2009-09-28

    The topological architecture of the cerebral anatomical network reflects the structural organization of the human brain. Recently, topological measures based on graph theory have provided new approaches for quantifying large-scale anatomical networks. Diffusion MRI studies have revealed the efficient small-world properties and modular structure of the anatomical network in normal subjects. However, no previous study has used diffusion MRI to reveal changes in the brain anatomical network in early blindness. Here, we utilized diffusion tensor imaging to construct binary anatomical networks for 17 early blind subjects and 17 age- and gender-matched sighted controls. We established the existence of structural connections between any pair of the 90 cortical and sub-cortical regions using deterministic tractography. Compared with controls, early blind subjects showed a decreased degree of connectivity, a reduced global efficiency, and an increased characteristic path length in their brain anatomical network, especially in the visual cortex. Moreover, we revealed some regions with motor or somatosensory function have increased connections with other brain regions in the early blind, which suggested experience-dependent compensatory plasticity. This study is the first to show alterations in the topological properties of the anatomical network in early blindness. From the results, we suggest that analyzing the brain's anatomical network obtained using diffusion MRI data provides new insights into the understanding of the brain's re-organization in the specific population with early visual deprivation.

  14. PET Image Reconstruction Using Information Theoretic Anatomical Priors

    PubMed Central

    Somayajula, Sangeetha; Panagiotou, Christos; Rangarajan, Anand; Li, Quanzheng; Arridge, Simon R.

    2011-01-01

    We describe a nonparametric framework for incorporating information from co-registered anatomical images into positron emission tomographic (PET) image reconstruction through priors based on information theoretic similarity measures. We compare and evaluate the use of mutual information (MI) and joint entropy (JE) between feature vectors extracted from the anatomical and PET images as priors in PET reconstruction. Scale-space theory provides a framework for the analysis of images at different levels of detail, and we use this approach to define feature vectors that emphasize prominent boundaries in the anatomical and functional images, and attach less importance to detail and noise that is less likely to be correlated in the two images. Through simulations that model the best case scenario of perfect agreement between the anatomical and functional images, and a more realistic situation with a real magnetic resonance image and a PET phantom that has partial volumes and a smooth variation of intensities, we evaluate the performance of MI and JE based priors in comparison to a Gaussian quadratic prior, which does not use any anatomical information. We also apply this method to clinical brain scan data using F18 Fallypride, a tracer that binds to dopamine receptors and therefore localizes mainly in the striatum. We present an efficient method of computing these priors and their derivatives based on fast Fourier transforms that reduce the complexity of their convolution-like expressions. Our results indicate that while sensitive to initialization and choice of hyperparameters, information theoretic priors can reconstruct images with higher contrast and superior quantitation than quadratic priors. PMID:20851790

  15. PET image reconstruction using information theoretic anatomical priors.

    PubMed

    Somayajula, Sangeetha; Panagiotou, Christos; Rangarajan, Anand; Li, Quanzheng; Arridge, Simon R; Leahy, Richard M

    2011-03-01

    We describe a nonparametric framework for incorporating information from co-registered anatomical images into positron emission tomographic (PET) image reconstruction through priors based on information theoretic similarity measures. We compare and evaluate the use of mutual information (MI) and joint entropy (JE) between feature vectors extracted from the anatomical and PET images as priors in PET reconstruction. Scale-space theory provides a framework for the analysis of images at different levels of detail, and we use this approach to define feature vectors that emphasize prominent boundaries in the anatomical and functional images, and attach less importance to detail and noise that is less likely to be correlated in the two images. Through simulations that model the best case scenario of perfect agreement between the anatomical and functional images, and a more realistic situation with a real magnetic resonance image and a PET phantom that has partial volumes and a smooth variation of intensities, we evaluate the performance of MI and JE based priors in comparison to a Gaussian quadratic prior, which does not use any anatomical information. We also apply this method to clinical brain scan data using F(18) Fallypride, a tracer that binds to dopamine receptors and therefore localizes mainly in the striatum. We present an efficient method of computing these priors and their derivatives based on fast Fourier transforms that reduce the complexity of their convolution-like expressions. Our results indicate that while sensitive to initialization and choice of hyperparameters, information theoretic priors can reconstruct images with higher contrast and superior quantitation than quadratic priors.

  16. Is clinical measurement of anatomic axis of the femur adequate?

    PubMed

    Wu, Chi-Chuan

    2017-08-01

    Background and purpose - The accuracy of using clinical measurement from the anterior superior iliac spine (ASIS) to the center of the knee to determine an anatomic axis of the femur has rarely been studied. A radiographic technique with a full-length standing scanogram (FLSS) was used to assess the adequacy of the clinical measurement. Patients and methods - 100 consecutive young adult patients (mean age 34 (20-40) years) with chronic unilateral lower extremity injuries were studied. The pelvis and intact contralateral lower extremity images in the FLSS were selected for study. The angles between the tibial axis and the femoral shaft anatomic axis (S-AA), the piriformis anatomic axis (P-AA), the clinical anatomic axis (C-AA), and the mechanical axis (MA) were compared between sexes. Results - Only the S-AA and C-AA angles were statistically significantly different in the 100 patients (3.6° vs. 2.8°; p = 0.03). There was a strong correlation between S-AA, P-AA, and C-AA angles (r > 0.9). The average intersecting angle between MA and S-AA in the femur in the 100 patients was 5.5°, and it was 4.8° between MA and C-AA. Interpretation - Clinical measurement of an anatomic axis from the ASIS to the center of the knee may be an adequate and acceptable method to determine lower extremity alignment. The optimal inlet for antegrade femoral intramedullary nailing may be the lateral edge of the piriformis fossa.

  17. Characterizing anatomical variability in breast CT images

    PubMed Central

    Metheany, Kathrine G.; Abbey, Craig K.; Packard, Nathan; Boone, John M.

    2008-01-01

    Previous work [Burgess , Med. Phys. 28, 419–437 (2001)] has shown that anatomical noise in projection mammography results in a power spectrum well modeled over a range of frequencies by a power law, and the exponent (β) of this power law plays a critical role in determining the size at which a growing lesion reaches the threshold for detection. In this study, the authors evaluated the power-law model for breast computed tomography (bCT) images, which can be thought of as thin sections through a three-dimensional (3D) volume. Under the assumption of a 3D power law describing the distribution of attenuation coefficients in the breast parenchyma, the authors derived the relationship between the power-law exponents of bCT and projection images and found it to be βsection=βproj−1. They evaluated this relationship on clinical images by comparing bCT images from a set of 43 patients to Burgess’ findings in mammography. They were able to make a direct comparison for 6 of these patients who had both a bCT exam and a digitized film-screen mammogram. They also evaluated segmented bCT images to investigate the extent to which the bCT power-law exponent can be explained by a binary model of attenuation coefficients based on the different attenuation of glandular and adipose tissue. The power-law model was found to be a good fit for bCT data over frequencies from 0.07to0.45cyc∕mm, where anatomical variability dominates the spectrum. The average exponent for bCT images was 1.86. This value is close to the theoretical prediction using Burgess’ published data for projection mammography and for the limited set of mammography data available from the authors’ patient sample. Exponents from the segmented bCT images (average value: 2.06) were systematically slightly higher than bCT images, with substantial correlation between the two (r=0.84). PMID:18975714

  18. Do retractile testes have anatomical anomalies?

    PubMed Central

    Anderson, Kleber M.; Costa, Suelen F.; Sampaio, Francisco J.B.; Favorito, Luciano A.

    2016-01-01

    ABSTRACT Objectives: To assess the incidence of anatomical anomalies in patients with retractile testis. Materials and Methods: We studied prospectively 20 patients (28 testes) with truly retractile testis and compared them with 25 human fetuses (50 testes) with testis in scrotal position. We analyzed the relations among the testis, epididymis and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis, we used a previous classification according to epididymis attachment to the testis and the presence of epididymis atresia. To analyze the structure of the PV, we considered two situations: obliteration of the PV and patency of the PV. We used the Chi-square test for contingency analysis of the populations under study (p <0.05). Results: The fetuses ranged in age from 26 to 35 weeks post-conception (WPC) and the 20 patients with retractile testis ranged in ages from 1 to 12 years (average of 5.8). Of the 50 fetal testes, we observed complete patency of the PV in 2 cases (4%) and epididymal anomalies (EAs) in 1 testis (2%). Of the 28 retractile testes, we observed patency of the PV in 6 cases (21.4%) and EA in 4 (14.28%). When we compared the incidence of EAs and PV patency we observed a significantly higher prevalence of these anomalies in retractile testes (p=0.0116). Conclusions: Retractile testis is not a normal variant with a significant risk of patent processus vaginalis and epididymal anomalies. PMID:27564294

  19. The anatomical distribution of genetic associations

    PubMed Central

    Wells, Alan; Kopp, Nathan; Xu, Xiaoxiao; O'Brien, David R.; Yang, Wei; Nehorai, Arye; Adair-Kirk, Tracy L.; Kopan, Raphael; Dougherty, J. D.

    2015-01-01

    Deeper understanding of the anatomical intermediaries for disease and other complex genetic traits is essential to understanding mechanisms and developing new interventions. Existing ontology tools provide functional, curated annotations for many genes and can be used to develop mechanistic hypotheses; yet information about the spatial expression of genes may be equally useful in interpreting results and forming novel hypotheses for a trait. Therefore, we developed an approach for statistically testing the relationship between gene expression across the body and sets of candidate genes from across the genome. We validated this tool and tested its utility on three applications. First, we show that the expression of genes in associated loci from GWA studies implicates specific tissues for 57 out of 98 traits. Second, we tested the ability of the tool to identify novel relationships between gene expression and phenotypes. Specifically, we experimentally confirmed an underappreciated prediction highlighted by our tool: that white blood cell count – a quantitative trait of the immune system – is genetically modulated by genes expressed in the skin. Finally, using gene lists derived from exome sequencing data, we show that human genes under selective constraint are disproportionately expressed in nervous system tissues. PMID:26586807

  20. Ipsilesional neglect: behavioural and anatomical features

    PubMed Central

    Kim, M; Na, D; Kim, G; Adair, J; Lee, K; Heilman, K

    1999-01-01

    OBJECTIVE—To learn more about the behavioural and anatomical features of ipsilesional neglect.
METHODS—Thirty consecutive patients with spatial neglect were tested on cancellation and line bisection tasks. To learn if patients with ipsilesional neglect demonstrate the sensory-attentional or motor-intentional type of neglect, a video apparatus was used that dissociates these determinants.
RESULTS—Five patients showed evidence of ipsilesional neglect. This phenomenon was seen only on the line bisection task. All patients with ipsilesional neglect had lesions involving frontal-subcortical regions. Although ipsilesional neglect evolved from early in three of five cases, the other patients displayed ipsilesional neglect without initial contralateral neglect, suggesting that ipsilesional neglect cannot be fully attributed to a compensatory strategy. The results of the tests that used the video apparatus indicate that right sided frontal or subcortical injury may induce contralateral attentional or intentional "approach" behaviours.
CONCLUSIONS—Ipsilesional neglect is most often associated with frontal-subcortical lesions, cannot be entirely attributed to a compensatory strategy, and may be induced by an attentional bias, an intentional bias, or both.

 PMID:10369819

  1. Anatomical site-specific modalities for hyperthermia.

    PubMed

    Bagshaw, M A; Taylor, M A; Kapp, D S; Meyer, J L; Samulski, T V; Lee, E R; Fessenden, P

    1984-10-01

    The clinical application of hyperthermia in the treatment of deep-seated tumors remains an empirical science. The pleomorphic nature of the neoplasms and the great diversity in the anatomy and physiology of the individual tumor locations make the treatment of nearly every neoplasm a unique challenge. A wide variety of devices is required, both for the administration of hyperthermia and for the measurement of the temperatures achieved. At Stanford University, these include the BSD Medical Corp. annular phased array system, an isospherical ultrasound device, and interstitial radiofrequency for deep heating. Ultrasound transducers and a variety of microwave applicators are used for superficial hyperthermia. Six illustrative case studies, selected from the 91 patients treated in our program since October 1981, are presented, with discussion and comparison of treatment devices. Difficulties in deep heating were encountered in several instances, believed secondary to the thickness of the s.c. fat, the relatively high heat-induced tumor blood flow, and the presence of adjacent bone. It is suggested that ultimate improvement in clinical results will be possible once a better understanding is achieved of such anatomical and physiological factors.

  2. Anatomical eponyms - unloved names in medical terminology.

    PubMed

    Burdan, F; Dworzański, W; Cendrowska-Pinkosz, M; Burdan, M; Dworzańska, A

    2016-01-01

    Uniform international terminology is a fundamental issue of medicine. Names of various organs or structures have developed since early human history. The first proper anatomical books were written by Hippocrates, Aristotle and Galen. For this reason the modern terms originated from Latin or Greek. In a modern time the terminology was improved in particular by Vasalius, Fabricius and Harvey. Presently each known structure has internationally approved term that is explained in anatomical or histological terminology. However, some elements received eponyms, terms that incorporate the surname of the people that usually describe them for the first time or studied them (e.g., circle of Willis, follicle of Graff, fossa of Sylvious, foramen of Monro, Adamkiewicz artery). Literature and historical hero also influenced medical vocabulary (e.g. Achilles tendon and Atlas). According to various scientists, all the eponyms bring colour to medicine, embed medical traditions and culture to our history but lack accuracy, lead of confusion, and hamper scientific discussion. The current article presents a wide list of the anatomical eponyms with their proper anatomical term or description according to international anatomical terminology. However, since different eponyms are used in various countries, the list could be expanded.

  3. Determining customer satisfaction in anatomic pathology.

    PubMed

    Zarbo, Richard J

    2006-05-01

    Measurement of physicians' and patients' satisfaction with laboratory services has become a standard practice in the United States, prompted by national accreditation requirements. Unlike other surveys of hospital-, outpatient care-, or physician-related activities, no ongoing, comprehensive customer satisfaction survey of anatomic pathology services is available for subscription that would allow continual benchmarking against peer laboratories. Pathologists, therefore, must often design their own local assessment tools to determine physician satisfaction in anatomic pathology. To describe satisfaction survey design that would elicit specific information from physician customers about key elements of anatomic pathology services. The author shares his experience in biannually assessing customer satisfaction in anatomic pathology with survey tools designed at the Henry Ford Hospital, Detroit, Mich. Benchmarks for physician satisfaction, opportunities for improvement, and characteristics that correlated with a high level of physician satisfaction were identified nationally from a standardized survey tool used by 94 laboratories in the 2001 College of American Pathologists Q-Probes quality improvement program. In general, physicians are most satisfied with professional diagnostic services and least satisfied with pathology services related to poor communication. A well-designed and conducted customer satisfaction survey is an opportunity for pathologists to periodically educate physician customers about services offered, manage unrealistic expectations, and understand the evolving needs of the physician customer. Armed with current information from physician customers, the pathologist is better able to strategically plan for resources that facilitate performance improvements in anatomic pathology laboratory services that align with evolving clinical needs in health care delivery.

  4. Piriformis fossa - an anatomical and orthopedics consideration.

    PubMed

    Lakhwani, O P; Mittal, P S; Naik, D C

    2014-03-01

    Piriformis fossa is an important anatomical landmark having significant clinical value in orthopedic surgery; but its location and anatomical relationship with surrounding structures are not clearly defined. Hence it is necessary to clearly describe it in respect to anatomical and orthopedic aspect. Fifty Cadaveric dry femoral bones and Dissection of the four hip specimens were used to study the Piriformis fossa in respect to location and its relationship with surrounding structures. Clinical importance of piriformis fossa was determined in reference to antegrade femoral nail insertion. Piriformis muscle and so called piriformis fossa are unrelated entities. Piriformis fossa is anatomical site of insertion of obturator externus. In dry cadaveric femora; fossa was not always located in the direction of femoral shaft. It was located in the direction of femoral shaft in 24% cases only. In 68% cases femoral canal was aligned lateral and in 8% cases, it lies medial to the fossa. Piriformis fossa should be named as Trorchanteric fossa or Obturator fossa for better anatomical description. So called Piriformis fossa does not found to be universally corresponding to femoral shaft hence selection of entry site should be based on variable proximal femur and area on femur which corresponds to femoral shaft.

  5. The Brain Atlas Concordance Problem: Quantitative Comparison of Anatomical Parcellations

    PubMed Central

    Bohland, Jason W.; Bokil, Hemant; Allen, Cara B.; Mitra, Partha P.

    2009-01-01

    Many neuroscientific reports reference discrete macro-anatomical regions of the brain which were delineated according to a brain atlas or parcellation protocol. Currently, however, no widely accepted standards exist for partitioning the cortex and subcortical structures, or for assigning labels to the resulting regions, and many procedures are being actively used. Previous attempts to reconcile neuroanatomical nomenclatures have been largely qualitative, focusing on the development of thesauri or simple semantic mappings between terms. Here we take a fundamentally different approach, discounting the names of regions and instead comparing their definitions as spatial entities in an effort to provide more precise quantitative mappings between anatomical entities as defined by different atlases. We develop an analytical framework for studying this brain atlas concordance problem, and apply these methods in a comparison of eight diverse labeling methods used by the neuroimaging community. These analyses result in conditional probabilities that enable mapping between regions across atlases, which also form the input to graph-based methods for extracting higher-order relationships between sets of regions and to procedures for assessing the global similarity between different parcellations of the same brain. At a global scale, the overall results demonstrate a considerable lack of concordance between available parcellation schemes, falling within chance levels for some atlas pairs. At a finer level, this study reveals spatial relationships between sets of defined regions that are not obviously apparent; these are of high potential interest to researchers faced with the challenge of comparing results that were based on these different anatomical models, particularly when coordinate-based data are not available. The complexity of the spatial overlap patterns revealed points to problems for attempts to reconcile anatomical parcellations and nomenclatures using strictly

  6. ["The Venus of Pest"--expedition of an anatomical beauty].

    PubMed

    Kleindienst, H

    1990-01-01

    The Semmelweis-Museum in Budapest, Hungary, has a small collection of anatomical wax models. Studying the correspondence of the Austrian emperor Joseph II., then King of Hungary with representatives of the Hungarian administration, we were able to find out the origin of these models, their transportation to Hungary and their large significance in anatomical teaching at the end of the 18th century in Hungary. These models are the result of a long-lasting cooperation between artists and anatomists, particularly in Italy. Their artistic climax is reached during the second term of the 18th century, reflecting the complex interaction of contemporary sociocultural trends i.e. popularization of results of scientific research, traits of enlightenment combined with an artistic hyperidealistic typization as known from classical antiquity and sponsored financially as a means of imperial representation. The aim of the study was to point to the eminent importance of this collection as a monument of cultural heritage.

  7. Analysis of anatomic variability in children with low mathematical skills

    NASA Astrophysics Data System (ADS)

    Han, Zhaoying; Fuchs, Lynn; Davis, Nikki; Cannistraci, Christopher J.; Anderson, Adam W.; Gore, John C.; Dawant, Benoit M.

    2008-03-01

    Mathematical difficulty affects approximately 5-9% of the population. Studies on individuals with dyscalculia, a neurologically based math disorder, provide important insight into the neural correlates of mathematical ability. For example, cognitive theories, neuropsychological studies, and functional neuroimaging studies in individuals with dyscalculia suggest that the bilateral parietal lobes and intraparietal sulcus are central to mathematical performance. The purpose of the present study was to investigate morphological differences in a group of third grade children with poor math skills. We compare population averages of children with low math skill (MD) to gender and age matched controls with average math ability. Anatomical data were gathered with high resolution MRI and four different population averaging methods were used to study the effect of the normalization technique on the results. Statistical results based on the deformation fields between the two groups show anatomical differences in the bilateral parietal lobes, right frontal lobe, and left occipital/parietal lobe.

  8. Anatomical complications of hysterectomy: A review.

    PubMed

    Ramdhan, Rebecca C; Loukas, Marios; Tubbs, R Shane

    2017-10-01

    Hysterectomy is the most commonly performed gynecological procedure in the United States with three possible surgical approaches; vaginal, abdominal and laparoscopic. As with any surgical procedure, various anatomical complications can arise. These include injuries to anatomical structures such as the urinary bladder, ureter, intestines, rectum, anus, and a multitude of nervous structures. Other complications include sexual dysfunction, vaginal cuff dehiscence, and urinary incontinence. Using standard search engines, the anatomical complications of hysterectomies are reviewed. In conclusion, surgeons who perform hysterectomies or are involved with postoperative hysterectomy patients should be familiar with the possible complications of this common procedure and the steps that can be taken to help reduce the risk of those complications. Clinicians should also inform their patients of the potential complications as they can affect lifestyle and comfort. Clin. Anat. 30:946-952, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. Anatomical variations in human carotid bodies.

    PubMed Central

    Khan, Q; Heath, D; Smith, P

    1988-01-01

    The variations in anatomical structure and position of both carotid bodies were noted in 100 consecutive subjects who came to necropsy. Considerable variations in form were found. Although most carotid bodies (83% on the right and 86% on the left) were of the classic ovoid type, an appreciable minority was bilobed (9% on the right and 7% on the left) or double (7% on the right and 6% on the left); 1% were leaf shaped. All these anatomical variants have to be distinguished from the pathologically enlarged carotid body that may have a smooth or finely nodular surface. Anatomical variants (such as the bilobed) may themselves enlarge as a consequence of carotid body hyperplasia. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 Fig 6 Fig 7 Fig 8 PMID:3209707

  10. Anatomical significance in aortoiliac occlusive disease.

    PubMed

    Wooten, Candace; Hayat, Munawar; du Plessis, Maira; Cesmebasi, Alper; Koesterer, Michael; Daly, Kevin P; Matusz, Petru; Tubbs, R Shane; Loukas, Marios

    2014-11-01

    Aortoiliac occlusive disease is a subset of peripheral arterial disease involving an atheromatous occlusion of the infrarenal aorta, common iliac arteries, or both. The disease, as it is known today, was described by the French surgeon René Leriche as a thrombotic occlusion of the end of the aorta. Leriche successfully linked the anatomic location of the occlusion with a unique triad of symptoms, including claudication, impotence, and decreased peripheral pulses. The anatomical location of the atheromatous lesions also has a direct influence on classification of the disease, as well as choice of treatment modality. Considering its impact on diagnosis and treatment, we aimed to provide a detailed understanding of the anatomical structures involved in aortoiliac occlusive disease. Familiarity with these structures will aid the physician in interpretation of radiologic images and surgical planning.

  11. An anatomically realistic temperature phantom for radiofrequency heating measurements

    PubMed Central

    Graedel, Nadine N.; Polimeni, Jonathan R.; Guerin, Bastien; Gagoski, Borjan; Wald, Lawrence L.

    2014-01-01

    Purpose An anthropomorphic phantom with realistic electrical properties allows for a more accurate reproduction of tissue current patterns during excitation. A temperature map can then probe the worst-case heating expected in the un-perfused case. We describe an anatomically realistic human head phantom that allows rapid 3D temperature mapping at 7 T. Methods The phantom was based on hand-labeled anatomical imaging data and consists of four compartments matching the corresponding human tissues in geometry and electrical properties. The increases in temperature resulting from radiofrequency excitation were measured with MR thermometry using a temperature sensitive contrast agent (TmDOTMA−) validated by direct fiber optic temperature measurements. Results Acquisition of 3D temperature maps of the full phantom with a temperature accuracy better than 0.1°C was achieved with an isotropic resolution of 5 mm and acquisition times of 2–4 minutes. Conclusion Our results demonstrate the feasibility of constructing anatomically realistic phantoms with complex geometries incorporating the ability to measure accurate temperature maps in the phantom. The anthropomorphic temperature phantom is expected to provide a useful tool for the evaluation of the heating effects of both conventional and parallel transmit pulses and help validate electromagnetic and temperature simulations. PMID:24549755

  12. Anatomic considerations for central venous cannulation

    PubMed Central

    Bannon, Michael P; Heller, Stephanie F; Rivera, Mariela

    2011-01-01

    Central venous cannulation is a commonly performed procedure which facilitates resuscitation, nutritional support, and long-term vascular access. Mechanical complications most often occur during insertion and are intimately related to the anatomic relationship of the central veins. Working knowledge of surface and deep anatomy minimizes complications. Use of surface anatomic landmarks to orient the deep course of cannulating needle tracts appropriately comprises the crux of complication avoidance. The authors describe use of surface landmarks to facilitate safe placement of internal jugular, subclavian, and femoral venous catheters. The role of real-time sonography as a safety-enhancing adjunct is reviewed. PMID:22312225

  13. Anatomical Volume Visualization with Weighted Distance Fields.

    PubMed

    Kerwin, Thomas; Hittle, Brad; Shen, Han-Wei; Stredney, Don; Wiet, Gregory

    2010-01-01

    We describe the use of the weighted distance transform (WDT) to enhance applications designed for volume visualization of segmented anatomical datasets. The WDT is presented as a general technique to generate a derived characteristic of a scalar field that can be used in multiple ways during rendering. We obtain real-time interaction with the volume by calculating the WDT on the graphics card. Several examples of this technique as it applies to an application for teaching anatomical structures are detailed, including rendering embedded structures, fuzzy boundaries, outlining, and indirect lighting estimation.

  14. Anatomical and psychometric relationships of behavioral neglect in daily living.

    PubMed

    Rousseaux, Marc; Allart, Etienne; Bernati, Thérèse; Saj, Arnaud

    2015-04-01

    Spatial neglect has been related to both cortical (predominantly at the temporal-parietal junction) and subcortical (predominantly of the superior longitudinal fasciculus) lesions. The objectives of this observational study were to specify the anatomical relationships of behavioral neglect in activities of daily living (N-ADLs), and the anatomical and psychometric relationships of N-ADLs on one hand and components of neglect (peripersonal neglect and personal neglect) and anosognosia on the other. Forty five patients were analyzed for behavioral difficulties in daily living (on the Catherine Bergego scale) and the main components of neglect (using conventional clinical assessments) during the first months post right hemisphere stroke. Voxel-based lesion-symptom mapping was used to identify brain areas within which lesions explained the severity of bias in each assessment (non-parametric permutation test; p<0.01, one tailed). N-ADLs was associated with lesions centered on the posterior part of the superior temporal gyrus and extending to the temporo-parietal junction, temporo-occipital junction and subcortical white matter (including the superior longitudinal fasciculus). Peripersonal neglect resulted from extended cortical lesions centered on the superior temporal gyrus and the inferior parietal gyrus, with subcortical extension. Personal neglect resulted predominantly from lesions centered on the somatosensory cortex and at a lesser degree on the superior temporal sulcus. Anosognosia resulted from lesions of the posterior inferior temporal gyrus and superior temporal gyrus. In anatomic terms, N-ADLs was strongly related to peripersonal neglect, and those relationships were also shown by the psychometric analysis. In conclusions, superior temporal gyrus and superior longitudinal fasciculus lesions have a pivotal role in N-ADLs. N-ADLs is principally related (anatomically and psychometrically) to peripersonal neglect, and at a lesser degree to anosognosia and

  15. Age prediction on the basis of brain anatomical measures.

    PubMed

    Valizadeh, S A; Hänggi, J; Mérillat, S; Jäncke, L

    2017-02-01

    In this study, we examined whether age can be predicted on the basis of different anatomical features obtained from a large sample of healthy subjects (n = 3,144). From this sample we obtained different anatomical feature sets: (1) 11 larger brain regions (including cortical volume, thickness, area, subcortical volume, cerebellar volume, etc.), (2) 148 cortical compartmental thickness measures, (3) 148 cortical compartmental area measures, (4) 148 cortical compartmental volume measures, and (5) a combination of the above-mentioned measures. With these anatomical feature sets, we predicted age using 6 statistical techniques (multiple linear regression, ridge regression, neural network, k-nearest neighbourhood, support vector machine, and random forest). We obtained very good age prediction accuracies, with the highest accuracy being R(2)  = 0.84 (prediction on the basis of a neural network and support vector machine approaches for the entire data set) and the lowest being R(2)  = 0.40 (prediction on the basis of a k-nearest neighborhood for cortical surface measures). Interestingly, the easy-to-calculate multiple linear regression approach with the 11 large brain compartments resulted in a very good prediction accuracy (R(2)  = 0.73), whereas the application of the neural network approach for this data set revealed very good age prediction accuracy (R(2)  = 0.83). Taken together, these results demonstrate that age can be predicted well on the basis of anatomical measures. The neural network approach turned out to be the approach with the best results. In addition, it was evident that good prediction accuracies can be achieved using a small but nevertheless age-representative dataset of brain features. Hum Brain Mapp 38:997-1008, 2017. © 2016 Wiley Periodicals, Inc.

  16. [Anatomical quantification of the tibial part of the plantar aponeurosis].

    PubMed

    Hiramoto, Y

    1983-03-01

    The metrical analysis of the anatomical characteristics is important because of its objectiveness. As it is concerned with the organs belonging to the locomotor system, the metrical method of the bones has already been systematized by Martin (1928), whereas the same kind of method for use on other organs remains undeveloped. The author aims to establish the metrical method of the plantar aponeurosis. The method for measuring the tibial part of the aponeurosis developed in this paper is sufficiently applicable for obtaining its principal anatomical characteristics. The results show that the tibial portion of the plantar aponeurosis becomes statistically significantly wider and thinner in its anterior part, and that the thickness of the tibial portion of the aponeurosis in the anterior part is larger on the right side than on the left side.

  17. Homografts and extra-anatomical reconstructions for infected vascular grafts.

    PubMed

    Diener, H; Hellwinklel, O; Carpenter, S; Larena-Avellaneda, A; Debus, E S

    2014-04-01

    Managing graft infections is a challenge in vascular surgery. The incidence of vascular graft infections varies between 2% and 6%. The number of patients treated by means of implantation of artificial prostheses is constantly growing. The treatment of vascular graft infections remains controversial. This article discusses in-situ repair and the role of extra-anatomic routes. Homografts present the lowest rate of reinfection with acceptable rates of degradation and aneurysm formation. Silvergrafts and synthetic grafts coated with antimicrobials show similar early and late mortality rates, but higher reinfection rates. The outcome extra-anatomic bypass surgery seems to be improved in actual series compared with historical results but their disadvantages (limited patency, higher rate of amputations as well as high rates of reintervention combined with higher early mortality) are obvious.

  18. [Anatomic bone and dento-alveolar changes in patients with lip incompetence].

    PubMed

    Pantoja, R; Cortes, J; Argandoña, J; Encina, S

    1995-01-01

    Twenty young patients with clinical labial incompetence have been studied cefalometrically using Delaire's Analysis, in order to determine anatomical alterations who explains this condition. In all of them we have found some anatomical alteration in sagital or vertical plane or both, in maxillary or mandibular squeletal bases or their dento-alveolar squeletic unit. Knowledge of anatomical factors contributing or determining labial incompetence is the key of the planification and execution of an etiologic approach, what is the best way to obtain physiological rapport and consequently good aesthetic results.

  19. Preliminary Study on Appearance-Based Detection of Anatomical Point Landmarks in Body Trunk CT Images

    NASA Astrophysics Data System (ADS)

    Nemoto, Mitsutaka; Nomura, Yukihiro; Hanaoka, Shohei; Masutani, Yoshitaka; Yoshikawa, Takeharu; Hayashi, Naoto; Yoshioka, Naoki; Ohtomo, Kuni

    Anatomical point landmarks as most primitive anatomical knowledge are useful for medical image understanding. In this study, we propose a detection method for anatomical point landmark based on appearance models, which include gray-level statistical variations at point landmarks and their surrounding area. The models are built based on results of Principal Component Analysis (PCA) of sample data sets. In addition, we employed generative learning method by transforming ROI of sample data. In this study, we evaluated our method with 24 data sets of body trunk CT images and obtained 95.8 ± 7.3 % of the average sensitivity in 28 landmarks.

  20. Statistical approach to anatomical landmark extraction in AP radiographs

    NASA Astrophysics Data System (ADS)

    Bernard, Rok; Pernus, Franjo

    2001-07-01

    A novel method for the automated extraction of important geometrical parameters of the pelvis and hips from APR images is presented. The shape and intensity variations in APR images are encompassed by the statistical shape and appearance models built from a set of training images for each of the three anatomies, i.e., pelvis, right and left hip, separately. The identification of the pelvis and hips is defined as a flexible object recognition problem, which is solved by generating anatomically plausible object instances and matching them to the APR image. The criterion function minimizes the resulting match error and considers the object topology. The obtained flexible object defines the positions of anatomical landmarks, which are further used to calculate the hip joint contact stress. A leave-one-out test was used to evaluate the performance of the proposed method on a set of 26 APR images. The results show the method is able to properly treat image variations and can reliably and accurately identify anatomies in the image and extract the anatomical landmarks needed in the hip joint contact stress calculation.

  1. An anatomically realistic temperature phantom for radiofrequency heating measurements.

    PubMed

    Graedel, Nadine N; Polimeni, Jonathan R; Guerin, Bastien; Gagoski, Borjan; Wald, Lawrence L

    2015-01-01

    An anthropomorphic phantom with realistic electrical properties allows for a more accurate reproduction of tissue current patterns during excitation. A temperature map can then probe the worst-case heating expected in the unperfused case. We describe an anatomically realistic human head phantom that allows rapid three-dimensional (3D) temperature mapping at 7T. The phantom was based on hand-labeled anatomical imaging data and consists of four compartments matching the corresponding human tissues in geometry and electrical properties. The increases in temperature resulting from radiofrequency excitation were measured with MR thermometry using a temperature-sensitive contrast agent (TmDOTMA(-)) validated by direct fiber optic temperature measurements. Acquisition of 3D temperature maps of the full phantom with a temperature accuracy better than 0.1°C was achieved with an isotropic resolution of 5 mm and acquisition times of 2-4 minutes. Our results demonstrate the feasibility of constructing anatomically realistic phantoms with complex geometries incorporating the ability to measure accurate temperature maps in the phantom. The anthropomorphic temperature phantom is expected to provide a useful tool for the evaluation of the heating effects of both conventional and parallel transmit pulses and help validate electromagnetic and temperature simulations. © 2014 Wiley Periodicals, Inc.

  2. A head and neck lymph node classification using an anatomical grid system while maintaining clinical relevance.

    PubMed

    Benninger, Brion; Barrett, Richard

    2011-10-01

    The current classification of head and neck lymph nodes lacks a standardized system that integrates basic anatomy and clinical relevance. Currently, anatomy texts, atlases, and journals used to educate future health care professionals use a classification system that differs from the commonly used clinical nomenclature. As a result, student trainees entering the professional world are confused by lymph node terminology. The purpose of this study was to suggest a lymph node classification system that accurately reflected anatomy and clinical applications. A literature search was conducted on anatomic and clinical texts, atlases, journals, and Web sites. Two recurring classification themes were found from anatomic texts and atlases: superficial and deep chains, and local anatomic structures. Since 1988 the clinical specialties have used a Roman numeral "level" system. The differences between anatomic and clinical classification systems have led to academic frustration. After analysis, a functional classification system was developed that integrated anatomic and clinical terminology from the current classification systems. This suggested system revised the clinically accepted level system approved in 1988 and replaced the terminology with an anatomically derived naming system. This system satisfies the need for a classification that unifies anatomic and clinical applications. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Sensitivity of predicted muscle forces during gait to anatomical variability in musculotendon geometry.

    PubMed

    Bosmans, Lode; Valente, Giordano; Wesseling, Mariska; Van Campen, Anke; De Groote, Friedl; De Schutter, Joris; Jonkers, Ilse

    2015-07-16

    Scaled generic musculoskeletal models are commonly used to drive dynamic simulations of motions. It is however, acknowledged that not accounting for variability in musculoskeletal geometry and musculotendon parameters may confound the simulation results, even when analysing control subjects. This study documents the three-dimensional anatomical variability of musculotendon origins and insertions of 33 lower limb muscles determined based on magnetic resonance imaging in six subjects. This anatomical variability was compared to the musculotendon point location in a generic musculoskeletal model. Furthermore, the sensitivity of muscle forces during gait, calculated using static optimization, to perturbations of the musculotendon point location was analyzed with a generic model. More specific, a probabilistic approach was used: for each analyzed musculotendon point, the three-dimensional location was re-sampled with a uniform Latin hypercube method within the anatomical variability and the static optimization problem was then re-solved for all perturbations. We found that musculotendon point locations in the generic model showed only variable correspondences with the anatomical variability. The anatomical variability of musculotendon point location did affect the calculated muscle forces: muscles most sensitive to perturbations within the anatomical variability are iliacus and psoas. Perturbation of the gluteus medius anterior, iliacus and psoas induces the largest concomitant changes in muscle forces of the unperturbed muscles. Therefore, when creating subject-specific musculoskeletal models, these attachment points should be defined accurately. In addition, the size of the anatomical variability of the musculotendon point location was not related to the sensitivity of the calculated muscle forces.

  4. Small-world anatomical networks in the human brain revealed by cortical thickness from MRI.

    PubMed

    He, Yong; Chen, Zhang J; Evans, Alan C

    2007-10-01

    An important issue in neuroscience is the characterization for the underlying architectures of complex brain networks. However, little is known about the network of anatomical connections in the human brain. Here, we investigated large-scale anatomical connection patterns of the human cerebral cortex using cortical thickness measurements from magnetic resonance images. Two areas were considered anatomically connected if they showed statistically significant correlations in cortical thickness and we constructed the network of such connections using 124 brains from the International Consortium for Brain Mapping database. Significant short- and long-range connections were found in both intra- and interhemispheric regions, many of which were consistent with known neuroanatomical pathways measured by human diffusion imaging. More importantly, we showed that the human brain anatomical network had robust small-world properties with cohesive neighborhoods and short mean distances between regions that were insensitive to the selection of correlation thresholds. Additionally, we also found that this network and the probability of finding a connection between 2 regions for a given anatomical distance had both exponentially truncated power-law distributions. Our results demonstrated the basic organizational principles for the anatomical network in the human brain compatible with previous functional networks studies, which provides important implications of how functional brain states originate from their structural underpinnings. To our knowledge, this study provides the first report of small-world properties and degree distribution of anatomical networks in the human brain using cortical thickness measurements.

  5. HPV Vaccine Effective at Multiple Anatomic Sites

    Cancer.gov

    A new study from NCI researchers finds that the HPV vaccine protects young women from infection with high-risk HPV types at the three primary anatomic sites where persistent HPV infections can cause cancer. The multi-site protection also was observed at l

  6. Anatomical Data for Analyzing Human Motion.

    ERIC Educational Resources Information Center

    Plagenhoef, Stanley; And Others

    1983-01-01

    Anatomical data obtained from cadavers and from water displacement studies with living subjects were used to determine the weight, center of gravity, and radius of gyration for 16 body segments. A lead model was used to study movement patterns of the trunk section of the body. (Authors/PP)

  7. Evolution of the Anatomical Theatre in Padova

    ERIC Educational Resources Information Center

    Macchi, Veronica; Porzionato, Andrea; Stecco, Carla; Caro, Raffaele

    2014-01-01

    The anatomical theatre played a pivotal role in the evolution of medical education, allowing students to directly observe and participate in the process of dissection. Due to the increase of training programs in clinical anatomy, the Institute of Human Anatomy at the University of Padova has renovated its dissecting room. The main guidelines in…

  8. Anatomical Data for Analyzing Human Motion.

    ERIC Educational Resources Information Center

    Plagenhoef, Stanley; And Others

    1983-01-01

    Anatomical data obtained from cadavers and from water displacement studies with living subjects were used to determine the weight, center of gravity, and radius of gyration for 16 body segments. A lead model was used to study movement patterns of the trunk section of the body. (Authors/PP)

  9. Anatomical characteristics of southern pine stemwood

    Treesearch

    Elaine T. Howard; Floyd G. Manwiller

    1968-01-01

    To obtain a definitive description of the wood and anatomy of all 10 species of southern pine, juvenile, intermediate, and mature wood was sampled at three heights in one tree of each species and examined under a light microscope. Photographs and three-dimensional drawings were made to illustrate the morphology. No significant anatomical differences were found...

  10. Giving Ourselves: The Ethics of Anatomical Donation

    ERIC Educational Resources Information Center

    Gunderman, Richard B.

    2008-01-01

    In some European countries, such as Italy, medical education is threatened by a dearth of anatomical specimens. Such a shortage could spread to other nations, including the United States. This article addresses two ethical questions in body donation. Why might people choose to donate their bodies to education and science? What sorts of ethical…

  11. Evolution of the Anatomical Theatre in Padova

    ERIC Educational Resources Information Center

    Macchi, Veronica; Porzionato, Andrea; Stecco, Carla; Caro, Raffaele

    2014-01-01

    The anatomical theatre played a pivotal role in the evolution of medical education, allowing students to directly observe and participate in the process of dissection. Due to the increase of training programs in clinical anatomy, the Institute of Human Anatomy at the University of Padova has renovated its dissecting room. The main guidelines in…

  12. [Anatomic variants of Meckel's cave on MRI].

    PubMed

    Benoudiba, F; Hadj-Rabia, M; Iffenecker, C; Fuerxer, F; Bekkali, F; Francke, J P; Doyon, D

    1998-10-01

    Magnetic resonance imaging (MRI) gives an accurate analysis of Meckel's cave variability. Images were acquired in 50 patients with several sections for anatomical comparison. Using several sections, MRI is a suitable method for better analysis of the trigeminal cistern. The most frequent findings are symmetrical trigeminal cisterns. Expansion of Meckel's cave or its disappearance has pathological significance.

  13. Collaborative regression-based anatomical landmark detection

    NASA Astrophysics Data System (ADS)

    Gao, Yaozong; Shen, Dinggang

    2015-12-01

    Anatomical landmark detection plays an important role in medical image analysis, e.g. for registration, segmentation and quantitative analysis. Among the various existing methods for landmark detection, regression-based methods have recently attracted much attention due to their robustness and efficiency. In these methods, landmarks are localised through voting from all image voxels, which is completely different from the classification-based methods that use voxel-wise classification to detect landmarks. Despite their robustness, the accuracy of regression-based landmark detection methods is often limited due to (1) the inclusion of uninformative image voxels in the voting procedure, and (2) the lack of effective ways to incorporate inter-landmark spatial dependency into the detection step. In this paper, we propose a collaborative landmark detection framework to address these limitations. The concept of collaboration is reflected in two aspects. (1) Multi-resolution collaboration. A multi-resolution strategy is proposed to hierarchically localise landmarks by gradually excluding uninformative votes from faraway voxels. Moreover, for informative voxels near the landmark, a spherical sampling strategy is also designed at the training stage to improve their prediction accuracy. (2) Inter-landmark collaboration. A confidence-based landmark detection strategy is proposed to improve the detection accuracy of ‘difficult-to-detect’ landmarks by using spatial guidance from ‘easy-to-detect’ landmarks. To evaluate our method, we conducted experiments extensively on three datasets for detecting prostate landmarks and head & neck landmarks in computed tomography images, and also dental landmarks in cone beam computed tomography images. The results show the effectiveness of our collaborative landmark detection framework in improving landmark detection accuracy, compared to other state-of-the-art methods.

  14. Collaborative Regression-based Anatomical Landmark Detection

    PubMed Central

    Gao, Yaozong; Shen, Dinggang

    2015-01-01

    Anatomical landmark detection plays an important role in medical image analysis, e.g., for registration, segmentation and quantitative analysis. Among various existing methods for landmark detection, regression-based methods recently have drawn much attention due to robustness and efficiency. In such methods, landmarks are localized through voting from all image voxels, which is completely different from classification-based methods that use voxel-wise classification to detect landmarks. Despite robustness, the accuracy of regression-based landmark detection methods is often limited due to 1) inclusion of uninformative image voxels in the voting procedure, and 2) lack of effective ways to incorporate inter-landmark spatial dependency into the detection step. In this paper, we propose a collaborative landmark detection framework to address these limitations. The concept of collaboration is reflected in two aspects. 1) Multi-resolution collaboration. A multi-resolution strategy is proposed to hierarchically localize landmarks by gradually excluding uninformative votes from faraway voxels. Moreover, for the informative voxels near the landmark, a spherical sampling strategy is also designed in the training stage to improve their prediction accuracy. 2) Inter-landmark collaboration. A confidence-based landmark detection strategy is proposed to improve the detection accuracy of “difficult-to-detect” landmarks by using spatial guidance from “easy-to-detect” landmarks. To evaluate our method, we conducted experiments extensively on three datasets for detecting prostate landmarks and head & neck landmarks in computed tomography (CT) images, and also dental landmarks in cone beam computed tomography (CBCT) images. The results show the effectiveness of our collaborative landmark detection framework in improving landmark detection accuracy, compared to other state-of-the-art methods. PMID:26579736

  15. Anatomical Variation of Human Collector Channel Orifices

    PubMed Central

    Bentley, Michael D.; Hann, Cheryl R.; Fautsch, Michael P.

    2016-01-01

    Purpose To examine the anatomical variation of normal human collector channel orifices and their relationship with Schlemm's canal. Methods Ten human anterior segments fixed by immersion or perfusion were dissected radially and further divided by fine dissection into corresponding inner and outer wall segments. The tissues were dehydrated, critical-point dried, sputter coated, and examined by scanning electron microscopy. Images were obtained at magnifications from ×200 to ×10,000. Selected radial collector channel regions were processed for plastic embedding. Results Two classes of collector channel orifices were identified. Simple oval orifices (54.7 ± 4.6–μm diameter) were lined with endothelial cells and most often occurred on a planar region of Schlemm's canal outer wall. Complex orifices (62.7 ± 3.4–μm diameter) were often found associated with septal columns and bridges, and typically covered with flap-like structures (10–40 μm) that extended between the inner and outer wall and over the collector channel orifices. Both simple and complex orifices had complete or partial lip-like rims. In orifices with partial rims, a trough-like groove was often visible on the outer wall surface opposite the lip. Transected septa and inner and outer wall adhesion sites were often found in association with complex collector channel orifices. Conclusions Collector channel orifice structure varied from simple ovals to complex tethered flaps and bridges. Collector channel orifices with complex flaps connect the inner and outer walls of Schlemm's canal, and may serve to enhance and regulate aqueous outflow in these regions. PMID:26975026

  16. Anatomically corrected malposition of great arteries.

    PubMed Central

    Anderson, R H; Becker, A E; Losekoot, T G; Gerlis, L M

    1975-01-01

    Four anomalous hearts are described in which the great arteries arise in unusual fashion from their morphologically appropriate ventricles. This malformation, previously termed anatomically corrected transposition, is now termed anatomically corrected malposition. This is because, following the precedent of Van Praagh and his associates, we now reserve the term 'transposition' to describe the situation in which both great arteries arise from separate morphologically inappropriate ventricles. All the hearts examined exhibited atrioventricular concordance, I with viscero-atrial situs inversus, and 3 with situs solitus. However, there were considerable variations in ventricular morphology between the cases. Thus, 2 cases exhibited atresia of the right atrioventricular valve, and in the remaining 2 cases right and levt ventricular sinuses were both identified. Two of the cases also had pulmonary atresia, and coronary artery anomalies were present in all 4. The cases emphasize the fact that the term anatomically corrected malposition describes not a discrete anomaly but only a ventriculo-arterial relation, which is one of ventriculo-arterial concordance. Doubt has previously been cast upon the existence of this as an anatomical entity. It is concluded that the relation does indeed exist, and furthermore can coexist with all varieties of atrioventricular relations. It is suggested that the differing atrioventricular relations can be distinguished by usage of the terms 'concordant' or 'discordant' anatomically corrected malposition. Finally, it is emphasized that it is necessary to distinguish this anomaly, which in most cases presents with left-sided anterior aorta, from the left-sided anterior aorta more frequently encountered in classically corrected transposition'. Images PMID:1191424

  17. Role of Anatomic variations of Uncinate Process in Frontal Sinusitis.

    PubMed

    Srivastava, Mohit; Tyagi, Sushant

    2016-12-01

    The osteomeatal complex plays an important role in the development of Chronic rhinosinusitis. The ethmoidal infundibulum is bordered medially by the uncinate process, and the anatomic relationship between the ethmoidal infundibulum and the frontal recess may depend upon the types of attachment of the uncinate process. The osteomeatal complex is the main area targeted in chronic rhinosinusitis and within it uncinate process is the first anatomical structure encountered. The aim of this study was to evaluate the types of attachment of the uncinate process and its implications in the development of sinus inflammation. The significance of anatomical variations of uncinate process in chronic sinusitis were evaluated. A prospective CT scan study on 64 patients of chronic sinusitis (128 uncinate processes) was done. The results were tabulated and analyzed using Statistical Package for Social Science 16.0. Type I superior attachment of uncinate process into the lamina papyracea was the most common variety in all ages and both sexes and a statistically significant association between Type 1 Uncinate process and frontal sinusitis was found. (P < 0.05). The superior attachment of uncinate process alters the frontal sinus drainage and causes the frontal sinusitis.

  18. Robust anatomical correspondence detection by hierarchical sparse graph matching.

    PubMed

    Guo, Yanrong; Wu, Guorong; Jiang, Jianguo; Shen, Dinggang

    2013-02-01

    Robust anatomical correspondence detection is a key step in many medical image applications such as image registration and motion correction. In the computer vision field, graph matching techniques have emerged as a powerful approach for correspondence detection. By considering potential correspondences as graph nodes, graph edges can be used to measure the pairwise agreement between possible correspondences. In this paper, we present a novel, hierarchical graph matching method with sparsity constraint to further augment the power of conventional graph matching methods in establishing anatomical correspondences, especially for the cases of large inter-subject variations in medical applications. Specifically, we first propose to measure the pairwise agreement between potential correspondences along a sequence of intensity profiles which reduces the ambiguity in correspondence matching. We next introduce the concept of sparsity on the fuzziness of correspondences to suppress the distraction from misleading matches, which is very important for achieving the accurate, one-to-one correspondences. Finally, we integrate our graph matching method into a hierarchical correspondence matching framework, where we use multiple models to deal with the large inter-subject anatomical variations and gradually refine the correspondence matching results between the tentatively deformed model images and the underlying subject image. Evaluations on both synthetic data and public hand X-ray images indicate that the proposed hierarchical sparse graph matching method yields the best correspondence matching performance in terms of both accuracy and robustness when compared with several conventional graph matching methods.

  19. Robust Anatomical Correspondence Detection by Hierarchical Sparse Graph Matching

    PubMed Central

    Guo, Yanrong; Wu, Guorong; Jiang, Jianguo

    2013-01-01

    Robust anatomical correspondence detection is a key step in many medical image applications such as image registration and motion correction. In the computer vision field, graph matching techniques have emerged as a powerful approach for correspondence detection. By considering potential correspondences as graph nodes, graph edges can be used to measure the pairwise agreement between possible correspondences. In this paper, we present a novel, hierarchical graph matching method with sparsity constraint to further augment the power of conventional graph matching methods in establishing anatomical correspondences, especially for the cases of large inter-subject variations in medical applications. Specifically, we first propose to measure the pairwise agreement between potential correspondences along a sequence of intensity profiles which reduces the ambiguity in correspondence matching. We next introduce the concept of sparsity on the fuzziness of correspondences to suppress the distraction from misleading matches, which is very important for achieving the accurate, one-to-one correspondences. Finally, we integrate our graph matching method into a hierarchical correspondence matching framework, where we use multiple models to deal with the large inter-subject anatomical variations and gradually refine the correspondence matching results between the tentatively deformed model images and the underlying subject image. Evaluations on both synthetic data and public hand X-ray images indicate that the proposed hierarchical sparse graph matching method yields the best correspondence matching performance in terms of both accuracy and robustness when compared with several conventional graph matching methods. PMID:23070298

  20. Rad-Path: integrated anatomical pathology and radiology undergraduate tutorials.

    PubMed

    Miller, Andrew; Rudland, Joy; Hurrell, Michael; Ali, Anthony

    2009-01-01

    The anatomical pathology tutorials for the fourth year of our undergraduate medical course at the University of Otago, Christchurch, New Zealand, were re-developed with the aim of promoting more active participation and application of learning by the students in their small group work. Radiology was integrated into half of the pathology tutorials with the objective of enhancing learning of both disciplines. The tutorials were designed to be easy to run for the tutors, who are mostly hospital-based staff. A set of 24 tutor-directed undergraduate anatomical pathology tutorials was re-developed into a case-based, student-centred format. Radiology learning was integrated into 12 tutorials. Student assessment was by way of three short answer examinations spaced throughout the course. Students and tutors completed evaluations of the tutorials. Student evaluations were positive, indicating the tutorials were considered valuable, relevant and a stimulus for thinking. Students and tutors endorsed the benefits of integrated pathology and radiology learning. Assessment results have demonstrated effective learning of pathology and radiology in the tutorials. The tutors found that the tutorials stimulated student engagement and were easy to run. The re-developed anatomical pathology tutorials with the integration of radiology appear to offer a number of benefits for learning of pathology and radiology.

  1. Alterations in Anatomical Covariance in the Prematurely Born.

    PubMed

    Scheinost, Dustin; Kwon, Soo Hyun; Lacadie, Cheryl; Vohr, Betty R; Schneider, Karen C; Papademetris, Xenophon; Constable, R Todd; Ment, Laura R

    2015-10-22

    Preterm (PT) birth results in long-term alterations in functional and structural connectivity, but the related changes in anatomical covariance are just beginning to be explored. To test the hypothesis that PT birth alters patterns of anatomical covariance, we investigated brain volumes of 25 PTs and 22 terms at young adulthood using magnetic resonance imaging. Using regional volumetrics, seed-based analyses, and whole brain graphs, we show that PT birth is associated with reduced volume in bilateral temporal and inferior frontal lobes, left caudate, left fusiform, and posterior cingulate for prematurely born subjects at young adulthood. Seed-based analyses demonstrate altered patterns of anatomical covariance for PTs compared with terms. PTs exhibit reduced covariance with R Brodmann area (BA) 47, Broca's area, and L BA 21, Wernicke's area, and white matter volume in the left prefrontal lobe, but increased covariance with R BA 47 and left cerebellum. Graph theory analyses demonstrate that measures of network complexity are significantly less robust in PTs compared with term controls. Volumes in regions showing group differences are significantly correlated with phonological awareness, the fundamental basis for reading acquisition, for the PTs. These data suggest both long-lasting and clinically significant alterations in the covariance in the PTs at young adulthood.

  2. Brain anatomical structure segmentation by hybrid discriminative/generative models.

    PubMed

    Tu, Z; Narr, K L; Dollar, P; Dinov, I; Thompson, P M; Toga, A W

    2008-04-01

    In this paper, a hybrid discriminative/generative model for brain anatomical structure segmentation is proposed. The learning aspect of the approach is emphasized. In the discriminative appearance models, various cues such as intensity and curvatures are combined to locally capture the complex appearances of different anatomical structures. A probabilistic boosting tree (PBT) framework is adopted to learn multiclass discriminative models that combine hundreds of features across different scales. On the generative model side, both global and local shape models are used to capture the shape information about each anatomical structure. The parameters to combine the discriminative appearance and generative shape models are also automatically learned. Thus, low-level and high-level information is learned and integrated in a hybrid model. Segmentations are obtained by minimizing an energy function associated with the proposed hybrid model. Finally, a grid-face structure is designed to explicitly represent the 3-D region topology. This representation handles an arbitrary number of regions and facilitates fast surface evolution. Our system was trained and tested on a set of 3-D magnetic resonance imaging (MRI) volumes and the results obtained are encouraging.

  3. Long-range population dynamics of anatomically defined neocortical networks

    PubMed Central

    Chen, Jerry L; Voigt, Fabian F; Javadzadeh, Mitra; Krueppel, Roland; Helmchen, Fritjof

    2016-01-01

    The coordination of activity across neocortical areas is essential for mammalian brain function. Understanding this process requires simultaneous functional measurements across the cortex. In order to dissociate direct cortico-cortical interactions from other sources of neuronal correlations, it is furthermore desirable to target cross-areal recordings to neuronal subpopulations that anatomically project between areas. Here, we combined anatomical tracers with a novel multi-area two-photon microscope to perform simultaneous calcium imaging across mouse primary (S1) and secondary (S2) somatosensory whisker cortex during texture discrimination behavior, specifically identifying feedforward and feedback neurons. We find that coordination of S1-S2 activity increases during motor behaviors such as goal-directed whisking and licking. This effect was not specific to identified feedforward and feedback neurons. However, these mutually projecting neurons especially participated in inter-areal coordination when motor behavior was paired with whisker-texture touches, suggesting that direct S1-S2 interactions are sensory-dependent. Our results demonstrate specific functional coordination of anatomically-identified projection neurons across sensory cortices. DOI: http://dx.doi.org/10.7554/eLife.14679.001 PMID:27218452

  4. "Anatomical simulation" of the biomechanical behavior of the human mandible.

    PubMed

    Kober, Cornelia; Hellmich, Christian; Stübinger, Stefan; Zeilhofer, Hans-Florian; Sader, Robert

    2015-01-01

    The load-carrying behavior of the human mandible can be described using finite element simulation, enabling investigations about physiological and pathological skeletal adaption. "Anatomical simulation" implies a stepwise approximation towards the anatomical reality. The project is structured in three steps. In Step 1, the preprocessing, the simulation model is provided. Step 2 is the numerical computation. Step 3 is dedicated to the interpretation of the results. The requirements of the preprocessing are: a) realization of the organ's individual anatomy, namely its outer shape; b) the tissue's elastic properties, thus its inner consistency; and c) the organ's mechanical loads. For physiological mandibular loading, these are due to muscles, temporomandibular joints, and tooth forces. Meanwhile, the reconstruction of the macroscopic anatomy from computed tomography data is standard. The periodontal ligament is inserted ex post using an approach developed by the authors. The bone is modeled anisotropically and inhomogeneously. By the visualization of the individual fiber course, the muscular force vectors are realized. The mandibular condyle is freely mobile in a kind of simplified joint capsule. For the realization of bite forces, several approaches are available. An extendible software tool is provided, enabling the user - by variable input of muscle and bite forces - to examine the individual patient's biomechanics, eg, the influence of the periodontal ligament, the condition of the temporomandibular joints, atrophic processes, or the biomechanical situation of dental implants. By stepwise approximation towards the anatomical reality, the mandibular simulation will be advanced to a valuable tool for diagnosis and prognosis.

  5. Anatomical and functional neuroimaging in awake, behaving marmosets.

    PubMed

    Silva, Afonso C

    2017-03-01

    The common marmoset (Callithrix jacchus) is a small New World monkey that has gained significant recent interest in neuroscience research, not only because of its compatibility with gene editing techniques, but also due to its tremendous versatility as an experimental animal model. Neuroimaging modalities, including anatomical (MRI) and functional magnetic resonance imaging (fMRI), complemented by two-photon laser scanning microscopy and electrophysiology, have been at the forefront of unraveling the anatomical and functional organization of the marmoset brain. High-resolution anatomical MRI of the marmoset brain can be obtained with remarkable cytoarchitectonic detail. Functional MRI of the marmoset brain has been used to study various sensory systems, including somatosensory, auditory, and visual pathways, while resting-state fMRI studies have unraveled functional brain networks that bear great correspondence to those previously described in humans. Two-photon laser scanning microscopy of the marmoset brain has enabled the simultaneous recording of neuronal activity from thousands of neurons with single cell spatial resolution. In this article, we aim to review the main results obtained by our group and by our colleagues in applying neuroimaging techniques to study the marmoset brain. © 2016 Wiley Periodicals, Inc. Develop Neurobiol 77: 373-389, 2017. © 2016 Wiley Periodicals, Inc.

  6. Early life body fatness and risk of colorectal cancer in US women and men – results from two large cohort studies

    PubMed Central

    Zhang, Xuehong; Wu, Kana; Giovannucci, Edward L.; Ma, Jing; Colditz, Graham A.; Fuchs, Charles S.; Willett, Walter C.; Stampfer, Meir J.; Nimptsch, Katharina; Ogino, Shuji; Wei, Esther K.

    2015-01-01

    Background The association between body fatness before adulthood and later risk of colorectal cancer remains unclear. We hypothesized that, independent of adult body fatness, early life body fatness would be associated with a higher risk of developing colorectal cancer. Methods We assessed body fatness during childhood and adolescence using a validated 9-level somatotype and inquired body weight in young adulthood in the Nurses' Health Study and Health Professionals Follow-up Study. We used Cox proportional hazard regression modeling to estimate relative risks (RRs, 95% CIs) adjusting for adult body mass index (BMI) and other known colorectal cancer risk factors. Results We identified 2,100 incident colorectal cancer cases (1,292 in women and 808 in men) during 22 years of follow-up. Among women, the RR(95% CI) for childhood body fatness of level 5 or higher versus level 1 was 1.28(1.04-1.58, p-trend=0.08) and for adolescent body fatness, it was 1.27(1.01-1.60, p-trend = 0.23). The corresponding RRs for men were 1.04(0.82-1.31, p-trend=0.48) and 0.98(0.75-1.27, p-trend=0.20), respectively. Results were generally similar across anatomic subsites within the colorectum. Additionally, the RRs comparing BMI categories ≥ 27.5 to < 19 kg/m2 were 1.44(1.06-1.95, at age 18, p-trend=0.009) for women and 1.18(0.84-1.65, at age 21, p-trend=0.57) for men. Conclusion Increased body fatness in early life, independent of adult obesity, might be a risk factor for colorectal cancer in women, but we observed a weaker association in men. Impact Our findings support the growing evidence that early life body fatness affects the risk of colorectal cancer many decades later. PMID:25777804

  7. Anatomical calibration for wearable motion capture systems: Video calibrated anatomical system technique.

    PubMed

    Bisi, Maria Cristina; Stagni, Rita; Caroselli, Alessio; Cappello, Angelo

    2015-08-01

    Inertial sensors are becoming widely used for the assessment of human movement in both clinical and research applications, thanks to their usability out of the laboratory. This work aims to propose a method for calibrating anatomical landmark position in the wearable sensor reference frame with an ease to use, portable and low cost device. An off-the-shelf camera, a stick and a pattern, attached to the inertial sensor, compose the device. The proposed technique is referred to as video Calibrated Anatomical System Technique (vCAST). The absolute orientation of a synthetic femur was tracked both using the vCAST together with an inertial sensor and using stereo-photogrammetry as reference. Anatomical landmark calibration showed mean absolute error of 0.6±0.5 mm: these errors are smaller than those affecting the in-vivo identification of anatomical landmarks. The roll, pitch and yaw anatomical frame orientations showed root mean square errors close to the accuracy limit of the wearable sensor used (1°), highlighting the reliability of the proposed technique. In conclusion, the present paper proposes and preliminarily verifies the performance of a method (vCAST) for calibrating anatomical landmark position in the wearable sensor reference frame: the technique is low time consuming, highly portable, easy to implement and usable outside laboratory.

  8. Anatomical accuracy of brain connections derived from diffusion MRI tractography is inherently limited.

    PubMed

    Thomas, Cibu; Ye, Frank Q; Irfanoglu, M Okan; Modi, Pooja; Saleem, Kadharbatcha S; Leopold, David A; Pierpaoli, Carlo

    2014-11-18

    Tractography based on diffusion-weighted MRI (DWI) is widely used for mapping the structural connections of the human brain. Its accuracy is known to be limited by technical factors affecting in vivo data acquisition, such as noise, artifacts, and data undersampling resulting from scan time constraints. It generally is assumed that improvements in data quality and implementation of sophisticated tractography methods will lead to increasingly accurate maps of human anatomical connections. However, assessing the anatomical accuracy of DWI tractography is difficult because of the lack of independent knowledge of the true anatomical connections in humans. Here we investigate the future prospects of DWI-based connectional imaging by applying advanced tractography methods to an ex vivo DWI dataset of the macaque brain. The results of different tractography methods were compared with maps of known axonal projections from previous tracer studies in the macaque. Despite the exceptional quality of the DWI data, none of the methods demonstrated high anatomical accuracy. The methods that showed the highest sensitivity showed the lowest specificity, and vice versa. Additionally, anatomical accuracy was highly dependent upon parameters of the tractography algorithm, with different optimal values for mapping different pathways. These results suggest that there is an inherent limitation in determining long-range anatomical projections based on voxel-averaged estimates of local fiber orientation obtained from DWI data that is unlikely to be overcome by improvements in data acquisition and analysis alone.

  9. Enhancing our understanding of anatomical diversity in Tomentella ectomycorrhizas: characterization of six new morphotypes.

    PubMed

    Jakucs, Erzsébet; Erős-Honti, Zsolt; Seress, Diána; Kovács, Gábor M

    2015-08-01

    Ectomycorrhizas (ECM) formed by Tomentella species (Thelephorales, Basidiomycota) were collected in beech forests of Hungary and studied using anatomical and molecular phylogenetic methods. The mycobionts were identified by analysing the sequences of nuclear ribosomal DNA (nrDNA) internal transcribed spacer (ITS) regions together with sequences obtained from public databases. At the sampling plots, we found the occurrence of 11 Tomentella morphotypes. Among these, six morphotypes (four identified, Tomentella atroarenicolor, Tomentella bryophila, Tomentella lapida, Tomentella subclavigera, and two unidentified) were morpho-anatomically characterized for the first time. Although the six morphotypes differed anatomically from each other and from Tomentella ectomycorrhizas described previously, they shared anatomical features common to tomentelloid ectomycorrhizas fungi. These results expand our understanding of the diversity of this widely distributed ectomycorrhizal genus.

  10. Reduction of variance in measurements of average metabolite concentration in anatomically-defined brain regions

    NASA Astrophysics Data System (ADS)

    Larsen, Ryan J.; Newman, Michael; Nikolaidis, Aki

    2016-11-01

    Multiple methods have been proposed for using Magnetic Resonance Spectroscopy Imaging (MRSI) to measure representative metabolite concentrations of anatomically-defined brain regions. Generally these methods require spectral analysis, quantitation of the signal, and reconciliation with anatomical brain regions. However, to simplify processing pipelines, it is practical to only include those corrections that significantly improve data quality. Of particular importance for cross-sectional studies is knowledge about how much each correction lowers the inter-subject variance of the measurement, thereby increasing statistical power. Here we use a data set of 72 subjects to calculate the reduction in inter-subject variance produced by several corrections that are commonly used to process MRSI data. Our results demonstrate that significant reductions of variance can be achieved by performing water scaling, accounting for tissue type, and integrating MRSI data over anatomical regions rather than simply assigning MRSI voxels with anatomical region labels.

  11. Correction of geometric distortions in EP images using nonrigid registration to corresponding anatomic images

    NASA Astrophysics Data System (ADS)

    Skerl, Darko; Pan, Shiyan; Li, Rui; Fitzpatrick, J. Michael; Parks, Mitchell H.; Martin, Peter R.; Morgan, Victoria L.; Dawant, Benoit M.

    2001-07-01

    The spatial resolution of echo planar image (EPI) data acquired for functional MRI (fMRI) studies is low. To facilitate their interpretation, conventional T1-weighted anatomical images are often acquired prior to the acquisition of the EP images. T1-weighted and EP images are then registered and activation patterns computed from the EP images are superimposed on the anatomic images. Registration between the anatomic and the EP images is required to compensate for patient motion between the acquisitions and for geometric distortions affecting EP images. Recently, methods have been proposed to register EP and anatomic images using non-rigid registration techniques. In these approaches, the transformation is parameterized using splines. Here, we propose an alternative solution to this problem based on optical flow with non-stationary stiffness constraint. The approach we propose also includes several preprocessing steps such as automatic skull removal and intensity remapping. Results obtained with eight studies on normal volunteers are presented.

  12. Anatomical Knee Variants in Discoid Lateral Meniscal Tears

    PubMed Central

    Chen, Xu-Xu; Li, Jian; Wang, Tao; Zhao, Yang; Kang, Hui

    2017-01-01

    Background: Discoid lateral meniscus was a common meniscal dysplasia and was predisposed to tear. There were some anatomical knee variants in patients with discoid lateral meniscus. The aim of this study was to analyze the relationship between anatomical knee variants and discoid lateral meniscal tears. Methods: There were totally 125 cases of discoid lateral meniscus enrolled in this study from February 2008 to December 2013. Eighty-seven patients who underwent arthroscopic surgery for right torn discoid lateral meniscus were enrolled in the torn group. An additional 38 patients who were incidentally identified as having intact discoid lateral menisci on magnetic resonance imaging (MRI) findings were included in the control group. All patients were evaluated for anatomical knee variants on plain radiographs, including lateral joint space distance, height of the lateral tibial spine, height of the fibular head, obliquity of the lateral tibial plateau, squaring of the lateral femoral condyle, cupping of the lateral tibial plateau, lateral femoral condylar notch, and condylar cutoff sign. The relationship between anatomical variants and meniscal tear was evaluated. These anatomical variants in cases with complete discoid meniscus were also compared with those in cases with incomplete discoid meniscus. Results: There were no significant differences between the two groups in lateral joint space distance (P = 0.528), height of the lateral tibial spine (P = 0.927), height of the fibular head (P = 0.684), obliquity of the lateral tibial plateau (P = 0.672), and the positive rates of squaring of the lateral femoral condyle (P = 0.665), cupping of the lateral tibial plateau (P = 0.239), and lateral femoral condylar notch (P = 0.624). The condylar cutoff sign was significantly different between the two groups, with the prominence ratio in the torn group being smaller than that in the control group (0.74 ± 0.11 vs. 0.81 ± 0.04, P = 0.049). With the decision value of the

  13. Anatomic fitting of total artificial hearts for in vivo evaluation.

    PubMed

    Gregory, Shaun D; Loechel, Nicole; Pearcy, Mark J; Fraser, John; Parnis, Steven; Cohn, William E; Timms, Daniel

    2013-08-01

    Successful anatomic fitting of a total artificial heart (TAH) is vital to achieve optimal pump hemodynamics after device implantation. Although many anatomic fitting studies have been completed in humans prior to clinical trials, few reports exist that detail the experience in animals for in vivo device evaluation. Optimal hemodynamics are crucial throughout the in vivo phase to direct design iterations and ultimately validate device performance prior to pivotal human trials. In vivo evaluation in a sheep model allows a realistically sized representation of a smaller patient, for which smaller third-generation TAHs have the potential to treat. Our study aimed to assess the anatomic fit of a single device rotary TAH in sheep prior to animal trials and to use the data to develop a three-dimensional, computer-aided design (CAD)-operated anatomic fitting tool for future TAH development. Following excision of the native ventricles above the atrio-ventricular groove, a prototype TAH was inserted within the chest cavity of six sheep (28-40 kg). Adjustable rods representing inlet and outlet conduits were oriented toward the center of each atrial chamber and the great vessels, with conduit lengths and angles recorded for future analysis. A three-dimensional, CAD-operated anatomic fitting tool was then developed, based on the results of this study, and used to determine the inflow and outflow conduit orientation of the TAH. The mean diameters of the sheep left atrium, right atrium, aorta, and pulmonary artery were 39, 33, 12, and 11 mm, respectively. The center-to-center distance and outer-edge-to-outer-edge distance between the atria, found to be 39 ± 9 mm and 72 ± 17 mm in this study, were identified as the most critical geometries for successful TAH connection. This geometric constraint restricts the maximum separation allowable between left and right inlet ports of a TAH to ensure successful alignment within the available atrial circumference. © 2013

  14. Anatomic variants mimicking pathology on echocardiography: differential diagnosis.

    PubMed

    Kim, Mi-Jeong; Jung, Hae Ok

    2013-09-01

    Differentiation of normal from abnormal findings is critical in echocardiography. Anatomic variants occurring in normal cardiac developments often simulate pathologic entities. This review focuses on the differential diagnosis of normal anatomic structures from pathologic ones in echocardiography.

  15. Chemical modification by pyridoxal 5'-phosphate and cyclohexane-1,2-dione indicates that Lys-7 and Arg-10 are involved in the p2 phosphate-binding subsite of bovine pancreatic ribonuclease A.

    PubMed Central

    Richardson, R M; Parés, X; Cuchillo, C M

    1990-01-01

    Steric and chemical evidence had previously shown that residues Lys-7 and/or Arg-10 of bovine pancreatic RNAase A could belong to the p2 phosphate-binding subsite, adjacent to the 3' side of the main site p1. In the present work chemical modification of the enzyme with pyridoxal 5'-phosphate and cyclohexane-1,2-dione was carried out in order to identify these residues positively as part of the p2 site. The reaction with pyridoxal 5'-phosphate yields three monosubstituted derivatives, at Lys-1, Lys-7 and Lys-41. A strong decrease in the yield of derivatives at Lys-7 and Lys-41 was observed when either p1 or p2 was specifically blocked by 5'-AMP or 3'-AMP respectively. These experiments indicate that both sites are needed for the reaction of pyridoxal 5'-phosphate with RNAase A to take place. The positive charge in one of the sites interacts with the phosphate group of pyridoxal 5'-phosphate, giving the proper orientation to the carbonyl group, which then reacts with the lysine residue present in the other site. The absence of reaction between pyridoxal 5'-phosphate and an RNAase derivative that has the p2 site blocked supports this hypothesis. Labelling of Lys-7 with pyridoxal 5'-phosphate has a more pronounced effect on the kinetics with RNA than with the smaller substrate 2',3'-cyclic CMP. In addition, when the phosphate moiety of the 5'-phosphopyridoxyl group was removed with alkaline phosphatase the kinetic constants with 2',3'-cyclic CMP returned to values very similar to those of the native enzyme, whereas a higher Km and lower Vmax. were still observed for RNA. This indicates that this new derivative has recovered a free p1 site and, hence, the capability to act on 2',3'-cyclic CMP, but the presence of the pyridoxyl group bound to Lys-7 is still blocking a secondary phosphate-binding site, namely p2. Finally, reaction of cyclohexane-1,2-dione at Arg-10 is suppressed in the presence of 3'-AMP but only a 19% decrease is observed with 5'-AMP, suggesting that Arg

  16. Anatomical basis of pedicles in breast reduction

    PubMed Central

    Coscarelli, Leonardo; Rancati, Alberto

    2017-01-01

    The mammary gland is composed of multiple tubules acinar pockets in which the secretory layer, connective tissue stroma, and fatty tissue all respond to hormonal and systemic influences. These structures are irrigated by three vascular pedicle branches, from the axillary artery, internal mammary artery, and intercostal artery. This vascular anastomotic arrangement forms the anatomical basis of the flaps used in breast reduction techniques. The veins form a strong subdermal network, latticed with the arterial network. The lymph vessels have three well-defined pedicles, skin, glandular and milk ducts that drain into internal, external, and posterior ducts. The understanding of these anatomical structures determines the selection of different pedicles in breast volume reduction and preservation of the nipple-areola complex circulation. PMID:28497019

  17. Anatomic pathology laboratory information systems: a review.

    PubMed

    Park, Seung Lyung; Pantanowitz, Liron; Sharma, Gaurav; Parwani, Anil Vasdev

    2012-03-01

    The modern anatomic pathology laboratory depends on a reliable information infrastructure to register specimens, record gross and microscopic findings, regulate laboratory workflow, formulate and sign out report(s), disseminate them to the intended recipients across the whole health system, and support quality assurance measures. This infrastructure is provided by the Anatomical Pathology Laboratory Information Systems (APLIS), which have evolved over decades and now are beginning to support evolving technologies like asset tracking and digital imaging. As digital pathology transitions from "the way of the future" to "the way of the present," the APLIS continues to be one of the key effective enablers of the scope and practice of pathology. In this review, we discuss the evolution, necessary components, architecture and functionality of the APLIS that are crucial to today's practicing pathologist and address the demands of emerging trends on the future APLIS.

  18. Modeling anatomical spatial relations with description logics.

    PubMed Central

    Schulz, S.; Hahn, U.; Romacker, M.

    2000-01-01

    Although spatial relations are essential for the anatomy domain, spatial reasoning is only weakly supported by medical knowledge representation systems. To remedy this shortcoming we express spatial relations that can intuitively be applied to anatomical objects (such as 'disconnected', 'externally connected', 'partial overlap' and 'proper part') within the formal framework of description logics. A special encoding of concept descriptions (in terms of SEP triplets) allows us to emulate spatial reasoning by classification-based reasoning. PMID:11079990

  19. [Dyspareunia after total abdominal hysterectomy. Anatomical relation].

    PubMed

    Monroy-Lozano, Blanca Estela; Motta-Martínez, Eduardo; Huitrón-García, Rafael; Zaldívar-Ramírez, Felipe Rafael; Hurtado-López, Luis Mauricio

    2006-01-01

    We undertook this study to determine whether anatomic changes after total abdominal hysterectomy are a cause of dyspareunia in premenopausal women. This is a comparative, prospective and longitudinal study in 50 premenopausal women with benign uterine disease without dyspareunia treated with total abdominal hysterectomy. Primary variable was presence of postsurgical dyspareunia. Secondary variables are presurgical and assessment 3 months after surgery of left, right, anterior and posterior vaginal longitude (VLL, VRL, VAL and VPL, respectively) expressed in centimeters, as well as of the vaginal volume (VV). Statistical analysis for mean, central tendency and t-test. Group 1 (G1) is comprised of patients with postsurgical dyspareunia and Group 2 (G2) is comprised of patients without dyspareunia. In G1, three patients (mean age: 42 years) had dyspareunia, pre- and postsurgical mean values were VV 146.6 and 100, VLL 8 and 7.3, VPL 9.16 and 7.3, VLL 8 and 7.3, VRL 8 and 7.3. In G2, 47 patients (mean age: 40.36 years) were without dyspareunia, pre- and postsurgical values were VV 150.6 and 121.57, VLL 8.81 and 8.12, VPL 9.7 and 8.69, VLL 9.24 and 8.3, VRL 9.28 and 8.33. We did not find significant differences between the groups. Two of the three patients with dyspareunia had a vaginal granuloma, but the third case did not show an anatomical cause. There is no relationship between total abdominal hysterectomy in premenopausal women and anatomical vaginal changes after surgery as assessed by vaginal volume and longitude. Presence of vaginal granuloma was responsible for dyspareunia in 4% of cases. Dyspareunia was found in 2% of premenopausal women without posthysterectomy anatomical cause.

  20. Procedure Planning: Anatomical Determinants of Strategy

    PubMed Central

    Hanratty, Colm; Walsh, Simon

    2014-01-01

    In contemporary practice there are three main methods that can be employed when attempting to open a chronic total occlusion (CTO) of a coronary artery; antegrade or retrograde wire escalation, antegrade dissection re-entry and retrograde dissection re-entry. This editorial will attempt to clarify the anatomical features that can be identified to help when deciding which of these strategies to employ initially and help understand the reasons for this decision. PMID:24694102

  1. Anatomical Ablation Strategy for Noninducible Fascicular Tachycardia.

    PubMed

    Talib, Ahmed Karim; Nogami, Akihiko

    2016-03-01

    The presence of structural heart disease does not exclude fascicular ventricular tachycardia (VT), especially if the VT is verapamil sensitive. An empirical anatomic approach is effective when fascicular VT is noninducible or if diastolic Purkinje potential (P1) cannot be recorded during VT mapping. Pace mapping at the successful ablation site is usually not effective because selective pacing of P1 is difficult and there is an antidromic activation of the proximal P1 potential.

  2. Anatomical MRI with an atomic magnetometer.

    PubMed

    Savukov, I; Karaulanov, T

    2013-06-01

    Ultra-low field (ULF) MRI is a promising method for inexpensive medical imaging with various additional advantages over conventional instruments such as low weight, low power, portability, absence of artifacts from metals, and high contrast. Anatomical ULF MRI has been successfully implemented with SQUIDs, but SQUIDs have the drawback of a cryogen requirement. Atomic magnetometers have sensitivity comparable to SQUIDs and can be in principle used for ULF MRI to replace SQUIDs. Unfortunately some problems exist due to the sensitivity of atomic magnetometers to a magnetic field and gradients. At low frequency, noise is also substantial and a shielded room is needed for improving sensitivity. In this paper, we show that at 85 kHz, the atomic magnetometer can be used to obtain anatomical images. This is the first demonstration of any use of atomic magnetometers for anatomical MRI. The demonstrated resolution is 1.1 mm×1.4 mm in about 6 min of acquisition with SNR of 10. Some applications of the method are discussed. We discuss several measures to increase the sensitivity to reach a resolution 1 mm×1 mm.

  3. Engineering anatomically shaped human bone grafts.

    PubMed

    Grayson, Warren L; Fröhlich, Mirjam; Yeager, Keith; Bhumiratana, Sarindr; Chan, M Ete; Cannizzaro, Christopher; Wan, Leo Q; Liu, X Sherry; Guo, X Edward; Vunjak-Novakovic, Gordana

    2010-02-23

    The ability to engineer anatomically correct pieces of viable and functional human bone would have tremendous potential for bone reconstructions after congenital defects, cancer resections, and trauma. We report that clinically sized, anatomically shaped, viable human bone grafts can be engineered by using human mesenchymal stem cells (hMSCs) and a "biomimetic" scaffold-bioreactor system. We selected the temporomandibular joint (TMJ) condylar bone as our tissue model, because of its clinical importance and the challenges associated with its complex shape. Anatomically shaped scaffolds were generated from fully decellularized trabecular bone by using digitized clinical images, seeded with hMSCs, and cultured with interstitial flow of culture medium. A bioreactor with a chamber in the exact shape of a human TMJ was designed for controllable perfusion throughout the engineered construct. By 5 weeks of cultivation, tissue growth was evidenced by the formation of confluent layers of lamellar bone (by scanning electron microscopy), markedly increased volume of mineralized matrix (by quantitative microcomputer tomography), and the formation of osteoids (histologically). Within bone grafts of this size and complexity cells were fully viable at a physiologic density, likely an important factor of graft function. Moreover, the density and architecture of bone matrix correlated with the intensity and pattern of the interstitial flow, as determined in experimental and modeling studies. This approach has potential to overcome a critical hurdle-in vitro cultivation of viable bone grafts of complex geometries-to provide patient-specific bone grafts for craniofacial and orthopedic reconstructions.

  4. Network predicting drug's anatomical therapeutic chemical code.

    PubMed

    Wang, Yong-Cui; Chen, Shi-Long; Deng, Nai-Yang; Wang, Yong

    2013-05-15

    Discovering drug's Anatomical Therapeutic Chemical (ATC) classification rules at molecular level is of vital importance to understand a vast majority of drugs action. However, few studies attempt to annotate drug's potential ATC-codes by computational approaches. Here, we introduce drug-target network to computationally predict drug's ATC-codes and propose a novel method named NetPredATC. Starting from the assumption that drugs with similar chemical structures or target proteins share common ATC-codes, our method, NetPredATC, aims to assign drug's potential ATC-codes by integrating chemical structures and target proteins. Specifically, we first construct a gold-standard positive dataset from drugs' ATC-code annotation databases. Then we characterize ATC-code and drug by their similarity profiles and define kernel function to correlate them. Finally, we use a kernel method, support vector machine, to automatically predict drug's ATC-codes. Our method was validated on four drug datasets with various target proteins, including enzymes, ion channels, G-protein couple receptors and nuclear receptors. We found that both drug's chemical structure and target protein are predictive, and target protein information has better accuracy. Further integrating these two data sources revealed more experimentally validated ATC-codes for drugs. We extensively compared our NetPredATC with SuperPred, which is a chemical similarity-only based method. Experimental results showed that our NetPredATC outperforms SuperPred not only in predictive coverage but also in accuracy. In addition, database search and functional annotation analysis support that our novel predictions are worthy of future experimental validation. In conclusion, our new method, NetPredATC, can predict drug's ATC-codes more accurately by incorporating drug-target network and integrating data, which will promote drug mechanism understanding and drug repositioning and discovery. NetPredATC is available at http

  5. An Anatomically Validated Brachial Plexus Contouring Method for Intensity Modulated Radiation Therapy Planning

    SciTech Connect

    Van de Velde, Joris; Audenaert, Emmanuel; Speleers, Bruno; Vercauteren, Tom; Mulliez, Thomas; Vandemaele, Pieter; Achten, Eric; Kerckaert, Ingrid; D'Herde, Katharina; De Neve, Wilfried; Van Hoof, Tom

    2013-11-15

    Purpose: To develop contouring guidelines for the brachial plexus (BP) using anatomically validated cadaver datasets. Magnetic resonance imaging (MRI) and computed tomography (CT) were used to obtain detailed visualizations of the BP region, with the goal of achieving maximal inclusion of the actual BP in a small contoured volume while also accommodating for anatomic variations. Methods and Materials: CT and MRI were obtained for 8 cadavers positioned for intensity modulated radiation therapy. 3-dimensional reconstructions of soft tissue (from MRI) and bone (from CT) were combined to create 8 separate enhanced CT project files. Dissection of the corresponding cadavers anatomically validated the reconstructions created. Seven enhanced CT project files were then automatically fitted, separately in different regions, to obtain a single dataset of superimposed BP regions that incorporated anatomic variations. From this dataset, improved BP contouring guidelines were developed. These guidelines were then applied to the 7 original CT project files and also to 1 additional file, left out from the superimposing procedure. The percentage of BP inclusion was compared with the published guidelines. Results: The anatomic validation procedure showed a high level of conformity for the BP regions examined between the 3-dimensional reconstructions generated and the dissected counterparts. Accurate and detailed BP contouring guidelines were developed, which provided corresponding guidance for each level in a clinical dataset. An average margin of 4.7 mm around the anatomically validated BP contour is sufficient to accommodate for anatomic variations. Using the new guidelines, 100% inclusion of the BP was achieved, compared with a mean inclusion of 37.75% when published guidelines were applied. Conclusion: Improved guidelines for BP delineation were developed using combined MRI and CT imaging with validation by anatomic dissection.

  6. Depressive Symptoms, Anatomical Region, and Clinical Outcomes for Patients Seeking Outpatient Physical Therapy for Musculoskeletal Pain

    PubMed Central

    Coronado, Rogelio A.; Beneciuk, Jason M.; Valencia, Carolina; Werneke, Mark W.; Hart, Dennis L.

    2011-01-01

    Background Clinical guidelines advocate the routine identification of depressive symptoms for patients with pain in the lumbar or cervical spine, but not for other anatomical regions. Objective The purpose of this study was to investigate the prevalence and impact of depressive symptoms for patients with musculoskeletal pain across different anatomical regions. Design This was a prospective, associational study. Methods Demographic, clinical, depressive symptom (Symptom Checklist 90–Revised), and outcome data were collected by self-report from a convenience sample of 8,304 patients. Frequency of severe depressive symptoms was assessed by chi-square analysis for demographic and clinical variables. An analysis of variance examined the influence of depressive symptoms and anatomical region on intake pain intensity and functional status. Separate hierarchical multiple regression models by anatomical region examined the influence of depressive symptoms on clinical outcomes. Results Prevalence of severe depression was higher in women, in industrial and pain clinics, and in patients who reported chronic pain or prior surgery. Lower prevalence rates were found in patients older than 65 years and those who had upper- or lower-extremity pain. Depressive symptoms had a moderate to large effect on pain ratings (Cohen d=0.55–0.87) and a small to large effect on functional status (Cohen d=0.28–0.95). In multivariate analysis, depressive symptoms contributed additional variance to pain intensity and functional status for all anatomical locations, except for discharge values for the cervical region. Conclusions Rates of depressive symptoms varied slightly based on anatomical region of musculoskeletal pain. Depressive symptoms had a consistent detrimental influence on outcomes, except on discharge scores for the cervical anatomical region. Expanding screening recommendations for depressive symptoms to include more anatomical regions may be indicated in physical therapy

  7. Anatomical models and wax Venuses: art masterpieces or scientific craft works?

    PubMed Central

    Ballestriero, R

    2010-01-01

    The art of wax modelling has an ancient origin but rose to prominence in 14th century Italy with the cult of votive artefacts. With the advent of Neoclassicism this art, now deemed repulsive, continued to survive in a scientific environment, where it flourished in the study of normal and pathological anatomy, obstetrics, zoology and botany. The achievement of having originated the creation of anatomical models in coloured wax must be ascribed to a joint effort undertaken by the Sicilian wax modeller Gaetano Giulio Zumbo and the French surgeon Guillaume Desnoues in the late 17th century. Interest in anatomical wax models spread throughout Europe during the 18th century, first in Bologna with Ercole Lelli, Giovanni Manzolini and Anna Morandi, and then in Florence with Felice Fontana and Clemente Susini. In England, the art of anatomical ceroplastics was brought to London from Florence by the sculptor Joseph Towne. Throughout the centuries many anatomical artists preferred this material due to the remarkable mimetic likeness obtained, far surpassing any other material. Independent of the material used, whether wood, wax or clay, anatomical models were always considered merely craft works confined to hospitals or faculties of medicine and have survived to this day only because of their scientific interest. Italian and English waxes are stylistically different but the remarkable results obtained by Susini and Towne, and the fact that some contemporary artists are again representing anatomical wax bodies in their works, makes the border that formerly separated art and craft indistinguishable. PMID:20002228

  8. Anatomical models and wax Venuses: art masterpieces or scientific craft works?

    PubMed

    Ballestriero, R

    2010-02-01

    The art of wax modelling has an ancient origin but rose to prominence in 14th century Italy with the cult of votive artefacts. With the advent of Neoclassicism this art, now deemed repulsive, continued to survive in a scientific environment, where it flourished in the study of normal and pathological anatomy, obstetrics, zoology and botany. The achievement of having originated the creation of anatomical models in coloured wax must be ascribed to a joint effort undertaken by the Sicilian wax modeller Gaetano Giulio Zumbo and the French surgeon Guillaume Desnoues in the late 17th century. Interest in anatomical wax models spread throughout Europe during the 18th century, first in Bologna with Ercole Lelli, Giovanni Manzolini and Anna Morandi, and then in Florence with Felice Fontana and Clemente Susini. In England, the art of anatomical ceroplastics was brought to London from Florence by the sculptor Joseph Towne. Throughout the centuries many anatomical artists preferred this material due to the remarkable mimetic likeness obtained, far surpassing any other material. Independent of the material used, whether wood, wax or clay, anatomical models were always considered merely craft works confined to hospitals or faculties of medicine and have survived to this day only because of their scientific interest. Italian and English waxes are stylistically different but the remarkable results obtained by Susini and Towne, and the fact that some contemporary artists are again representing anatomical wax bodies in their works, makes the border that formerly separated art and craft indistinguishable.

  9. Correlations between anatomic variations of maxillary sinus ostium and postoperative complication after sinus lifting

    PubMed Central

    2016-01-01

    Objectives The maxillary sinus mucosa is reported to recover to preoperative sterility after sinus floor elevation. However, when drainage of maxillary sinus is impaired, recovery can be delayed and maxillary sinusitis can occur. Therefore, in this study, we investigated the correlations between anatomic variants that can interrupt the ostium of the maxillary sinus and incidence of complication after sinus lifting. Materials and Methods The subjects are 81 patients who underwent sinus lifting in Wonkwang University Dental Hospital (Iksan, Korea). Computed tomography (CT) images of the subjects were reviewed for presence of nasal septum deviation, anatomic variants of the middle turbinate, and Haller cells. Correlations between anatomic variations and occurrence of maxillary sinusitis were statistically analyzed. Results Patients with anatomic variants of ostio-meatal units, such as deviated nasal septum, concha bullosa or paradoxical curvature of the middle turbinate, or Haller cells, showed a higher rate of complication. However, only presence of Haller cell showed statistically significant. Conclusion Before sinus lifting, CT images are recommended to detect anatomic variants of the ostio-meatal complex. If disadvantageous anatomic variants are detected, the use of nasal decongestants should be considered to reduce the risk of postoperative sinusitis. PMID:27847736

  10. Development of the Anatomical Quality Assurance (AQUA) checklist: Guidelines for reporting original anatomical studies.

    PubMed

    Tomaszewski, Krzysztof A; Henry, Brandon Michael; Kumar Ramakrishnan, Piravin; Roy, Joyeeta; Vikse, Jens; Loukas, Marios; Tubbs, R Shane; Walocha, Jerzy A

    2017-01-01

    The rise of evidence-based anatomy has emphasized the need for original anatomical studies with high clarity, transparency, and comprehensiveness in reporting. Currently, inconsistencies in the quality and reporting of such studies have placed limits on accurate reliability and impact assessment. Our aim was to develop a checklist of reporting items that should be addressed by authors of original anatomical studies. The study steering committee formulated a preliminary conceptual design and began to generate items on the basis of a literature review and expert opinion. This led to the development of a preliminary checklist. The validity of this checklist was assessed by a Delphi procedure, and feedback from the Delphi panelists, who were experts in the area of anatomical research, was used to improve it. The Delphi procedure involved 12 experts in anatomical research. It comprised two rounds, after which unanimous consensus was reached regarding the items to be included in the checklist. The steering committee agreed to name the checklist AQUA. The preliminary AQUA Checklist consisted of 26 items divided into eight sections. Following round 1, some of the items underwent major revision and three new ones were introduced. The checklist was revised only for minor language inaccuracies after round 2. The final version of the AQUA Checklist consisted of the initial eight sections with a total of 29 items. The steering committee hopes the AQUA Checklist will improve the quality and reporting of anatomical studies. Clin. Anat. 30:14-20, 2017. © 2016 Wiley Periodicals, Inc.

  11. Development of the anatomical quality assessment (AQUA) tool for the quality assessment of anatomical studies included in meta-analyses and systematic reviews.

    PubMed

    Henry, Brandon Michael; Tomaszewski, Krzysztof A; Ramakrishnan, Piravin Kumar; Roy, Joyeeta; Vikse, Jens; Loukas, Marios; Tubbs, R Shane; Walocha, Jerzy A

    2017-01-01

    Critical appraisal of anatomical studies is essential before the evidence from them undergoes meta-epidemiological synthesis. However, no instrument for appraising anatomical studies with inherent applicability to different study designs is available. We aim to develop a generic yet comprehensive tool for assessing the quality of anatomical studies using a formal consensus method. The study steering committee formulated an initial conceptual design and generated items for a preliminary tool on the basis of a literature review and expert opinion. A Delphi procedure was then adopted to assess the validity of the preliminary tool. Feedback from the Delphi panelists was used to improve it. The Delphi procedure involved 12 experts in anatomical research. It comprised two rounds, after which unanimous consensus was reached about the items to be included. The preliminary tool consisted of 20 items, which were phrased as signaling questions and organized into five domains: 1. Aim and subject characteristics, 2. Study design, 3. Characterization of methods, 4. Descriptive anatomy, and 5. Results reporting. Each domain was set to end with a risk of bias question. Following round 1, some of the items underwent major revision, although agreement was reached regarding inclusion of all the domains and signaling questions in the preliminary tool. The tool was revised only for minor language inaccuracies after round 2. The AQUA Tool was designed to assess the quality and reliability of anatomical studies. It is currently undergoing a validation process. Clin. Anat. 30:6-13, 2017. © 2016 Wiley Periodicals, Inc.

  12. Anatomical study of a posterior cerebral lesion producing dyslexia.

    PubMed

    Van Buren, J M

    1979-07-01

    After an "occipital lobectomy" that resulted in a severe dyslexia and a moderate dysgraphia-dyscalculia, anatomical study showed damage to the posterior extremity of the angular gyrus and degeneration in the posteroinferior pulvinar. This is in contrast to an earlier case that had degeneration in the anterosuperior pulvinor associated with a small anterior temporoparietal infarct and a well-documented receptive-expressive aphasia. However, the role of the pulvinar in speech function remains uncertain. The surgeon should be aware of the short distance between the angular gyrus and both the midline and the occipital pole because a lesion here during an "occipital lobectomy" produces a distressing and durable speech impairment.

  13. TOPICAL REVIEW: Anatomical imaging for radiotherapy

    NASA Astrophysics Data System (ADS)

    Evans, Philip M.

    2008-06-01

    The goal of radiation therapy is to achieve maximal therapeutic benefit expressed in terms of a high probability of local control of disease with minimal side effects. Physically this often equates to the delivery of a high dose of radiation to the tumour or target region whilst maintaining an acceptably low dose to other tissues, particularly those adjacent to the target. Techniques such as intensity modulated radiotherapy (IMRT), stereotactic radiosurgery and computer planned brachytherapy provide the means to calculate the radiation dose delivery to achieve the desired dose distribution. Imaging is an essential tool in all state of the art planning and delivery techniques: (i) to enable planning of the desired treatment, (ii) to verify the treatment is delivered as planned and (iii) to follow-up treatment outcome to monitor that the treatment has had the desired effect. Clinical imaging techniques can be loosely classified into anatomic methods which measure the basic physical characteristics of tissue such as their density and biological imaging techniques which measure functional characteristics such as metabolism. In this review we consider anatomical imaging techniques. Biological imaging is considered in another article. Anatomical imaging is generally used for goals (i) and (ii) above. Computed tomography (CT) has been the mainstay of anatomical treatment planning for many years, enabling some delineation of soft tissue as well as radiation attenuation estimation for dose prediction. Magnetic resonance imaging is fast becoming widespread alongside CT, enabling superior soft-tissue visualization. Traditionally scanning for treatment planning has relied on the use of a single snapshot scan. Recent years have seen the development of techniques such as 4D CT and adaptive radiotherapy (ART). In 4D CT raw data are encoded with phase information and reconstructed to yield a set of scans detailing motion through the breathing, or cardiac, cycle. In ART a set of

  14. Benchmarking Academic Anatomic Pathologists: The Association of Pathology Chairs Survey.

    PubMed

    Ducatman, Barbara S; Parslow, Tristram

    2016-01-01

    The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA) or Vizient-AAMC Faculty Practice Solutions Center(®) (FPSC) databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization's methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical "full-time faculty" (0.60 clinical full-time equivalent and above). The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs-reported median work relative value unit productivity

  15. Anatomical considerations on the discomalleolar ligament

    PubMed Central

    RODRÍGUEZ-VÁZQUEZ, J. F.; MÉRIDA-VELASCO, J. R.; MÉRIDA-VELASCO, J. A.; JIMÉNEZ-COLLADO, J.

    1998-01-01

    A study was carried out on the discomalleolar ligament by dissection of adult human cadavers. The ligament corresponds to the most internal portion of the superior lamina of the temporomandibular joint capsule. It extends from the posterointernal portion of the temporomandibular joint disc, penetrates the petrotympanic fissure and reaches the malleus of the middle ear. Because of its morphology and anatomical arrangement the discomalleolar ligament should be considered as an intrinsic ligament of the temporomandibular joint and distinguished from the tympanic portion of the sphenomandibular ligament (anterior ligament of the malleus). PMID:9723988

  16. Jugular foramen: anatomic and computed tomographic study

    SciTech Connect

    Daniels, D.L.; Williams, A.L.; Haughton, V.M.

    1984-01-01

    The computed tomographic (CT) appearance of the jugular foramen was examined in detail, and anatomic and CT sections were correlated. The pars nervosa and pars vascularis were identified, and, with intravenous contrast enhancement, a rapid sequence of scans at a gantry angle of +30/sup 0/ to the canthomeatal line demonstrated cranial nerves IX, X, and XI. The osseous margins of the jugular foramen were best shown by CT at planes of sections parallel and positive (0/sup 0/-30/sup 0/) to the canthomeatal line. CT can be used to evaluate osseous anatomy and the jugular foramen with precision sufficient to confidently exclude an intracanalicular mass.

  17. Reflective journals: unmasking student perceptions of anatomical education.

    PubMed

    Lazarus, L; Sookrajh, R; Satyapal, K S

    2017-01-01

    In medical education, reflection has been considered to be a core skill in professional competence. The anatomy laboratory is an ideal setting for faculty/ student interaction and provides invaluable opportunities for active learning and reflection on anatomical knowledge. This study was designed to record student attitudes regarding human cadaveric dissection, explore their experiences of anatomy through an analysis of their journal-reflective writings and determine whether this type of creative writing had a beneficial effect on those students who chose to complete them. A total of 75 journals from Medical and Allied Health Science students were collected and analysed. Results were categorised according to the following themes: (i) Dissecting room stressors (27.6%); (ii) Educational value of dissection (26.3%); (iii) Appreciation, Gratitude, Respect and Curiosity for the cadaver (18.9%); (iv) Positive and negative sentiments expressed in the dissecting room (25.8%); (v) Benefit of alternate teaching modalities (4.6%); (vi) Spirituality/Religious Beliefs (3.7%); (vii) Shared humanity and emotional bonds (3.69%); (viii) Acknowledgement of human anatomical variations (3.2%); (ix) Beauty and complexity of the human body (1.8%) and (x) Psychological detachment (0.9%). Students appreciated the opportunity to share their emotions and reflect on the humanistic dimension of anatomy as a subject. Student reflections illustrated clearly their thoughts and some of the difficult issues with which they wrestled. The anatomy laboratory is seen as the budding clinician's first encounter with a patient, albeit a cadaver. This was the first time that reflective journals were given to students in the discipline. Reflective journals allow students to express themselves in an open-ended and creative fashion. It also assists students to integrate anatomy and clinical medicine and assists in applying their basic anatomical knowledge in an authentic, yet safe environment.

  18. Anatomical and functional retinal changes in multiple sclerosis

    PubMed Central

    Cennamo, G; Romano, M R; Vecchio, E C; Minervino, C; della Guardia, C; Velotti, N; Carotenuto, A; Montella, S; Orefice, G; Cennamo, G

    2016-01-01

    Aims The aims of this study was to report anatomical changes of the ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) thickness, and macular volume in patients with multiple sclerosis (MS). We also investigated the correlation between anatomical and functional changes in terms of visual acuity and macular sensitivity investigated and visual fields. Methods Prospective comparative study included 105 eyes of 53 consecutive patients. The patients were divided into two groups: group A included 56 eyes of 28 patients with diagnosis of MS; group B involved 49 eyes of 25 healthy patients. The examination included Goldmann tonometry, biomicroscopic and fundus oculi examination, retinography, GCC examination, circumpapillary RNFL (cpRNFL), and macular volume. The functional test included measurement of best-corrected visual acuity (BCVA), visual field, and MP. Results MS group showed a significant reduced GCC, cpRNFL, macular volume, BCVA, visual field, and macular sensitivity compared with the control group (P<0.001). This reduction was more representative (P<0.001) in patients with MS complicated by optic neuritis (ON). We found in the MS group a strong correlation between GCC thickness and macular volume (r2=0.59, P<0.001) and also between GCC and RNFL thickness (r2=0.48, P<0.001). There was also a correlation between macular sensitivity and macular volume reduction (r2=0.25, P<0.001) and also between RNFL and macular volume (r2=0.43, P<0.001). Conclusions The significant statistical evidence and the strong correlation between anatomical and functional parameters support the use of OCT and MP in the evaluation, treatment, and follow-up of patients diagnosed with MS. PMID:26681148

  19. The Anatomical and Functional Organization of the Human Visual Pulvinar.

    PubMed

    Arcaro, Michael J; Pinsk, Mark A; Kastner, Sabine

    2015-07-08

    The pulvinar is the largest nucleus in the primate thalamus and contains extensive, reciprocal connections with visual cortex. Although the anatomical and functional organization of the pulvinar has been extensively studied in old and new world monkeys, little is known about the organization of the human pulvinar. Using high-resolution functional magnetic resonance imaging at 3 T, we identified two visual field maps within the ventral pulvinar, referred to as vPul1 and vPul2. Both maps contain an inversion of contralateral visual space with the upper visual field represented ventrally and the lower visual field represented dorsally. vPul1 and vPul2 border each other at the vertical meridian and share a representation of foveal space with iso-eccentricity lines extending across areal borders. Additional, coarse representations of contralateral visual space were identified within ventral medial and dorsal lateral portions of the pulvinar. Connectivity analyses on functional and diffusion imaging data revealed a strong distinction in thalamocortical connectivity between the dorsal and ventral pulvinar. The two maps in the ventral pulvinar were most strongly connected with early and extrastriate visual areas. Given the shared eccentricity representation and similarity in cortical connectivity, we propose that these two maps form a distinct visual field map cluster and perform related functions. The dorsal pulvinar was most strongly connected with parietal and frontal areas. The functional and anatomical organization observed within the human pulvinar was similar to the organization of the pulvinar in other primate species. The anatomical organization and basic response properties of the visual pulvinar have been extensively studied in nonhuman primates. Yet, relatively little is known about the functional and anatomical organization of the human pulvinar. Using neuroimaging, we found multiple representations of visual space within the ventral human pulvinar and

  20. [Measurement and analysis of anatomical parameter values in tree shrews].

    PubMed

    Li, Bo; Zhang, Rong-Ping; Li, Jin-Tao; He, Bao-Li; Zhen, Hong; Wang, Li-Mei; Jiao, Jian-Lin

    2013-04-01

    Anatomical parameter values in tree shrews are major biological characteristic indicators in laboratory animals. Body size, bones and mammilla, organ weights, coefficient intestinal canal and other anatomical data were measured and analyzed in laboratory domesticated tree shrews (7 to 9 months of age). Measurement of 31 anatomical parameters showed that body height, width of the right ear, ileum and colon had significant differences between males and females (P<0.05). Highly significant differences were also found in body slanting length, chest depth, torso length, left and right forelimb length, right hind limb length, left and right ear length, left ear width, keel bone length, left and right tibia length, duodenum and jejunum (P<0.01). With body length as the dependent variable, and tail length, torso length, right and left forelimb length, and left and right hind limb length as independent variables for stepwise regression analysis, the regression equation for body length = 13.90 + tail length × 0.16. The results of 37 organs weights between female and male tree shrews showed very significant differences (P<0.01) for weight of heart, lungs, spleen, left and right kidney, bladder, left and right hippocampus, left submandibular gland, and left and right thyroid gland, as well as significant (P<0.05) differences in the small intestine, right submandibular gland, and left adrenal gland. The coefficient of heart, lung, stomach, bladder, small and large intestine, brain, right hippocampus, and left adrenal gland showed highly significant differences (P<0.01), while differences in the right kidney, left hippocampus, left submandibular gland, right adrenal gland, and left and right thyroid gland were significant (P<0.05). With animal weight as the dependent variable and indicators of heart, lung, liver, spleen, left and right kidney and brain as independent variables for stepwise regression analysis, the regression equation showed that weight = 62.73 + left kidney

  1. The Anatomical and Functional Organization of the Human Visual Pulvinar

    PubMed Central

    Pinsk, Mark A.; Kastner, Sabine

    2015-01-01

    The pulvinar is the largest nucleus in the primate thalamus and contains extensive, reciprocal connections with visual cortex. Although the anatomical and functional organization of the pulvinar has been extensively studied in old and new world monkeys, little is known about the organization of the human pulvinar. Using high-resolution functional magnetic resonance imaging at 3 T, we identified two visual field maps within the ventral pulvinar, referred to as vPul1 and vPul2. Both maps contain an inversion of contralateral visual space with the upper visual field represented ventrally and the lower visual field represented dorsally. vPul1 and vPul2 border each other at the vertical meridian and share a representation of foveal space with iso-eccentricity lines extending across areal borders. Additional, coarse representations of contralateral visual space were identified within ventral medial and dorsal lateral portions of the pulvinar. Connectivity analyses on functional and diffusion imaging data revealed a strong distinction in thalamocortical connectivity between the dorsal and ventral pulvinar. The two maps in the ventral pulvinar were most strongly connected with early and extrastriate visual areas. Given the shared eccentricity representation and similarity in cortical connectivity, we propose that these two maps form a distinct visual field map cluster and perform related functions. The dorsal pulvinar was most strongly connected with parietal and frontal areas. The functional and anatomical organization observed within the human pulvinar was similar to the organization of the pulvinar in other primate species. SIGNIFICANCE STATEMENT The anatomical organization and basic response properties of the visual pulvinar have been extensively studied in nonhuman primates. Yet, relatively little is known about the functional and anatomical organization of the human pulvinar. Using neuroimaging, we found multiple representations of visual space within the ventral

  2. A multicentre, prospective, randomized, controlled trial comparing EVARREST™ fibrin sealant patch to standard of care in controlling bleeding following elective hepatectomy: anatomic versus non-anatomic resection

    PubMed Central

    Koea, Jonathan B.; Batiller, Jonathan; Aguirre, Nicolas; Shen, Jessica; Kocharian, Richard; Bochicchio, Grant; Garden, O. James

    2016-01-01

    Background This multicentre, randomized clinical trial assessed the safety and effectiveness of the EVARREST™ Fibrin Sealant Patch (FP) in treating parenchymal bleeding following anatomic and non-anatomic liver resections. Methods One hundred and two patients were stratified according to the type of hepatic resection (anatomic/non-anatomic), and randomized (1:1) after identification of an appropriate bleeding site, to FP vs Standard of Care (SoC, manual compression ± topical haemostat). The primary endpoint was haemostasis at 4 min from bleeding site identification with no re-bleeding requiring re-treatment. Results The FP was superior in achieving haemostasis at 4 min (96%, 48/50) to SoC (46%, 24/52; p < 0.001). Stratification for resection type showed treatment differences for primary endpoint for anatomic (24/25 FP vs 13/23 SoC; p = 0.001) and non-anatomic liver resections (24/25FP vs 11/29 SoC; p < 0.001). Adverse events related to the study procedure were reported in 40/50 patients (80%) in the FP group and 43/52 patients (83%) in the SoC group. One (2%) adverse event (infected intra-abdominal fluid collection) was possibly related to study treatment. Conclusion This clinical trial confirms that the FP is safe and highly effective in controlling parenchymal bleeding following hepatectomy regardless of the type of resection. ClinicalTrials.gov NCT01993888. PMID:27017161

  3. Isolated Male Epispadias: Anatomic Functional Restoration Is the Primary Goal

    PubMed Central

    Bruneel, Elke; Ploumidis, Achilles; Van Laecke, Erik; Hoebeke, Piet

    2016-01-01

    Background. Isolated male epispadias (IME) is a rare congenital penile malformation, as often part of bladder-exstrophy-epispadias complex (BEEC). In its isolated presentation, it consists in a defect of the dorsal aspect of the penis, leaving the urethral plate open. Occurrence of urinary incontinence is related to the degree of dorsal displacement of the meatus and the underlying underdevelopment of the urethral sphincter. The technique for primary IME reconstruction, based on anatomic restoration of the urethra and bladder neck, is here illustrated. Patients and Methods. A retrospective database was created with patients who underwent primary IME repair between June 1998 and February 2014. Intraoperative variables, postoperative complications, and outcomes were assessed. A descriptive statistical analysis was performed. Results and Limitations. Eight patients underwent primary repair, with penopubic epispadias (PPE) in 3, penile epispadias (PE) in 2, and glandular epispadias (GE) in 3. Median age at surgery was 13.0 months [7–47]; median follow-up was 52 months [9–120]. Complications requiring further surgery were reported in two patients, while further esthetic surgeries were required in 4 patients. Conclusion. Anatomical restoration in primary IME is safe and effective, with acceptable results given the initial pathology. PMID:27722172

  4. Digital imaging applications in anatomic pathology.

    PubMed

    Leong, F Joel W-M; Leong, Anthony S-Y

    2003-03-01

    Digital imaging has progressed at a rapid rate and is likely to eventually replace chemical photography in most areas of professional and amateur digital image acquisition. In pathology, digital microscopy has implications beyond that of taking a photograph. The arguments for adopting this new medium are compelling, and given similar developments in other areas of pathology and radiologic imaging, acceptance of the digital medium should be viewed as a component of the technological evolution of the laboratory. A digital image may be stored, replicated, catalogued, employed for educational purposes, transmitted for further interpretation (telepathology), analyzed for salient features (medical vision/image analysis), or form part of a wider digital healthcare strategy. Despite advances in digital camera technology, good image acquisition still requires good microscope optics and the correct calibration of all system components, something which many neglect. The future of digital imaging in pathology is very promising and new applications in the fields of automated quantification and interpretation are likely to have profound long-term influence on the practice of anatomic pathology. This paper discusses the state of the art of digital imaging in anatomic pathology.

  5. Arthroscopic Anatomic Glenoid Reconstruction Without Subscapularis Split

    PubMed Central

    Wong, Ivan H.; Urquhart, Nathan

    2015-01-01

    The role of bone loss from the anterior glenoid in recurrent shoulder instability has been well established. We present a completely arthroscopic technique for reconstructing the anterior glenoid with distal tibial allograft and without a subscapularis split. We perform the arthroscopy in the lateral position. We measure and size an allograft distal tibial graft and place it arthroscopically. We use an inside-out medial portal to introduce the graft into the shoulder, passing it through the rotator interval and above the subscapularis. A double-cannula system is used to pass the graft, which is temporarily fixed with K-wires and held in place with cannulated screws. We then perform a Bankart-like repair of the soft tissues to balance the shoulder and augment our repair. Our technique is not only anatomic in the re-creation of the glenoid surface but also anatomic in the preservation of the coracoid and subscapularis tendon and repair of the capsulolabral complex. PMID:26697303

  6. Anatomical and molecular imaging of skin cancer

    PubMed Central

    Hong, Hao; Sun, Jiangtao; Cai, Weibo

    2008-01-01

    Skin cancer is the most common form of cancer types. It is generally divided into two categories: melanoma (∼ 5%) and nonmelanoma (∼ 95%), which can be further categorized into basal cell carcinoma, squamous cell carcinoma, and some rare skin cancer types. Biopsy is still the gold standard for skin cancer evaluation in the clinic. Various anatomical imaging techniques have been used to evaluate different types of skin cancer lesions, including laser scanning confocal microscopy, optical coherence tomography, high-frequency ultrasound, terahertz pulsed imaging, magnetic resonance imaging, and some other recently developed techniques such as photoacoustic microscopy. However, anatomical imaging alone may not be sufficient in guiding skin cancer diagnosis and therapy. Over the last decade, various molecular imaging techniques (in particular single photon emission computed tomography and positron emission tomography) have been investigated for skin cancer imaging. The pathways or molecular targets that have been studied include glucose metabolism, integrin αvβ3, melanocortin-1 receptor, high molecular weight melanoma-associated antigen, and several other molecular markers. Preclinical molecular imaging is thriving all over the world, while clinical molecular imaging has not lived up to the expectations because of slow bench-to-bedside translation. It is likely that this situation will change in the near future and molecular imaging will truly play an important role in personalized medicine of melanoma patients. PMID:21437135

  7. Anatomic Optical Coherence Tomography of Upper Airways

    NASA Astrophysics Data System (ADS)

    Chin Loy, Anthony; Jing, Joseph; Zhang, Jun; Wang, Yong; Elghobashi, Said; Chen, Zhongping; Wong, Brian J. F.

    The upper airway is a complex and intricate system responsible for respiration, phonation, and deglutition. Obstruction of the upper airways afflicts an estimated 12-18 million Americans. Pharyngeal size and shape are important factors in the pathogenesis of airway obstructions. In addition, nocturnal loss in pharyngeal muscular tone combined with high pharyngeal resistance can lead to collapse of the airway and periodic partial or complete upper airway obstruction. Anatomical optical coherence tomography (OCT) has the potential to provide high-speed three-dimensional tomographic images of the airway lumen without the use of ionizing radiation. In this chapter we describe the methods behind endoscopic OCT imaging and processing to generate full three dimensional anatomical models of the human airway which can be used in conjunction with numerical simulation methods to assess areas of airway obstruction. Combining this structural information with flow dynamic simulations, we can better estimate the site and causes of airway obstruction and better select and design surgery for patients with obstructive sleep apnea.

  8. Anatomical Modularity of Verbal Working Memory? Functional Anatomical Evidence from a Famous Patient with Short-Term Memory Deficits

    PubMed Central

    Paulesu, Eraldo; Shallice, Tim; Danelli, Laura; Sberna, Maurizio; Frackowiak, Richard S. J.; Frith, Chris D.

    2017-01-01

    Cognitive skills are the emergent property of distributed neural networks. The distributed nature of these networks does not necessarily imply a lack of specialization of the individual brain structures involved. However, it remains questionable whether discrete aspects of high-level behavior might be the result of localized brain activity of individual nodes within such networks. The phonological loop of working memory, with its simplicity, seems ideally suited for testing this possibility. Central to the development of the phonological loop model has been the description of patients with focal lesions and specific deficits. As much as the detailed description of their behavior has served to refine the phonological loop model, a classical anatomoclinical correlation approach with such cases falls short in telling whether the observed behavior is based on the functions of a neural system resembling that seen in normal subjects challenged with phonological loop tasks or whether different systems have taken over. This is a crucial issue for the cross correlation of normal cognition, normal physiology, and cognitive neuropsychology. Here we describe the functional anatomical patterns of JB, a historical patient originally described by Warrington et al. (1971), a patient with a left temporo-parietal lesion and selective short phonological store deficit. JB was studied with the H215O PET activation technique during a rhyming task, which primarily depends on the rehearsal system of the phonological loop. No residual function was observed in the left temporo-parietal junction, a region previously associated with the phonological buffer of working memory. However, Broca's area, the major counterpart of the rehearsal system, was the major site of activation during the rhyming task. Specific and autonomous activation of Broca's area in the absence of afferent inputs from the other major anatomical component of the phonological loop shows that a certain degree of functional

  9. Comparison of in vitro flows past a mechanical heart valve in anatomical and axisymmetric aorta models

    NASA Astrophysics Data System (ADS)

    Haya, Laura; Tavoularis, Stavros

    2017-06-01

    Flow characteristics past a bileaflet mechanical heart valve were measured under physiological flow conditions in a straight tube with an axisymmetric expansion, similar to vessels used in previous studies, and in an anatomical model of the aorta. We found that anatomical features, including the three-lobed sinus and the aorta's curvature affected significantly the flow characteristics. The turbulent and viscous stresses were presented and discussed as indicators for potential blood damage and thrombosis. Both types of stresses, averaged over the two axial measurement planes, were significantly lower in the anatomical model than in the axisymmetric one. This difference was attributed to the lower height-to-width ratio and more gradual contraction of the anatomical aortic sinus. The curvature of the aorta caused asymmetries in the velocity and stress distributions during forward flow. Secondary flows resulting from the aorta's curvature are thought to have redistributed the fluid stresses transversely, resulting in a more homogeneous stress distribution in the anatomical aortic root than in the axisymmetric root. The results of this study demonstrate the importance of modelling accurately the aortic geometry in experimental and computational studies of prosthetic devices. Moreover, our findings suggest that grafts used for aortic root replacement should approximate as closely as possible the shape of the natural sinuses.

  10. Comparison of femur tunnel aperture location in patients undergoing transtibial and anatomical single-bundle anterior cruciate ligament reconstruction.

    PubMed

    Lee, Dae-Hee; Kim, Hyun-Jung; Ahn, Hyeong-Sik; Bin, Seong-Il

    2016-12-01

    Although three-dimensional computed tomography (3D-CT) has been used to compare femoral tunnel position following transtibial and anatomical anterior cruciate ligament (ACL) reconstruction, no consensus has been reached on which technique results in a more anatomical position because methods of quantifying femoral tunnel position on 3D-CT have not been consistent. This meta-analysis was therefore performed to compare femoral tunnel location following transtibial and anatomical ACL reconstruction, in both the low-to-high and deep-to-shallow directions. This meta-analysis included all studies that used 3D-CT to compare femoral tunnel location, using quadrant or anatomical coordinate axis methods, following transtibial and anatomical (AM portal or OI) single-bundle ACL reconstruction. Six studies were included in the meta-analysis. Femoral tunnel location was 18 % higher in the low-to-high direction, but was not significant in the deep-to-shallow direction, using the transtibial technique than the anatomical methods, when measured using the anatomical coordinate axis method. When measured using the quadrant method, however, femoral tunnel positions were significantly higher (21 %) and shallower (6 %) with transtibial than anatomical methods of ACL reconstruction. The anatomical ACL reconstruction techniques led to a lower femoral tunnel aperture location than the transtibial technique, suggesting the superiority of anatomical techniques for creating new femoral tunnels during revision ACL reconstruction in femoral tunnel aperture location in the low-to-high direction. However, the mean difference in the deep-to-shallow direction differed by method of measurement. Meta-analysis, Level II.

  11. Comparison of outcome after anatomic double-bundle and antero-medial portal non-anatomic single-bundle reconstruction in ACL-injured patients.

    PubMed

    Karikis, Ioannis; Ahldén, Mattias; Casut, Abraham; Sernert, Ninni; Kartus, Jüri

    2017-04-01

    The aim of this study was to compare anatomic double-bundle anterior cruciate ligament reconstruction with non-anatomic single-bundle reconstruction. In a prospective consecutive series, 94 unselected patients [45 anatomic double-bundle (ADB) and 49 non-anatomic single-bundle (SB)] underwent ACL reconstruction involving hamstring tendon autograft, interference screw fixation on both the femoral and tibial side and drilling the femoral tunnel(s) through the antero-medial portal in both groups. In the ADB group, the remnants of the ACL were identified and the grafts were placed anatomically. In the SB group, traditional placement of the graft was performed in a less anatomic manner. Pre-operatively, the groups were comparable in terms of age, gender, time between injury and operation and associated injuries. One independent physiotherapist performed all the pre-operative and post-operative assessments. The follow-up period was 26 (22-34) and 24 (23-30) months in the ADB and SB groups, respectively (p = 0.005). At follow-up, 78 % in the ADB group and 74 % in the SB group had a negative pivot-shift test (n.s.). The KT-1000 134N measurements were 2 (-5 to 10.5) and 2 (-4 to 7) mm in the ADB and SB groups, respectively (n.s.). At follow-up, the extension deficit was significantly larger in the ADB group than in the SB group (p = 0.001). The Tegner activity scale was significantly higher in the ADB group both pre-operatively and at follow-up (p = 0.03 and p = 0.004). In overall terms, both groups had improved significantly at the two-year follow-up. In an unselected group of ACL-injured patients, anatomic double-bundle reconstruction did not result in better rotational or antero-posterior stability measurements than antero-medial portal non-anatomic single-bundle reconstruction at the two-year follow-up. III.

  12. Using 3D modeling techniques to enhance teaching of difficult anatomical concepts

    PubMed Central

    Pujol, Sonia; Baldwin, Michael; Nassiri, Joshua; Kikinis, Ron; Shaffer, Kitt

    2016-01-01

    Rationale and Objectives Anatomy is an essential component of medical education as it is critical for the accurate diagnosis in organs and human systems. The mental representation of the shape and organization of different anatomical structures is a crucial step in the learning process. The purpose of this pilot study is to demonstrate the feasibility and benefits of developing innovative teaching modules for anatomy education of first-year medical students based on 3D reconstructions from actual patient data. Materials and Methods A total of 196 models of anatomical structures from 16 anonymized CT datasets were generated using the 3D Slicer open-source software platform. The models focused on three anatomical areas: the mediastinum, the upper abdomen and the pelvis. Online optional quizzes were offered to first-year medical students to assess their comprehension in the areas of interest. Specific tasks were designed for students to complete using the 3D models. Results Scores of the quizzes confirmed a lack of understanding of 3D spatial relationships of anatomical structures despite standard instruction including dissection. Written task material and qualitative review by students suggested that interaction with 3D models led to a better understanding of the shape and spatial relationships among structures, and helped illustrate anatomical variations from one body to another. Conclusion The study demonstrates the feasibility of one possible approach to the generation of 3D models of the anatomy from actual patient data. The educational materials developed have the potential to supplement the teaching of complex anatomical regions and help demonstrate the anatomic variation among patients. PMID:26897601

  13. Reconstruction of the medial patellofemoral ligament using the adductor magnus tendon: an anatomic study.

    PubMed

    Jacobi, Matthias; Reischl, Nikolaus; Bergmann, Mathias; Bouaicha, Samy; Djonov, Valentin; Magnussen, Robert A

    2012-01-01

    The aims of this study were to evaluate the anatomic feasibility of medial patellofemoral ligament (MPFL) reconstruction using a part of the adductor magnus tendon and to identify possible risks. Twenty cadaveric knees were dissected. The distal part of the adductor magnus tendon was evaluated with respect to the anatomic topography and its utility for MPFL reconstruction. To estimate the risk of injuring the neurovascular structures, the distance from the adductor tubercle to the adductor hiatus was evaluated. An MPFL reconstruction was carried out by preserving the distal insertion on the adductor tubercle and redirecting the proximal portion of the tendon to the medial aspect of the patella. The anatomic investigation showed the following relationships: The mean distance from the adductor tubercle to the adductor hiatus was 99 ± 14 mm (range, 80 to 120 mm). A graft length of 52 ± 5 mm (range, 45 to 63 mm) with the addition of 10 to 20 mm for fixation was found to be necessary for MPFL reconstruction. The difference between the desired graft length and the distance to the adductor hiatus was found to be at least 30 mm in all cases (mean, 46 mm). Leaving the graft attached to the adductor tubercle resulted in a nearly anatomic femoral attachment of the reconstructed MPFL. Complete detachment of the distal adductor magnus attachment was consistently avoidable. The adductor magnus tendon was found to be a useful graft for MPFL reconstruction. However, anatomic dangers (damage to the neurovascular bundle of the adductor hiatus, the saphenous nerve, or the saphenous branch of the descending genicular artery) during graft harvest must be considered. Anatomic knowledge is essential during adductor magnus tendon harvest to avoid damage to neurovascular structures. The adductor magnus tendon is an interesting alternative graft option for MPFL reconstruction if anatomic dangers are considered and avoided. Copyright © 2012 Arthroscopy Association of North America

  14. Grafting the alar rim: application as anatomical graft.

    PubMed

    Gruber, Ronald P; Fox, Paige; Peled, Anne; Belek, Kyle A

    2014-12-01

    Alar rim contour and alar rim grafts have become essential components of rhinoplasty. Ideally, grafts of the nose should be anatomical in shape. So doing might make grafts of the alar rim more robust. The authors considered doing that by applying the graft as a continuous extension of the lateral crus. Twelve patients (two men and 10 women) constituted the study group (seven primary and five secondary cases). Of those, there were five concave rims, two concave rims with rim retraction, two boxy tips, and three cephalically oriented lateral crura. Surgical technique included the following: (1) an open approach was used; (2) a marginal incision that ignored the caudal margin of the lateral crus (the incision went straight posteriorly to a point 5 to 6 mm from the rim margin) was used; (3) a triangular graft was made to cover the exposed vestibular skin; (4) it was secured end to end to the caudal border of the lateral crus; and (5) the poster end was allowed to sit in a small subcutaneous pocket. Follow-up was 11 to 19 months. All 12 patients exhibited good rims as judged by a blinded panel. Rim retraction was not fully corrected in one patient, but no further treatment was required. One patient did require a secondary small rim graft for residual rim concavity. The concept of grafting the alar rim is strongly supported by the authors' results. The modifications the authors applied by designing the graft to be anatomical in shape has been a technical help.

  15. Tubular surface segmentation for extracting anatomical structures from medical imagery.

    PubMed

    Mohan, Vandana; Sundaramoorthi, Ganesh; Tannenbaum, Allen

    2010-12-01

    This work provides a model for tubular structures, and devises an algorithm to automatically extract tubular anatomical structures from medical imagery. Our model fits many anatomical structures in medical imagery, in particular, various fiber bundles in the brain (imaged through diffusion-weighted magnetic resonance (DW-MRI)) such as the cingulum bundle, and blood vessel trees in computed tomography angiograms (CTAs). Extraction of the cingulum bundle is of interest because of possible ties to schizophrenia, and extracting blood vessels is helpful in the diagnosis of cardiovascular diseases. The tubular model we propose has advantages over many existing approaches in literature: fewer degrees-of-freedom over a general deformable surface hence energies defined on such tubes are less sensitive to undesirable local minima, and the tube (in 3-D) can be naturally represented by a 4-D curve (a radius function and centerline), which leads to computationally less costly algorithms and has the advantage that the centerline of the tube is obtained without additional effort. Our model also generalizes to tubular trees, and the extraction algorithm that we design automatically detects and evolves branches of the tree. We demonstrate the performance of our algorithm on 20 datasets of DW-MRI data and 32 datasets of CTA, and quantify the results of our algorithm when expert segmentations are available.

  16. Anatomic patterning in the expression of vestibulosympathetic reflexes

    NASA Technical Reports Server (NTRS)

    Kerman, I. A.; Yates, B. J.; McAllen, R. M.

    2000-01-01

    To investigate the possibility that expression of vestibulosympathetic reflexes (VSR) is related to a nerve's anatomic location rather than its target organ, we compared VSR recorded from the same type of postganglionic fiber [muscle vasoconstrictor (MVC)] located at three different rostrocaudal levels: hindlimb, forelimb, and face. Experiments were performed on chloralose-anesthetized cats, and vestibular afferents were stimulated electrically. Single MVC unit activity was extracted by spike shape analysis of few-fiber recordings, and unit discrimination was confirmed by autocorrelation. Poststimulus time histogram analysis revealed that about half of the neurons were initially inhibited by vestibular stimulation (type 1 response), whereas the other MVC fibers were initially strongly excited (type 2 response). MVC units with types 1 and 2 responses were present in the same nerve fascicle. Barosensitivity was equivalent in the two groups, but fibers showing type 1 responses fired significantly faster than those giving type 2 responses (0.29 +/- 0.04 vs. 0.20 +/- 0.02 Hz). Nerve fibers with type 1 responses were most common in the hindlimb (21 of 29 units) and least common in the face (2 of 11 units), the difference in relative proportion being significant (P < 0.05, chi(2) test). These results support the hypothesis that VSR are anatomically patterned.

  17. Anatomic patterning in the expression of vestibulosympathetic reflexes

    NASA Technical Reports Server (NTRS)

    Kerman, I. A.; Yates, B. J.; McAllen, R. M.

    2000-01-01

    To investigate the possibility that expression of vestibulosympathetic reflexes (VSR) is related to a nerve's anatomic location rather than its target organ, we compared VSR recorded from the same type of postganglionic fiber [muscle vasoconstrictor (MVC)] located at three different rostrocaudal levels: hindlimb, forelimb, and face. Experiments were performed on chloralose-anesthetized cats, and vestibular afferents were stimulated electrically. Single MVC unit activity was extracted by spike shape analysis of few-fiber recordings, and unit discrimination was confirmed by autocorrelation. Poststimulus time histogram analysis revealed that about half of the neurons were initially inhibited by vestibular stimulation (type 1 response), whereas the other MVC fibers were initially strongly excited (type 2 response). MVC units with types 1 and 2 responses were present in the same nerve fascicle. Barosensitivity was equivalent in the two groups, but fibers showing type 1 responses fired significantly faster than those giving type 2 responses (0.29 +/- 0.04 vs. 0.20 +/- 0.02 Hz). Nerve fibers with type 1 responses were most common in the hindlimb (21 of 29 units) and least common in the face (2 of 11 units), the difference in relative proportion being significant (P < 0.05, chi(2) test). These results support the hypothesis that VSR are anatomically patterned.

  18. Zinc deficiency affects physiological and anatomical characteristics in maize leaves.

    PubMed

    Mattiello, Edson M; Ruiz, Hugo A; Neves, Julio C L; Ventrella, Marília C; Araújo, Wagner L

    2015-07-01

    Zinc (Zn) is an essential microelement involved in several plant physiological processes. Therefore, it is important to identify Zn deficiencies promptly--before extensive damage occurs to the plant. The diagnostic tools that are used to identify Zn deficiencies are very important in areas where Zn deficiencies occur. Such diagnostic tools are vital for nutritional management and fertilizer recommendations. The current study investigated the effects of Zn deficiency on maize plants by recording a number of physiological and anatomical parameters. A Zn omission trial (from 0 to 22 days) was carried out to produce plants that had varying degrees of Zn deficiency. Typical symptoms of Zn deficiency (e.g. chlorotic stripes and purple shades on the edges and leaf sheath) appeared 16 days after the omission of Zn from nutrient solutions. As the time of Zn omission increased, there were significant decreases in net photosynthesis, stomatal conductance, maximal efficiency of photosystem I (evaluated by Fv/Fm), biomass (dry weight) and Zn concentrations in plants. Zinc-deficient plants also had a lower vascular bundle proportion coupled with a higher stomata density. These physiological and anatomical changes negatively impacted plant growth. Moreover, they occurred before visible symptoms of Zn deficiency were observed. Zinc concentrations were recorded for younger leaves, rather than for more mature leaves, which is usually recommended for plant analysis. The results demonstrate that the analysis of Zn in young leaves of maize is a very sensitive indicator of Zn status. Copyright © 2015 Elsevier GmbH. All rights reserved.

  19. Functional Connectivity Patterns of Visual Cortex Reflect its Anatomical Organization.

    PubMed

    Genç, Erhan; Schölvinck, Marieke Louise; Bergmann, Johanna; Singer, Wolf; Kohler, Axel

    2016-09-01

    The brain is continuously active, even without external input or task demands. This so-called resting-state activity exhibits a highly specific spatio-temporal organization. However, how exactly these activity patterns map onto the anatomical and functional architecture of the brain is still unclear. We addressed this question in the human visual cortex. We determined the representation of the visual field in visual cortical areas of 44 subjects using fMRI and examined resting-state correlations between these areas along the visual hierarchy, their dorsal and ventral segments, and between subregions representing foveal versus peripheral parts of the visual field. We found that retinotopically corresponding regions, particularly those representing peripheral visual fields, exhibit strong correlations. V1 displayed strong internal correlations between its dorsal and ventral segments and the highest correlation with LGN compared with other visual areas. In contrast, V2 and V3 showed weaker correlations with LGN and stronger between-area correlations, as well as with V4 and hMT+. Interhemispheric correlations between homologous areas were especially strong. These correlation patterns were robust over time and only marginally altered under task conditions. These results indicate that resting-state fMRI activity closely reflects the anatomical organization of the visual cortex both with respect to retinotopy and hierarchy.

  20. Anatomical and functional characteristics of carotid sinus stimulation in humans

    NASA Technical Reports Server (NTRS)

    Querry, R. G.; Smith, S. A.; Stromstad, M.; Ide, K.; Secher, N. H.; Raven, P. B.

    2001-01-01

    Transmission characteristics of pneumatic pressure to the carotid sinus were evaluated in 19 subjects at rest and during exercise. Either a percutaneous fluid-filled (n = 12) or balloon-tipped catheter (n = 7) was placed at the carotid bifurcation to record internal transmission of external neck pressure/neck suction (NP/NS). Sustained, 5-s pulses, and rapid ramping pulse protocols (+40 to -80 Torr) were recorded. Transmission of pressure stimuli was less with the fluid-filled catheter compared with that of the balloon-tipped catheter (65% vs. 82% negative pressure, 83% vs. 89% positive pressure; P < 0.05). Anatomical location of the carotid sinus averaged 3.2 cm (left) and 3.6 cm (right) from the gonion of the mandible with a range of 0-7.5 cm. Transmission was not altered by exercise or Valsalva maneuver, but did vary depending on the position of the carotid sinus locus beneath the sealed chamber. These data indicate that transmission of external NP/NS was higher than previously recorded in humans, and anatomical variation of carotid sinus location and equipment design can affect transmission results.

  1. Identifying anatomical shape difference by regularized discriminative direction.

    PubMed

    Zhou, Luping; Hartley, Richard; Wang, Lei; Lieby, Paulette; Barnes, Nick

    2009-06-01

    Identifying the shape difference between two groups of anatomical objects is important for medical image analysis and computer-aided diagnosis. A method called "discriminative direction" in the literature has been proposed to solve this problem. In that method, the shape difference between groups is identified by deforming a shape along the discriminative direction. This paper conducts a thorough study about inferring this discriminative direction in an efficient and accurate way. First, finding the discriminative direction is reformulated as a preimage problem in kernel-based learning. This provides a complementary but conceptually simpler solution than the previous method. More importantly, we find that a shape deforming along the original discriminative direction cannot faithfully maintain its anatomical correctness. This unnecessarily introduces spurious shape differences and leads to inaccurate analysis. To overcome this problem, this paper further proposes a regularized discriminative direction by requiring a shape to conform to its underlying distribution when it deforms. Two different approaches are developed to impose the regularization, one from the perspective of probability distributions and the other from a geometric point of view, and their relationship is discussed. After verifying their superior performance through controlled experiments, we apply the proposed methods to detecting and localizing the hippocampal shape difference between sexes. We get results consistent with other independent research, providing a more compact representation of the shape difference compared with the established discriminative direction method.

  2. Tubular Surface Segmentation for Extracting Anatomical Structures From Medical Imagery

    PubMed Central

    Sundaramoorthi, Ganesh; Tannenbaum, Allen

    2011-01-01

    This work provides a model for tubular structures, and devises an algorithm to automatically extract tubular anatomical structures from medical imagery. Our model fits many anatomical structures in medical imagery, in particular, various fiber bundles in the brain (imaged through diffusion-weighted magnetic resonance (DW-MRI)) such as the cingulum bundle, and blood vessel trees in computed tomography angiograms (CTAs). Extraction of the cingulum bundle is of interest because of possible ties to schizophrenia, and extracting blood vessels is helpful in the diagnosis of cardiovascular diseases. The tubular model we propose has advantages over many existing approaches in literature: fewer degrees-of-freedom over a general deformable surface hence energies defined on such tubes are less sensitive to undesirable local minima, and the tube (in 3-D) can be naturally represented by a 4-D curve (a radius function and centerline), which leads to computationally less costly algorithms and has the advantage that the centerline of the tube is obtained without additional effort. Our model also generalizes to tubular trees, and the extraction algorithm that we design automatically detects and evolves branches of the tree. We demonstrate the performance of our algorithm on 20 datasets of DW-MRI data and 32 datasets of CTA, and quantify the results of our algorithm when expert segmentations are available. PMID:21118754

  3. Anatomical and functional characteristics of carotid sinus stimulation in humans

    NASA Technical Reports Server (NTRS)

    Querry, R. G.; Smith, S. A.; Stromstad, M.; Ide, K.; Secher, N. H.; Raven, P. B.

    2001-01-01

    Transmission characteristics of pneumatic pressure to the carotid sinus were evaluated in 19 subjects at rest and during exercise. Either a percutaneous fluid-filled (n = 12) or balloon-tipped catheter (n = 7) was placed at the carotid bifurcation to record internal transmission of external neck pressure/neck suction (NP/NS). Sustained, 5-s pulses, and rapid ramping pulse protocols (+40 to -80 Torr) were recorded. Transmission of pressure stimuli was less with the fluid-filled catheter compared with that of the balloon-tipped catheter (65% vs. 82% negative pressure, 83% vs. 89% positive pressure; P < 0.05). Anatomical location of the carotid sinus averaged 3.2 cm (left) and 3.6 cm (right) from the gonion of the mandible with a range of 0-7.5 cm. Transmission was not altered by exercise or Valsalva maneuver, but did vary depending on the position of the carotid sinus locus beneath the sealed chamber. These data indicate that transmission of external NP/NS was higher than previously recorded in humans, and anatomical variation of carotid sinus location and equipment design can affect transmission results.

  4. Generating Facial Expressions Using an Anatomically Accurate Biomechanical Model.

    PubMed

    Wu, Tim; Hung, Alice; Mithraratne, Kumar

    2014-11-01

    This paper presents a computational framework for modelling the biomechanics of human facial expressions. A detailed high-order (Cubic-Hermite) finite element model of the human head was constructed using anatomical data segmented from magnetic resonance images. The model includes a superficial soft-tissue continuum consisting of skin, the subcutaneous layer and the superficial Musculo-Aponeurotic system. Embedded within this continuum mesh, are 20 pairs of facial muscles which drive facial expressions. These muscles were treated as transversely-isotropic and their anatomical geometries and fibre orientations were accurately depicted. In order to capture the relative composition of muscles and fat, material heterogeneity was also introduced into the model. Complex contact interactions between the lips, eyelids, and between superficial soft tissue continuum and deep rigid skeletal bones were also computed. In addition, this paper investigates the impact of incorporating material heterogeneity and contact interactions, which are often neglected in similar studies. Four facial expressions were simulated using the developed model and the results were compared with surface data obtained from a 3D structured-light scanner. Predicted expressions showed good agreement with the experimental data.

  5. Anatomical-based segmentation with stenosis bridging and gap closing in atherosclerotic cardiac MSCT

    NASA Astrophysics Data System (ADS)

    Merges, Reto D.; Rinck, Daniel; Sühling, Michael; Dössel, Olaf; Scheuering, Michael

    2006-03-01

    In the diagnosis of coronary artery disease, 3D-multi-slice computed tomography (MSCT) has recently become more and more important. In this work, an anatomical-based method for the segmentation of atherosclerotic coronary arteries in MSCT is presented. This technique is able to bridge severe stenosis, image artifacts or even full vessel occlusions. Different anatomical structures (aorta, blood-pool of the heart chambers, coronary arteries and their orifices) are detected successively to incorporate anatomical knowledge into the algorithm. The coronary arteries are segmented by a simulated wave propagation method to be able to extract anatomically spatial relations from the result. In order to bridge segmentation breaks caused by stenosis or image artifacts, the spatial location, its anatomical relation and vessel curvature-propagation are taken into account to span a dynamic search space for vessel bridging and gap closing. This allows the prevention of vessel misidentifications and improves segmentation results significantly. The robustness of this method is proven on representative medical data sets.

  6. Anatomical image-guided fluorescence molecular tomography reconstruction using kernel method

    NASA Astrophysics Data System (ADS)

    Baikejiang, Reheman; Zhao, Yue; Fite, Brett Z.; Ferrara, Katherine W.; Li, Changqing

    2017-05-01

    Fluorescence molecular tomography (FMT) is an important in vivo imaging modality to visualize physiological and pathological processes in small animals. However, FMT reconstruction is ill-posed and ill-conditioned due to strong optical scattering in deep tissues, which results in poor spatial resolution. It is well known that FMT image quality can be improved substantially by applying the structural guidance in the FMT reconstruction. An approach to introducing anatomical information into the FMT reconstruction is presented using the kernel method. In contrast to conventional methods that incorporate anatomical information with a Laplacian-type regularization matrix, the proposed method introduces the anatomical guidance into the projection model of FMT. The primary advantage of the proposed method is that it does not require segmentation of targets in the anatomical images. Numerical simulations and phantom experiments have been performed to demonstrate the proposed approach's feasibility. Numerical simulation results indicate that the proposed kernel method can separate two FMT targets with an edge-to-edge distance of 1 mm and is robust to false-positive guidance and inhomogeneity in the anatomical image. For the phantom experiments with two FMT targets, the kernel method has reconstructed both targets successfully, which further validates the proposed kernel method.

  7. Anatomical aspects of sinus floor elevations.

    PubMed

    van den Bergh, J P; ten Bruggenkate, C M; Disch, F J; Tuinzing, D B

    2000-06-01

    Inadequate bone height in the lateral part of the maxilla forms a contra-indication for implant surgery. This condition can be treated with an internal augmentation of the maxillary sinus floor. This sinus floor elevation, formerly called sinus lifting, consists of a surgical procedure in which a top hinge door in the lateral maxillary sinus wall is prepared and internally rotated to a horizontal position. The new elevated sinus floor, together with the inner maxillary mucosa, will create a space that can be filled with graft material. Sinus lift procedures depend greatly on fragile structures and anatomical variations. The variety of anatomical modalities in shape of the inner aspect of the maxillary sinus defines the surgical approach. Conditions such as sinus floor convolutions, sinus septum, transient mucosa swelling and narrow sinus may form a (usually relative) contra-indication for sinus floor elevation. Absolute contra-indications are maxillary sinus diseases (tumors) and destructive former sinus surgery (like the Caldwell-Luc operation). The lateral sinus wall is usually a thin bone plate, which is easily penetrated with rotating or sharp instruments. The fragile Schneiderian membrane plays an important role for the containment of the bonegraft. The surgical procedure of preparing the trap door and luxating it, together with the preparation of the sinus mucosa, may cause a mucosa tear. Usually, when these perforations are not too large, they will fold together when turning the trap door inward and upward, or they can be glued with a fibrin sealant, or they can be covered with a resorbable membrane. If the perforation is too large, a cortico-spongious block graft can be considered. However, in most cases the sinus floor elevation will be deleted. Perforations may also occur due to irregularities in the sinus floor or even due to immediate contact of sinus mucosa with oral mucosa. Obstruction of the antro-nasal foramen is, due to its high location, not a

  8. Fleck, anatomical drawings and early modern history.

    PubMed

    Lowy, Ilana

    2008-01-01

    In 2003, the historian of medicine Michael Stolberg, contested the argument--developed by Thomas Laqueur and Londa Schiebinger--that in the XVIII century, anatomists shifted from a one-sex to a two-sexes model. Laqueur and Schiebinger linked the new focus on anatomical differences between the sexes to the rise of egalitarian aspirations during the Enlightenment, and a consecutive need to ground male domination in invariable "laws of nature". Stolberg claimed that the shift to the two sexes model occurred in the early modern period, and was mainly motivated by developments within medicine. This article examines the 2003 debate on the origin of "two sexes" model in the light of a 1939 controversy that opposed the historian of medicine Tadeusz Bilikiewicz, who advocated a focus on a "spirit" of an earlier epoch, and the pioneer of sociology of science Ludwik Fleck, who promoted the study of the "thought styles" of specific scientific communities.

  9. Ballistics and anatomical modelling - A review.

    PubMed

    Humphrey, Caitlin; Kumaratilake, Jaliya

    2016-11-01

    Ballistics is the study of a projectiles motion and can be broken down into four stages: internal, intermediate, external and terminal ballistics. The study of the effects a projectile has on a living tissue is referred to as wound ballistics and falls within terminal ballistics. To understand the effects a projectile has on living tissues the mechanisms of wounding need to be understood. These include the permanent and temporary cavities, energy, yawing, tumbling and fragmenting. Much ballistics research has been conducted including using cadavers, animal models and simulants such as ballistics ordnance gelatine. Further research is being conducted into developing anatomical, 3D, experimental and computational models. However, these models need to accurately represent the human body and its heterogeneous nature which involves understanding the biomechanical properties of the different tissues and organs. Further research is needed to accurately represent the human tissues with simulants and is slowly being conducted. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Bidirectional mereological reasoning in anatomical knowledge bases.

    PubMed Central

    Schulz, S.

    2001-01-01

    Mereological relationships--relationships between parts and wholes--are essential for ontological engineering in the anatomical domain. We propose a knowledge engineering approach that emulates mereological reasoning by taxonomic reasoning based on SEP triplets, a special data structure for the encoding of part-whole relations, which is fully embedded in the formal framework of standard description logics. We extend the SEP formalism in order to account not only for the part-of but also for the has-part relation, both being considered transitive in our domain. Furthermore we analyze the distinction between the ontological primitives singletons, collections and mass concepts in the anatomy domain and sketch how reasoning about these kinds of concepts can be accounted for in a knowledge representation language, using the extended SEP formalism. PMID:11825258

  11. Anatomical basis of central venous catheter fracture.

    PubMed

    Jensen, Mark O

    2008-03-01

    Central venous catheter fracture is a rare complication of long-term indwelling subclavian venous access. Subclavian vein access has been the recommended approach for placing central venous catheters. The anatomical landmark method for subclavian access remains a highly successful and nonequipment-dependent method for rapid central access. More recently, the internal jugular vein approach has emerged as the preferred route for long-term central venous access. However, variations in internal jugular vein anatomy make the landmark method less reliable. Use of two-dimensional real-time ultrasound during internal jugular vein access is associated with better success, a lower complication rate, and faster access. A case of central venous catheter fracture initiated an internal review of long-term central venous access procedures. We have converted to a predominantly internal jugular vein approach. This case report and literature review may assist other physicians and institutions in re-evaluating long-term central venous access protocols.

  12. Anatomic Brain Asymmetry in Vervet Monkeys

    PubMed Central

    Fears, Scott C.; Scheibel, Kevin; Abaryan, Zvart; Lee, Chris; Service, Susan K.; Jorgensen, Matthew J.; Fairbanks, Lynn A.; Cantor, Rita M.; Freimer, Nelson B.; Woods, Roger P.

    2011-01-01

    Asymmetry is a prominent feature of human brains with important functional consequences. Many asymmetric traits show population bias, but little is known about the genetic and environmental sources contributing to inter-individual variance. Anatomic asymmetry has been observed in Old World monkeys, but the evidence for the direction and extent of asymmetry is equivocal and only one study has estimated the genetic contributions to inter-individual variance. In this study we characterize a range of qualitative and quantitative asymmetry measures in structural brain MRIs acquired from an extended pedigree of Old World vervet monkeys (n = 357), and implement variance component methods to estimate the proportion of trait variance attributable to genetic and environmental sources. Four of six asymmetry measures show pedigree-level bias and one of the traits has a significant heritability estimate of about 30%. We also found that environmental variables more significantly influence the width of the right compared to the left prefrontal lobe. PMID:22205941

  13. Anatomic brain asymmetry in vervet monkeys.

    PubMed

    Fears, Scott C; Scheibel, Kevin; Abaryan, Zvart; Lee, Chris; Service, Susan K; Jorgensen, Matthew J; Fairbanks, Lynn A; Cantor, Rita M; Freimer, Nelson B; Woods, Roger P

    2011-01-01

    Asymmetry is a prominent feature of human brains with important functional consequences. Many asymmetric traits show population bias, but little is known about the genetic and environmental sources contributing to inter-individual variance. Anatomic asymmetry has been observed in Old World monkeys, but the evidence for the direction and extent of asymmetry is equivocal and only one study has estimated the genetic contributions to inter-individual variance. In this study we characterize a range of qualitative and quantitative asymmetry measures in structural brain MRIs acquired from an extended pedigree of Old World vervet monkeys (n = 357), and implement variance component methods to estimate the proportion of trait variance attributable to genetic and environmental sources. Four of six asymmetry measures show pedigree-level bias and one of the traits has a significant heritability estimate of about 30%. We also found that environmental variables more significantly influence the width of the right compared to the left prefrontal lobe.

  14. MRI anatomical variants of mammillary bodies.

    PubMed

    Tagliamonte, Micaela; Sestieri, Carlo; Romani, Gian Luca; Gallucci, Massimo; Caulo, Massimo

    2015-01-01

    The mammillary bodies (MBs) are classically defined as a pair of small round structures located on the undersurface of the diencephalon. The systematic observation of MR brain images of patients with neurological diseases, but also of healthy subjects enrolled in research protocols, reveals, however, a greater anatomical variability. The aim of the present study was to define the spectrum of such variability using spatial normalized 3D TFE T1-weighted MR images in a group of 151 healthy right-handed young subjects (78 females, age range 16-39 years). The MBs were identified on reformatted coronal and axial images and classified according to morphological, positional and numerical criteria. On the basis of coronal images, MBs were first divided into symmetrical (86.1 %) and asymmetrical (13.9 %), depending on their respective height. Symmetrical MBs were further subdivided into three variants [type A (2.7 %), B (76.2 %), C (7.3 %)] according to the depth of the intermammillary sulcus. Two morphological variants were defined on axial images, depending on whether the MBs were circular (63.6 %) or elliptic (36.4 %). This latter group was further divided in two subgroups, depending on whether the MBs were parallel (21.9 %) or convergent (14.6 %). Finally, two subjects (1.3 %) presented a supernumeral MB. The transverse size of the third ventricle was greater in the type A compared to the type B and C groups. Gender did not significantly affect the frequency of MBs variants, except for the three symmetrical subgroups in which the variants A and C were more frequent in males than in females. These findings suggest the presence of an anatomical variability of the MBs, in contrast to their classical definition. Therefore, atypical presentation of MBs can be the expression of this variability rather than a marker of neurological disorders (i.e. cerebral malformation, mesial temporal sclerosis, Wernicke-Korsakoff syndrome).

  15. How spatial abilities and dynamic visualizations interplay when learning functional anatomy with 3D anatomical models.

    PubMed

    Berney, Sandra; Bétrancourt, Mireille; Molinari, Gaëlle; Hoyek, Nady

    2015-01-01

    The emergence of dynamic visualizations of three-dimensional (3D) models in anatomy curricula may be an adequate solution for spatial difficulties encountered with traditional static learning, as they provide direct visualization of change throughout the viewpoints. However, little research has explored the interplay between learning material presentation formats, spatial abilities, and anatomical tasks. First, to understand the cognitive challenges a novice learner would be faced with when first exposed to 3D anatomical content, a six-step cognitive task analysis was developed. Following this, an experimental study was conducted to explore how presentation formats (dynamic vs. static visualizations) support learning of functional anatomy, and affect subsequent anatomical tasks derived from the cognitive task analysis. A second aim was to investigate the interplay between spatial abilities (spatial visualization and spatial relation) and presentation formats when the functional anatomy of a 3D scapula and the associated shoulder flexion movement are learned. Findings showed no main effect of the presentation formats on performances, but revealed the predictive influence of spatial visualization and spatial relation abilities on performance. However, an interesting interaction between presentation formats and spatial relation ability for a specific anatomical task was found. This result highlighted the influence of presentation formats when spatial abilities are involved as well as the differentiated influence of spatial abilities on anatomical tasks. © 2015 American Association of Anatomists.

  16. An automated method to position prosthetic components within multiple anatomical spaces.

    PubMed

    Viceconti, Marco; Testi, Debora; Simeoni, Monica; Zannoni, Cinzia

    2003-02-01

    The level of fit and fill of a stem in the host femur is the most critical factor for the mechanical stability and success of the prosthesis. It would be useful to have a simulation tool able to investigate the anatomical compatibility of a new implant in a large library of femoral anatomies in the early phases of the design process. In order to realise this tool, it is necessary to develop an automatic method for the positioning of the stem in a database of anatomies. The aim of this study was to develop and evaluate a method for the automatic positioning of the stem geometry in the anatomical CT dataset. Two different strategies were considered: a completely automatic registration technique and a semi-automatic method based on an anatomical referencing. The two procedures were compared to the manual positioning obtained by an expert surgeon in a set of nine CT datasets. For both methods in each femur the positioning and the orientation of the stem were good. The results showed a better level of fitting for the automatic method, while the shift of the hip joint centre was lower for the anatomical referencing technique. However, the anatomical referencing method requires a higher computational effort without being significantly better than the automatic method. For this reason, the automatic method should be chosen to develop the automatic positioning of a stem in a database of anatomies.

  17. Anatomical sciences: A foundation for a solid learning experience in dental technology and dental prosthetics.

    PubMed

    Bakr, Mahmoud M; Thompson, C Mark; Massadiq, Magdalena

    2016-09-01

    Basic science courses are extremely important as a foundation for scaffolding knowledge and then applying it in future courses, clinical situations as well as in a professional career. Anatomical sciences, which include tooth morphology, oral histology, oral embryology, and head and neck anatomy form a core part of the preclinical courses in dental technology programs. In this article, the importance and relevance of anatomical sciences to dental personnel with no direct contact with patients (dental technicians) and limited discipline related contact with patients (dental prosthetists) is highlighted. Some light is shed on the role of anatomical sciences in the pedagogical framework and its significance in the educational process and interprofessional learning of dental technicians and prosthetists using oral biology as an example in the dental curriculum. To conclude, anatomical sciences allow dental technicians and prosthetists to a gain a better insight of how tissues function, leading to a better understanding of diagnosis, comprehensive treatment planning and referrals if needed. Patient communication and satisfaction also increases as a result of this deep understanding of oral tissues. Anatomical sciences bridge the gap between basic science, preclinical, and clinical courses, which leads to a holistic approach in patient management. Finally, treatment outcomes are positively affected due to the appreciation of the macro and micro structure of oral tissues. Anat Sci Educ. © 2016 American Association of Anatomists.

  18. [Anatomic variations and references of the sphenopalatine foramen in cadaveric specimens: a Mexican study].

    PubMed

    Morales-Cadena, Mauricio; González-Juárez, Fernando; Tapia-Álvarez, Liliana; Fernando-Macías Valle, Luis

    2014-01-01

    The sphenopalatine foramen is located on the lateral nasal wall and has multiple variants and anatomic landmarks that are important to know to optimize RESULTS in the surgical management of posterior epistaxis. This study describes the endoscopic anatomy of the sphenopalatine foramen, related structures and anatomic variations in a Mexican population. We performed a prospective, observational, and experimental study. Five cadaveric specimens were included. Dissections were performed to identify the anatomy of the sphenopalatine foramen and anatomic variants. Measurements were obtained from different anatomic references to the columella. Of a total of ten dissections, in 100% of cases ethmoid crests were identified anterior to the sphenopalatine foramen. Localization of the sphenopalatine foramen in the lateral nasal wall in 60% cases was in the transition from middle meatus with superior meatus. The vidian nerve in 90% of cases was located superior and posterior to the sphenopalatine foramen. For the measurements, no significant differences between the two sides of each specimen were noticed. The sphenopalatine foramen presents multiple anatomic variants and numerous landmarks, which are important to comprehend in order to perform a successful and safe endoscopic sinus surgery.

  19. Qualitative comparison of anatomical microdissection, Sihler's staining and computerized reconstruction methods for visualizing intramuscular nerve branches.

    PubMed

    Gülekon, Nadir; Peker, Tuncay; Turgut, Hasan Basri; Anil, Afitap; Karaköse, Mustafa

    2007-07-01

    STATING BACKGROUND: This study was designed to examine the entire intramuscular nerve distribution pattern of various human skeletal muscles in fetuses. In the present study rhomboid major, trapezius, long head of the biceps femoris and masseter muscles were investigated in five 18 weeks old fetal cadavers. Anatomical microdissection was applied to one fetal cadaver. In two fetuses, the extramuscular (main), major and minor nerve branches, and anastomosis were examined using Sihler's staining and labeling. In the remaining two fetuses, consecutive slices with 0.5 mm interval and 5 microm thickness were obtained from each skeletal muscle. These slices were stained with S100 for the demonstration of the nerve fibers and thereafter 3D reconstruction images were constituted using PC software. Anatomical microdissection, Sihler's staining and computerized reconstruction methods were compared to demonstrate the intramuscular nerve distribution pattern. Demonstration of the intramuscular minor nerve branches and anastomosis showed difficulties in anatomical dissected specimens when compared with three-dimensionally reconstructed images and specimens obtained with Sihler's staining technique. Nevertheless, anatomical dissection is a simple method whereas Sihler's technique and computer aided 3D reconstruction are complex methods and take a long time to complete. The obtained information exposed that staining technique and the 3D reconstructions appeared to provide better results than did anatomical dissection.

  20. Passive vs. active virtual reality learning: the effects on short- and long-term memory of anatomical structures.

    PubMed

    Phelps, Andrew; Fritchle, Alicia; Hoffman, Helene

    2004-01-01

    This pilot study compares the differences in learning outcomes when students are presented with either an active (student-centered) or passive (teacher-centered) virtual reality-based anatomy lesson. The "active" lesson used UCSD's Anatomic VisualizeR and enabled students to interact with 3D models and control presentation of learning materials. The "passive" lesson used a digital recording of an anatomical expert's tour of the same VR lesson played back as a QuickTime movie. Subsequent examination of the recall and retention of the studied anatomic objects were comparable in both groups. Issues underlying these results are discussed.

  1. Variation in Stem Anatomical Characteristics of Campanuloideae Species in Relation to Evolutionary History and Ecological Preferences

    PubMed Central

    Schweingruber, Fritz Hans; Říha, Pavel; Doležal, Jiří

    2014-01-01

    Background The detailed knowledge of plant anatomical characters and their variation among closely related taxa is key to understanding their evolution and function. We examined anatomical variation in 46 herbaceous taxa from the subfamily Campanuloideae (Campanulaceae) to link this information with their phylogeny, ecology and comparative material of 56 woody tropical taxa from the subfamily Lobelioideae. The species studied covered major environmental gradients from Mediterranean to Arctic zones, allowing us to test hypotheses on the evolution of anatomical structure in relation to plant competitive ability and ecological preferences. Methodology/Principal Findings To understand the evolution of anatomical diversity, we reconstructed the phylogeny of studied species from nucleotide sequences and examined the distribution of anatomical characters on the resulting phylogenetic tree. Redundancy analysis, with phylogenetic corrections, was used to separate the evolutionary inertia from the adaptation to the environment. A large anatomical diversity exists within the Campanuloideae. Traits connected with the quality of fibres were the most congruent with phylogeny, and the Rapunculus 2 (“phyteumoid”) clade was especially distinguished by a number of characters (absence of fibres, pervasive parenchyma, type of rays) from two other clades (Campanula s. str. and Rapunculus 1) characterized by the dominance of fibres and the absence of parenchyma. Septate fibres are an exclusive trait in the Lobelioideae, separating it clearly from the Campanuloideae where annual rings, pervasive parenchyma and crystals in the phellem are characteristic features. Conclusions/Significance Despite clear phylogenetic inertia in the anatomical features studied, the ecological attributes and plant height had a significant effect on anatomical divergence. From all three evolutionary clades, the taller species converged towards similar anatomical structure, characterized by a smaller number

  2. Pure Laparoscopic Liver Resection for Malignant Liver Tumor: Anatomic Resection Versus Nonanatomic Resection

    PubMed Central

    Chen, Ya-Xi; Xiu, Dian-Rong; Yuan, Chun-Hui; Jiang, Bin; Ma, Zhao-Lai

    2016-01-01

    Background: Laparoscopic liver resection (LLR) has been considered to be safe and feasible. However, few studies focused on the comparison between the anatomic and nonanatomic LLR. Therefore, the purpose of this study was to compare the perioperative factors and outcomes of the anatomic and nonanatomic LLR, especially the area of liver parenchymal transection and blood loss per unit area. Methods: In this study, surgical and oncological data of patients underwent pure LLR procedures for malignant liver tumor were prospectively collected. Blood loss per unit area of liver parenchymal transection was measured and considered as an important parameter. All procedures were conducted by a single surgeon. Results: During nearly 5 years, 84 patients with malignant liver tumor received a pure LLR procedure were included. Among them, 34 patients received anatomic LLR and 50 received nonanatomic LLR, respectively. Patients of the two groups were similar in terms of demographic features and tumor characteristics, despite the tumor size was significantly larger in the anatomic LLR group than that in the nonanatomic LLR group (4.77 ± 2.57 vs. 2.87 ± 2.10 cm, P = 0.001). Patients who underwent anatomic resection had longer operation time (364.09 ± 131.22 vs. 252.00 ± 135.21 min, P < 0.001) but less blood loss per unit area (7.85 ± 7.17 vs. 14.17 ± 10.43 ml/cm2, P = 0.018). Nonanatomic LLR was associated with more blood loss when the area of parenchymal transection was equal to the anatomic LLR. No mortality occurred during the hospital stay and 30 days after the operation. Moreover, there was no difference in the incidence of postoperative complications. The disease-free and overall survival rates showed no significant differences between the anatomic LLR and nonanatomic LLR groups. Conclusions: Both anatomic and nonanatomic pure LLR are safe and feasible. Measuring the area of parenchymal transection is a simple and effective method to estimate the outcomes of the liver

  3. Identifying Mismatches in Alignments of Large Anatomical Ontologies

    PubMed Central

    Zhang, Songmao; Bodenreider, Olivier

    2007-01-01

    Objective: The objective of this study is to propose a model of matching errors for identifying mismatches in alignments of large anatomical ontologies. Methods: Three approaches to identifying mismatches are utilized: 1) lexical, based on the presence of modifiers in the names of the concepts aligned; 2) structural, identifying conflicting relations resulting from the alignment; and 3) semantic, based on disjoint top-level categories across ontologies. Results: 83% of the potential mismatches identified by the HMatch system are identified by at least one of the approaches. Conclusions: Although not a substitute for a careful validation of the matches, these approaches significantly reduce the need for manual validation by effectively characterizing most mismatches. PMID:18693957

  4. Can the Misinterpretation Amendment Rate Be Used as a Measure of Interpretive Error in Anatomic Pathology?: Implications of a Survey of the Directors of Anatomic and Surgical Pathology.

    PubMed

    Parkash, Vinita; Fadare, Oluwole; Dewar, Rajan; Nakhleh, Raouf; Cooper, Kumarasen

    2017-03-01

    A repeat survey of the Association of the Directors of Anatomic and Surgical Pathology, done 10 years after the original was used to assess trends and variability in classifying scenarios as errors, and the preferred post signout report modification for correcting error by the membership of the Association of the Directors of Anatomic and Surgical Pathology. The results were analyzed to inform on whether interpretive amendment rates might act as surrogate measures of interpretive error in pathology. An analyses of the responses indicated that primary level misinterpretations (benign to malignant and vice versa) were universally qualified as error; secondary-level misinterpretations or misclassifications were inconsistently labeled error. There was added variability in the preferred post signout report modification used to correct report alterations. The classification of a scenario as error appeared to correlate with severity of potential harm of the missed call, the perceived subjectivity of the diagnosis, and ambiguity of reporting terminology. Substantial differences in policies for error detection and optimal reporting format were documented between departments. In conclusion, the inconsistency in labeling scenarios as error, disagreement about the optimal post signout report modification for the correction of the error, and variability in error detection policies preclude the use of the misinterpretation amendment rate as a surrogate measure for error in anatomic pathology. There is little change in uniformity of definition, attitudes and perception of interpretive error in anatomic pathology in the last 10 years.

  5. [Historical development of modern anatomical education in Japan].

    PubMed

    Sakai, Tatsuo

    2008-12-01

    The medical schools in the beginning of Meiji era were diverse both in the founders and in the way of education, frequently employing foreign teachers of various nationalities. In 1871, German teachers were appointed to organized medical education at the medical school of the university of Tokyo. The anatomical education in the school was conducted by German teachers, i.e. Miller (1871-1873), Dönitz (1873-1877), Gierke (1877-1880) and Disse (1880-1885), followed by Koganei who returned from the study in Germany. In 1882 (Meiji 15th), the general rule for medical school was enforced so that the medical schools were practically obliged to employ numbers of graduates of the university of Tokyo. In 1887 (Meiji 20th), the educational system was reformed so that many of the medical schools were closed, and the medical schools were integrated into one university, five national senior high schools and three prefectural ones in addition to four private ones. After that most of anatomical teachers were either graduates of the university of Tokyo or those who studied in the anatomical department of the university. Before 1877 (Meiji 10th), the anatomical books were mainly translated from English books, and foreign teachers of various nationality were employed in many medical schools in Japan. After 1877 (Meiji 10th), the anatomical books based on the lectures by German teachers at the university of Tokyo were published. The anatomical books after 1887 (Meiji 20th) were written based on German books, and the German anatomical terms were utilized. After 1905 (Meiji 38th), the original Japanese anatomical books appeared, employing international anatomical terms. At the first meeting of Japanese Association of Anatomists in 1893 (Meiji 26th), the Japanese anatomical teachers met together and most of them were graduates of the university of Tokyo or fellows of its anatomical department.

  6. Recent advances in standards for Collaborative Digital Anatomic Pathology.

    PubMed

    Daniel, Christel; Macary, François; Rojo, Marcial García; Klossa, Jacques; Laurinavičius, Arvydas; Beckwith, Bruce A; Della Mea, Vincenzo

    2011-03-30

    Collaborative Digital Anatomic Pathology refers to the use of information technology that supports the creation and sharing or exchange of information, including data and images, during the complex workflow performed in an Anatomic Pathology department from specimen reception to report transmission and exploitation. Collaborative Digital Anatomic Pathology can only be fully achieved using medical informatics standards. The goal of the international integrating the Healthcare Enterprise (IHE) initiative is precisely specifying how medical informatics standards should be implemented to meet specific health care needs and making systems integration more efficient and less expensive. To define the best use of medical informatics standards in order to share and exchange machine-readable structured reports and their evidences (including whole slide images) within hospitals and across healthcare facilities. Specific working groups dedicated to Anatomy Pathology within multiple standards organizations defined standard-based data structures for Anatomic Pathology reports and images as well as informatic transactions in order to integrate Anatomic Pathology information into the electronic healthcare enterprise. The DICOM supplements 122 and 145 provide flexible object information definitions dedicated respectively to specimen description and Whole Slide Image acquisition, storage and display. The content profile "Anatomic Pathology Structured Report" (APSR) provides standard templates for structured reports in which textual observations may be bound to digital images or regions of interest. Anatomic Pathology observations are encoded using an international controlled vocabulary defined by the IHE Anatomic Pathology domain that is currently being mapped to SNOMED CT concepts. Recent advances in standards for Collaborative Digital Anatomic Pathology are a unique opportunity to share or exchange Anatomic Pathology structured reports that are interoperable at an international

  7. Anatomic Basis for Brachial Plexus Block at the Costoclavicular Space: A Cadaver Anatomic Study.

    PubMed

    Sala-Blanch, Xavier; Reina, Miguel Angel; Pangthipampai, Pawinee; Karmakar, Manoj Kumar

    2016-01-01

    The costoclavicular space (CCS), which is located deep and posterior to the midpoint of the clavicle, may be a better site for infraclavicular brachial plexus block than the traditional lateral paracoracoid site. However, currently, there is paucity of data on the anatomy of the brachial plexus at the CCS. We undertook this cadaver anatomic study to define the anatomy of the cords of the brachial plexus at the CCS and thereby establish the anatomic basis for ultrasound-guided infraclavicular brachial plexus block at this proximal site. The anatomy and topography of the cords of the brachial plexus at the CCS was evaluated in 8 unembalmed (cryopreserved), thawed, fresh adult human cadavers using anatomic dissection, and transverse anatomic and histological sections, of the CCS. The cords of the brachial plexus were located lateral and parallel to the axillary artery at the CCS. The topography of the cords, relative to the axillary artery and to one another, in the transverse (axial) plane was also consistent at the CCS. The lateral cord was the most superficial of the 3 cords and it was always anterior to both the medial and posterior cords. The medial cord was directly posterior to the lateral cord but medial to the posterior cord. The posterior cord was the lateral most of the 3 cords at the CCS and it was immediately lateral to the medial cord but posterolateral to the lateral cord. The cords of the brachial plexus are clustered together lateral to the axillary artery, and share a consistent relation relative to one another and to the axillary artery, at the CCS.

  8. Parametric Anatomical Modeling: a method for modeling the anatomical layout of neurons and their projections

    PubMed Central

    Pyka, Martin; Klatt, Sebastian; Cheng, Sen

    2014-01-01

    Computational models of neural networks can be based on a variety of different parameters. These parameters include, for example, the 3d shape of neuron layers, the neurons' spatial projection patterns, spiking dynamics and neurotransmitter systems. While many well-developed approaches are available to model, for example, the spiking dynamics, there is a lack of approaches for modeling the anatomical layout of neurons and their projections. We present a new method, called Parametric Anatomical Modeling (PAM), to fill this gap. PAM can be used to derive network connectivities and conduction delays from anatomical data, such as the position and shape of the neuronal layers and the dendritic and axonal projection patterns. Within the PAM framework, several mapping techniques between layers can account for a large variety of connection properties between pre- and post-synaptic neuron layers. PAM is implemented as a Python tool and integrated in the 3d modeling software Blender. We demonstrate on a 3d model of the hippocampal formation how PAM can help reveal complex properties of the synaptic connectivity and conduction delays, properties that might be relevant to uncover the function of the hippocampus. Based on these analyses, two experimentally testable predictions arose: (i) the number of neurons and the spread of connections is heterogeneously distributed across the main anatomical axes, (ii) the distribution of connection lengths in CA3-CA1 differ qualitatively from those between DG-CA3 and CA3-CA3. Models created by PAM can also serve as an educational tool to visualize the 3d connectivity of brain regions. The low-dimensional, but yet biologically plausible, parameter space renders PAM suitable to analyse allometric and evolutionary factors in networks and to model the complexity of real networks with comparatively little effort. PMID:25309338

  9. Parametric Anatomical Modeling: a method for modeling the anatomical layout of neurons and their projections.

    PubMed

    Pyka, Martin; Klatt, Sebastian; Cheng, Sen

    2014-01-01

    Computational models of neural networks can be based on a variety of different parameters. These parameters include, for example, the 3d shape of neuron layers, the neurons' spatial projection patterns, spiking dynamics and neurotransmitter systems. While many well-developed approaches are available to model, for example, the spiking dynamics, there is a lack of approaches for modeling the anatomical layout of neurons and their projections. We present a new method, called Parametric Anatomical Modeling (PAM), to fill this gap. PAM can be used to derive network connectivities and conduction delays from anatomical data, such as the position and shape of the neuronal layers and the dendritic and axonal projection patterns. Within the PAM framework, several mapping techniques between layers can account for a large variety of connection properties between pre- and post-synaptic neuron layers. PAM is implemented as a Python tool and integrated in the 3d modeling software Blender. We demonstrate on a 3d model of the hippocampal formation how PAM can help reveal complex properties of the synaptic connectivity and conduction delays, properties that might be relevant to uncover the function of the hippocampus. Based on these analyses, two experimentally testable predictions arose: (i) the number of neurons and the spread of connections is heterogeneously distributed across the main anatomical axes, (ii) the distribution of connection lengths in CA3-CA1 differ qualitatively from those between DG-CA3 and CA3-CA3. Models created by PAM can also serve as an educational tool to visualize the 3d connectivity of brain regions. The low-dimensional, but yet biologically plausible, parameter space renders PAM suitable to analyse allometric and evolutionary factors in networks and to model the complexity of real networks with comparatively little effort.

  10. A probabilistic framework to infer brain functional connectivity from anatomical connections.

    PubMed

    Deligianni, Fani; Varoquaux, Gael; Thirion, Bertrand; Robinson, Emma; Sharp, David J; Edwards, A David; Rueckert, Daniel

    2011-01-01

    We present a novel probabilistic framework to learn across several subjects a mapping from brain anatomical connectivity to functional connectivity, i.e. the covariance structure of brain activity. This prediction problem must be formulated as a structured-output learning task, as the predicted parameters are strongly correlated. We introduce a model selection framework based on cross-validation with a parametrization-independent loss function suitable to the manifold of covariance matrices. Our model is based on constraining the conditional independence structure of functional activity by the anatomical connectivity. Subsequently, we learn a linear predictor of a stationary multivariate autoregressive model. This natural parameterization of functional connectivity also enforces the positive-definiteness of the predicted covariance and thus matches the structure of the output space. Our results show that functional connectivity can be explained by anatomical connectivity on a rigorous statistical basis, and that a proper model of functional connectivity is essential to assess this link.

  11. Anatomical Connections of the Functionally Defined "Face Patches" in the Macaque Monkey.

    PubMed

    Grimaldi, Piercesare; Saleem, Kadharbatcha S; Tsao, Doris

    2016-06-15

    The neural circuits underlying face recognition provide a model for understanding visual object representation, social cognition, and hierarchical information processing. A fundamental piece of information lacking to date is the detailed anatomical connections of the face patches. Here, we injected retrograde tracers into four different face patches (PL, ML, AL, AM) to characterize their anatomical connectivity. We found that the patches are strongly and specifically connected to each other, and individual patches receive inputs from extrastriate cortex, the medial temporal lobe, and three subcortical structures (the pulvinar, claustrum, and amygdala). Inputs from prefrontal cortex were surprisingly weak. Patches were densely interconnected to one another in both feedforward and feedback directions, inconsistent with a serial hierarchy. These results provide the first direct anatomical evidence that the face patches constitute a highly specialized system and suggest that subcortical regions may play a vital role in routing face-related information to subsequent processing stages.

  12. Anatomical and physiological responses of Colorado blue spruce to vehicle exhausts.

    PubMed

    Qin, Xuebo; Sun, Nan; Ma, Lixin; Chang, Yingqiao; Mu, Liqiang

    2014-09-01

    In order to examine whether the leaves of the Colorado blue spruce (Picea pungens) are damaged or not by traffic pollution, the traits of the anatomy and physiology of its leaves are investigated by exposure to vehicle exhausts in a laboratory experiment lasting 30 days. The results show that both the anatomical structures and physiological traits of the leaves are significantly affected by vehicle exhausts. The anatomical structures, including epidermis, cuticle, palisade, and spongy parenchyma are modified when exposed to the high concentrations (≥ 0.4 mg/m(3)) of vehicle exhausts. However, physiological traits such as total chlorophyll content are not changed when exposed to different concentrations of vehicle exhaust. Unlike the total chlorophyll content, the electrical conductivities increased, whereas the POD activities decreased when presented in vehicle exhausts. The present study indicates that the Colorado blue spruce changes its anatomical structures and physiological traits to avoid possible damage by vehicle exhausts.

  13. The semantic anatomical network: Evidence from healthy and brain-damaged patient populations.

    PubMed

    Fang, Yuxing; Han, Zaizhu; Zhong, Suyu; Gong, Gaolang; Song, Luping; Liu, Fangsong; Huang, Ruiwang; Du, Xiaoxia; Sun, Rong; Wang, Qiang; He, Yong; Bi, Yanchao

    2015-09-01

    Semantic processing is central to cognition and is supported by widely distributed gray matter (GM) regions and white matter (WM) tracts. The exact manner in which GM regions are anatomically connected to process semantics remains unknown. We mapped the semantic anatomical network (connectome) by conducting diffusion imaging tractography in 48 healthy participants across 90 GM "nodes," and correlating the integrity of each obtained WM edge and semantic performance across 80 brain-damaged patients. Fifty-three WM edges were obtained whose lower integrity associated with semantic deficits and together with their linked GM nodes constitute a semantic WM network. Graph analyses of this network revealed three structurally segregated modules that point to distinct semantic processing components and identified network hubs and connectors that are central in the communication across the subnetworks. Together, our results provide an anatomical framework of human semantic network, advancing the understanding of the structural substrates supporting semantic processing.

  14. Anatomical connections of the functionally-defined “face patches” in the macaque monkey

    PubMed Central

    Saleem, Kadharbatcha S.

    2017-01-01

    The neural circuits underlying face recognition provide a model for understanding visual object representation, social cognition, and hierarchical information processing. A fundamental piece of information lacking to date is the detailed anatomical connections of the face patches. Here, we injected retrograde tracers into four different face patches (PL, ML, AL, AM) to characterize their anatomical connectivity. We found that the patches are strongly and specifically connected to each other, and individual patches receive inputs from extrastriate cortex, the medial temporal lobe, and three subcortical structures (the pulvinar, claustrum, and amygdala). Inputs from prefrontal cortex were surprisingly weak. Patches were densely interconnected to one another in both feedforward and feedback directions, inconsistent with a serial hierarchy. These results provide the first direct anatomical evidence that the face patches constitute a highly specialized system, and suggest that subcortical regions may play a vital role in routing face-related information to subsequent processing stages. PMID:27263973

  15. Anatomical Basis of Dynamic Modulation of Tympanic Tension in the Water Monitor Lizard, Varanus salvator.

    PubMed

    Han, Dawei; Young, Bruce A

    2016-09-01

    Amphibious vertebrates, such as the water monitor (Varanus salvator), require anatomical and/or neural specializations to cope with pressure changes on the tympanic membrane when transiting between air and water. V. salvator has internally coupled ears which are distinguished by (patent) anatomical conduits through the skull linking the middle ear cavities on both sides of the head. We describe a small skeletal muscle in V. salvator which inserts onto the middle ear ossicle and the tympanic membrane. Laser doppler vibrometry demonstrates that contraction of this muscle both increases the vibrational velocity of the tympanic membrane and changes the waveform pattern of the tympanic displacement. The combined anatomical and functional results suggest that V. salvator is capable of actively modulating the tension of the tympanic membrane. Anat Rec, 299:1270-1280, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. SU-C-207B-02: Maximal Noise Reduction Filter with Anatomical Structures Preservation

    SciTech Connect

    Maitree, R; Guzman, G; Chundury, A; Roach, M; Yang, D

    2016-06-15

    Purpose: All medical images contain noise, which can result in an undesirable appearance and can reduce the visibility of anatomical details. There are varieties of techniques utilized to reduce noise such as increasing the image acquisition time and using post-processing noise reduction algorithms. However, these techniques are increasing the imaging time and cost or reducing tissue contrast and effective spatial resolution which are useful diagnosis information. The three main focuses in this study are: 1) to develop a novel approach that can adaptively and maximally reduce noise while preserving valuable details of anatomical structures, 2) to evaluate the effectiveness of available noise reduction algorithms in comparison to the proposed algorithm, and 3) to demonstrate that the proposed noise reduction approach can be used clinically. Methods: To achieve a maximal noise reduction without destroying the anatomical details, the proposed approach automatically estimated the local image noise strength levels and detected the anatomical structures, i.e. tissue boundaries. Such information was used to adaptively adjust strength of the noise reduction filter. The proposed algorithm was tested on 34 repeating swine head datasets and 54 patients MRI and CT images. The performance was quantitatively evaluated by image quality metrics and manually validated for clinical usages by two radiation oncologists and one radiologist. Results: Qualitative measurements on repeated swine head images demonstrated that the proposed algorithm efficiently removed noise while preserving the structures and tissues boundaries. In comparisons, the proposed algorithm obtained competitive noise reduction performance and outperformed other filters in preserving anatomical structures. Assessments from the manual validation indicate that the proposed noise reduction algorithm is quite adequate for some clinical usages. Conclusion: According to both clinical evaluation (human expert ranking) and

  17. A Channelized Hotelling Observer Study of Lesion Detection in SPECT MAP Reconstruction Using Anatomical Priors

    PubMed Central

    Kulkarni, S.; Khurd, P.; Hsiao, I.; Zhou, L.; Gindi, G.

    2010-01-01

    In emission tomography, anatomical side information, in the form of organ and lesion boundaries, derived from intra-patient coregistered CT or MR scans can be incorporated into the reconstruction. Our interest is in exploring the efficacy of such side information for lesion detectability. To assess detectability we used the SNR of a channelized Hotelling observer and a signal-known exactly/background known exactly detection task. In simulation studies we incorporated anatomical side information into a SPECT MAP (maximum a posteriori) reconstruction by smoothing within but not across organ or lesion boundaries. A non-anatomical prior was applied by uniform smoothing across the entire image. We investigated whether the use of anatomical priors with organ boundaries alone or with perfect lesion boundaries alone would change lesion detectability relative to the case of a prior with no anatomical information. Furthermore, we investigated whether any such detectability changes for the organ-boundary case would be a function of the distance of the lesion to the organ boundary. We also investigated whether any detectability changes for the lesion-boundary case would be a function of the degree of proximity, i.e. a difference in the radius of the true functional lesion and the radius of the anatomical lesion boundary. Our results showed almost no detectability difference with vs without organ boundaries at any lesion-to-organ boundary distance. Our results also showed no difference in lesion detectability with and without lesion boundaries, and no variation of lesion detectability with degree of proximity. PMID:17664562

  18. A biomechanical comparison of conventional versus an anatomic plate and compression bolts for fixation of intra-articular calcaneal fractures.

    PubMed

    Wang, Haili; Yang, Zhaoxu; Wu, Zhanpo; Chen, Wei; Zhang, Qi; Li, Ming; Li, Zhiyong; Zhang, Yingze

    2012-08-01

    The purpose of this study was to compare the biomechanical stability obtained by using our technique featured an anatomical plate and compression bolts versus that of the conventional anatomic plate and cancellous screws in the fixation of intraarticular calcaneal fractures. Eighteen fresh frozen lower limbs of cadavers were used to create a reproductive Sanders type-III calcaneal fracture model by using osteotomy. The calcaneus fractures were randomly selected to be fixed either using our anatomical plate and compression bolts or conventional anatomic plate and cancellous screws. Reduction of fracture was evaluated through X radiographs. Each calcaneus was successively loaded at a frequency of 1 Hz for 1000 cycles through the talus using an increasing axial force 20 N to 200 N and 20 N to 700 N, representing the partial weight bearing and full weight bearing, respectively, and then the specimens were loaded to failure. Data extracted from the mechanical testing machine were recorded and used to test for difference in the results with the Wilcoxon signed rank test. No significant difference was found between our fixation technique and conventional technique in displacement during 20-200 N cyclic loading (P=0.06), while the anatomical plate and compression bolts showed a great lower irreversible deformation during 20-700 N cyclic loading (P=0.008). The load achieved at loss of fixation of the constructs for the two groups had significant difference: anatomic plate and compression bolts at 3839.6±152.4 N and anatomic plate and cancellous screws at 3087.3±58.9 N (P=0.008). There was no significant difference between the ultimate displacements. Our technique featured anatomical plate and compression bolts for calcaneus fracture fixation was demonstrated to provide biomechanical stability as good as or better than the conventional anatomic plate and cancellous screws under the axial loading. The study supports the mechanical viability of using our plate and

  19. Complex vestibular macular anatomical relationships need a synthetic approach

    NASA Technical Reports Server (NTRS)

    Ross, M. D.

    2001-01-01

    Mammalian vestibular maculae are anatomically organized for complex parallel processing of linear acceleration information. Anatomical findings in rat maculae are provided in order to underscore this complexity, which is little understood functionally. This report emphasizes that a synthetic approach is critical to understanding how maculae function and the kind of information they conduct to the brain.

  20. 16 CFR Figure 1 to Part 1203 - Anatomical Planes

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Anatomical Planes 1 Figure 1 to Part 1203 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR BICYCLE HELMETS Pt. 1203, Fig. 1 Figure 1 to Part 1203—Anatomical Planes ER10MR98.001...

  1. 16 CFR Figure 1 to Part 1203 - Anatomical Planes

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Anatomical Planes 1 Figure 1 to Part 1203 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR BICYCLE HELMETS Pt. 1203, Fig. 1 Figure 1 to Part 1203—Anatomical Planes ER10MR98.001...

  2. 16 CFR Figure 1 to Part 1203 - Anatomical Planes

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Anatomical Planes 1 Figure 1 to Part 1203 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR BICYCLE HELMETS Pt. 1203, Fig. 1 Figure 1 to Part 1203—Anatomical Planes ER10MR98.001...

  3. 16 CFR Figure 1 to Part 1203 - Anatomical Planes

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Anatomical Planes 1 Figure 1 to Part 1203 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR BICYCLE HELMETS Pt. 1203, Fig. 1 Figure 1 to Part 1203—Anatomical Planes ER10MR98.001...

  4. 16 CFR Figure 1 to Part 1203 - Anatomical Planes

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Anatomical Planes 1 Figure 1 to Part 1203 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR BICYCLE HELMETS Pt. 1203, Fig. 1 Figure 1 to Part 1203—Anatomical Planes ER10MR98.001...

  5. Complex vestibular macular anatomical relationships need a synthetic approach

    NASA Technical Reports Server (NTRS)

    Ross, M. D.

    2001-01-01

    Mammalian vestibular maculae are anatomically organized for complex parallel processing of linear acceleration information. Anatomical findings in rat maculae are provided in order to underscore this complexity, which is little understood functionally. This report emphasizes that a synthetic approach is critical to understanding how maculae function and the kind of information they conduct to the brain.

  6. PET image reconstruction with anatomical edge guided level set prior

    NASA Astrophysics Data System (ADS)

    Cheng-Liao, Jinxiu; Qi, Jinyi

    2011-11-01

    Acquiring both anatomical and functional images during one scan, PET/CT systems improve the ability to detect and localize abnormal uptakes. In addition, CT images provide anatomical boundary information that can be used to regularize positron emission tomography (PET) images. Here we propose a new approach to maximum a posteriori reconstruction of PET images with a level set prior guided by anatomical edges. The image prior models both the smoothness of PET images and the similarity between functional boundaries in PET and anatomical boundaries in CT. Level set functions (LSFs) are used to represent smooth and closed functional boundaries. The proposed method does not assume an exact match between PET and CT boundaries. Instead, it encourages similarity between the two boundaries, while allowing different region definition in PET images to accommodate possible signal and position mismatch between functional and anatomical images. While the functional boundaries are guaranteed to be closed by the LSFs, the proposed method does not require closed anatomical boundaries and can utilize incomplete edges obtained from an automatic edge detection algorithm. We conducted computer simulations to evaluate the performance of the proposed method. Two digital phantoms were constructed based on the Digimouse data and a human CT image, respectively. Anatomical edges were extracted automatically from the CT images. Tumors were simulated in the PET phantoms with different mismatched anatomical boundaries. Compared with existing methods, the new method achieved better bias-variance performance. The proposed method was also applied to real mouse data and achieved higher contrast than other methods.

  7. Standards to support information systems integration in anatomic pathology.

    PubMed

    Daniel, Christel; García Rojo, Marcial; Bourquard, Karima; Henin, Dominique; Schrader, Thomas; Della Mea, Vincenzo; Gilbertson, John; Beckwith, Bruce A

    2009-11-01

    Integrating anatomic pathology information- text and images-into electronic health care records is a key challenge for enhancing clinical information exchange between anatomic pathologists and clinicians. The aim of the Integrating the Healthcare Enterprise (IHE) international initiative is precisely to ensure interoperability of clinical information systems by using existing widespread industry standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7). To define standard-based informatics transactions to integrate anatomic pathology information to the Healthcare Enterprise. We used the methodology of the IHE initiative. Working groups from IHE, HL7, and DICOM, with special interest in anatomic pathology, defined consensual technical solutions to provide end-users with improved access to consistent information across multiple information systems. The IHE anatomic pathology technical framework describes a first integration profile, "Anatomic Pathology Workflow," dedicated to the diagnostic process including basic image acquisition and reporting solutions. This integration profile relies on 10 transactions based on HL7 or DICOM standards. A common specimen model was defined to consistently identify and describe specimens in both HL7 and DICOM transactions. The IHE anatomic pathology working group has defined standard-based informatics transactions to support the basic diagnostic workflow in anatomic pathology laboratories. In further stages, the technical framework will be completed to manage whole-slide images and semantically rich structured reports in the diagnostic workflow and to integrate systems used for patient care and those used for research activities (such as tissue bank databases or tissue microarrayers).

  8. Designing Allosteric Regulators of Thrombin. Exosite 2 Features Multiple Sub-Sites That Can Be Targeted By Sulfated Small Molecules for Inducing Inhibition

    PubMed Central

    Sidhu, Preetpal Singh; Abdel Aziz, May H.; Sarkar, Aurijit; Mehta, Akul Y.; Zhou, Qibing; Desai, Umesh R.

    2013-01-01

    We recently designed a group of novel exosite 2-directed, sulfated, small, allosteric inhibitors of thrombin. To develop more potent inhibitors, monosulfated benzofuran tri- and tetrameric homologs of the parent designed dimers were synthesized in 7–8 steps and found to exhibit a wide range of potencies. Among these, trimer 9a was found to be nearly 10-fold more potent than the first generation molecules. Michaelis-Menten studies indicated an allosteric mechanism of inhibition. Competitive studies using a hirudin peptide (exosite 1 ligand) and, unfractionated heparin, heparin octasaccharide and γ′-fibrinogen peptide (exosite 2 ligands), demonstrated exosite 2 recognition in a manner different from the parent dimers. Alanine scanning mutagenesis of 12 Arg/Lys residues of exosite 2 revealed a defect in 9a potency for Arg233Ala thrombin only confirming the major difference in site of recognition between the two structurally related sulfated benzofurans. The results suggest that multiple avenues are available within exosite 2 for inducing thrombin inhibition. PMID:23718540

  9. Joint Modeling of Anatomical and Functional Connectivity for Population Studies

    PubMed Central

    Rathi, Yogesh; Kubicki, Marek; Westin, Carl-Fredrik; Golland, Polina

    2015-01-01

    We propose a novel probabilistic framework to merge information from diffusion weighted imaging tractography and resting-state functional magnetic resonance imaging correlations to identify connectivity patterns in the brain. In particular, we model the interaction between latent anatomical and functional connectivity and present an intuitive extension to population studies. We employ the EM algorithm to estimate the model parameters by maximizing the data likelihood. The method simultaneously infers the templates of latent connectivity for each population and the differences in connectivity between the groups. We demonstrate our method on a schizophrenia study. Our model identifies significant increases in functional connectivity between the parietal/posterior cingulate region and the frontal lobe and reduced functional connectivity between the parietal/posterior cingulate region and the temporal lobe in schizophrenia. We further establish that our model learns predictive differences between the control and clinical populations, and that combining the two modalities yields better results than considering each one in isolation. PMID:21878411

  10. A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

    PubMed

    Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

    2017-01-01

    This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

  11. [Aging of the respiratory system: anatomical changes and physiological consequences].

    PubMed

    Ketata, W; Rekik, W K; Ayadi, H; Kammoun, S

    2012-10-01

    The respiratory system undergoes progressive involution with age, resulting in anatomical and functional changes that are exerted on all levels. The rib cage stiffens and respiratory muscles weaken. Distal bronchioles have reduced diameter and tend to be collapsed. Mobilized lung volumes decrease with age while residual volume increases. Gas exchanges are modified with a linear decrease of PaO(2) up to the age of 70 years and a decreased diffusing capacity of carbon monoxide. Ventilatory responses to hypercapnia, hypoxia and exercise decrease in the elderly. Knowledge of changes in the respiratory system related to advancing age is a medical issue of great importance in order to distinguish the effects of aging from those of diseases.

  12. The anatomical and compositional basis of leaf mass per area.

    PubMed

    John, Grace P; Scoffoni, Christine; Buckley, Thomas N; Villar, Rafael; Poorter, Hendrik; Sack, Lawren

    2017-04-01

    Leaf dry mass per unit leaf area (LMA) is a central trait in ecology, but its anatomical and compositional basis has been unclear. An explicit mathematical and physical framework for quantifying the cell and tissue determinants of LMA will enable tests of their influence on species, communities and ecosystems. We present an approach to explaining LMA from the numbers, dimensions and mass densities of leaf cells and tissues, which provided unprecedented explanatory power for 11 broadleaved woody angiosperm species diverse in LMA (33-262 g m(-2) ; R(2)  = 0.94; P < 0.001). Across these diverse species, and in a larger comparison of evergreen vs. deciduous angiosperms, high LMA resulted principally from larger cell sizes, greater major vein allocation, greater numbers of mesophyll cell layers and higher cell mass densities. This explicit approach enables relating leaf anatomy and composition to a wide range of processes in physiological, evolutionary, community and macroecology.

  13. Craniofacial pain and anatomical abnormalities of the nasal cavities.

    PubMed

    Mendonça, Jeferson Cedaro de; Bussoloti Filho, Ivo

    2005-01-01

    The causal relation between anatomical variations of the nose and headaches and facial pain is analyzed through literature review of the topic. The pathogenesis that can be involved in this relation proves to be wider than simple alteration of nasal septum and turbinates that can cause mechanical stimulus through contact between these structures, which covers infectious factors, neurogenic inflammation, correlation with migraines and the role of nasal obstruction. The clinical findings of a lot of authors including the test with topical anesthetic to prove this causal relation, the indication of surgical treatment, in addition to good results of this treatment, are reported. The mechanism of pain relief obtained through surgical correction of nasal septum and turbinate is discussed. These data make us conclude that there are multiple etiologic factors involved, which makes us question the fundamental role of the mechanical aspect.

  14. Prostatome: A combined anatomical and disease based MRI atlas of the prostate

    PubMed Central

    Rusu, Mirabela; Bloch, B. Nicolas; Jaffe, Carl C.; Genega, Elizabeth M.; Lenkinski, Robert E.; Rofsky, Neil M.; Feleppa, Ernest; Madabhushi, Anant

    2014-01-01

    Purpose: In this work, the authors introduce a novel framework, the anatomically constrained registration (AnCoR) scheme and apply it to create a fused anatomic-disease atlas of the prostate which the authors refer to as the prostatome. The prostatome combines a MRI based anatomic and a histology based disease atlas. Statistical imaging atlases allow for the integration of information across multiple scales and imaging modalities into a single canonical representation, in turn enabling a fused anatomical-disease representation which may facilitate the characterization of disease appearance relative to anatomic structures. While statistical atlases have been extensively developed and studied for the brain, approaches that have attempted to combine pathology and imaging data for study of prostate pathology are not extant. This works seeks to address this gap. Methods: The AnCoR framework optimizes a scoring function composed of two surface (prostate and central gland) misalignment measures and one intensity-based similarity term. This ensures the correct mapping of anatomic regions into the atlas, even when regional MRI intensities are inconsistent or highly variable between subjects. The framework allows for creation of an anatomic imaging and a disease atlas, while enabling their fusion into the anatomic imaging-disease atlas. The atlas presented here was constructed using 83 subjects with biopsy confirmed cancer who had pre-operative MRI (collected at two institutions) followed by radical prostatectomy. The imaging atlas results from mapping thein vivo MRI into the canonical space, while the anatomic regions serve as domain constraints. Elastic co-registration MRI and corresponding ex vivo histology provides “ground truth” mapping of cancer extent on in vivo imaging for 23 subjects. Results: AnCoR was evaluated relative to alternative construction strategies that use either MRI intensities or the prostate surface alone for registration. The AnCoR framework

  15. Prostatome: A combined anatomical and disease based MRI atlas of the prostate

    SciTech Connect

    Rusu, Mirabela; Madabhushi, Anant; Bloch, B. Nicolas; Jaffe, Carl C.; Genega, Elizabeth M.; Lenkinski, Robert E.; Rofsky, Neil M.; Feleppa, Ernest

    2014-07-15

    Purpose: In this work, the authors introduce a novel framework, the anatomically constrained registration (AnCoR) scheme and apply it to create a fused anatomic-disease atlas of the prostate which the authors refer to as the prostatome. The prostatome combines a MRI based anatomic and a histology based disease atlas. Statistical imaging atlases allow for the integration of information across multiple scales and imaging modalities into a single canonical representation, in turn enabling a fused anatomical-disease representation which may facilitate the characterization of disease appearance relative to anatomic structures. While statistical atlases have been extensively developed and studied for the brain, approaches that have attempted to combine pathology and imaging data for study of prostate pathology are not extant. This works seeks to address this gap. Methods: The AnCoR framework optimizes a scoring function composed of two surface (prostate and central gland) misalignment measures and one intensity-based similarity term. This ensures the correct mapping of anatomic regions into the atlas, even when regional MRI intensities are inconsistent or highly variable between subjects. The framework allows for creation of an anatomic imaging and a disease atlas, while enabling their fusion into the anatomic imaging-disease atlas. The atlas presented here was constructed using 83 subjects with biopsy confirmed cancer who had pre-operative MRI (collected at two institutions) followed by radical prostatectomy. The imaging atlas results from mapping thein vivo MRI into the canonical space, while the anatomic regions serve as domain constraints. Elastic co-registration MRI and corresponding ex vivo histology provides “ground truth” mapping of cancer extent on in vivo imaging for 23 subjects. Results: AnCoR was evaluated relative to alternative construction strategies that use either MRI intensities or the prostate surface alone for registration. The AnCoR framework

  16. Anatomical decomposition in dual energy chest digital tomosynthesis

    NASA Astrophysics Data System (ADS)

    Lee, Donghoon; Kim, Ye-seul; Choi, Sunghoon; Lee, Haenghwa; Choi, Seungyeon; Kim, Hee-Joung

    2016-03-01

    Lung cancer is the leading cause of cancer death worldwide and the early diagnosis of lung cancer has recently become more important. For early screening lung cancer, computed tomography (CT) has been used as a gold standard for early diagnosis of lung cancer [1]. The major advantage of CT is that it is not susceptible to the problem of misdiagnosis caused by anatomical overlapping while CT has extremely high radiation dose and cost compared to chest radiography. Chest digital tomosynthesis (CDT) is a recently introduced new modality for lung cancer screening with relatively low radiation dose compared to CT [2] and also showing high sensitivity and specificity to prevent anatomical overlapping occurred in chest radiography. Dual energy material decomposition method has been proposed for better detection of pulmonary nodules as means of reducing the anatomical noise [3]. In this study, possibility of material decomposition in CDT was tested by simulation study and actual experiment using prototype CDT. Furthermore organ absorbed dose and effective dose were compared with single energy CDT. The Gate v6 (Geant4 application for tomographic emission), and TASMIP (Tungsten anode spectral model using the interpolating polynomial) code were used for simulation study and simulated cylinder shape phantom consisted of 4 inner beads which were filled with spine, rib, muscle and lung equivalent materials. The patient dose was estimated by PCXMC 1.5 Monte Carlo simulation tool [4]. The tomosynthesis scan was performed with a linear movement and 21 projection images were obtained over 30 degree of angular range with 1.5° degree of angular interval. The proto type CDT system has same geometry with simulation study and composed of E7869X (Toshiba, Japan) x-ray tube and FDX3543RPW (Toshiba, Japan) detector. The result images showed that reconstructed with dual energy clearly visualize lung filed by removing unnecessary bony structure. Furthermore, dual energy CDT could enhance

  17. Swept-source anatomic optical coherence elastography of porcine trachea

    NASA Astrophysics Data System (ADS)

    Bu, Ruofei; Price, Hillel; Mitran, Sorin; Zdanski, Carlton; Oldenburg, Amy L.

    2016-02-01

    Quantitative endoscopic imaging is at the vanguard of novel techniques in the assessment upper airway obstruction. Anatomic optical coherence tomography (aOCT) has the potential to provide the geometry of the airway lumen with high-resolution and in 4 dimensions. By coupling aOCT with measurements of pressure, optical coherence elastography (OCE) can be performed to characterize airway wall stiffness. This can aid in identifying regions of dynamic collapse as well as informing computational fluid dynamics modeling to aid in surgical decision-making. Toward this end, here we report on an anatomic optical coherence tomography (aOCT) system powered by a wavelength-swept laser source. The system employs a fiber-optic catheter with outer diameter of 0.82 mm deployed via the bore of a commercial, flexible bronchoscope. Helical scans are performed to measure the airway geometry and to quantify the cross-sectional-area (CSA) of the airway. We report on a preliminary validation of aOCT for elastography, in which aOCT-derived CSA was obtained as a function of pressure to estimate airway wall compliance. Experiments performed on a Latex rubber tube resulted in a compliance measurement of 0.68+/-0.02 mm2/cmH2O, with R2=0.98 over the pressure range from 10 to 40 cmH2O. Next, ex vivo porcine trachea was studied, resulting in a measured compliance from 1.06+/-0.12 to 3.34+/-0.44 mm2/cmH2O, (R2>0.81). The linearity of the data confirms the elastic nature of the airway. The compliance values are within the same order-of-magnitude as previous measurements of human upper airways, suggesting that this system is capable of assessing airway wall compliance in future human studies.

  18. Coordination chemistry of [HFe(CN)(2)(CO)(3)](-) and its derivatives: toward a model for the iron subsite of the [NiFe]-hydrogenases.

    PubMed

    Whaley, C Matthew; Rauchfuss, Thomas B; Wilson, Scott R

    2009-05-18

    The photoreaction of Fe(CO)(5) and cyanide salts in MeCN solution affords the dianion [Fe(CN)(2)(CO)(3)](2-), conveniently isolated as [K(18-crown-6)](2)[Fe(CN)(2)(CO)(3)]. Solutions of [Fe(CN)(2)(CO)(3)](2-) oxidize irreversibly at -600 mV (vs Ag/AgCl) to give primarily [Fe(CN)(3)(CO)(3)](-). Protonation of the dianion affords the hydride [K(18-crown-6)][HFe(CN)(2)(CO)(3)] with a pK(a) approximately 17 (MeCN). The ferrous hydride exhibits enhanced electrophilicity vs its dianionic precursor, which resists substitution. Treatment of [K(18-crown-6)][Fe(CN)(2)(CO)(3)] with tertiary phosphines and phosphites gives isomeric mixtures of [HFe(CN)(2)(CO)(2)L](-) (L = P(OPh)(3) and PPh(3)). Carbonyl substitution on [1H(CO)(2)](-) by P(OPh)(3) is first-order in both the phosphite and iron (k = 0.18 M(-1) s(-1) at 22 degrees C) with DeltaH(double dagger) = 51.6 kJ mol(-1) and DeltaS(double dagger) = -83.0 J K(-1) mol(-1). These ligands are displaced under an atmosphere of CO. With cis-Ph(2)PCH=CHPPh(2) (dppv), we obtained the monocarbonyl, [HFe(CN)(2)(CO)(dppv)](-), a highly basic hydride (pK(a) > 23.3) that rearranges in solution to a single isomer. Treatment of [K(18-crown-6)][HFe(CN)(2)(CO)(3)] with Et(4)NCN resulted in rapid deprotonation to give [Fe(CN)(2)(CO)(3)](2-) and HCN. The tricyano hydride [HFe(CN)(3)(CO)(2)](2-) is prepared by the reaction of [HFe(CN)(2)(CO)(2)(PPh(3))](-) and [K(18-crown-6)]CN. Similar to the phosphine and phosphite derivatives, [HFe(CN)(3)(CO)(2)](2-) exists as a mixture of all three possible isomers. Protonation of the hydrides [HFe(CN)(2)(CO)(dppv)](-) and [HFe(CN)(3)(CO)(2)](-) in acetonitrile solutions releases H(2) and gives the corresponding acetonitrile complexes [K(18-crown-6)][Fe(CN)(3)(NCMe)(CO)(2)] and Fe(CN)(2)(NCMe)(CO)(dppv). Alkylation of [K(18-crown-6)](2)[Fe(CN)(2)(CO)(3)] with MeOTf gives the thermally unstable [MeFe(CN)(2)(CO)(3)](-), which was characterized spectroscopically at -40 degrees C. Reaction of dppv with [Me

  19. The anatomic basis of parathyroid surgery.

    PubMed

    Wang, C

    1976-03-01

    A study of 645 normal adult parathyroid glands in 160 cadavers revealed that there is a definite pattern of anatomic distribution on the basis of the embryologic development of the parathyroid, thyroid, and thymic glands. The sites of predilection of the upper gland (Parathyroid IV) are, in order of frequency, the cricothyroid junction; the dorsum of the upper pole of the thyroid; and the retropharyngeal space. Those of the lower gland (Parathyroid III) are at the lower pole of the thyroid and the thymic tongue; rarely in the upper, the lateral neck, or the mediastinum. An understanding of the developmental relationship of the parathyroid glands to the thyroid and the thymus is fundamental in the delineation of the embryologic origin of the parathyroid glands. The parathyroid gland, located within the surgical capsule of the thyroid (subcapsular), when diseased, remains in place locally. A gland outside of the capsule (extracapsular) is often displaced into the posterior or anterior mediastinum. A collective assessment of the size, weight, color, shape, and consistency of the parathyroid gland is mandatory in the determination of its normalcy. Frozen section examination for stromal and intracellular fatty content is an added assurance of normalcy. That parathyroid glands sink in saline solution, and fat globules float, may aid in differentiating the two types of tissue. Supernumerary, fused, and intrathyroidal parathyroids, albeit rare, are of surgical importance.

  20. Anatomical constraints for neuromagnetic source models

    NASA Astrophysics Data System (ADS)

    George, John S.; Lewis, Paul S.; Ranken, D. M.; Kaplan, L.; Wood, C. C.

    1991-07-01

    The localization of neural electromagnetic sources from measurements at the head surface requires the solution of an inverse problem; that is, the determination of the number, location, spatial configuration, strength, and time-course of the neuronal currents that give rise to the magnetic field or potential distribution. In most general form, the neuromagnetic and electrical inverse problems are ill-posed and have no unique solution; however, approximate solutions are possible if assumptions are made regarding the shape and conductivity of the head and the number and configuration of neuronal currents responsible for the surface distributions. To help resolve ambiguities and to reduce the number and range of free parameters required to model complex neuromagnetic sources, the authors are investigating strategies to constrain the locations of allowable sources, based on a knowledge of individual anatomy. The key assumption, justified by both physiological evidence and theoretical considerations, is that the dominant neuromagnetic sources which contribute to surface field distributions reside within the cortex. It is demonstrated that anatomically constrained source modeling strategies can produce significant improvements in source localization; however, the conclusion is that additional improvements in model fitting or source reconstruction procedures are required.

  1. Training models of anatomic shape variability

    PubMed Central

    Merck, Derek; Tracton, Gregg; Saboo, Rohit; Levy, Joshua; Chaney, Edward; Pizer, Stephen; Joshi, Sarang

    2008-01-01

    Learning probability distributions of the shape of anatomic structures requires fitting shape representations to human expert segmentations from training sets of medical images. The quality of statistical segmentation and registration methods is directly related to the quality of this initial shape fitting, yet the subject is largely overlooked or described in an ad hoc way. This article presents a set of general principles to guide such training. Our novel method is to jointly estimate both the best geometric model for any given image and the shape distribution for the entire population of training images by iteratively relaxing purely geometric constraints in favor of the converging shape probabilities as the fitted objects converge to their target segmentations. The geometric constraints are carefully crafted both to obtain legal, nonself-interpenetrating shapes and to impose the model-to-model correspondences required for useful statistical analysis. The paper closes with example applications of the method to synthetic and real patient CT image sets, including same patient male pelvis and head and neck images, and cross patient kidney and brain images. Finally, we outline how this shape training serves as the basis for our approach to IGRT∕ART. PMID:18777919

  2. Anatomical considerations on the corona mortis.

    PubMed

    Rusu, Mugurel Constantin; Cergan, Romica; Motoc, Andrei Gheorghe Marius; Folescu, Roxana; Pop, Elena

    2010-01-01

    The corona mortis (CMOR) represents the vascular connection of the obturator and external iliac systems. We aimed to evaluate by dissections the morphological possibilities of the CMOR and their individual combinations. For the study we used 20 human adult cadavers that were bilaterally dissected (40 hemipelvises), with evidences of the vascular elements at the level of the superior pubic branch in 32 (80%) of hemipelvises. The morphological patterns we identified were classified in three types (I-III): I. arterial CMOR (10 hemipelvises): I.1. obturator artery (OA) from the external iliac artery (EIA); I.2. OA from the inferior epigastric artery (IEA); I.3. anastomosis of the OA and IEA; I.4. pubic branches of the OA, in the absence of any anastomosis with the EIA system; II. venous CMOR (6 hemipelvises): II.1. obturator vein (OV) draining into the external iliac vein (EIV); II.2. OV draining into the inferior epigastric vein (IEV); II.3. venous anastomosis of the OV and IEV and III combined, arterial and venous CMOR (16 hemipelvises). We classified the combined coronae mortis in nine different subtypes that mainly (but not exclusively) correspond to various combinations of types I and II. The surgical relevance of the vascular relations of the superior branch of pubis (in trauma, orthopedic approaches, hernia repair, embolizations and intra-arterial infusions) recommends a detailed knowledge of the morphological and topographical possibilities of the crown of death and the individual evaluation of this risky anatomical structure.

  3. Anatomical variations of the second thoracic ganglion.

    PubMed

    Singh, B; Ramsaroop, L; Partab, P; Moodley, J; Satyapal, K S

    2005-04-01

    In recent years the second thoracic ganglion has gained anatomical significance as an important conduit for sympathetic innervation of the upper extremity. Thoracoscopic excision of the second thoracic ganglion is now widely recognized as affording the most effective treatment option for palmar hyperhidrosis. This study recorded the incidence, location and associated additional neural connections of the second thoracic ganglion. Bilateral dissection of 20 adult cadavers was undertaken, and all neural connections of the second thoracic ganglion were recorded. Nineteen cadavers (95%) demonstrated additional neural connections between the first thoracic ventral ramus and second intercostal nerve. These were classified as either type A (47.5%) or type B (45%) using the intrathoracic ramus (nerve of Kuntz) between the second intercostal nerve and the ventral ramus of the first thoracic nerve as a basis on both right and left sides. The second thoracic ganglion was commonly located (92.5%) in the second intercostal space at the level of the intervertebral disc between the second and third thoracic vertebrae. Fused ganglia between the second thoracic and first thoracic (5%) and stellate (5%) ganglia were noted. These findings should assist the operating surgeon with a clear knowledge of the anatomy of the second thoracic ganglion during thoracoscopic sympathectomy with a view to improving the success rate for upper limb sympathectomy.

  4. Bifid Rib: Anatomical Considerations in Three Cases

    PubMed Central

    Song, Wu-Chul; Kim, Sang-Hyun; Park, Dae-Kyoon

    2009-01-01

    The present study involved a detailed investigation of 3 cases of bifid rib, focusing on anatomical features, and classified them into 2 types. The bifid ribs were in the right fourth rib of all 3 male cadavers. The upper intercostal spaces of the fourth bifid rib were considerably narrowed, whereas the lower intercostal spaces were widened. Although the size and shape of the bifid space between the upper and lower divisions of the bifid rib were different, the intercostal muscles were present in the bifid space in all cases. The third anterior intercostal artery from the internal thoracic artery supplied the bifid space in all cases. In 2 cases, the fourth intercostal nerve ran along the inferior margin of the fourth bifid rib and innervated the muscles of the bifid space. In the third case, there was another branch from the third intercostal nerve supplying the muscles of the bifid space as well as the fourth intercostal nerve. The bifid ribs are associated with other diseases or develop accidentally or sporadically. Knowledge of this malformation is needed for the differential diagnosis with other diseases, such as a chest wall tumor or costal fracture. PMID:19430569

  5. Is the cervical fascia an anatomical proteus?

    PubMed

    Natale, Gianfranco; Condino, Sara; Stecco, Antonio; Soldani, Paola; Belmonte, Monica Mattioli; Gesi, Marco

    2015-11-01

    The cervical fasciae have always represented a matter of debate. Indeed, in the literature, it is quite impossible to find two authors reporting the same description of the neck fascia. In the present review, a historical background was outlined, confirming that the Malgaigne's definition of the cervical fascia as an anatomical Proteus is widely justified. In an attempt to provide an essential and a more comprehensive classification, a fixed pattern of description of cervical fasciae is proposed. Based on the morphogenetic criteria, two fascial groups have been recognized: (1) fasciae which derive from primitive fibro-muscular laminae (muscular fasciae or myofasciae); (2) fasciae which derive from connective thickening (visceral fasciae). Topographic and comparative approaches allowed to distinguish three different types of fasciae in the neck: the superficial, the deep and the visceral fasciae. The first is most connected to the skin, the second to the muscles and the third to the viscera. The muscular fascia could be further divided into three layers according to the relationship with the different muscles.

  6. Anatomical pediatric model for craniosynostosis surgical training.

    PubMed

    Coelho, Giselle; Warf, Benjamin; Lyra, Marcos; Zanon, Nelci

    2014-12-01

    Several surgical training simulators have been created to improve the learning curve of residents in neurosurgery and plastic surgery. Laboratory training is fundamental for acquiring familiarity with the techniques of surgery and the skill in handling instruments. The aim of this study is to present a novel simulator for training in the technique of craniosynostectomy, specifically for the scaphocephaly type. This realistic simulator was built with a synthetic thermo-retractile and thermo-sensible rubber which, when combined with different polymers, produces more than 30 different formulas. These formulas present textures, consistencies, and mechanical resistance similar to many human tissues. Fiberglass molds in the shape of the skull constitute the basic structure of the craniosynostectomy training module. It has been possible to perform computerized tomography images due to the radiopacity of this simulator and to compare the pre- and postoperative images. The authors present a training model to practice the biparietal remodeling used in scaphocephaly correction. All aspects of the procedure are simulated: the skin incision, the subcutaneous and subperiosteal dissection, the osteotomies, and finally, the skull remodeling with absorbable microplates. The presence of superior sagittal sinus can simulate emergency situations with bleeding. The authors conclude that this training model can represent a fairly useful method to accustom trainees to the required surgical techniques and simulates well the steps of standard surgery for scaphocephaly. This training provides an alternative to the use of human cadavers and animal models. Furthermore, it can represent the anatomical alteration precisely as well as intraoperative emergency situations.

  7. The anatomic basis of parathyroid surgery.

    PubMed Central

    Wang, C

    1976-01-01

    A study of 645 normal adult parathyroid glands in 160 cadavers revealed that there is a definite pattern of anatomic distribution on the basis of the embryologic development of the parathyroid, thyroid, and thymic glands. The sites of predilection of the upper gland (Parathyroid IV) are, in order of frequency, the cricothyroid junction; the dorsum of the upper pole of the thyroid; and the retropharyngeal space.Those of the lower gland (Parathyroid III) are at the lower pole of the thyroid and the thymic tongue; rarely in the upper, the lateral neck, or the mediastinum. An understanding of the developmental relationship of the parathyroid glands to the thyroid and the thymus is fundamental in the delineation of the embryologic origin of the parathyroid glands. The parathyroid gland, located within the surgical capsule of the thyroid (subcapsular), when diseased, remains in place locally. A gland outside of the capsule (extracapsular) is often displaced into the posterior or anterior mediastinum. A collective assessment of the size, weight, color, shape, and consistency of the parathyroid gland is mandatory in the determination of its normalcy. Frozen section examination for stromal and intracellular fatty content is an added assurance of normalcy. That parathyroid glands sink in saline solution, and fat globules float, may aid in differentiating the two types of tissue. Supernumerary, fused, and intrathyroidal parathyroids, albeit rare, are of surgical importance. PMID:1259483

  8. Anatomic basis for delayed diagnosis of appendicitis.

    PubMed

    Poole, G V

    1990-07-01

    Gangrene or perforation of the appendix is often caused by failure to make an early diagnosis of appendicitis. Variability in the anatomic location of the appendix can be responsible for atypical manifestations of appendicitis and diagnostic errors. Over a 52-month period, 125 appendectomies were done for suspected appendicitis at a military hospital. After excluding cases in which the location of the appendix was not provided, 106 cases were available for review. Fifteen patients (14%) did not have appendicitis. The appendix was found in the true pelvis, was behind the ileum or ileocolic mesentery, or was both retrocolic and retroperitoneal in 11 of 16 patients (69%) with gangrenous or perforative appendicitis. In contrast, the appendix was in one of these three sites in only four of 75 patients (5%) with simple appendicitis (P less than .001). Both physicians and patients were responsible for diagnostic delays, but the paucity of symptoms and signs in patients with a "hidden" appendix was the most likely cause of failure to diagnose appendicitis before perforation.

  9. Lateral femoral cutaneous neuralgia: an anatomical insight.

    PubMed

    Dias Filho, L C; Valença, M M; Guimarães Filho, F A V; Medeiros, R C; Silva, R A M; Morais, M G V; Valente, F P; França, S M L

    2003-07-01

    A detailed anatomic study was carried out on the lateral femoral cutaneous nerve to better understand the etiology and treatment of lateral femoral cutaneous neuralgia. As it passed from the pelvis into the thigh, the lateral femoral cutaneous nerve ran through an "aponeuroticofascial tunnel," beginning at the iliopubic tract and ending at the inguinal ligament; as it passed through the tunnel, an enlargement in its side-to-side diameter was observed, suggesting that the fascial structures proximal to the inguinal ligament may be implicated in the genesis of lateral femoral cutaneous neuralgia. The finding of pseudoneuromas at this location, distant from the inguinal ligament, supports this hypothesis. The anterior superior iliac spine is located approximately 0.7 cm from the lateral femoral cutaneous nerve and serves as the bony landmark for nerve localization. Within the first 3 cm of leaving the pelvis, the lateral femoral cutaneous nerve was observed deep to the fascia lata; therefore, surgical dissection within the subcutaneous fascia may be conducted with relative impunity near the anterior superior iliac spine just inferior to the inguinal ligament. In 36% of cases there was no posterior branch of the nerve, which is correlated to lateral femoral cutaneous neuralgia symptoms often being limited to the anterior branch region. An accessory nerve was found in 30% of cases. Copyright 2003 Wiley-Liss, Inc.

  10. Metabolic and anatomic thyroid emergencies: a review.

    PubMed

    Smallridge, R C

    1992-02-01

    To review the diagnosis and management of thyroid diseases, both metabolic (thyroid storm and myxedema coma) and anatomic (substernal goiter, lymphoma, anaplastic carcinoma) that may require intensive care therapy. English-language articles were identified through a search of the MEDLINE and Index Medicus databases. Bibliographies of retrieved articles were examined for relevant articles. Approximately 250 articles were reviewed. Those articles deemed most representative were utilized. Case reports were included to highlight rare, but potentially lethal complications. All data were analyzed by one observer. Limitations of the data are discussed. Guidelines for determining the etiology of thyrotoxic crisis are outlined. Criteria for distinguishing critically ill hypothyroid patients from those patients with the euthyroid sick syndrome are given. Therapy for both disorders must be aggressive and multifaceted, and detailed management is indicated. Substernal goiter is almost always benign, but may cause various acute complications, including dyspnea, respiratory failure, superior vena caval syndrome, esophageal varices (downhill), and others. Surgery almost always corrects the problem. Lymphomas present with rapid thyroid enlargement. Recent studies suggest that surgery may assume more of a supportive role, used principally to obtain adequate tissue for histologic classification. Thyroid disorders can produce emergencies requiring the attention of multiple medical and surgical specialists. While management is often successful, future studies should address the following three areas: a) optimization of thyroid hormone dose for treatment of myxedema coma; b) clarification of the role of radiotherapy and/or chemotherapy for thyroid lymphoma; and c) more effective therapy for anaplastic carcinoma.

  11. Employing anatomical knowledge in vertebral column labeling

    NASA Astrophysics Data System (ADS)

    Yao, Jianhua; Summers, Ronald M.

    2009-02-01

    The spinal column constitutes the central axis of human torso and is often used by radiologists to reference the location of organs in the chest and abdomen. However, visually identifying and labeling vertebrae is not trivial and can be timeconsuming. This paper presents an approach to automatically label vertebrae based on two pieces of anatomical knowledge: one vertebra has at most two attached ribs, and ribs are attached only to thoracic vertebrae. The spinal column is first extracted by a hybrid method using the watershed algorithm, directed acyclic graph search and a four-part vertebra model. Then curved reformations in sagittal and coronal directions are computed and aggregated intensity profiles along the spinal cord are analyzed to partition the spinal column into vertebrae. After that, candidates for rib bones are detected using features such as location, orientation, shape, size and density. Then a correspondence matrix is established to match ribs and vertebrae. The last vertebra (from thoracic to lumbar) with attached ribs is identified and labeled as T12. The rest of vertebrae are labeled accordingly. The method was tested on 50 CT scans and successfully labeled 48 of them. The two failed cases were mainly due to rudimentary ribs.

  12. The Application of an Anatomical Database for Fetal Congenital Heart Disease

    PubMed Central

    Yang, Li; Pei, Qiu-Yan; Li, Yun-Tao; Yang, Zhen-Juan

    2015-01-01

    Background: Fetal congenital heart anomalies are the most common congenital anomalies in live births. Fetal echocardiography (FECG) is the only prenatal diagnostic approach used to detect fetal congenital heart disease (CHD). FECG is not widely used, and the antenatal diagnosis rate of CHD varies considerably. Thus, mastering the anatomical characteristics of different kinds of CHD is critical for ultrasound physicians to improve FECG technology. The aim of this study is to investigate the applications of a fetal CHD anatomic database in FECG teaching and training program. Methods: We evaluated 60 transverse section databases including 27 types of fetal CHD built in the Prenatal Diagnosis Center in Peking University People's Hospital. Each original database contained 400–700 cross-sectional digital images with a resolution of 3744 pixels × 5616 pixels. We imported the database into Amira 5.3.1 (Australia Visage Imaging Company, Australia) three-dimensional (3D) software. The database functions use a series of 3D software visual operations. The features of the fetal CHD anatomical database were analyzed to determine its applications in FECG continuing education and training. Results: The database was rebuilt using the 3D software. The original and rebuilt databases can be displayed dynamically, continuously, and synchronically and can be rotated at arbitrary angles. The sections from the dynamic displays and rotating angles are consistent with the sections in FECG. The database successfully reproduced the anatomic structures and spatial relationship features of different fetal CHDs. We established a fetal CHD anatomy training database and a standardized training database for FECG. Ultrasound physicians and students can learn the anatomical features of fetal CHD and FECG through either centralized training or distance education. Conclusions: The database of fetal CHD successfully reproduced the anatomic structures and spatial relationship of different kinds of

  13. Comparison of work-related fear-avoidance beliefs across different anatomical locations with musculoskeletal pain.

    PubMed

    Simon, Corey B; Stryker, Sandra E; George, Steven Z

    2011-01-01

    The influence of work-related fear-avoidance on pain and function has been consistently reported for patients with musculoskeletal low back pain. Emerging evidence suggests similar influences exist for other anatomical locations of musculoskeletal pain, such as the cervical spine and extremities. However, research is limited in comparing work-related fear-avoidance and associations with clinical outcomes across different anatomical locations. The purpose of this study was to examine the associations between work-related fear-avoidance, gender, and clinical outcomes across four different musculoskeletal pain locations for patients being treated in an outpatient physical therapy setting. This study was a secondary analysis of data obtained prospectively from a cohort of 313 participants receiving physical therapy from an outpatient clinic. No interaction was found between gender and anatomical location of musculoskeletal pain on work-related fear-avoidance scores. Work-related fear-avoidance scores were higher in the cervical group versus the lower extremity group; however, there were no other differences across anatomical locations. Work-related fear-avoidance influenced intake pain intensity in patients with spine pain but not extremity pain. Conversely, work-related fear-avoidance influenced intake function for participants with extremity pain but not spine pain. Similar results were observed for change scores, with higher work-related fear-avoidance being associated with more, not less, change in pain and function for certain anatomical locations. These findings suggest that work-related fear-avoidance is similar for patients experiencing musculoskeletal pain. However, associations between work-related fear-avoidance and clinical outcomes may differ based on the anatomical location of that pain. Further, increased work-related fear-avoidance may not be indicative of poor clinical outcomes for this type of patient population.

  14. Multivariate pattern analysis reveals anatomical connectivity differences between the left and right mesial temporal lobe epilepsy.

    PubMed

    Fang, Peng; An, Jie; Zeng, Ling-Li; Shen, Hui; Chen, Fanglin; Wang, Wensheng; Qiu, Shijun; Hu, Dewen

    2015-01-01

    Previous studies have demonstrated differences of clinical signs and functional brain network organizations between the left and right mesial temporal lobe epilepsy (mTLE), but the anatomical connectivity differences underlying functional variance between the left and right mTLE remain uncharacterized. We examined 43 (22 left, 21 right) mTLE patients with hippocampal sclerosis and 39 healthy controls using diffusion tensor imaging. After the whole-brain anatomical networks were constructed for each subject, multivariate pattern analysis was applied to classify the left mTLE from the right mTLE and extract the anatomical connectivity differences between the left and right mTLE patients. The classification results reveal 93.0% accuracy for the left mTLE versus the right mTLE, 93.4% accuracy for the left mTLE versus controls and 90.0% accuracy for the right mTLE versus controls. Compared with the right mTLE, the left mTLE exhibited a different connectivity pattern in the cortical-limbic network and cerebellum. The majority of the most discriminating anatomical connections were located within or across the cortical-limbic network and cerebellum, thereby indicating that these disease-related anatomical network alterations may give rise to a portion of the complex of emotional and memory deficit between the left and right mTLE. Moreover, the orbitofrontal gyrus, cingulate cortex, hippocampus and parahippocampal gyrus, which exhibit high discriminative power in classification, may play critical roles in the pathophysiology of mTLE. The current study demonstrated that anatomical connectivity differences between the left mTLE and the right mTLE may have the potential to serve as a neuroimaging biomarker to guide personalized diagnosis of the left and right mTLE.

  15. Anatomical background noise power spectrum in differential phase contrast breast images

    NASA Astrophysics Data System (ADS)

    Garrett, John; Ge, Yongshuai; Li, Ke; Chen, Guang-Hong

    2015-03-01

    In x-ray breast imaging, the anatomical noise background of the breast has a significant impact on the detection of lesions and other features of interest. This anatomical noise is typically characterized by a parameter, β, which describes a power law dependence of anatomical noise on spatial frequency (the shape of the anatomical noise power spectrum). Large values of β have been shown to reduce human detection performance, and in conventional mammography typical values of β are around 3.2. Recently, x-ray differential phase contrast (DPC) and the associated dark field imaging methods have received considerable attention as possible supplements to absorption imaging for breast cancer diagnosis. However, the impact of these additional contrast mechanisms on lesion detection is not yet well understood. In order to better understand the utility of these new methods, we measured the β indices for absorption, DPC, and dark field images in 15 cadaver breast specimens using a benchtop DPC imaging system. We found that the measured β value for absorption was consistent with the literature for mammographic acquisitions (β = 3.61±0.49), but that both DPC and dark field images had much lower values of β (β = 2.54±0.75 for DPC and β = 1.44±0.49 for dark field). In addition, visual inspection showed greatly reduced anatomical background in both DPC and dark field images. These promising results suggest that DPC and dark field imaging may help provide improved lesion detection in breast imaging, particularly for those patients with dense breasts, in whom anatomical noise is a major limiting factor in identifying malignancies.

  16. An interactive three-dimensional virtual body structures system for anatomical training over the internet.

    PubMed

    Temkin, Bharti; Acosta, Eric; Malvankar, Ameya; Vaidyanath, Sreeram

    2006-04-01

    The Visible Human digital datasets make it possible to develop computer-based anatomical training systems that use virtual anatomical models (virtual body structures-VBS). Medical schools are combining these virtual training systems and classical anatomy teaching methods that use labeled images and cadaver dissection. In this paper we present a customizable web-based three-dimensional anatomy training system, W3D-VBS. W3D-VBS uses National Library of Medicine's (NLM) Visible Human Male datasets to interactively locate, explore, select, extract, highlight, label, and visualize, realistic 2D (using axial, coronal, and sagittal views) and 3D virtual structures. A real-time self-guided virtual tour of the entire body is designed to provide detailed anatomical information about structures, substructures, and proximal structures. The system thus facilitates learning of visuospatial relationships at a level of detail that may not be possible by any other means. The use of volumetric structures allows for repeated real-time virtual dissections, from any angle, at the convenience of the user. Volumetric (3D) virtual dissections are performed by adding, removing, highlighting, and labeling individual structures (and/or entire anatomical systems). The resultant virtual explorations (consisting of anatomical 2D/3D illustrations and animations), with user selected highlighting colors and label positions, can be saved and used for generating lesson plans and evaluation systems. Tracking users' progress using the evaluation system helps customize the curriculum, making W3D-VBS a powerful learning tool. Our plan is to incorporate other Visible Human segmented datasets, especially datasets with higher resolutions, that make it possible to include finer anatomical structures such as nerves and small vessels.

  17. Digital preservation of anatomical variation: 3D-modeling of embalmed and plastinated cadaveric specimens using uCT and MRI.

    PubMed

    Moore, Colin W; Wilson, Timothy D; Rice, Charles L

    2017-01-01

    Anatomy educators have an opportunity to teach anatomical variations as a part of medical and allied health curricula using both cadaveric and three-dimensional (3D) digital models of these specimens. Beyond published cadaveric case reports, anatomical variations identified during routine gross anatomy dissection can be powerful teaching tools and a medium to discuss several anatomical sub-disciplines from embryology to medical imaging. The purpose of this study is to document how cadaveric anatomical variation identified during routine dissection can be scanned using medical imaging techniques to create two-dimensional axial images and interactive 3D models for teaching and learning of anatomical variations. Three cadaveric specimens (2 formalin embalmed, 1 plastinated) depicting anatomical variations and an embryological malformation were scanned using magnetic resonance imaging (MRI) and micro-computed tomography (μCT) for visualization in cross-section and for creation of 3D volumetric models. Results provide educational options to enable visualization and facilitate learning of anatomical variations from cross-sectional scans. Furthermore, the variations can be highlighted, digitized, modeled and manipulated using 3D imaging software and viewed in the anatomy laboratory in conjunction with traditional anatomical dissection. This study provides an example for anatomy educators to teach and describe anatomical variations in the undergraduate medical curriculum. Copyright © 2016 Elsevier GmbH. All rights reserved.

  18. Ability of NIR diffuse optical tomography in providing both anatomical and functional image

    NASA Astrophysics Data System (ADS)

    Zhao, Huijuan; Gao, Feng; Tanikawa, Yukari; Homma, Kazuhiro; Yamada, Yukio

    2003-10-01

    The experimental results of NIR optical tomographic imaging on human limbs are shown in this paper. The absolute absorption and scattering images roughly revealed the anatomical structure of the targets, where the bones were distinguished from the muscle. The images of the hemoglobin concentration changes calculated from differential image of absorption at two wavelengths showed the physiological phenomena during the forearm exercise.

  19. Arterial blood supply of the mesocolic areas. An anatomical and radiological study.

    PubMed

    Bertelli, E; Guidotti, A; Mancini, S

    1989-01-01

    The authors report on first observations on the vascularization of the areae mesocolicae which resulted from radioanatomical studies made in collaboration with the Institute of General Clinical Surgery of the University of Siena. Three areae can be distinguished: colocolica (Treitz), sigmoidea or intersigmoidea, and intercolica. The investigations were carried out using selective preoperative angiography and the injection of anatomical preparations.

  20. Anatomical characteristics of fusoid cells and vascular bundles in Fargesia yunnanensis leaves

    Treesearch

    Shuguang Wang; Hui Zhang; Shuyan Lin; Chungyun Hse; Yulong Ding

    2016-01-01

    As of today, the functions of fusoid cell, and the transport and loading pathways of photoassimilate in bamboo leaves are still not clear. In this paper, the leaves of Fargesia yunnanensis from a greenhouse and the wild were respectively used as samples to analyze the anatomical characteristics of fusoid cells and vascular bundles. The results showed that the bamboo...

  1. Prostatome: a combined anatomical and disease based MRI atlas of the prostate.

    PubMed

    Rusu, Mirabela; Bloch, B Nicolas; Jaffe, Carl C; Genega, Elizabeth M; Lenkinski, Robert E; Rofsky, Neil M; Feleppa, Ernest; Madabhushi, Anant

    2014-07-01

    In this work, the authors introduce a novel framework, the anatomically constrained registration (AnCoR) scheme and apply it to create a fused anatomic-disease atlas of the prostate which the authors refer to as the prostatome. The prostatome combines a MRI based anatomic and a histology based disease atlas. Statistical imaging atlases allow for the integration of information across multiple scales and imaging modalities into a single canonical representation, in turn enabling a fused anatomical-disease representation which may facilitate the characterization of disease appearance relative to anatomic structures. While statistical atlases have been extensively developed and studied for the brain, approaches that have attempted to combine pathology and imaging data for study of prostate pathology are not extant. This works seeks to address this gap. The AnCoR framework optimizes a scoring function composed of two surface (prostate and central gland) misalignment measures and one intensity-based similarity term. This ensures the correct mapping of anatomic regions into the atlas, even when regional MRI intensities are inconsistent or highly variable between subjects. The framework allows for creation of an anatomic imaging and a disease atlas, while enabling their fusion into the anatomic imaging-disease atlas. The atlas presented here was constructed using 83 subjects with biopsy confirmed cancer who had pre-operative MRI (collected at two institutions) followed by radical prostatectomy. The imaging atlas results from mapping thein vivo MRI into the canonical space, while the anatomic regions serve as domain constraints. Elastic co-registration MRI and corresponding ex vivo histology provides "ground truth" mapping of cancer extent on in vivo imaging for 23 subjects. AnCoR was evaluated relative to alternative construction strategies that use either MRI intensities or the prostate surface alone for registration. The AnCoR framework yielded a central gland Dice

  2. Anatomical Correlates of Non-Verbal Perception in Dementia Patients

    PubMed Central

    Lin, Pin-Hsuan; Chen, Hsiu-Hui; Chen, Nai-Ching; Chang, Wen-Neng; Huang, Chi-Wei; Chang, Ya-Ting; Hsu, Shih-Wei; Hsu, Che-Wei; Chang, Chiung-Chih

    2016-01-01

    Purpose: Patients with dementia who have dissociations in verbal and non-verbal sound processing may offer insights into the anatomic basis for highly related auditory modes. Methods: To determine the neuronal networks on non-verbal perception, 16 patients with Alzheimer’s dementia (AD), 15 with behavior variant fronto-temporal dementia (bv-FTD), 14 with semantic dementia (SD) were evaluated and compared with 15 age-matched controls. Neuropsychological and auditory perceptive tasks were included to test the ability to compare pitch changes, scale-violated melody and for naming and associating with environmental sound. The brain 3D T1 images were acquired and voxel-based morphometry (VBM) was used to compare and correlated the volumetric measures with task scores. Results: The SD group scored the lowest among 3 groups in pitch or scale-violated melody tasks. In the environmental sound test, the SD group also showed impairment in naming and also in associating sound with pictures. The AD and bv-FTD groups, compared with the controls, showed no differences in all tests. VBM with task score correlation showed that atrophy in the right supra-marginal and superior temporal gyri was strongly related to deficits in detecting violated scales, while atrophy in the bilateral anterior temporal poles and left medial temporal structures was related to deficits in environmental sound recognition. Conclusions: Auditory perception of pitch, scale-violated melody or environmental sound reflects anatomical degeneration in dementia patients and the processing of non-verbal sounds are mediated by distinct neural circuits. PMID:27630558

  3. 4D measurement system for automatic location of anatomical structures

    NASA Astrophysics Data System (ADS)

    Witkowski, Marcin; Sitnik, Robert; Kujawińska, Małgorzata; Rapp, Walter; Kowalski, Marcin; Haex, Bart; Mooshake, Sven

    2006-04-01

    Orthopedics and neurosciences are fields of medicine where the analysis of objective movement parameters is extremely important for clinical diagnosis. Moreover, as there are significant differences between static and dynamic parameters, there is a strong need of analyzing the anatomical structures under functional conditions. In clinical gait analysis the benefits of kinematical methods are undoubted. In this paper we present a 4D (3D + time) measurement system capable of automatic location of selected anatomical structures by locating and tracing the structures' position and orientation in time. The presented system is designed to help a general practitioner in diagnosing selected lower limbs' dysfunctions (e.g. knee injuries) and also determine if a patient should be directed for further examination (e.g. x-ray or MRI). The measurement system components are hardware and software. For the hardware part we adapt the laser triangulation method. In this way we can evaluate functional and dynamic movements in a contact-free, non-invasive way, without the use of potentially harmful radiation. Furthermore, opposite to marker-based video-tracking systems, no preparation time is required. The software part consists of a data acquisition module, an image processing and point clouds (point cloud, set of points described by coordinates (x, y, z)) calculation module, a preliminary processing module, a feature-searching module and an external biomechanical module. The paper briefly presents the modules mentioned above with the focus on the feature-searching module. Also we present some measurement and analysis results. These include: parameters maps, landmarks trajectories in time sequence and animation of a simplified model of lower limbs.

  4. Anatomical Brain Images Alone Can Accurately Diagnose Chronic Neuropsychiatric Illnesses

    PubMed Central

    Bansal, Ravi; Staib, Lawrence H.; Laine, Andrew F.; Hao, Xuejun; Xu, Dongrong; Liu, Jun; Weissman, Myrna; Peterson, Bradley S.

    2012-01-01

    Objective Diagnoses using imaging-based measures alone offer the hope of improving the accuracy of clinical diagnosis, thereby reducing the costs associated with incorrect treatments. Previous attempts to use brain imaging for diagnosis, however, have had only limited success in diagnosing patients who are independent of the samples used to derive the diagnostic algorithms. We aimed to develop a classification algorithm that can accurately diagnose chronic, well-characterized neuropsychiatric illness in single individuals, given the availability of sufficiently precise delineations of brain regions across several neural systems in anatomical MR images of the brain. Methods We have developed an automated method to diagnose individuals as having one of various neuropsychiatric illnesses using only anatomical MRI scans. The method employs a semi-supervised learning algorithm that discovers natural groupings of brains based on the spatial patterns of variation in the morphology of the cerebral cortex and other brain regions. We used split-half and leave-one-out cross-validation analyses in large MRI datasets to assess the reproducibility and diagnostic accuracy of those groupings. Results In MRI datasets from persons with Attention-Deficit/Hyperactivity Disorder, Schizophrenia, Tourette Syndrome, Bipolar Disorder, or persons at high or low familial risk for Major Depressive Disorder, our method discriminated with high specificity and nearly perfect sensitivity the brains of persons who had one specific neuropsychiatric disorder from the brains of healthy participants and the brains of persons who had a different neuropsychiatric disorder. Conclusions Although the classification algorithm presupposes the availability of precisely delineated brain regions, our findings suggest that patterns of morphological variation across brain surfaces, extracted from MRI scans alone, can successfully diagnose the presence of chronic neuropsychiatric disorders. Extensions of these

  5. Identifying Anatomical Origins of Coexisting Oscillations in the Cortical Microcircuit

    PubMed Central

    Bos, Hannah; Diesmann, Markus; Helias, Moritz

    2016-01-01

    Oscillations are omnipresent in neural population signals, like multi-unit recordings, EEG/MEG, and the local field potential. They have been linked to the population firing rate of neurons, with individual neurons firing in a close-to-irregular fashion at low rates. Using a combination of mean-field and linear response theory we predict the spectra generated in a layered microcircuit model of V1, composed of leaky integrate-and-fire neurons and based on connectivity compiled from anatomical and electrophysiological studies. The model exhibits low- and high-γ oscillations visible in all populations. Since locally generated frequencies are imposed onto other populations, the origin of the oscillations cannot be deduced from the spectra. We develop an universally applicable systematic approach that identifies the anatomical circuits underlying the generation of oscillations in a given network. Based on a theoretical reduction of the dynamics, we derive a sensitivity measure resulting in a frequency-dependent connectivity map that reveals connections crucial for the peak amplitude and frequency of the observed oscillations and identifies the minimal circuit generating a given frequency. The low-γ peak turns out to be generated in a sub-circuit located in layer 2/3 and 4, while the high-γ peak emerges from the inter-neurons in layer 4. Connections within and onto layer 5 are found to regulate slow rate fluctuations. We further demonstrate how small perturbations of the crucial connections have significant impact on the population spectra, while the impairment of other connections leaves the dynamics on the population level unaltered. The study uncovers connections where mechanisms controlling the spectra of the cortical microcircuit are most effective. PMID:27736873

  6. Optimizing Reconstruction with Periorbital Transplantation: Clinical Indications and Anatomic Considerations

    PubMed Central

    Sosin, Michael; Mundinger, Gerhard S.; Dorafshar, Amir H.; Iliff, Nicholas T.; Christensen, Joani M.; Christy, Michael R.; Bojovic, Branko

    2016-01-01

    Background: Complex periorbital subunit reconstruction is challenging because the goals of effective reconstruction vary from one individual to another. The purpose of this article is to explore the indications and anatomic feasibility of periorbital transplantation by reviewing our institutional repository of facial injury. Methods: Institutional review board approval was obtained at the R Adams Cowley Shock Trauma Center for a retrospective chart review conducted on patients with periorbital defects. Patient history, facial defects, visual acuity, and periorbital function were critically reviewed to identify indications for periorbital or total face (incorporating the periorbital subunit) vascularized composite allotransplantation. Cadaveric allograft harvest was then designed and performed for specific patient defects to determine anatomic feasibility. Disease conditions not captured by our patient population warranting consideration were reviewed. Results: A total of 7 facial or periorbital transplant candidates representing 6 different etiologies were selected as suitable indications for periorbital transplantation. Etiologies included trauma, burn, animal attack, and tumor, whereas proposed transplants included isolated periorbital and total face transplants. Allograft recovery was successfully completed in 4 periorbital subunits and 1 full face. Dual vascular supply was achieved in 5 of 6 periorbital subunits (superficial temporal and facial vessels). Conclusions: Transplantation of isolated periorbital structures or full face transplantation including periorbital structures is technically feasible. The goal of periorbital transplantation is to re-establish protective mechanisms of the eye, to prevent deterioration of visual acuity, and to optimize aesthetic outcomes. Criteria necessary for candidate selection and allograft design are identified by periorbital defect, periorbital function, ophthalmologic evaluation, and defect etiology. PMID:27014557

  7. Auxiliary anatomical labels for joint segmentation and atlas registration

    NASA Astrophysics Data System (ADS)

    Gass, Tobias; Szekely, Gabor; Goksel, Orcun

    2014-03-01

    This paper studies improving joint segmentation and registration by introducing auxiliary labels for anatomy that has similar appearance to the target anatomy while not being part of that target. Such auxiliary labels help avoid false positive labelling of non-target anatomy by resolving ambiguity. A known registration of a segmented atlas can help identify where a target segmentation should lie. Conversely, segmentations of anatomy in two images can help them be better registered. Joint segmentation and registration is then a method that can leverage information from both registration and segmentation to help one another. It has received increasing attention recently in the literature. Often, merely a single organ of interest is labelled in the atlas. In the presense of other anatomical structures with similar appearance, this leads to ambiguity in intensity based segmentation; for example, when segmenting individual bones in CT images where other bones share the same intensity profile. To alleviate this problem, we introduce automatic generation of additional labels in atlas segmentations, by marking similar-appearance non-target anatomy with an auxiliary label. Information from the auxiliary-labeled atlas segmentation is then incorporated by using a novel coherence potential, which penalizes differences between the deformed atlas segmentation and the target segmentation estimate. We validated this on a joint segmentation-registration approach that iteratively alternates between registering an atlas and segmenting the target image to find a final anatomical segmentation. The results show that automatic auxiliary labelling outperforms the same approach using a single label atlasses, for both mandibular bone segmentation in 3D-CT and corpus callosum segmentation in 2D-MRI.

  8. Mathematical modelling of the growth of human fetus anatomical structures.

    PubMed

    Dudek, Krzysztof; Kędzia, Wojciech; Kędzia, Emilia; Kędzia, Alicja; Derkowski, Wojciech

    2016-07-08

    The goal of this study was to present a procedure that would enable mathematical analysis of the increase of linear sizes of human anatomical structures, estimate mathematical model parameters and evaluate their adequacy. Section material consisted of 67 foetuses-rectus abdominis muscle and 75 foetuses- biceps femoris muscle. The following methods were incorporated to the study: preparation and anthropologic methods, image digital acquisition, Image J computer system measurements and statistical analysis method. We used an anthropologic method based on age determination with the use of crown-rump length-CRL (V-TUB) by Scammon and Calkins. The choice of mathematical function should be based on a real course of the curve presenting growth of anatomical structure linear size Ύ in subsequent weeks t of pregnancy. Size changes can be described with a segmental-linear model or one-function model with accuracy adequate enough for clinical purposes. The interdependence of size-age is described with many functions. However, the following functions are most often considered: linear, polynomial, spline, logarithmic, power, exponential, power-exponential, log-logistic I and II, Gompertz's I and II and von Bertalanffy's function. With the use of the procedures described above, mathematical models parameters were assessed for V-PL (the total length of body) and CRL body length increases, rectus abdominis total length h, its segments hI, hII, hIII, hIV, as well as biceps femoris length and width of long head (LHL and LHW) and of short head (SHL and SHW). The best adjustments to measurement results were observed in the exponential and Gompertz's models.

  9. Anatomic skull base education using advanced neuroimaging techniques.

    PubMed

    de Notaris, Matteo; Topczewski, Thomaz; de Angelis, Michelangelo; Enseñat, Joaquim; Alobid, Isam; Gondolbleu, Amer Mustafa; Soria, Guadalupe; Gonzalez, Joan Berenguer; Ferrer, Enrique; Prats-Galino, Alberto

    2013-02-01

    The goal of the present article was to describe our dissection training system applied to a variety of endoscopic endonasal approaches. It allows one to perform a 3D virtual dissection of the desired approach and to analyze and quantify critical surgical measurements. All the human cadaveric heads were dissected at the Laboratory of Surgical Neuro-Anatomy (LSNA) of the University of Barcelona (Spain). The model surgical training protocol was designed as follows: 1) virtual dissection of the selected approach using our dissection training 3D model; 2) preliminary exploration of each specimen using a second 3D model based on a preoperative computed tomographic scan; 3) cadaveric anatomic dissection with the aid of a neuronavigation system; and 4) quantification and analysis of the collected data. The virtual dissection of the selected approach, preliminary exploration of each specimen, a real laboratory dissection experience, and finally, the analysis of data retrieved during the dissection step was a complete method for training manual dexterity and hand-eye coordination and to improve the general knowledge of surgical approaches. The present model results are found to be effective, providing a valuable representation of the surgical anatomy as well as a 3D visual feedback, thus improving study, design, and execution in a variety of approaches. Such a system can also be developed as a preoperative planning tool that will allow the neurosurgeon to practice and manipulate 3D representations of the critical anatomic landmarks involved in the endoscopic endonasal approaches to the skull base. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. OSTEOTOMIES OF THE CORACOID PROCESS: AN ANATOMICAL STUDY

    PubMed Central

    Terra, Bernardo Barcellos; de Figueiredo, Eduardo Antônio; Marczyk, Carlos Stanislaw Fleury; Monteiro, Gustavo Cará; de Castro Pochini, Alberto; Andreoli, Carlos Vicente; Ejnisman, Benno

    2015-01-01

    Objective: Relate the main tendinous and ligamentous structures attached in the coracoid process, correlating it to several levels of osteotomy and describing the involved structures. Methods: Thirty shoulders were dissected. The coracoid process with mainly inserted anatomic structures was dissected, and five levels of osteotomy (1.0; 1.5; 2.0; 2.5; 3.0 cm) were made from the apex of the process and the mainly involved structures were recorded. Results: In osteotomies of 1.0 cm, in 100% of the cases only the conjoint tendon (CT). In osteotomies of 1.5 cm there were 63.33% of cases involved with the CT and the Pectoralis minor (PMi), in 20% of cases only the CT, and in 16.66% the CT, PMi, and the coracohumeral ligament (CUL). In osteotomies of 2.0 cm, in 80% of the shoulders, the osteotomies embraced the CT, PMi and the CUL, and in 20% only the CT and the PMi were involved. In the osteotomies of 2.5cm there was involvement of the CT, PMi and CUL in 100% of cases. In the osteotomies of 3.0cm, six cases (20%) have presented an injury on the trapezoid ligament, and in 100% of these osteotomies, the osteotomized distal fragment had embraced the CT, PMi, CUL. Conclusion: The knowledge of anatomic structures inserted and involved in the osteotomies cuts of the coracoid process is very importan to lead with osteotomies performed in the treatment techniques of the coracoid process. Osteotomies of 3.0 cm can injure the trapezoid ligament. PMID:27042643

  11. Anatomical and Radiological Aspects of the Supratrochlear Foramen in Brazilians

    PubMed Central

    Gutfiten-Schlesinger, Gabriel; Leite, Túlio FO; Pires, Lucas AS; Silva, Julio G.

    2016-01-01

    Introduction The supratrochlear foramen is an anatomic variation of great clinical and anthropologic interest. Although many studies addressed this subject in different ethnic groups, there are no studies regarding Brazilians. Aim To verify the incidence and morphometric measures of the supratrochlear foramen in Brazilian humeri. Materials and Methods A total of 330 dry humeri were analysed and divided in three groups: bones presenting the supratrochlear foramen (Group 1), bones displaying a translucent foramen (Group 2) and humeri without the foramen (Group 3). The aperture was measured with a digital vernier caliper. Radiographic pictures with different incidences were taken. Results Our analysis showed that 22.5% of humeri belonged in Group 1, 41.2% in Group 2, and 36.3% in Group 3. The mean vertical diameter and the mean horizontal diameter of the supratrochlear foramen on the left side were 2.779±2.050 mm and 2.332±1.23 mm, respectively. The mean vertical diameter and the mean horizontal diameter of the foramen on the right side were 2.778±2.197 mm, and 2.365±1.396 mm, respectively. The student’s t-test showed that there was no significant difference regarding the size of the foramen between both sides. The best X-ray machine setup was 50 kilo voltage and 0.08 milliamperage per second, associated with a slight increase in the distance of the x-ray tube. Conclusion The aperture seems to be the key point during the pre-operative planning of intramedullary fixation, since it has direct relation to the size of the intramedullary canal, thus, being an entity of clinical, anatomical, anthropological, radiological, and surgical interest. PMID:27790415

  12. Comparison of anatomic landmarks and ultrasound guidance for intercostal nerve injections in cadavers.

    PubMed

    Bhatia, Anuj; Gofeld, Michael; Ganapathy, Sugantha; Hanlon, John; Johnson, Marjorie

    2013-01-01

    Intercostal nerve (ICN) injections are routinely performed under anatomic landmark or fluoroscopic guidance for acute and chronic pain indications. Ultrasound (US) is being used increasingly to perform ICN injections, but there is lack of evidence to support categorically the benefits of US over conventional techniques. We compared guidance with US versus anatomic landmarks for accuracy and safety of ICN injections in cadavers in a 2-phase study that included evaluation of deposition of injected dye by dissection and spread of contrast on fluoroscopy. A cadaver experiment was performed to validate US as an imaging modality for ICN blocks. In the first phase of the study, 12 ICN injections with 2 different volumes of dye were performed in 1 cadaver using anatomic landmarks on one side and US-guidance on the other (6 injections on each side). The cadaver was then dissected to evaluate spread of the dye. The second phase of the study consisted of 74 ICN injections (37 US-guided and 37 using anatomic landmarks) of contrast dye in 6 non-embalmed cadavers followed by fluoroscopy to evaluate spread of the contrast dye. In the first phase of the study, the intercostal space was identified with US at all levels. Injection of 2 mL of dye was sufficient to ensure compete staining of the ICN for 5 of 6 US-guided injections but anatomic landmark guidance resulted in correct injection at only 2 of 6 intercostal spaces. No intravascular injection was found on dissection with either of the guidance techniques. In the second phase of the study, US-guidance was associated with a higher rate of intercostal spread of 1 mL of contrast dye on fluoroscopy compared with anatomic landmarks guidance (97% vs 70%; P = 0.017). Ultrasound confers higher accuracy and allows use of lower volumes of injectate compared with anatomic landmarks as a guidance method for ICN injections in cadavers. Ultrasound may be a viable alternative to anatomic landmarks as a guidance method for ICN injections.

  13. ANATOMICAL RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT OF THE KNEE: DOUBLE BAND OR SINGLE BAND?

    PubMed Central

    Zanella, Luiz Antonio Zanotelli; Junior, Adair Bervig; Badotti, Augusto Alves; Michelin, Alexandre Froes; Algarve, Rodrigo Ilha; de Quadros Martins, Cesar Antonio

    2015-01-01

    Objective: To evaluate the double-band and single-band techniques for anatomical reconstruction of the anterior cruciate ligament of the knee and demonstrate that the double-band technique not only provides greater anterior stability but also causes less pain and a better subjective patient response. Methods: We selected 42 patients who underwent anterior cruciate ligament reconstruction, by means of either the single-band anatomical reconstruction technique, using flexor tendon grafts with two tunnels, or the double-band anatomical reconstruction technique, using four tunnels and grafts from the semitendinosus and gracilis tendons. All fixations were performed using interference screws. There was no variation in the sample. Before the operation, the objective and subjective IKDC scores, Lysholm score and length of time with the injury were evaluated. All these variables were reassessed six months later, and the KT-1000 correlation with the contralateral knee was also evaluated. Results: There was no significant difference between the two groups in subjective evaluations, but the single-band group showed better results in relation to range of motion and objective evaluations including KT-1000 (with statistical significance). Conclusion: Our study demonstrated that there was no difference between the two groups in subjective evaluations, but better results were found using the single-band anatomical technique, in relation to objective evaluations. PMID:27042621

  14. [The anatomical revolution and the transition of anatomical conception in late imperial china].

    PubMed

    Sihn, Kyu Hwan

    2012-04-30

    This paper aimed to examine the anatomical revolution from Yilingaicuo (Correcting the Errors of Medicine) and Quantixinlun(Outline of Anatomy and Physiology) in late imperial China. As the cephalocentrism which the brain superintend human operation of the mind was diffused in China since 16th century, the cephalocentrism and the cardiocentrism had competed for the hegemony of anatomical conception. Because of the advent of Yilingaicuo and Quantixinlun, the cephalocentrism became the main stream in the anatomical conception. The supporters of the Wang Yangming's Xinxue(the Learning of Heart and Mind) argued that the heart was the central organ of perception, sensitivity, and morality of the human body in medicine since 16th century. Even reformist and revolutionary intellectuals like Tan sitong and Mao zedong who had supported the Wang Yangming's Xinxue embraced the cephalocentrism in the late 19th century and the early 20th century. May Fourth intellectuals had not obsessed metaphysical interpretation of human body any more in the New Culture Movement in 1910s. They regarded human body as the object of research and writing. The anatomy was transformed into the instrumental knowledge for mutilation of the body. Yilingaicuo challenged the traditional conception of body, and Chinese intellectuals drew interest in the anatomy knowledge based on real mutilation. Quantixinlun based on Western medicine fueled a controversy about anatomy. Though new knowledge of anatomy was criticized by traditional Chinese medical doctors from the usefulness and morality of anatomy, nobody disavowed new knowledge of anatomy from the institutionalization of Western medicine in medical school. The internal development of cephalocentrism and positivism had influence on anatomy in China since 16th century. The advent of Yilingaicuo and Quantixinlun provided the milestone of new anatomy, though both sides represented traditional Chinese medicine and Western medicine respectively. They

  15. Thoughts on practical core elements of an ethical anatomical education.

    PubMed

    Hildebrandt, Sabine

    2016-01-01

    While questions of ethics in body procurement have become a focus of attention in many medical schools around the world, the recent report by a medical student regarding disturbing incidences in an anatomical dissection course (Terry, ) underlines the importance of a discussion of ethical practices in anatomical education. Here thoughts on core elements of instruction are proposed which are based on the premise that both, ethical body procurement and ethical anatomical education, are the foundation for a humanism-based professional training of students in medicine. As the anatomical dissection course presents an exceptional situation for students, practical guidelines for a curriculum founded on ethical considerations are essential. They include a preparatory phase before the start of the course in which students are asked about their expectations and fears concerning anatomical dissection; an introduction to the history and ethics of anatomy; a time for reflection in the dissection room before the start of dissection; a regular opportunity for reflections on dissection in parallel to the course with students and faculty; and a memorial service for the donors organized by students for faculty, students and donor families. Finally, anatomical faculty should undergo training in ethical educational practices. Many anatomy programs have incorporated various of these ideas, while others have not done so. Guidelines for ethical anatomical practices can strengthen the foundation of a humanistic approach to medicine in future physicians and health care workers.

  16. The peroneocuboid joint: morphogenesis and anatomical study

    PubMed Central

    Guimerá, V; Lafuente, A; Zambrana, L; Rodriguez-Niedenführ, M; Sañudo, J R; Vazquez, T

    2015-01-01

    The peroneocuboid joint, between the peroneus longus tendon and the cuboid bone, has not been anatomically well-defined and no embryological study has been published. Furthermore, the ossification of the os peroneum (a sesamoid inside the peroneus longus tendon) and its associated pathology has been considered to be generated by orthostatic and/or mechanical loads. A light microscopy analysis of serially sectioned human embryonic and fetal feet, the analysis of human adult feet by means of standard macroscopic dissection, X-ray and histological techniques have been carried out. The peroneus longus tendon was fully visible until its insertion in the 1st metatarsal bone already at embryonic stage 23 (56–57 days). The peroneocuboid joint cavity appeared at the transition of the embryonic to the fetal period (8–9th week of gestation) and was independent of the proximal synovial sheath. The joint cavity extended from the level of the calcaneocuboid joint all the way to the insertion of the peroneus longus tendon in the 1st metatarsal bone. The frenular ligaments, fixing the peroneus longus tendon to the 5th metatarsal bone or the long calcaneocuboid ligament, developed in the embryonic period. The peroneus longus tendon presented a thickening in the area surrounding the cuboid bone as early as the fetal period. This thickening may be considered the precursor of the os peroneum and was similar in shape and in size relation to the tendon, to the os peroneum observed in adults. To the best of our knowledge, this is the first study to show that the os peroneum, articular facets of the peroneus longus tendon and cuboid bone, the peroneocuboid joint and the frenular ligaments appear during the embryonic/fetal development period and therefore they can not be generated exclusively by orthostatic and mechanical forces or pathological processes. PMID:25384452

  17. An anatomic study of the iliotibial tract.

    PubMed

    Vieira, Eduardo Luís Cruells; Vieira, Eduardo Alvaro; da Silva, Rogério Teixeira; Berlfein, Paulo Augusto dos Santos; Abdalla, Rene Jorge; Cohen, Moisés

    2007-03-01

    To identify the structure of the iliotibial tract at knee level, as well as its insertions, layer arrangement, and relationship with other structures of the lateral region of the knee and to compare the findings with available literature. Ten detailed anatomic dissections were performed by using incisions as recommended by the literature in fresh cadaver knees identifying the iliotibial tract components. The authors observed an iliotibial tract arrangement in superficial, deep, and capsular-osseous layers. Insertions have been described as follows: at linea aspera, at the upper border of the lateral epicondyle, at the patella, and at Gerdy's tibial tuberculum and across the capsular-osseous layer. The iliotibial tract (ITT) has important interconnections to the femur, the patella, and the lateral tibia; the iliopatellar band joins the ITT to the patella through the superficial oblique retinaculum and the lateral femoropatellar ligament, and the ITT capsular-osseous layer presents differentiated fibers in an arched arrangement that borders the femoral condyle and inserts laterally to the Gerdy's tubercle. The iliotibial tract can be considered as an anterolateral knee stabilizer, particularly its capsular-osseous layer, which, together with the anterior cruciate ligament, constitutes a functional unit forming a spatial "horseshoe" form. The detailed description of the structures forming iliotibial tract plays an important role in the study of knee instabilities. Its important tibial, femoral, and patellar connections are described so that better understanding of tibial femoral instability on the lateral side as well as patellofemoral instability can be achieved and mechanisms of repair can be conceived.

  18. An anatomically oriented breast model for MRI

    NASA Astrophysics Data System (ADS)

    Kutra, Dominik; Bergtholdt, Martin; Sabczynski, Jörg; Dössel, Olaf; Buelow, Thomas

    2015-03-01

    Breast cancer is the most common cancer in women in the western world. In the breast cancer care-cycle, MRIis e.g. employed in lesion characterization and therapy assessment. Reading of a single three dimensional image or comparing a multitude of such images in a time series is a time consuming task. Radiological reporting is done manually by translating the spatial position of a finding in an image to a generic representation in the form of a breast diagram, outlining quadrants or clock positions. Currently, registration algorithms are employed to aid with the reading and interpretation of longitudinal studies by providing positional correspondence. To aid with the reporting of findings, knowledge about the breast anatomy has to be introduced to translate from patient specific positions to a generic representation. In our approach we fit a geometric primitive, the semi-super-ellipsoid to patient data. Anatomical knowledge is incorporated by fixing the tip of the super-ellipsoid to the mammilla position and constraining its center-point to a reference plane defined by landmarks on the sternum. A coordinate system is then constructed by linearly scaling the fitted super-ellipsoid, defining a unique set of parameters to each point in the image volume. By fitting such a coordinate system to a different image of the same patient, positional correspondence can be generated. We have validated our method on eight pairs of baseline and follow-up scans (16 breasts) that were acquired for the assessment of neo-adjuvant chemotherapy. On average, the location predicted and the actual location of manually set landmarks are within a distance of 5.6 mm. Our proposed method allows for automatic reporting simply by uniformly dividing the super-ellipsoid around its main axis.

  19. Anatomical and technical considerations in surface electromyography.

    PubMed

    Ferdjallah, M; Wertsch, J J

    1998-11-01

    Despite the technical and clinical limitations of surface EMG, it is essential in the physical medicine and rehabilitation field. Surface EMG has evolved from a secondary means of clinical assessment to a primary factor in determining and predicting clinical outcomes. Computer models of electrical muscular activity are currently implemented to assist in designing proper instrumentation and electrode with optimum dimensions. These models could be expanded to simulate pathological motor functions to help understand functional abnormalities even before clinical interventions. Currently, several groups all over the world are investigating the use of multichannel surface EMG. This technological advancement would have an immediate impact on several medical fields. For instance, tendon transfers are performed to improve function in peripheral nerve injury, brachial plexus lesion, spinal cord injury, and cerebral palsy. There are potential uses for multichannel surface EMG, both preoperatively and postoperatively. Preoperatively choosing the muscle for transfer has been largely based on clinical grounds. Multichannel surface EMG could give a more objective database to assess prognosis and determine which muscle to transfer. Postoperatively, multichannel surface EMG can provide a systematic way of assessing changes in gross muscle topography caused by the tendon transfer. Other applications of multichannel surface EMG would be for bony and soft tissue deformity from arthritis, heterotopic ossification, amputation, or burns. Multichannel surface EMG would allow clinicians to get a broader picture of the skeletal muscle activity despite the fact that it is physically impossible for the patient to assume the anatomic position used for traditional isolated electrode placement. Individuals with physical disabilities that affect their ability to assume the usual posture for electrophysiologic testing may benefit considerably from development of multichannel electrophysiologic

  20. Anatomical study for SLAP lesion repair.

    PubMed

    Arai, Ryuzo; Kobayashi, Masahiko; Harada, Hideto; Tsukiyama, Hiroyuki; Saji, Takahiko; Toda, Yoshinobu; Hagiwara, Yoshihiro; Miura, Takashi; Matsuda, Shuichi

    2014-02-01

    The purpose of this study was to meticulously observe the structures around the origin of the long head of the biceps tendon (LHB) in order to propose a method of anatomical superior labrum anterior and posterior repair. Twenty-eight shoulders of 16 cadavers with intact LHB origin were macroscopically investigated. Among them, 20 shoulders with an intact superior labrum were additionally observed, to determine whether the anterior edge of LHB on the labrum (point 'A') was anterior to the supraglenoid tubercle. Serial sections vertical to LHB were observed using ordinary light and polarized microscopy in three glenoids and scanning acoustic microscopy in one. The labrum had a meniscal appearance, and no LHB fibre was sent anterior to the anterior edge of the supraglenoid tubercle. 'A' was not located more posterior than the supraglenoid tubercle. All specimens had the so-called 'the sheet-like structure', in which the portion closer to the LHB origin tends to be stiffer. Fibres of the sheet-like structure ran vertically to LHB. Fibre orientation and the stiffness of the sheet-like structure suggest its support of LHB. As LHB fibres do not anteriorly cross over 'A', 'A' could be a landmark for the anterior border of LHB, independent from the sheet-like structure. Considering a previous report mentioning that the horizontal mattress suture maintains the meniscus-like structure which might be sufficient for proper motion of the normal superior labrum, the horizontal mattress suture not crossing over 'A' should be recommended from the viewpoint of functional anatomy.

  1. The peroneocuboid joint: morphogenesis and anatomical study.

    PubMed

    Guimerá, V; Lafuente, A; Zambrana, L; Rodriguez-Niedenführ, M; Sañudo, J R; Vazquez, T

    2015-01-01

    The peroneocuboid joint, between the peroneus longus tendon and the cuboid bone, has not been anatomically well-defined and no embryological study has been published. Furthermore, the ossification of the os peroneum (a sesamoid inside the peroneus longus tendon) and its associated pathology has been considered to be generated by orthostatic and/or mechanical loads. A light microscopy analysis of serially sectioned human embryonic and fetal feet, the analysis of human adult feet by means of standard macroscopic dissection, X-ray and histological techniques have been carried out. The peroneus longus tendon was fully visible until its insertion in the 1st metatarsal bone already at embryonic stage 23 (56-57 days). The peroneocuboid joint cavity appeared at the transition of the embryonic to the fetal period (8-9th week of gestation) and was independent of the proximal synovial sheath. The joint cavity extended from the level of the calcaneocuboid joint all the way to the insertion of the peroneus longus tendon in the 1st metatarsal bone. The frenular ligaments, fixing the peroneus longus tendon to the 5th metatarsal bone or the long calcaneocuboid ligament, developed in the embryonic period. The peroneus longus tendon presented a thickening in the area surrounding the cuboid bone as early as the fetal period. This thickening may be considered the precursor of the os peroneum and was similar in shape and in size relation to the tendon, to the os peroneum observed in adults. To the best of our knowledge, this is the first study to show that the os peroneum, articular facets of the peroneus longus tendon and cuboid bone, the peroneocuboid joint and the frenular ligaments appear during the embryonic/fetal development period and therefore they can not be generated exclusively by orthostatic and mechanical forces or pathological processes.

  2. Development of a quantitative multivariable radiographic method to evaluate anatomic changes associated with laminitis in the forefeet of donkeys.

    PubMed

    Collins, Simon N; Dyson, Sue J; Murray, Rachel C; Newton, J Richard; Burden, Faith; Trawford, Andrew F

    2012-08-01

    To establish and validate an objective method of radiographic diagnosis of anatomic changes in laminitic forefeet of donkeys on the basis of data from a comprehensive series of radiographic measurements. 85 donkeys with and 85 without forelimb laminitis for baseline data determination; a cohort of 44 donkeys with and 18 without forelimb laminitis was used for validation analyses. For each donkey, lateromedial radiographic views of 1 weight-bearing forelimb were obtained; images from 11 laminitic and 2 nonlaminitic donkeys were excluded (motion artifact) from baseline data determination. Data from an a priori selection of 19 measurements of anatomic features of laminitic and nonlaminitic donkey feet were analyzed by use of a novel application of multivariate statistical techniques. The resultant diagnostic models were validated in a blinded manner with data from the separate cohort of laminitic and nonlaminitic donkeys. Data were modeled, and robust statistical rules were established for the diagnosis of anatomic changes within laminitic donkey forefeet. Component 1 scores ≤ -3.5 were indicative of extreme anatomic change, and scores from -2.0 to 0.0 denoted modest change. Nonlaminitic donkeys with a score from 0.5 to 1.0 should be considered as at risk for laminitis. Results indicated that the radiographic procedures evaluated can be used for the identification, assessment, and monitoring of anatomic changes associated with laminitis. Screening assessments by use of this method may enable early detection of mild anatomic change and identification of at-risk donkeys.

  3. Nomina anatomica. Anatomic terminology and the old French terminology.

    PubMed

    Chiapas-Gasca, Karla; Passos, Luiz Fernando De Souza; Euzébio Ribeiro, Sandra Lúcia; Villaseñor-Ovies, Pablo

    A surprising finding in our seminars in Latin America and Spain was that approximately half of the participants continued to use the old French anatomical nomenclature. The substance of this paper is a table in which we compare the anatomical names for the items reviewed in our seminar, in a Spanish version of the old French nomenclature and in the Spanish, Portuguese, and English versions of the currently employed anatomical terms. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  4. A reusable anatomically segmented digital mannequin for public health communication.

    PubMed

    Fujieda, Kaori; Okubo, Kosaku

    2016-01-01

    The ongoing development of world wide web technologies has facilitated a change in health communication, which has now become bi-directional and encompasses people with diverse backgrounds. To enable an even greater role for medical illustrations, a data set, BodyParts3D, has been generated and its data set can be used by anyone to create and exchange customised three-dimensional (3D) anatomical images. BP3D comprises more than 3000 3D object files created by segmenting a digital mannequin in accordance with anatomical naming conventions. This paper describes the methodologies and features used to generate an anatomically correct male mannequin.

  5. [Problems on Czech anatomical nomenclature in forensic medicine].

    PubMed

    Necas, P; Hejna, P

    2009-07-01

    The paper describes the medico-legal language style of texts which are often meant for non-medical scholars. Traditionally, the Czech language has been used in forensic medicine, instead of Latin (words with Latin roots). The paper also presents requirements for the language style of medico-legal texts as we have found them in academic publications. The core of the paper is an analysis of the anatomical terms extracted from autopsy protocols. We focus on designation of those anatomical structures which do not have their established Czech equivalents. Possibilities of a future research of the Czech anatomical nomenclature standardization for speech recognition (e.g., autopsy protocols) are mentioned.

  6. Anatomic changes due to interspecific grafting in cassava (Manihot esculenta).

    PubMed

    Bomfim, N; Ribeiro, D G; Nassar, N M A

    2011-05-31

    Cassava rootstocks of varieties UnB 201 and UnB 122 grafted with scions of Manihot fortalezensis were prepared for anatomic study. The roots were cut, stained with safranin and alcian blue, and examined microscopically, comparing them with sections taken from ungrafted roots. There was a significant decrease in number of pericyclic fibers, vascular vessels and tyloses in rootstocks. They exhibited significant larger vessels. These changes in anatomic structure are a consequence of genetic effects caused by transference of genetic material from scion to rootstock. The same ungrafted species was compared. This is the first report on anatomic changes due to grafting in cassava.

  7. Sex determination of Joseon people skeletons based on anatomical, cultural and molecular biological clues.

    PubMed

    Kim, Yi-Suk; Oh, Chang Seok; Lee, Sang Jun; Park, Jun Bum; Kim, Myeung Ju; Shin, Dong Hoon

    2011-12-20

    Sex determination is very integral to examinations conducted by anatomists on human skeletons discovered in the archaeological field. In Korea, as in other countries, cultural or anatomical information has been the tool of first resort in making such determinations. In cases in which anatomical examination has revealed only borderline characteristics, PCR-based analysis of X/Y-chromosome genes has been employed. Even so, there are as yet very few reports on how accurately the respective results correspond with each other. In this study on 34 examined medieval Korean skeletons, 11 (32.3%) showed perfectly matching results for the three methods of sex determination. In the cases in which the cultural and anatomical findings were discordant, the amelogenin assay corroborated either the former or the latter. Although we must admit the relatively limited role of aDNA analysis, when only very small amounts of amplifiable DNA remain, we believe that the amelogenin assay can be very meaningful to Korean anatomists when employed in adjunct to conventional anatomically or culturally based sex determination.

  8. Effects of anatomical position on esophageal transit time: A biomagnetic diagnostic technique

    PubMed Central

    Cordova-Fraga, Teodoro; Sosa, Modesto; Wiechers, Carlos; la Roca-Chiapas, Jose Maria De; Moreles, Alejandro Maldonado; Bernal-Alvarado, Jesus; Huerta-Franco, Raquel

    2008-01-01

    AIM: To study the esophageal transit time (ETT) and compare its mean value among three anatomical inclinations of the body; and to analyze the correlation of ETT to body mass index (BMI). METHODS: A biomagnetic technique was implemented to perform this study: (1) The transit time of a magnetic marker (MM) through the esophagus was measured using two fluxgate sensors placed over the chest of 14 healthy subjects; (2) the ETT was assessed in three anatomical positions (at upright, fowler, and supine positions; 90º, 45º and 0º, respectively). RESULTS: ANOVA and Tuckey post-hoc tests demonstrated significant differences between ETT mean of the different positions. The ETT means were 5.2 ± 1.1 s, 6.1 ± 1.5 s, and 23.6 ± 9.2 s for 90º, 45º and 0º, respectively. Pearson correlation results were r = -0.716 and P < 0.001 by subjects’ anatomical position, and r = -0.024 and P > 0.05 according the subject’s BMI. CONCLUSION: We demonstrated that using this biomagnetic technique, it is possible to measure the ETT and the effects of the anatomical position on the ETT. PMID:18837088

  9. Combining Spatial Priors and Anatomical Information for fMRI Detection

    PubMed Central

    Wells, William M.; Golland, Polina

    2013-01-01

    In this paper, we analyze Markov Random Field (MRF) as a spatial regularizer in fMRI detection. The low signal-to-noise ratio (SNR) in fMRI images presents a serious challenge for detection algorithms, making regularization necessary to achieve good detection accuracy. Gaussian smoothing, traditionally employed to boost SNR, often produces over-smoothed activation maps. Recently, the use of MRF priors has been suggested as an alternative regularization approach. However, solving for an optimal configuration of the MRF is NP-hard in general. In this work, we investigate fast inference algorithms based on the Mean Field approximation in application to MRF priors for fMRI detection. Furthermore, we propose a novel way to incorporate anatomical information into the MRF-based detection framework and into the traditional smoothing methods. Intuitively speaking, the anatomical evidence increases the likelihood of activation in the gray matter and improves spatial coherency of the resulting activation maps within each tissue type. Validation using the receiver operating characteristic (ROC) analysis and the confusion matrix analysis on simulated data illustrates substantial improvement in detection accuracy using the anatomically guided MRF spatial regularizer. We further demonstrate the potential benefits of the proposed method in real fMRI signals of reduced length. The anatomically guided MRF regularizer enables significant reduction of the scan length while maintaining the quality of the resulting activation maps. PMID:20362488

  10. Construction and biomechanical properties of polyaxial self-locking anatomical plate based on the geometry of distal tibia.

    PubMed

    Liang, Weiguo; Ye, Weixiong; Ye, Dongping; Zhou, Ziqiang; Chen, Zhiguang; Li, Aiguo; Xie, Zong-Han; Zhang, Lihai; Xu, Jiake

    2014-01-01

    In order to provide scientific and empirical evidence for the clinical application of the polyaxial self-locking anatomical plate, 80 human tibias from healthy adults were scanned by spiral CT and their three-dimensional images were reconstructed using the surface shaded display (SSD) method. Firstly, based on the geometric data of distal tibia, a polyaxial self-locking anatomical plate for distal tibia was designed and constructed. Biomechanical tests were then performed by applying axial loading, 4-point bending, and axial torsion loading on the fracture fixation models of fresh cadaver tibias. Our results showed that variation in twisting angles of lateral tibia surface was found in various segments of the distal tibia. The polyaxial self-locking anatomical plate was constructed based on the geometry of the distal tibia. Compared to the conventional anatomical locking plate, the polyaxial self-locking anatomical plate of the distal tibia provides a better fit to the geometry of the distal tibia of the domestic population, and the insertion angle of locking screws can be regulated up to 30°. Collectively, this study assesses the geometry of the distal tibia and provides variable locking screw trajectory to improve screw-plate stability through the design of a polyaxial self-locking anatomical plate.

  11. Relationship between Peeled Internal Limiting Membrane Area and Anatomic Outcomes following Macular Hole Surgery: A Quantitative Analysis

    PubMed Central

    Goker, Yasin Sakir; Koc, Mustafa; Yuksel, Kemal; Yazici, Ahmet Taylan; Gunes, Hasan; Ozpinar, Yavuz

    2016-01-01

    Purpose. To quantitatively evaluate the effects of peeled internal limiting membrane (ILM) area and anatomic outcomes following macular hole surgery using spectral domain optical coherence tomography (SD-OCT). Methods. Forty-one eyes in 37 consecutive patients with idiopathic, Gass stage 3-4 macular hole (MH) were enrolled in this retrospective comparative study. All patients were divided into 2 groups according to anatomic success or failure. Basal MH diameter, peeled ILM area, and MH height were calculated using SD-OCT. Other prognostic parameters, including age, stage, preoperative BCVA, and symptom duration were also assessed. Results. Thirty-two cases were classified as anatomic success, and 9 cases were classified as anatomic failure. Peeled ILM area was significantly wider and MH basal diameter was significantly less in the anatomic success group (p = 0.024 and 0.032, resp.). Other parameters did not demonstrate statistical significance. Conclusion. The findings of the present study show that the peeled ILM area can affect the anatomic outcomes of MH surgery. PMID:27413544

  12. [VASCULAR ANATOMICAL STUDY ON TIBIAL OSTEOTOMY LENGTHENING].

    PubMed

    Wang, Bin; Wang, Pengfei; Wang, Yupeng; Jia, Song; Yang, Huanyou; Yin, Jiali; Jiang, Wenping; Zhao, Gang

    2015-07-01

    To provide the anatomical basis for the selection of osteotomy site in leg lengthening or tibial slip. Between August 2010 and July 2014, 10 adult fresh amputated leg specimens were collected. The pressure perfusion of red latex was performed by the popliteal artery. The anterior tibial artery and its main branches were separated and exposed, and the periosteal branch of anterior tibial artery was adequately exposed; the posterior tibial artery and its main branches were exposed; the peroneal artery was separated and exposed. The tibial and peroneal artery and its branches were observed and measured. When measuring the proximal end, the medial tibial plateau bone margin, the most prominent part of the tibial tuberosity, and the fibular head edge were used as a reference; when measuring the distal end, distal medial condyle of tibia malleolus tip, tibial lateral malleolus lateral tip, and distal tibial articular surface were used as a reference; the vertical distance between tibia proximal and distal main arteries and bone end reference was measured to determine the optimal osteotomy position of upper and lower tibia. The osteotomy index was calculated which was used to represent the relative position of osteotomy site in the whole tibia. The proximal tibial osteotomy site located at (78.2 ± 19.5) mm from medial tibial plateau margin, (41.8 ± 16.0) mm from the tibial tuberosity pole, and (66.7 ± 16.4) mm from the fibular head edge. The distal tibial osteotomy site located at (70.8 ± 12.1) mm above the inferior margin of tibial medial malleolus, (83.3 ± 13.0) mm above the inferior margin of lateral malleolus tip, and (59.1 ± 11.7) mm from distal tibial articular surface. The proximal tibial osteotomy index was 18.45-23.35 (mean, 20.46); the distal tibial osteotomy index was 14.36-23.05 (mean, 18.81). The metaphyseal-diaphyseal connection shold be selected in the proximal and distal tibia osteotomy, the lower one third of the tibia is not suitable for ostetomy.

  13. Anatomical terminology and nomenclature: past, present and highlights.

    PubMed

    Kachlik, David; Baca, Vaclav; Bozdechova, Ivana; Cech, Pavel; Musil, Vladimir

    2008-08-01

    The anatomical terminology is a base for medical communication. It is elaborated into a nomenclature in Latin. Its history goes back to 1895, when the first Latin anatomical nomenclature was published as Basiliensia Nomina Anatomica. It was followed by seven revisions (Jenaiensia Nomina Anatomica 1935, Parisiensia Nomina Anatomica 1955, Nomina Anatomica 2nd to 6th edition 1960-1989). The last revision, Terminologia Anatomica, (TA) created by the Federative Committee on Anatomical Terminology and approved by the International Federation of Associations of Anatomists, was published in 1998. Apart from the official Latin anatomical terminology, it includes a list of recommended English equivalents. In this article, major changes and pitfalls of the nomenclature are discussed, as well as the clinical anatomy terms. The last revision (TA) is highly recommended to the attention of not only teachers, students and researchers, but also to clinicians, doctors, translators, editors and publishers to be followed in their activities.

  14. Anatomical influences on internally coupled ears in reptiles.

    PubMed

    Young, Bruce A

    2016-10-01

    Many reptiles, and other vertebrates, have internally coupled ears in which a patent anatomical connection allows pressure waves generated by the displacement of one tympanic membrane to propagate (internally) through the head and, ultimately, influence the displacement of the contralateral tympanic membrane. The pattern of tympanic displacement caused by this internal coupling can give rise to novel sensory cues. The auditory mechanics of reptiles exhibit more anatomical variation than in any other vertebrate group. This variation includes structural features such as diverticula and septa, as well as coverings of the tympanic membrane. Many of these anatomical features would likely influence the functional significance of the internal coupling between the tympanic membranes. Several of the anatomical components of the reptilian internally coupled ear are under active motor control, suggesting that in some reptiles the auditory system may be more dynamic than previously recognized.

  15. Interactive anatomical teaching: Integrating radiological anatomy within topographic anatomy.

    PubMed

    Abed Rabbo, F; Garrigues, F; Lefèvre, C; Seizeur, R

    2016-03-01

    Hours attributed to teaching anatomy have been reduced in medical curricula through out the world. In consequence, changes in anatomical curriculum as well as in teaching methods are becoming necessary. New methods of teaching are being evaluated. We present in the following paper an example of interactive anatomical teaching associating topographic anatomy with ultrasonographic radiological anatomy. The aim was to explicitly show anatomical structures of the knee and the ankle through dissection and ultrasonography. One cadaver was used as an ultrasonographic model and the other was dissected. Anatomy of the knee and ankle articulations was studied through dissection and ultrasonography. The students were able to simultaneously assimilate both anatomical aspects of radiological and topographic anatomy. They found the teaching very helpful and practical. This body of work provides example of a teaching method combining two important aspects of anatomy to help the students understand both aspects simultaneously. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Anatomical brain atlas for NIRS measurements of brain activation

    NASA Astrophysics Data System (ADS)

    Caffini, Matteo; Zucchelli, Lucia; Contini, Davide; Cubeddu, Rinald