Herd outbreak of bovine tuberculosis illustrates that route of infection correlates with anatomic distribution of lesions in cattle and cats.

PubMed

Fitzgerald, Scott D; Hollinger, Charlotte; Mullaney, Thomas P; Bruning-Fann, Colleen S; Tilden, John; Smith, Rick; Averill, James; Kaneene, John B

2016-03-01

An outbreak of bovine tuberculosis (TB) in a Michigan dairy herd resulted in quarantine, depopulation, pathology, and epidemiologic investigations. This herd, compared to other TB-infected herds in Michigan, was unusual in the long-term feeding of waste milk to its replacement calves. The herd had 80 cattle with positive results on caudal fold test or gamma interferon testing, which were reclassified as suspects because the herd had never been known to be tuberculous previously. Autopsy revealed striking variation in the anatomic distribution of gross anatomic lesions, microscopic lesions, and culture-positive lymph nodes between the adult cattle, the calves, and the domestic cats present on the farm. Adult cattle had lesions and culture-positive lymph nodes predominantly within the thoracic lymph nodes, whereas cats had 50% of their lesions and culture-positive lymph nodes in their abdomens, and 50% of positive calves had culture-positive lymph nodes in their abdomens. This difference in anatomic distribution correlated with the likely routes of infection, which are believed to be by direct airborne transmission in adult cattle and indirect ingestion of contaminated milk in both calves and cats. Although TB literature over the past 100-plus years states that the route of infection may manifest itself in differences in lesion anatomic distribution, our team has been working with TB for over 20 years, and we have never encountered such striking variation between different groups of animals on the same farm. © 2016 The Author(s).

Gemelli-obturator complex in the deep gluteal space: an anatomic and dynamic study.

PubMed

Balius, Ramon; Susín, Antonio; Morros, Carles; Pujol, Montse; Pérez-Cuenca, Dolores; Sala-Blanch, Xavier

2018-06-01

To investigate the behavior of the sciatic nerve during hip rotation at subgluteal space. Sonographic examination (high-resolution ultrasound machine at 5.0-14 MHZ) of the gemelli-obturator internus complex following two approaches: (1) a study on cadavers and (2) a study on healthy volunteers. The cadavers were examined in pronation, pelvis-fixed position by forcing internal and external rotations of the hip with the knee in 90° flexion. Healthy volunteers were examined during passive internal and external hip rotation (prone position; lumbar and pelvic regions fixed). Subjects with a history of major trauma, surgery or pathologies affecting the examined regions were excluded. The analysis included eight hemipelvis from six fresh cadavers and 31 healthy volunteers. The anatomical study revealed the presence of connective tissue attaching the sciatic nerve to the structures of the gemellus-obturator system at deep subgluteal space. The amplitude of the nerve curvature during rotating position was significantly greater than during resting position. During passive internal rotation, the sciatic nerve of both cadavers and healthy volunteers transformed from a straight structure to a curved structure tethered at two points as the tendon of the obturator internus contracted downwards. Conversely, external hip rotation caused the nerve to relax. Anatomically, the sciatic nerve is closely related to the gemelli-obturator internus complex. This relationship results in a reproducible dynamic behavior of the sciatic nerve during passive hip rotation, which may contribute to explain the pathological mechanisms of the obturator internal gemellus syndrome.

Measurement of gastrocnemius muscle elasticity by shear wave elastography: association with passive ankle joint stiffness and sex differences.

PubMed

Chino, Kentaro; Takahashi, Hideyuki

2016-04-01

Passive joint stiffness is an important quantitative measure of flexibility, but is affected by muscle volume and all of the anatomical structures located within and over the joint. Shear wave elastography can assess muscle elasticity independent of the influences of muscle volume and the other nearby anatomical structures. We determined how muscle elasticity, as measured using shear wave elastography, is associated with passive joint stiffness and patient sex. Twenty-six healthy men (24.4 ± 5.9 years) and 26 healthy women (25.2 ± 4.8 years) participated in this study. The passive ankle joint stiffness and tissue elasticity of the medial gastrocnemius (MG) were quantified with the ankle in 30° plantar flexion (PF), a neutral anatomical position (NE), and 20° dorsiflexion (DF). No significant difference in passive joint stiffness by sex was observed with the ankle in PF, but significantly greater passive ankle joint stiffness in men than in women was observed in NE and DF. The MG elasticity was not significantly associated with joint stiffness in PF or NE, but it was significantly associated with joint stiffness in DF. There were no significant differences in MG elasticity by sex at any ankle position. Muscle elasticity, measured independent of the confounding effects of muscle volume and the other nearby anatomical structures, is associated with passive joint stiffness in the joint position where the muscle is sufficiently lengthened, but does not vary by sex in any joint position tested.

[Anatomical rationale for lingual nerve injury prevention during mandibular block].

PubMed

Semkin, V A; Dydikin, S S; Kuzin, A V; Sogacheva, V V

2015-01-01

The topographic and anatomical study of lingual nerve structural features was done. It was revealed that during mandibular anesthesia possible lingual nerve injury can occur if puncture needle is lower than 1 cm. of molars occlusal surface level. The position of the lingual nerve varies withmandible movements. At the maximum open mouth lingual nerve is not mobile and is pressed against the inner surface of the mandibular ramus by the medial pterygoid muscle and the temporal muscle tendon. When closing the mouth to 1.25±0.2 cmfrom the physiological maximum, lingual nerve is displaced posteriorly from the internal oblique line of the mandible and gets mobile. On the basis of topographic and anatomic features of the lingual nervestructure the authors recommend the re-do of inferior alveolar nerve block, a semi-closed mouth position or the use the "high block techniques" (Torus anesthesia, Gow-Gates, Vazirani-Akinozi).

[Anatomical study of men's nipple areola complex].

PubMed

Vaucher, R; Dast, S; Assaf, N; Sinna, R

2016-06-01

The surgical approach of gynecomastia, sexual reassignment surgery in female-to-male transsexuals and the increase of number of obese wishing to turn to plastic surgery led us to deepen the anatomical knowledge of the nipple areola complex (NAC) in men, poorly retailed in the literature. By inspiring us of the methodology of a Japanese study, we studied 50 healthy volunteers male, from 18 to 55 years old, from July till August 2015. We measured various distances relative to the NAC to define its vertical and horizontal position, as well as the internipple distance according to the size, to the weight and to the body mass index (BMI). At the end of the analysis, we were able to underline a lower vertical thoracic position of the NAC in the tall category of person, a more side horizontal position to the subject presenting a high BMI and a linear relation between the BMI and the internipple (Em) defined by (Em)=8.96×BMI. The surgeon's judgment and the desires of the patient are essentials basis of therapeutics decisions that could be lean on this anatomical study, which allowed to establish an idea of the cartography of the NAC in man. It will be interesting and necessary to confront it with other studies with larger scale. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Computed Tomographic Analysis of Ventral Atlantoaxial Optimal Safe Implantation Corridors in 27 Dogs.

PubMed

Leblond, Guillaume; Gaitero, Luis; Moens, Noel M M; Zur Linden, Alex; James, Fiona M K; Monteith, Gabrielle J; Runciman, John

2017-11-01

Objectives  Ventral atlantoaxial stabilization techniques are challenging surgical procedures in dogs. Available surgical guidelines are based upon subjective anatomical landmarks, and limited radiographic and computed tomographic data. The aims of this study were (1) to provide detailed anatomical descriptions of atlantoaxial optimal safe implantation corridors to generate objective recommendations for optimal implant placements and (2) to compare anatomical data obtained in non-affected Toy breed dogs, affected Toy breed dogs suffering from atlantoaxial instability and non-affected Beagle dogs. Methods  Anatomical data were collected from a prospectively recruited population of 27 dogs using a previously validated method of optimal safe implantation corridor analysis using computed tomographic images. Results  Optimal implant positions and three-dimensional numerical data were generated successfully in all cases. Anatomical landmarks could be used to generate objective definitions of optimal insertion points which were applicable across all three groups. Overall the geometrical distribution of all implant sites was similar in all three groups with a few exceptions. Clinical Significance  This study provides extensive anatomical data available to facilitate surgical planning of implant placement for atlantoaxial stabilization. Our data suggest that non-affected Toy breed dogs and non-affected Beagle dogs constitute reasonable research models to study atlantoaxial stabilization constructs. Schattauer GmbH Stuttgart.

Anthropometric Renal Anatomic Alterations Between Supine and Prone Positions in Percutaneous Renal Ablation for Renal Cortical Neoplasms.

PubMed

Lusch, Achim; Fujimoto, Scott; Findeiss, Laura K; Okhunov, Zhamshid; McDougall, Elspeth M; Landman, Jaime

2016-02-01

To establish patterns of anatomic changes relevant to the kidney and colon during positional change between the supine and prone positions as noted on CT scans performed during percutaneous cryoablation for renal cortical neoplasms (RCN). Nineteen patients undergoing percutaneous cryoablation for RCN with abdominal CT scan in both the supine and prone positions were included in the study. We documented the anterior/posterior, medial/lateral, and cranial/caudal anatomic changes of the kidney, kidney rotation, and the proportion of the kidney whose access was limited by the liver, spleen, and lung. We also calculated the length of the percutaneous access tract and the distance between the colon and kidney in hilar position as well as the anterior/posterior location of the colon relative to the kidney. In the prone position, the kidney lies significantly more anteriorly on both sides: 4.7 cm vs 4.3 cm (L) and 4.4 cm vs 4.1 cm (R) (p = 0.02 and p = 0.03, respectively). On prone CT images, both kidneys are more cranial when compared with the supine position: 80.4 mm vs 60.8 mm (L) and 87.2 mm vs 57.4 mm (R) (p = 0.002 and p < 0.001, respectively). The skin to tumor distance is significantly shorter in the prone position (p < 0.0001 [L], p = 0.005 [R]). The colon lies closer to the hilum of the kidney and is more posteriorly located in the prone position: 1.21 cm vs 1.04 cm (L) and 0.80 cm vs 0.70 cm (R) (p = 0.005 and p = 0.005, respectively). In the prone position, the lung covers a significantly larger proportion of the right kidney (27.3 mm vs 6.05 mm, p = 0.0001). We documented clinically significant anatomic alterations between supine and prone CT imaging. The changes associated with the prone position modify percutaneous access, particularly for right upper pole tumors. Prone imaging before surgery may be helpful in selected cases.

Comparison of directly measured arterial blood pressure at various anatomic locations in anesthetized dogs.

PubMed

Acierno, Mark J; Domingues, Michelle E; Ramos, Sara J; Shelby, Amanda M; da Cunha, Anderson F

2015-03-01

To determine whether directly measured arterial blood pressure differs among anatomic locations and whether arterial blood pressure is influenced by body position. 33 client-owned dogs undergoing anesthesia. Dogs undergoing anesthetic procedures had 20-gauge catheters placed in both the superficial palmar arch and the contralateral dorsal pedal artery (group 1 [n = 20]) or the superficial palmar arch and median sacral artery (group 2 [13]). Dogs were positioned in dorsal recumbency, and mean arterial blood pressure (MAP), systolic arterial blood pressure (SAP), and diastolic arterial blood pressure (DAP) were recorded for both arteries 4 times (2-minute interval between successive measurements). Dogs were positioned in right lateral recumbency, and blood pressure measurements were repeated. Differences were detected between pressures measured at the 2 arterial sites in both groups. This was especially true for SAP measurements in group 1, in which hind limb measurements were a mean of 16.12 mm Hg higher than carpus measurements when dogs were in dorsal recumbency and 14.70 mm Hg higher than carpus measurements when dogs were in lateral recumbency. Also, there was significant dispersion about the mean for all SAP, DAP, and MAP measurements. Results suggested that arterial blood pressures may be dependent on anatomic location and body position. Because this may affect outcomes of studies conducted to validate indirect blood pressure measurement systems, care must be used when developing future studies or interpreting previous results.

Shoulder instability: impact of glenohumeral arthrotomography on treatment.

PubMed

el-Khoury, G Y; Kathol, M H; Chandler, J B; Albright, J P

1986-09-01

We used arthrotomography to study the glenoid labrum in 114 patients. Sixty-nine of the patients had anatomic instability of the shoulder (including recurrent dislocation and subluxation of the shoulder), and 45 patients had functional instability of the shoulder (denoted by chronic pain, clicking of the joint, and the sensation that an unstable condition exists without the objective signs of it). Labral tears were revealed arthrotomographically in 86% of the patients with anatomic instability, while only 40% of the patients with functional instability had labral abnormalities, and these were primarily of minor severity. Fifty-six patients (44 of whom had anatomic instability; 12, functional instability) required surgery. The surgical findings were correlated with the arthrotomographic findings, and no false-positive results were revealed. However, arthrotomography demonstrated only part of the pathologic condition of two patients. These results confirm that there is a strong correlation between labral pathologic conditions and anatomic instability of the shoulder. Arthrotomographic studies have a great impact on the selection of therapy in cases of both anatomic and functional instability of the shoulder.

Anatomic motor point localization for partial quadriceps block in spasticity.

PubMed

Albert, T; Yelnik, A; Colle, F; Bonan, I; Lassau, J P

2000-03-01

To identify the location of the vastus intermedius nerve and its motor point (point M) and to precisely identify its coordinates in relation to anatomic surface landmarks. Descriptive study. Anatomy institute of a university school of medicine. Twenty-nine adult cadaver limbs immobilized in anatomic position. Anatomic dissection to identify point M. Anatomic surface landmarks were point F, the issuing point of femoral nerve under the inguinal ligament; point R, the middle of superior edge of the patella; segment FR, which corresponds to thigh length; point M', point M orthogonal projection on segment FR. Absolute vertical coordinate, distance FM, relative vertical coordinate compared to the thigh length, FM'/FR ratio; absolute horizontal coordinate, distance MM'. The absolute vertical coordinate was 11.7+/-2 cm. The relative vertical coordinate was at .29+/-.04 of thigh length. The horizontal coordinate was at 2+/-.5 cm lateral to the FR line. Point M can be defined with relative precision by two coordinates. Application and clinical interest of nerve blocking using these coordinates in quadriceps spasticity should be studied.

Anatomical location of metastatic lymph nodes: an indispensable prognostic factor for gastric cancer patients who underwent curative resection.

PubMed

Zhao, Bochao; Zhang, Jingting; Zhang, Jiale; Chen, Xiuxiu; Chen, Junqing; Wang, Zhenning; Xu, Huimian; Huang, Baojun

2018-02-01

Although the numeric-based lymph node (LN) staging was widely used in the worldwide, it did not represent the anatomical location of metastatic lymph nodes (MLNs) and not reflect extent of LN dissection. Therefore, in the present study, we investigated whether the anatomical location of MLNs was still necessary to evaluate the prognosis of node-positive gastric cancer (GC) patients. We reviewed 1451 GC patients who underwent radical gastrectomy in our institution between January 1986 and January 2008. All patients were reclassified into several groups according to the anatomical location of MLNs and the number of MLNs. The prognostic differences between different patient groups were compared and clinicopathologic features were analyzed. In the present study, both anatomical location of MLNs and the number of MLNs were identified as the independent prognostic factors (p < .01). The patients with extraperigastric LN involvement showed a poorer prognosis compared with the perigastric-only group (p < .001). For the N1-N2 stage patients, the prognostic discrepancy was still observed among them when the anatomical location of MLNs was considered (p < .05). For the N3-stage patients, although the anatomical location of MLNs had no significant effect on the prognosis of these patients, the higher number of MLNs in the extraperigastric area was correlated with the unfavorable prognosis (p < .05). The anatomical location of MLNs was an important factor influencing the prognostic outcome of GC patients. To provide more accurate prognostic information for GC patients, the anatomical location of MLNs should not be ignored.

Radiologic assessment of femoral and tibial tunnel placement based on anatomic landmarks in arthroscopic single bundle anterior cruciate ligament reconstruction

PubMed Central

Nema, Sandeep Kumar; Balaji, Gopisankar; Akkilagunta, Sujiv; Menon, Jagdish; Poduval, Murali; Patro, Dilip

2017-01-01

Background: Accurate tibial and femoral tunnel placement has a significant effect on outcomes after anterior cruciate ligament reconstruction (ACLR). Postoperative radiographs provide a reliable and valid way for the assessment of anatomical tunnel placement after ACLR. The aim of this study was to examine the radiographic location of tibial and femoral tunnels in patients who underwent arthroscopic ACLR using anatomic landmarks. Patients who underwent arthroscopic ACLR from January 2014 to March 2016 were included in this retrospective cohort study. Materials and Methods: 45 patients who underwent arthroscopic ACLR, postoperative radiographs were studied. Femoral and tibial tunnel positions on sagittal and coronal radiographic views, graft impingement, and femoral roof angle were measured. Radiological parameters were summarized as mean ± standard deviation and proportions as applicable. Interobserver agreement was measured using intraclass correlation coefficient. Results: The position of the tibial tunnel was found to be at an average of 35.1% ± 7.4% posterior from the anterior edge of the tibia. The femoral tunnel was found at an average of 30% ± 1% anterior to the posterior femoral cortex along the Blumensaat's line. Radiographic impingement was found in 34% of the patients. The roof angle averaged 34.3° ± 4.3°. The position of the tibial tunnel was found at an average of 44.16% ± 3.98% from the medial edge of the tibial plateau. The coronal tibial tunnel angle averaged 67.5° ± 8.9°. The coronal angle of the femoral tunnel averaged 41.9° ± 8.5°. Conclusions: The femoral and tibial tunnel placements correlated well with anatomic landmarks except for radiographic impingement which was present in 34% of the patients. PMID:28566780

Radiologic assessment of femoral and tibial tunnel placement based on anatomic landmarks in arthroscopic single bundle anterior cruciate ligament reconstruction.

PubMed

Nema, Sandeep Kumar; Balaji, Gopisankar; Akkilagunta, Sujiv; Menon, Jagdish; Poduval, Murali; Patro, Dilip

2017-01-01

Accurate tibial and femoral tunnel placement has a significant effect on outcomes after anterior cruciate ligament reconstruction (ACLR). Postoperative radiographs provide a reliable and valid way for the assessment of anatomical tunnel placement after ACLR. The aim of this study was to examine the radiographic location of tibial and femoral tunnels in patients who underwent arthroscopic ACLR using anatomic landmarks. Patients who underwent arthroscopic ACLR from January 2014 to March 2016 were included in this retrospective cohort study. 45 patients who underwent arthroscopic ACLR, postoperative radiographs were studied. Femoral and tibial tunnel positions on sagittal and coronal radiographic views, graft impingement, and femoral roof angle were measured. Radiological parameters were summarized as mean ± standard deviation and proportions as applicable. Interobserver agreement was measured using intraclass correlation coefficient. The position of the tibial tunnel was found to be at an average of 35.1% ± 7.4% posterior from the anterior edge of the tibia. The femoral tunnel was found at an average of 30% ± 1% anterior to the posterior femoral cortex along the Blumensaat's line. Radiographic impingement was found in 34% of the patients. The roof angle averaged 34.3° ± 4.3°. The position of the tibial tunnel was found at an average of 44.16% ± 3.98% from the medial edge of the tibial plateau. The coronal tibial tunnel angle averaged 67.5° ± 8.9°. The coronal angle of the femoral tunnel averaged 41.9° ± 8.5°. The femoral and tibial tunnel placements correlated well with anatomic landmarks except for radiographic impingement which was present in 34% of the patients.

An international ecological study of adult height in relation to cancer incidence for 24 anatomical sites.

PubMed

Jiang, Yannan; Marshall, Roger J; Walpole, Sarah C; Prieto-Merino, David; Liu, Dong-Xu; Perry, Jo K

2015-03-01

Anthropometric indices associated with childhood growth and height attained in adulthood, have been associated with an increased incidence of certain malignancies. To evaluate the cancer-height relationship, we carried out a study using international data, comparing various cancer rates with average adult height of women and men in different countries. An ecological analysis of the relationship between country-specific cancer incidence rates and average adult height was conducted for twenty-four anatomical cancer sites. Age-standardized rates were obtained from GLOBOCAN 2008. Average female (112 countries) and male (65 countries) heights were sourced and compiled primarily from national health surveys. Graphical and weighted regression analysis was conducted, taking into account BMI and controlling for the random effect of global regions. A significant positive association between a country's average adult height and the country's overall cancer rate was observed in both men and women. Site-specific cancer incidence for females was positively associated with height for most cancers: lung, kidney, colorectum, bladder, melanoma, brain and nervous system, breast, non-Hodgkin lymphoma, multiple myeloma, corpus uteri, ovary, and leukemia. A significant negative association was observed with cancer of the cervix uteri. In males, site-specific cancer incidence was positively associated with height for cancers of the brain and nervous system, kidney, colorectum, non-Hodgkin lymphoma, multiple myeloma, prostate, testicular, lip and oral cavity, and melanoma. Incidence of cancer was associated with tallness in the majority of anatomical/cancer sites investigated. The underlying biological mechanisms are unclear, but may include nutrition and early-life exposure to hormones, and may differ by anatomical site.

The Lateral Meniscus as a Guide to Anatomical Tibial Tunnel Placement During Anterior Cruciate Ligament Reconstruction.

PubMed

Kassam, A M; Tillotson, L; Schranz, P J; Mandalia, V I

2015-01-01

The aim of the study is to show, on an MRI scan, that the posterior border of the anterior horn of the lateral meniscus (AHLM) could guide tibial tunnel position in the sagittal plane and provide anatomical graft position. One hundred MRI scans were analysed with normal cruciate ligaments and no evidence of meniscal injury. We measured the distance between the posterior border of the AHLM and the midpoint of the ACL by superimposing sagittal images. The mean distance between the posterior border of the AHLM and the ACL midpoint was -0.1mm (i.e. 0.1mm posterior to the ACL midpoint). The range was 5mm to -4.6mm. The median value was 0.0mm. 95% confidence interval was from -0.5 to 0.3mm. A normal, parametric distribution was observed and Intra- and inter-observer variability showed significant correlation (p<0.05) using Pearsons Correlation test (intra-observer) and Interclass correlation (inter-observer). Using the posterior border of the AHLM is a reproducible and anatomical marker for the midpoint of the ACL footprint in the majority of cases. It can be used intra-operatively as a guide for tibial tunnel insertion and graft placement allowing anatomical reconstruction. There will inevitably be some anatomical variation. Pre-operative MRI assessment of the relationship between AHLM and ACL footprint is advised to improve surgical planning. Level 4.

A Reinforcement-Based Learning Paradigm Increases Anatomical Learning and Retention—A Neuroeducation Study

PubMed Central

Anderson, Sarah J.; Hecker, Kent G.; Krigolson, Olave E.; Jamniczky, Heather A.

2018-01-01

In anatomy education, a key hurdle to engaging in higher-level discussion in the classroom is recognizing and understanding the extensive terminology used to identify and describe anatomical structures. Given the time-limited classroom environment, seeking methods to impart this foundational knowledge to students in an efficient manner is essential. Just-in-Time Teaching (JiTT) methods incorporate pre-class exercises (typically online) meant to establish foundational knowledge in novice learners so subsequent instructor-led sessions can focus on deeper, more complex concepts. Determining how best do we design and assess pre-class exercises requires a detailed examination of learning and retention in an applied educational context. Here we used electroencephalography (EEG) as a quantitative dependent variable to track learning and examine the efficacy of JiTT activities to teach anatomy. Specifically, we examined changes in the amplitude of the N250 and reward positivity event-related brain potential (ERP) components alongside behavioral performance as novice students participated in a series of computerized reinforcement-based learning modules to teach neuroanatomical structures. We found that as students learned to identify anatomical structures, the amplitude of the N250 increased and reward positivity amplitude decreased in response to positive feedback. Both on a retention and transfer exercise when learners successfully remembered and translated their knowledge to novel images, the amplitude of the reward positivity remained decreased compared to early learning. Our findings suggest ERPs can be used as a tool to track learning, retention, and transfer of knowledge and that employing the reinforcement learning paradigm is an effective educational approach for developing anatomical expertise. PMID:29467638

A Reinforcement-Based Learning Paradigm Increases Anatomical Learning and Retention-A Neuroeducation Study.

PubMed

Anderson, Sarah J; Hecker, Kent G; Krigolson, Olave E; Jamniczky, Heather A

2018-01-01

In anatomy education, a key hurdle to engaging in higher-level discussion in the classroom is recognizing and understanding the extensive terminology used to identify and describe anatomical structures. Given the time-limited classroom environment, seeking methods to impart this foundational knowledge to students in an efficient manner is essential. Just-in-Time Teaching (JiTT) methods incorporate pre-class exercises (typically online) meant to establish foundational knowledge in novice learners so subsequent instructor-led sessions can focus on deeper, more complex concepts. Determining how best do we design and assess pre-class exercises requires a detailed examination of learning and retention in an applied educational context. Here we used electroencephalography (EEG) as a quantitative dependent variable to track learning and examine the efficacy of JiTT activities to teach anatomy. Specifically, we examined changes in the amplitude of the N250 and reward positivity event-related brain potential (ERP) components alongside behavioral performance as novice students participated in a series of computerized reinforcement-based learning modules to teach neuroanatomical structures. We found that as students learned to identify anatomical structures, the amplitude of the N250 increased and reward positivity amplitude decreased in response to positive feedback. Both on a retention and transfer exercise when learners successfully remembered and translated their knowledge to novel images, the amplitude of the reward positivity remained decreased compared to early learning. Our findings suggest ERPs can be used as a tool to track learning, retention, and transfer of knowledge and that employing the reinforcement learning paradigm is an effective educational approach for developing anatomical expertise.

Estimation of lung tumor position from multiple anatomical features on 4D-CT using multiple regression analysis.

PubMed

Ono, Tomohiro; Nakamura, Mitsuhiro; Hirose, Yoshinori; Kitsuda, Kenji; Ono, Yuka; Ishigaki, Takashi; Hiraoka, Masahiro

2017-09-01

To estimate the lung tumor position from multiple anatomical features on four-dimensional computed tomography (4D-CT) data sets using single regression analysis (SRA) and multiple regression analysis (MRA) approach and evaluate an impact of the approach on internal target volume (ITV) for stereotactic body radiotherapy (SBRT) of the lung. Eleven consecutive lung cancer patients (12 cases) underwent 4D-CT scanning. The three-dimensional (3D) lung tumor motion exceeded 5 mm. The 3D tumor position and anatomical features, including lung volume, diaphragm, abdominal wall, and chest wall positions, were measured on 4D-CT images. The tumor position was estimated by SRA using each anatomical feature and MRA using all anatomical features. The difference between the actual and estimated tumor positions was defined as the root-mean-square error (RMSE). A standard partial regression coefficient for the MRA was evaluated. The 3D lung tumor position showed a high correlation with the lung volume (R = 0.92 ± 0.10). Additionally, ITVs derived from SRA and MRA approaches were compared with ITV derived from contouring gross tumor volumes on all 10 phases of the 4D-CT (conventional ITV). The RMSE of the SRA was within 3.7 mm in all directions. Also, the RMSE of the MRA was within 1.6 mm in all directions. The standard partial regression coefficient for the lung volume was the largest and had the most influence on the estimated tumor position. Compared with conventional ITV, average percentage decrease of ITV were 31.9% and 38.3% using SRA and MRA approaches, respectively. The estimation accuracy of lung tumor position was improved by the MRA approach, which provided smaller ITV than conventional ITV. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Comparisons of Computed Mobile Phone Induced SAR in the SAM Phantom to That in Anatomically Correct Models of the Human Head

PubMed Central

Beard, Brian B.; Kainz, Wolfgang; Onishi, Teruo; Iyama, Takahiro; Watanabe, Soichi; Fujiwara, Osamu; Wang, Jianqing; Bit-Babik, Giorgi; Faraone, Antonio; Wiart, Joe; Christ, Andreas; Kuster, Niels; Lee, Ae-Kyoung; Kroeze, Hugo; Siegbahn, Martin; Keshvari, Jafar; Abrishamkar, Houman; Simon, Winfried; Manteuffel, Dirk; Nikoloski, Neviana

2018-01-01

The specific absorption rates (SAR) determined computationally in the specific anthropomorphic mannequin (SAM) and anatomically correct models of the human head when exposed to a mobile phone model are compared as part of a study organized by IEEE Standards Coordinating Committee 34, SubCommittee 2, and Working Group 2, and carried out by an international task force comprising 14 government, academic, and industrial research institutions. The detailed study protocol defined the computational head and mobile phone models. The participants used different finite-difference time-domain software and independently positioned the mobile phone and head models in accordance with the protocol. The results show that when the pinna SAR is calculated separately from the head SAR, SAM produced a higher SAR in the head than the anatomically correct head models. Also the larger (adult) head produced a statistically significant higher peak SAR for both the 1- and 10-g averages than did the smaller (child) head for all conditions of frequency and position. PMID:29515260

Three-Dimensional Display Technologies for Anatomical Education: A Literature Review

NASA Astrophysics Data System (ADS)

Hackett, Matthew; Proctor, Michael

2016-08-01

Anatomy is a foundational component of biological sciences and medical education and is important for a variety of clinical tasks. To augment current curriculum and improve students' spatial knowledge of anatomy, many educators, anatomists, and researchers use three-dimensional (3D) visualization technologies. This article reviews 3D display technologies and their associated assessments for anatomical education. In the first segment, the review covers the general function of displays employing 3D techniques. The second segment of the review highlights the use and assessment of 3D technology in anatomical education, focusing on factors such as knowledge gains, student perceptions, and cognitive load. The review found 32 articles on the use of 3D displays in anatomical education and another 38 articles on the assessment of 3D displays. The review shows that the majority (74 %) of studies indicate that the use of 3D is beneficial for many tasks in anatomical education, and that student perceptions are positive toward the technology.

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. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

TVT-S in the U position--anatomical study.

PubMed

Hubka, Petr; Nanka, Ondrej; Martan, Alois; Grim, Milos; Zvarova, Jana; Masata, Jaromir

2011-02-01

The objective is to describe the anatomical position of tension-free vaginal tape Secur (TVT-S) in the U position regarding possible injury and fixation site. We placed TVT-S inserters bilaterally in 13 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle. In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 2.83 cm (standard deviation (SD) 0.87 cm) on the left, 2.92 cm (SD 1.24 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 38.5%. In fresh frozen bodies, results were fundamentally similar (p > 0.05). There is a risk of injury to the obturator bundle and urinary bladder during TVT-S; however, there is a significant risk of inserting the TVT-S inserter outside the obturator internus muscle (into the lesser pelvis). The position of TVT-S does not change significantly after legs mal-positioning.

Anatomically constrained dipole adjustment (ANACONDA) for accurate MEG/EEG focal source localizations

NASA Astrophysics Data System (ADS)

Im, Chang-Hwan; Jung, Hyun-Kyo; Fujimaki, Norio

2005-10-01

This paper proposes an alternative approach to enhance localization accuracy of MEG and EEG focal sources. The proposed approach assumes anatomically constrained spatio-temporal dipoles, initial positions of which are estimated from local peak positions of distributed sources obtained from a pre-execution of distributed source reconstruction. The positions of the dipoles are then adjusted on the cortical surface using a novel updating scheme named cortical surface scanning. The proposed approach has many advantages over the conventional ones: (1) as the cortical surface scanning algorithm uses spatio-temporal dipoles, it is robust with respect to noise; (2) it requires no a priori information on the numbers and initial locations of the activations; (3) as the locations of dipoles are restricted only on a tessellated cortical surface, it is physiologically more plausible than the conventional ECD model. To verify the proposed approach, it was applied to several realistic MEG/EEG simulations and practical experiments. From the several case studies, it is concluded that the anatomically constrained dipole adjustment (ANACONDA) approach will be a very promising technique to enhance accuracy of focal source localization which is essential in many clinical and neurological applications of MEG and EEG.

Influence of mask type and mask position on the effectiveness of bag-mask ventilation in a neonatal manikin.

PubMed

Deindl, Philipp; O'Reilly, Megan; Zoller, Katharina; Berger, Angelika; Pollak, Arnold; Schwindt, Jens; Schmölzer, Georg M

2014-01-01

Anatomical face mask with an air cushion rim might be placed accidentally in a false orientation on the newborn's face or filled with various amounts of air during neonatal resuscitation. Both false orientation as well as variable filling may reduce a tight seal and therefore hamper effective positive pressure ventilation (PPV). We aimed to measure the influence of mask type and mask position on the effectiveness of PPV. Twenty neonatal staff members delivered PPV to a modified, leak-free manikin. Resuscitation parameters were recorded using a self-inflatable bag PPV with an Intersurgical anatomical air cushion rim face mask (IS) and a size 0/1 Laerdal round face mask. Three different positions of the IS were tested: correct position, 90° and 180° rotation in reference to the midline of the face. IS masks in each correct position on the face but with different inflation of the air cushion (empty, 10, 20 and 30 mL). Mask leak was similar with mask rotation to either 90° or 180° but significantly increased from 27 (13-73) % with an adequate filled IS mask compared to 52 (16-83) % with an emptied air cushion rim. Anatomical-shaped face mask had similar mask leaks compared to round face mask. A wrongly positioned anatomical-shaped mask does not influence mask leak. Mask leak significantly increased once the air cushion rim was empty, which may cause failure in mask PPV.

Anatomic Relationship Between Right Recurrent Laryngeal Nerve and Cervical Fascia and Its Application Significance in Anterior Cervical Spine Surgical Approach.

PubMed

Shan, Jianlin; Jiang, Heng; Ren, Dajiang; Wang, Chongwei

2017-04-15

An anatomic study of anterior cervical dissection of 42 embalmed cadavers. The aim was to study the anatomic relationship between recurrent laryngeal nerve (RLN) and cervical fascia combined with the requirements in anterior cervical spine surgery (ACSS). There has been no systematic research about how to avoid RLN injury in anterior cervical spine surgical approach from the aspect of the anatomic relationship between RLN and cervical fascia. Forty-two adult cadavers were dissected to observe the relationships between RLN and different cervical fascia layers. RLN pierced out the alar fascia from the inner edge of the carotid sheath in all cases, and the piercing position in 22 cases (52.4%) was located at the lower segment of T1. The enter point into visceral fascia of RLN was located at C7-T1 in 25 cases (59.5%). The middle layer of deep cervical fascia exhibited the most stable anatomic relationship with RLN at the carotid sheath confluence site. Pulling visceral sheath leftwards would significantly increase the RLN tension. Using the close and stable relationship between RLN and cervical fascia could help to avoid RLN injury in anterior cervical spine surgical approach. 4.

Energy dynamics of the intraventricular vortex after mitral valve surgery.

PubMed

Nakashima, Kouki; Itatani, Keiichi; Kitamura, Tadashi; Oka, Norihiko; Horai, Tetsuya; Miyazaki, Shohei; Nie, Masaki; Miyaji, Kagami

2017-09-01

Mitral valve morphology after mitral valve surgery affects postoperative intraventricular flow patterns and long-term cardiac performance. We visualized ventricular flow by echocardiography vector flow mapping (VFM) to reveal the impact of different mitral valve procedures. Eleven cases of mechanical mitral valve replacement (nine in the anti-anatomical and two in the anatomical position), three bioprosthetic mitral valve replacements, and four mitral valve repairs were evaluated. The mean age at the procedure was 57.4 ± 17.8 year, and the echocardiography VFM in the apical long-axis view was performed 119.9 ± 126.7 months later. Flow energy loss (EL), kinetic pressure (KP), and the flow energy efficiency ratio (EL/KP) were measured. The cases with MVR in the anatomical position and with valve repair had normal vortex directionality ("Clockwise"; N = 6), whereas those with MVR in the anti-anatomical position and with a bioprosthetic mitral valve had the vortex in the opposite direction ("Counterclockwise"; N = 12). During diastole, vortex direction had no effect on EL ("Clockwise": 0.080 ± 0.025 W/m; "Counterclockwise": 0.083 ± 0.048 W/m; P = 0.31) or KP ("Clockwise": 0.117 ± 0.021 N; "Counterclockwise": 0.099 ± 0.057 N; P = 0.023). However, during systole, the EL/KP ratio was significantly higher in the "Counterclockwise" vortex than that in the "Clockwise" vortex (1.056 ± 0.463 vs. 0.617 ± 0.158; P = 0.009). MVP and MVR with a mechanical valve in the anatomical position preserve the physiological vortex, whereas MVR with a mechanical valve in the anti-anatomical position and a bioprosthetic mitral valve generate inefficient vortex flow patterns, resulting in a potential increase in excessive cardiac workload.

Pregnancy outcomes among patients with recurrent pregnancy loss and uterine anatomic abnormalities.

PubMed

Gabbai, Daniel; Harlev, Avi; Friger, Michael; Steiner, Naama; Sergienko, Ruslan; Kreinin, Andrey; Bashiri, Asher

2017-07-25

Different etiologies for recurrent pregnancy loss have been identified, among them are: anatomical, endocrine, genetic, chromosomal and thrombophilia pathologies. To assess medical and obstetric characteristics, and pregnancy outcomes, among women with uterine abnormalities and recurrent pregnancy loss (RPL). This study also aims to assess the impact of uterine anatomic surgical correction on pregnancy outcomes. A retrospective case control study of 313 patients with two or more consecutive pregnancy losses followed by a subsequent (index) pregnancy. Anatomic abnormalities were detected in 80 patients. All patients were evaluated and treated in the RPL clinic at Soroka University Medical Center. Out of 80 patients with uterine anatomic abnormalities, 19 underwent surgical correction, 32 did not and 29 had no clear record of surgical intervention, and thus were excluded from this study. Women with anatomic abnormalities had a higher rate of previous cesarean section (18.8% vs. 8.6%, P=0.022), tended to have a lower number of previous live births (1.05 vs. 1.37, P=0.07), and a higher rate of preterm delivery (22.9% vs. 10%, P=0.037). Using multivariate logistic regression analysis, anatomic abnormality was identified as an independent risk factor for RPL in patients with previous cesarean section after controlling for place of residence, positive genetic/autoimmune/endocrine workup, and fertility problems (OR 7.22; 95% CI 1.17-44.54, P=0.03). Women suffering from anatomic abnormalities tended to have a higher rate of pregnancy loss compared to those without anatomic abnormalities (40% vs. 30.9%, P=0.2). The difference in pregnancy loss rate among women who underwent surgical correction compared to those who did not was not statistically significant. In patients with previous cesarean section, uterine abnormality is an independent risk factor for pregnancy loss. Surgical correction of uterine abnormalities among RPL patients might have the potential to improve live birth rate.

The Effect of Anatomic Factors on Tongue Position Variability during Consonants

ERIC Educational Resources Information Center

Rudy, Krista; Yunusova, Yana

2013-01-01

Purpose: This study sought to investigate the effect of palate morphology and anthropometric measures of the head on positional variability of the tongue during consonants. Method: An electromagnetic tracking system was used to record tongue movements of 21 adults. Each talker produced a series of symmetrical VCV syllables containing one of the…

Intercondylar roof impingement pressure after anterior cruciate ligament reconstruction in a porcine model.

PubMed

Iriuchishima, Takanori; Tajima, Goro; Ingham, Sheila J M; Shen, Wei; Horaguchi, Takashi; Saito, Akiyoshi; Smolinski, Patrick; Fu, Freddie H

2009-06-01

Anterior cruciate ligament (ACL) graft impingement against the intercondylar roof has been postulated, but not thoroughly investigated. The roof impingement pressure changes with different tibial and femoral tunnel positions in ACL reconstruction. Anterior tibial translation is also affected by the tunnel positions of ACL reconstruction. The study design included a controlled laboratory study. In 15 pig knees, the impingement pressure between ACL and intercondylar roof was measured using pressure sensitive film before and after ACL single bundle reconstruction. ACL reconstructions were performed in each knee with two different tibial and femoral tunnel position combinations: (1) tibial antero-medial (AM) tunnel to femoral AM tunnel (AM to AM) and (2) tibial postero-lateral (PL) tunnel to femoral High-AM tunnel (PL to High-AM). Anterior tibial translation (ATT) was evaluated after each ACL reconstruction using robotic/universal force-moment sensor testing system. Neither the AM to AM nor the PL to High-AM ACL reconstruction groups showed significant difference when compared with intact ACL in roof impingement pressure. The AM to AM group had a significantly higher failure load than PL to High-AM group. This study showed how different tunnel placements affect the ACL-roof impingement pressure and anterior-posterior laxity in ACL reconstruction. Anatomical ACL reconstruction does not cause roof impingement and it has a biomechanical advantage in ATT when compared with non-anatomical ACL reconstructions in the pig knee. There is no intercondylar roof impingement after anatomical single bundle ACL reconstruction.

A systematic review of studies on anatomical position of electrode contacts used for chronic subthalamic stimulation in Parkinson's disease.

PubMed

Caire, François; Ranoux, Danièle; Guehl, Dominique; Burbaud, Pierre; Cuny, Emmanuel

2013-09-01

The dorso-lateral part of the subthalamic nucleus (STN) is considered as the usual target of deep brain stimulation for Parkinson's disease. Nevertheless, the exact anatomical location of the electrode contacts used for chronic stimulation is still a matter of debate. The aim of this study was to perform a systematic review of the existing literature on this issue. We searched for studies on the anatomical location of active contacts published until December 2012. We identified 13 studies, published between 2002 and 2010, including 260 patients and 466 electrodes. One hundred and sixty-four active contacts (35 %) were identified within the STN, 117 (25 %) at the interface between STN and the surrounding structures, 184 (40 %) above the STN and one within the substantia nigra. We observed great discrepancies between the different series. The contra-lateral improvement was between 37 and 78.5 % for contacts located within the STN, between 48.6 and 73 % outside the STN, between 65.3 and 66 % at the interface. The authors report no clear correlation between anatomical location and stimulation parameters. Post-operative analysis of the anatomical location of active contacts is difficult, and all the methods used are debatable. The relationship between the anatomical location of active contacts and the clinical effectiveness of stimulation is unclear. It would be necessary to take into account the volume of the electrode contacts and the diffusion of the stimulation. We can nevertheless assume that the interface between dorso-lateral STN, zona incerta and Forel's fields could be directly involved in the effects of stimulation.

A machine learning approach for classification of anatomical coverage in CT

NASA Astrophysics Data System (ADS)

Wang, Xiaoyong; Lo, Pechin; Ramakrishna, Bharath; Goldin, Johnathan; Brown, Matthew

2016-03-01

Automatic classification of anatomical coverage of medical images is critical for big data mining and as a pre-processing step to automatically trigger specific computer aided diagnosis systems. The traditional way to identify scans through DICOM headers has various limitations due to manual entry of series descriptions and non-standardized naming conventions. In this study, we present a machine learning approach where multiple binary classifiers were used to classify different anatomical coverages of CT scans. A one-vs-rest strategy was applied. For a given training set, a template scan was selected from the positive samples and all other scans were registered to it. Each registered scan was then evenly split into k × k × k non-overlapping blocks and for each block the mean intensity was computed. This resulted in a 1 × k3 feature vector for each scan. The feature vectors were then used to train a SVM based classifier. In this feasibility study, four classifiers were built to identify anatomic coverages of brain, chest, abdomen-pelvis, and chest-abdomen-pelvis CT scans. Each classifier was trained and tested using a set of 300 scans from different subjects, composed of 150 positive samples and 150 negative samples. Area under the ROC curve (AUC) of the testing set was measured to evaluate the performance in a two-fold cross validation setting. Our results showed good classification performance with an average AUC of 0.96.

Is transverse acetabular ligament an anatomical landmark to reliably orient the cup in primary total hip arthroplasty?

PubMed

Viste, A; Chouteau, J; Testa, R; Chèze, L; Fessy, M-H; Moyen, B

2011-05-01

Accurate positioning of the acetabular cup in primary total hip arthroplasty is critical to decrease the rate of dislocation. Inaccurate orientation of the cup is the most common error during this procedure. Target acetabular orientation is still controversial. An original study found a dislocation rate of 0.6% when the cup was aligned with the transverse acetabular ligament (TAL). TAL is a patient-specific anatomical landmark and a tool for cup orientation. Eight cadaveric pelves (14 hips included for study) were harvested in toto at our research laboratory. Anatomical versions of the TAL, labrum and horns were measured in relation to the anterior pelvic plane. A navigator sensor and an optoelectronic device (Motion Analysis™) were used. Anatomical versions of the TAL, horns and labrum averaged 1.9° (range, -8° to +13.3°), 3° (range, -12.2° to 14°), and 26.3° (range, 17.4° to 41.8°), respectively. To our knowledge, this is the first study to report the orientation of the periacetabular soft-tissues. TAL anteversion was outside the safe zone described by Lewinnek, while labrum anteversion was within this safe-zone. We discuss the reference used, Lewinnek's safe zone, and functional orientation of the implants. Lewinnek's safe-zone does not seem to be valid. The TAL seems to be a specific reference for each patient but its reliability must still be confirmed as an adequate reference for positioning the cup in total hip arthroplasty. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

A study of the anatomy and injection techniques of the ovine stifle by positive contrast arthrography, computed tomography arthrography and gross anatomical dissection.

PubMed

Vandeweerd, Jean-Michel; Kirschvink, Nathalie; Muylkens, Benoit; Depiereux, Eric; Clegg, Peter; Herteman, Nicolas; Lamberts, Matthieu; Bonnet, Pierre; Nisolle, Jean-Francois

2012-08-01

Although ovine stifle models are commonly used to study osteoarthritis, meniscal pathology and cruciate ligament injuries and repair, there is little information about the anatomy of the joint or techniques for synovial injections. The objectives of this study were to improve anatomical knowledge of the synovial cavities of the ovine knee and to compare intra-articular injection techniques. Synovial cavities of 24 cadaver hind limbs from 12 adult sheep were investigated by intra-articular resin, positive-contrast arthrography, computed tomography (CT) arthrography and gross anatomical dissection. Communication between femoro-patellar, medial femoro-tibial and lateral femoro-tibial compartments occurred in all cases. The knee joint should be considered as one synovial structure with three communicating compartments. Several unreported features were observed, including a communication between the medial femoro-tibial and lateral femoro-tibial compartments and a latero-caudal recess of the lateral femoro-tibial compartment. No intermeniscal ligament was identified. CT was able to define many anatomical features of the stifle, including the anatomy of the tendinous synovial recess on the lateral aspect of the proximal tibia under the combined tendon of the peroneus tertius, extensor longus digitorum and extensor digiti III proprius. An approach for intra-articular injection into this recess (the subtendinous technique) was assessed and compared with the retropatellar and paraligamentous techniques. All three injection procedures were equally successful, but the subtendinous technique appeared to be most appropriate for synoviocentesis and for injections in therapeutic research protocols with less risk of damaging the articular cartilage. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Influence of Knee Flexion Angle for Graft Fixation on Rotational Knee Stability During Anterior Cruciate Ligament Reconstruction: A Biomechanical Study.

PubMed

Debandi, Aníbal; Maeyama, Akira; Hoshino, Yuichi; Asai, Shigehiro; Goto, Bunsei; Smolinski, Patrick; Fu, Freddie H

2016-11-01

To evaluate the effect of knee flexion angle for hamstring graft fixation, full extension (FE), or 30°, on acceleration of the knee motion during pivot-shift testing after either anatomic or nonanatomic anterior cruciate ligament (ACL) reconstruction using triaxial accelerometry. Two types of ACL reconstructions (anatomic and nonanatomic) using 2 different angles of knee flexion during graft fixation (FE and 30°) were performed on 12 fresh-frozen human knees making 4 groups: anatomic-FE, anatomic-30°, nonanatomic-FE, and nonanatomic-30°. Manual pivot-shift testing was performed at ACL-intact, ACL-deficient, and ACL-reconstructed conditions. Three-dimensional acceleration of knee motion was recorded using a triaxial accelerometer. The anatomic-30° group showed the smallest overall magnitude of acceleration among the ACL-reconstructed groups (P = .0039). There were no significant differences among the anatomic-FE group, the nonanatomic-FE group, and the nonantomic-30° group (anatomic-FE vs nonanatomic-FE, P = .1093; anatomic-FE vs nonanatomic-30°, P = .8728; and nonanatomic-FE vs nonanatomic-30°, P = .1093). After ACL transection, acceleration was reduced by ACL reconstruction with the exception of the nonanatomic-FE group that did not show a significant difference when compared with the ACL-deficient (P = .4537). The anatomic ACL reconstruction with the graft fixed at 30° of knee flexion better restored rotational knee stability compared with FE. An ACL graft fixed with the knee at FE in anatomic position did not show a significant difference compared with the nonanatomic ACL reconstructions. Knee flexion angle at the time of graft fixation for ACL reconstruction can be considered to maximize the rotational knee stability. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

An anatomically based protocol for the description of foot segment kinematics during gait.

PubMed

Leardini, A; Benedetti, M G; Catani, F; Simoncini, L; Giannini, S

1999-10-01

To design a technique for the in vivo description of ankle and other foot joint rotations to be applied in routine functional evaluation using non-invasive stereophotogrammetry. Position and orientation of tibia/fibula, calcaneus, mid-foot, 1st metatarsal and hallux segments were tracked during the stance phase of walking in nine asymptomatic subjects. Rigid clusters of reflective markers were used for foot segment pose estimation. Anatomical landmark calibration was applied for the reconstruction of anatomical landmarks. Previous studies have analysed only a limited number of joints or have proposed invasive techniques. Anatomical landmark trajectories were reconstructed in the laboratory frame using data from the anatomical calibration procedure. Anatomical co-ordinate frames were defined using the obtained landmark trajectories. Joint co-ordinate systems were used to calculate corresponding joint rotations in all three anatomical planes. The patterns of the joint rotations were highly repeatable within subjects. Consistent patterns between subjects were also exhibited at most of the joints. The method proposed enables a detailed description of ankle and other foot joint rotations on an anatomical base. Joint rotations can therefore be expressed in the well-established terminology necessary for their clinical interpretation. Functional evaluation of patients affected by foot diseases has recently called for more detailed and non-invasive protocols for the description of foot joint rotations during gait. The proposed method can help clinicians to distinguish between normal and pathological pattern of foot joint rotations, and to quantitatively assess the restoration of normal function after treatment.

Anatomical landmarks for the localization of the greater palatine foramen – a study of 1200 head CTs, 150 dry skulls, systematic review of literature and meta-analysis

PubMed Central

Tomaszewska, Iwona M; Tomaszewski, Krzysztof A; Kmiotek, Elizabeth K; Pena, Iwona Z; Urbanik, Andrzej; Nowakowski, Michał; Walocha, Jerzy A

2014-01-01

Accurate knowledge of greater palatine foramen (GPF) anatomy is necessary when performing a variety of anaesthesiological, dental or surgical procedures. The first aim of this study was to localize the GPF in relation to multiple anatomical landmarks. The second aim was to perform a systematic review of literature, and to conduct a meta-analysis on the subject of GPF position to aid clinicians in their practice. One-hundred and fifty dry, adult, human skulls and 1200 archived head computed tomography scans were assessed and measured in terms of GPF relation to other anatomical reference points. A systematic literature search was performed using the PubMed, Embase and Web of Science databases, and a meta-analysis on the subject of GPF relation to the maxillary molars was conducted. On average, in the Polish population, the GPF was positioned 15.9 ± 1.5 mm from the midline maxillary suture (MMS), 3.0 ± 1.2 mm from the alveolar ridge (AR) and 17.0 ± 1.5 mm from the posterior nasal spine (PNS); 74.7% of GPF were positioned opposite the third maxillary molar (M3). Twenty-seven studies were included in the systematic review and 23 in the meta-analysis (n = 6927 GPF). The pooled prevalence of the GPF being positioned opposite the M3 was 63.9% (95% confidence interval = 56.6–70.9%). Concluding, the GPF is most often located opposite the M3 in the majority of the world's populations. The maxillary molars are the best landmarks for locating the GPF. In edentulous patients the most useful points for approximating the position of the GPF are the AR, MMS and PNS. This study introduces an easy and repeatable classification to reference the GPF to the maxillary molars. PMID:25131842

[How safe are orthoroentgenograms in determining the amount of correction for varus deformities?].

PubMed

Gürsu, Sarper; Yıldırım, Timur; Issın, Ahmet; Sofu, Hakan; Sahin, Vedat

2014-01-01

In this study, we evaluated the effects of the distance of the legs from the midline on alignment and angles of the lower extremities in orthoroentgenograms. Between March 2012 and April 2013, 95 limbs of 56 patients with varus deformity who underwent orthoroentgenogram to identify the amount of joint laxity in two positions were included in this study. The initial X-ray was performed with the feet in contact, while the other was performed as the legs were abducted to be in line with the shoulders. For each orthoroentgenogram, the mean mechanical axis angle, anatomical axis, and joint line orientation angles were measured retrospectively. These measurements were repeated for 43 limbs with varus deformity >10°. In the orthoroentgenograms with the feet in contact, the mean mechanical axis angle was 9.58°±5.7°, (0.20°; 26.0°), the mean anatomical axis angle 3.65°±6.14°, (-9.0°; 21.0°), and the mean joint line orientation angle -3.41°±2.52°, (-12.0°; 1.60°). In the orthoroentgenograms with the legs abducted, the mean mechanical axis angle was 7.73°±5.58°, (-3.0°; 23.0°), the mean anatomical axis angle 2.62°±5.87°, (-11.0°; 18.30°), and mean joint line orientation angle was -2.44°±2.41°, (-13.0°; 3.0°). The differences in the angles between the two positions were statistically significant (p<0.005). Our study results showed that the mean values of mechanical axis angle, anatomical axis and the joint line orientation angle were higher in orthoroentgenograms with the feet in contact than the orthoroentgenograms with the legs abducted in patients with varus gonarthrosis. We suggest that this may lead to mistakes in the preoperative planning. Ideal positions should be standardized to minimize possible problems.

Effects of instructional strategies using cross sections on the recognition of anatomical structures in correlated CT and MR images.

PubMed

Khalil, Mohammed K; Paas, Fred; Johnson, Tristan E; Su, Yung K; Payer, Andrew F

2008-01-01

This research is an effort to best utilize the interactive anatomical images for instructional purposes based on cognitive load theory. Three studies explored the differential effects of three computer-based instructional strategies that use anatomical cross-sections to enhance the interpretation of radiological images. These strategies include: (1) cross-sectional images of the head that can be superimposed on radiological images, (2) transparent highlighting of anatomical structures in radiological images, and (3) cross-sectional images of the head with radiological images presented side-by-side. Data collected included: (1) time spent on instruction and on solving test questions, (2) mental effort during instruction and test, and (3) students' performance to identify anatomical structures in radiological images. Participants were 28 freshmen medical students (15 males and 13 females) and 208 biology students (190 females and 18 males). All studies used posttest-only control group design, and the collected data were analyzed by either t test or ANOVA. In self-directed computer-based environments, the strategies that used cross sections to improve students' ability to recognize anatomic structures in radiological images showed no significant positive effects. However, when increasing the complexity of the instructional materials, cross-sectional images imposed a higher cognitive load, as indicated by higher investment of mental effort. There is not enough evidence to claim that the simultaneous combination of cross sections and radiological images has no effect on the identification of anatomical structures in radiological images for novices. Further research that control for students' learning and cognitive style is needed to reach an informative conclusion.

Anatomy in the Third Reich: Careers disrupted by National Socialist Policies.

PubMed

Hildebrandt, Sabine

2012-06-01

The history of anatomy in the Third Reich is still insufficiently explored, especially concerning its victims. These include not only the victims of the NS regime whose bodies were used in anatomical dissection, but also the Scholars of Anatomy whose careers were disrupted by NS policies. The spectrum of career disruption spanned from short-term suspension from work to death in concentration camps. In this study, the biographies of 462 Scholars of Anatomy were examined. 414 were members of the Anatomische Gesellschaft (Anatomical Society). Eighty-six persons (80 men, 6 women) were identified whose anatomical careers were disrupted by National Socialist policies. Sixty-two of them were members of the Anatomical Society. Their subsequent fate was dependent on the stage of the scholars' careers, their field of expertise, reason for dismissal (i.e. so-called Jewish descent or political dissent), nationality, country of residence or exile. Forty-three scholars emigrated, of whom 6 returned to positions in Germany and Austria after the war. Twenty-one remained in their home countries, of whom 17 were later reinstated in their positions. Twelve scholars were imprisoned, and 5 died in concentration camps. Five fates remain unresolved. As diverse as this group of scholars was, all of them had in common that a criminal regime forced them, being innocent of any crime, out of their position and work. Further work including the exploration of potential archival sources is necessary before a detailed and complete recounting of each individual life is possible. Copyright © 2011 Elsevier GmbH. All rights reserved.

Accuracy of chest radiography for positioning of the umbilical venous catheter.

PubMed

Guimarães, Adriana F M; Souza, Aline A C G de; Bouzada, Maria Cândida F; Meira, Zilda M A

To evaluate the accuracy of the simultaneous analysis of three radiographic anatomical landmarks - diaphragm, cardiac silhouette, and vertebral bodies - in determining the position of the umbilical venous catheter distal end using echocardiography as a reference standard. This was a cross-sectional, observational study, with the prospective inclusion of data from all neonates born in a public reference hospital, between April 2012 and September 2013, submitted to umbilical venous catheter insertion as part of their medical care. The position of the catheter distal end, determined by the simultaneous analysis of three radiographic anatomical landmarks, was compared with the anatomical position obtained by echocardiography; sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Of the 162 newborns assessed by echocardiography, only 44 (27.16%) had the catheter in optimal position, in the thoracic portion of the inferior vena cava or at the junction of the inferior vena cava with the right atrium. The catheters were located in the left atrium and interatrial septum in 54 (33.33%) newborns, in the right atrium in 26 (16.05%), intra-hepatic in 37 (22.84%), and intra-aortic in-one newborn (0.62%). The sensitivity, specificity and accuracy of the radiography to detect the catheter in the target area were 56%, 71%, and 67.28%, respectively. Anteroposterior radiography of the chest alone is not able to safely define the umbilical venous catheter position. Echocardiography allows direct visualization of the catheter tip in relation to vascular structures and, whenever possible, should be considered to identify the location of the umbilical venous catheter. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Early postoperative cartilage evaluation by magnetic resonance imaging using T2 mapping after arthroscopic partial medial meniscectomy.

PubMed

Kato, Kammei; Arai, Yuji; Ikoma, Kazuya; Nakagawa, Shuji; Inoue, Hiroaki; Kan, Hiroyuki; Matsuki, Tomohiro; Fujiwara, Hiroyoshi; Kubo, Toshikazu

2015-12-01

This study was performed to quantitatively evaluate postoperative changes in cartilage by T2 mapping after arthroscopic partial medial meniscectomy. The study enrolled 17 patients with 20 knees that underwent arthroscopic partial medial meniscectomy. MRI was performed preoperatively and at six months postoperatively, with subjects evaluated by T2 mapping of the central part of the medial condyle of the femur in the sagittal plane. Regions of interest (ROIs) were set at 10 points between the point of intersection of the anatomical axis of the femur and the articular surface of the medial condyle and posterior area approximately 90 degrees to the anatomical axis. Pre- and postoperative T2 values at each ROI were evaluated. Postoperative T2 values were significantly longer than preoperative values at approximately 20, 30, 40, and 50 degrees to the anatomical axis of the femur. The maximum change between pre- and postoperative T2 values was +6.65% at 30 degrees to the anatomical axis. Mechanical stress at positions approximately 20, 30, 40, and 50 degrees relative to the anatomical axis of the femur increased soon after arthroscopic medial meniscectomy. These findings indicate the start of degeneration, via disorganization of collagen arrays, of the articular cartilage and increased water content. Copyright © 2015. Published by Elsevier Inc.

The effect of peer assisted learning (PAL) on anatomic competencies of prospective student’s biology teachers

NASA Astrophysics Data System (ADS)

Diana, S.

2018-05-01

Research about the effect of Peer Assisted Learning (PAL) strategy on Plant Anatomy Course, which aims to improve anatomic competencies of prospective student’s biology teacher, has been done. This study used a quasi-experimental pre-test post-test control group design. The draft includes a group of students who were given a pre-test which is then followed by observing the PAL treatment process and post-test. The other students group (control) was given the pre-test and post-test only. The PAL program began with a discussion between the lecturer and the tutor about the pretest results and then discussion between the tutors and their tutees in the class about the responses items. After that, all students were assigned to answer a set of response items, and then did the posttest. The results showed that the PAL strategy can increase student’s anatomic literacy significantly and can increase student’s anatomic lab skills no significantly. Thus the PAL strategy implementation has a potential to improve student’s anatomic competencies. The generally students weaknesses were they lack practice in interpreting of research results in the graphs form and rarely shared about anatomic lab skills. All students respond positively to the PAL strategy.

Anatomical landmark asymmetry assessment in the lumbar spine and pelvis: a review of reliability.

PubMed

Stovall, Bradley Alan; Kumar, Shrawan

2010-01-01

The purpose of this article is to review current research investigating the reliability of bony anatomical landmark positional asymmetry assessment in the lumbar spine and pelvis, to determine the agreement on findings between authors, and to explore future directions in the area to address the significant issues. The databases MEDLINE, CINAHL, AMED, MANTIS, Academic Search Complete, and Web of Knowledge were searched. A total of 23 articles were identified and reviewed, 10 of which met the inclusion criteria. For these 10 articles, the average interexaminer reliability for bony anatomical landmark positional asymmetry assessment was slightly above chance for all landmarks except medial malleolus, which had fair reliability. Interexaminer reliability on average was less than intraexaminer reliability (anterior superior iliac spine, k = 0.128/0.414; posterior superior iliac spine, k = 0.092/0.371). All interexaminer reliability averages were below values of clinical significance. From the current literature review, bony anatomical landmark positional asymmetry assessment in the lumbar spine and pelvis has not been demonstrated to be a reliable assessment method. However, there are unexplored factors that, after standardization, may improve reliability and further the understanding of musculoskeletal palpatory examination.

Fusion Imaging: A Novel Staging Modality in Testis Cancer

PubMed Central

Sterbis, Joseph R.; Rice, Kevin R.; Javitt, Marcia C.; Schenkman, Noah S.; Brassell, Stephen A.

2010-01-01

Objective: Computed tomography and chest radiographs provide the standard imaging for staging, treatment, and surveillance of testicular germ cell neoplasms. Positron emission tomography has recently been utilized for staging, but is somewhat limited in its ability to provide anatomic localization. Fusion imaging combines the metabolic information provided by positron emission tomography with the anatomic precision of computed tomography. To the best of our knowledge, this represents the first study of the effectiveness using fusion imaging in evaluation of patients with testis cancer. Methods: A prospective study of 49 patients presenting to Walter Reed Army Medical Center with testicular cancer from 2003 to 2009 was performed. Fusion imaging was compared with conventional imaging, tumor markers, pathologic results, and clinical follow-up. Results: There were 14 true positives, 33 true negatives, 1 false positive, and 1 false negative. Sensitivity, specificity, positive predictive value, and negative predictive value were 93.3, 97.0, 93.3, and 97.0% respectively. In 11 patient scenarios, fusion imaging differed from conventional imaging. Utility was found in superior lesion detection compared to helical computed tomography due to anatomical/functional image co-registration, detection of micrometastasis in lymph nodes (pathologic nodes < 1cm), surveillance for recurrence post-chemotherapy, differentiating fibrosis from active disease in nodes < 2.5cm, and acting as a quality assurance measure to computed tomography alone. Conclusions: In addition to demonstrating a sensitivity and specificity comparable or superior to conventional imaging, fusion imaging shows promise in providing additive data that may assist in clinical decision-making. PMID:21103077

Fusion imaging: a novel staging modality in testis cancer.

PubMed

Sterbis, Joseph R; Rice, Kevin R; Javitt, Marcia C; Schenkman, Noah S; Brassell, Stephen A

2010-11-05

Computed tomography and chest radiographs provide the standard imaging for staging, treatment, and surveillance of testicular germ cell neoplasms. Positron emission tomography has recently been utilized for staging, but is somewhat limited in its ability to provide anatomic localization. Fusion imaging combines the metabolic information provided by positron emission tomography with the anatomic precision of computed tomography. To the best of our knowledge, this represents the first study of the effectiveness using fusion imaging in evaluation of patients with testis cancer. A prospective study of 49 patients presenting to Walter Reed Army Medical Center with testicular cancer from 2003 to 2009 was performed. Fusion imaging was compared with conventional imaging, tumor markers, pathologic results, and clinical follow-up. There were 14 true positives, 33 true negatives, 1 false positive, and 1 false negative. Sensitivity, specificity, positive predictive value, and negative predictive value were 93.3, 97.0, 93.3, and 97.0% respectively. In 11 patient scenarios, fusion imaging differed from conventional imaging. Utility was found in superior lesion detection compared to helical computed tomography due to anatomical/functional image co-registration, detection of micrometastasis in lymph nodes (pathologic nodes < 1cm), surveillance for recurrence post-chemotherapy, differentiating fibrosis from active disease in nodes < 2.5cm, and acting as a quality assurance measure to computed tomography alone. In addition to demonstrating a sensitivity and specificity comparable or superior to conventional imaging, fusion imaging shows promise in providing additive data that may assist in clinical decision-making.

Pelvis and lower limb anatomical landmark calibration precision and its propagation to bone geometry and joint angles.

PubMed

della Croce, U; Cappozzo, A; Kerrigan, D C

1999-03-01

Human movement analysis using stereophotogrammetry is based on the reconstruction of the instantaneous laboratory position of selected bony anatomical landmarks (AL). For this purpose, knowledge of an AL's position in relevant bone-embedded frames is required. Because ALs are not points but relatively large and curved areas, their identification by palpation or other means is subject to both intra- and inter-examiner variability. In addition, the local position of ALs, as reconstructed using an ad hoc experimental procedure (AL calibration), is affected by photogrammetric errors. The intra- and inter-examiner precision with which local positions of pelvis and lower limb palpable bony ALs can be identified and reconstructed were experimentally assessed. Six examiners and two subjects participated in the study. Intra- and inter-examiner precision (RMS distance from the mean position) resulted in the range 6-21 mm and 13-25 mm, respectively. Propagation of the imprecision of ALs to the orientation of bone-embedded anatomical frames and to hip, knee and ankle joint angles was assessed. Results showed that this imprecision may cause distortion in joint angle against time functions to the extent that information relative to angular movements in the range of 10 degrees or lower may be concealed. Bone geometry parameters estimated using the same data showed that the relevant precision does not allow for reliable bone geometry description. These findings, together with those relative to skin movement artefacts reported elsewhere, assist the human movement analyst's consciousness of the possible limitations involved in 3D movement analysis using stereophotogrammetry and call for improvements of the relevant experimental protocols.

An anatomic and morphometric study of C2 nerve root ganglion and its corresponding foramen.

PubMed

Bilge, Okan

2004-03-01

Exposing and measuring the dorsal root ganglion of the second cervical spinal nerve (C2 ganglion) and the second intervertebral space, which is present between posterior arch of atlas (APA) and lamina of axis (LA). This study aims to investigate the shape, size, and relation of the C2 ganglion with the adjacent structures that limits the corresponding intervertebral space and the alterations of relation between C2 ganglion and APA and between C2 ganglion and LA with the movements of the head bilaterally. In previous studies, the position and the heights of the C2 ganglion have been described. But the shape of the C2 ganglion and its relation to APA and LA by the movement of the head had not been considered previously. Upper cervical spines of 20 cadavers were dissected posteriorly. The muscles attaching to the atlas and axis were resected to ease the head movements. The heights of the C2 ganglion and space were measured in anatomic position and in hyperextension with opposite rotation position of the head. Originally in this study, plastic dough casts were used to obtain reliable outcomes. The shape of the ganglions was defined in three types: 70% were oval, 20% were spindle-like, and 10% were spherical. The height of the C2 ganglion was 4.97 +/- 0.92 mm on the right side and 4.6 +/- 0.84 mm on the left side. The height of the intervertebral space in anatomic position and in hyperextension with rotation to the opposite position of the head were, respectively, 9.74 +/- 1.77 mm and 7.48 +/- 1.44 mm on the right side and 9.64 +/- 1.47 mm and 7.12 +/- 0.96 mm on the left side. There was no bone contact or impact to the ganglion in each position of the head. The C2 ganglions are confident in their place between APA and LA. No bone contact to the C2 ganglion was detected in either normal limited or in forced head motions.

Longitudinal shapes of the tibia and femur are unrelated and variable.

PubMed

Howell, Stephen M; Kuznik, Kyle; Hull, Maury L; Siston, Robert A

2010-04-01

In general practice, short films of the knee are used to assess component position and define the entry point for intramedullary femoral alignment in TKAs; however, whether it is justified to use the short film commonly used in research settings and everyday practice as a substitute for the whole leg view is controversial and needs clarification. In 138 long leg CT scanograms we measured the angle formed by the anatomic axis of the proximal fourth of the tibia and the mechanical axis of the tibia, the angle formed by the anatomic axis of the distal fourth of the femur and the mechanical axis of the femur, the "bow" of the tibia (as reflected by the offset of the anatomic axis from the center of the talus), and the "bow" of the femur (as reflected by the offset of the anatomic axis from the center of the femoral head). Because the angle formed by these axes and the bow of the tibia and femur have wide variability in females and males, a short film of the knee should not be used in place of the whole leg view when accurate assessment of component position and limb alignment is essential. A previous study of normal limbs found that only 2% of subjects have a neutral hip-knee-ankle axis, which can be explained by the wide variability of the bow in the tibia and femur and the lack of correlation between the bow of the tibia and femur in a given limb as shown in the current study.

Estimating anatomical wrist joint motion with a robotic exoskeleton.

PubMed

Rose, Chad G; Kann, Claudia K; Deshpande, Ashish D; O'Malley, Marcia K

2017-07-01

Robotic exoskeletons can provide the high intensity, long duration targeted therapeutic interventions required for regaining motor function lost as a result of neurological injury. Quantitative measurements by exoskeletons have been proposed as measures of rehabilitative outcomes. Exoskeletons, in contrast to end effector designs, have the potential to provide a direct mapping between human and robot joints. This mapping rests on the assumption that anatomical axes and robot axes are aligned well, and that movement within the exoskeleton is negligible. These assumptions hold well for simple one degree-of-freedom joints, but may not be valid for multi-articular joints with unique musculoskeletal properties such as the wrist. This paper presents an experiment comparing robot joint kinematic measurements from an exoskeleton to anatomical joint angles measured with a motion capture system. Joint-space position measurements and task-space smoothness metrics were compared between the two measurement modalities. The experimental results quantify the error between joint-level position measurements, and show that exoskeleton kinematic measurements preserve smoothness characteristics found in anatomical measures of wrist movements.

[Ten years after the latest revision International Anatomical Terminology].

PubMed

Kachlík, D; Bozdechová, I; Cech, P; Musil, V; Báca, V

2008-01-01

Ten years ago, the latest revision of the Latin anatomical nomenclature was approved and published as Terminologia Anatomica (International Anatomical Terminology), and is acknowledged by the organization uniting national anatomical societies--International Federation of Associations of Anatomists. The authors concentrate on new terms included in the nomenclature and on the linguistic changes of terminology. The most frequent errors done by medical specialists in the usage of the Latin anatomical terminology are emphasized and the situation of eponyms in contemporary anatomy is discussed in detail as well. The last version of the nomenclature makes its way very slowly in the professional community and it is necessary to refer to positive changes and advantages it has brought. The usage of this Latin anatomical nomenclature version is suggested by the International Federation to follow in theoretical and clinical fields of medicine. The authors of the article strongly recommend using the recent revision of the Latin anatomical nomenclature both in the oral and written forms, when educating and publishing.

Further evidence on the anatomical placement of the human eyeball for facial approximation and craniofacial superimposition.

PubMed

Stephan, Carl N; Huang, Anne J R; Davidson, Paavi L

2009-03-01

Recently a small sampled cadaver study (n = 4) suggested that the human eyeballs are placed closer to the orbital roof and lateral orbital wall as first reported in the anatomical literature many years previously. This contrasts with central positioning of the eyeball within the orbit as advocated by the facial approximation literature. Given the limits of such small samples, this study re-examined globe position in nine new cadavers to help clarify which relationship is accurate. The results essentially confirm prior empirical findings except that the mean lateral divergences from the orbit center were found to be larger--the eyeball was found to be "displaced" 1.4 mm superiorly and 2.4 mm laterally. Medians calculated across all 13 cadavers from this study and the above-mentioned recent report refine these measurements to 1.4 and 2.3 mm respectively. Globe projection values were identical to those observed for living individuals (c. 16 mm).

Skeletal idiopathic osteosclerosis helps to perform personal identification of unknown decedents: A novel contribution from anatomical variants through CT scan.

PubMed

De Angelis, D; Gibelli, D; Palazzo, E; Sconfienza, L; Obertova, Z; Cattaneo, C

2016-07-01

Personal identification consists of the comparison of ante-mortem information from a missing person with post-mortem data obtained from an unidentified corpse. Such procedure is based on the assessment of individualizing features which may help in providing a conclusive identification between ante-mortem and post-mortem material. Anatomical variants may provide important clues to correctly identify human remains. Areas of idiopathic osteosclerosis (IO), or dense bone islands (DBIs) characterized by radiopaque areas of dense, trabeculated, non-inflamed vital bone represent one of these, potentially individualizing, anatomical features. This study presents a case where the finding of DBI was crucial for a positive identification through CT-scan. A decomposed body was found in an apartment in June 2014 in advanced decomposition and no dental records were available to perform a comparison for positive identification. Genetic tests were not applicable because of the lack of relatives in a direct line. The analysis of the only ante-mortem documentation, a CT-scan to the deceased dating back to August 2009, showed the presence of three DBIs within the trabecular bone of the proximal portion of the right femur. The same bony district was removed from the corpse during the autopsy and analysed by CT-scan, which verified the presence of the same features. Forensic practitioners should therefore be aware of the great importance of anatomical bone variants, such as dense bone islands for identification purposes, and the importance of advanced radiological technique for addressing the individualizing potential of such variants. We propose that anatomical variants of the human skeleton should be considered as being "primary identification characteristics" similar to dental status, fingerprints and DNA. Copyright © 2016 The Chartered Society of Forensic Sciences. Published by Elsevier Ireland Ltd. All rights reserved.

[Leonardo da Vinci and his studies on the human fetus and the placenta].

PubMed

Cataldi, L; Fanos, V

2000-01-01

To review the accuracy of Leonardo's anatomical studies of the female external genitalia and the foetus, particularly those concerning the umbilical cord with its blood vessels. The anatomical drawings of Leonardo da Vinci which are now stored in the Windors Castle near London were reviewed and the accuracy of the details of the genital apparatus and foetus was evaluated. A written comment characterizes many of his drawings. He described accurately the position of the uterine blood vessels and the relationship between the pelvic organs. However his drawing and description of the female external genitalia and human placenta was incorrect because his understanding of it was inadequate. He believed that the human placenta had cotyledons like that of the ungulate uterus (drown side A of sheet 19). At the top of that sheet some Leonardo's details of the anatomic relationship are shown. In our opinion, Leonardo's misunderstanding is probably because he was only able to perform one anatomical dissection of a pregnant women and foetus and therefore his knowledge was limited. The resulting documentation of the pregnant women and foetus was therefore heavily supplemented with his enormous experience in animal anatomy.

Transcatheter aortic valve implantation using anatomically oriented, marrow stromal cell-based, stented, tissue-engineered heart valves: technical considerations and implications for translational cell-based heart valve concepts.

PubMed

Emmert, Maximilian Y; Weber, Benedikt; Behr, Luc; Sammut, Sebastien; Frauenfelder, Thomas; Wolint, Petra; Scherman, Jacques; Bettex, Dominique; Grünenfelder, Jürg; Falk, Volkmar; Hoerstrup, Simon P

2014-01-01

While transcatheter aortic valve implantation (TAVI) has rapidly evolved for the treatment of aortic valve disease, the currently used bioprostheses are prone to continuous calcific degeneration. Thus, autologous, cell-based, living, tissue-engineered heart valves (TEHVs) with regeneration potential have been suggested to overcome these limitations. We investigate the technical feasibility of combining the concept of TEHV with transapical implantation technology using a state-of-the-art transcatheter delivery system facilitating the exact anatomical position in the systemic circulation. Trileaflet TEHVs fabricated from biodegradable synthetic scaffolds were sewn onto self-expanding Nitinol stents seeded with autologous marrow stromal cells, crimped and transapically delivered into the orthotopic aortic valve position of adult sheep (n = 4) using the JenaValve transapical TAVI System (JenaValve, Munich, Germany). Delivery, positioning and functionality were assessed by angiography and echocardiography before the TEHV underwent post-mortem gross examination. For three-dimensional reconstruction of the stent position of the anatomically oriented system, a computed tomography analysis was performed post-mortem. Anatomically oriented, transapical delivery of marrow stromal cell-based TEHV into the orthotopic aortic valve position was successful in all animals (n = 4), with a duration from cell harvest to TEHV implantation of 101 ± 6 min. Fluoroscopy and echocardiography displayed sufficient positioning, thereby entirely excluding the native leaflets. There were no signs of coronary obstruction. All TEHV tolerated the loading pressure of the systemic circulation and no acute ruptures occurred. Animals displayed intact and mobile leaflets with an adequate functionality. The mean transvalvular gradient was 7.8 ± 0.9 mmHg, and the mean effective orifice area was 1.73 ± 0.02 cm(2). Paravalvular leakage was present in two animals, and central aortic regurgitation due to a single-leaflet prolapse was detected in two, which was primarily related to the leaflet design. No stent dislocation, migration or affection of the mitral valve was observed. For the first time, we demonstrate the technical feasibility of a transapical TEHV delivery into the aortic valve position using a commercially available and clinically applied transapical implantation system that allows for exact anatomical positioning. Our data indicate that the combination of TEHV and a state-of-the-art transapical delivery system is feasible, representing an important step towards translational, transcatheter-based TEHV concepts.

Pyloric localisation in 57 dogs of breeds susceptible to gastric dilatation-volvulus in the UK using computed tomography.

PubMed

Tomlinson, A W; Lillis, S M; German, A J; Burrow, R D

2016-12-17

Describe the location of the pylorus using CT in dog breeds susceptible to gastric dilatation-volvulus in the UK. Descriptive anatomical study. Abdominal CT scans of 57 client-owned dogs were reviewed to assess pyloric position relative to the 9th, 10th, 11th and 13th ribs and 2 and 3 cm caudal to the 13th rib at the 8, 9 and 10 o'clock positions. The angle of the pylorus from the centre of the abdominal cavity relative to the sagittal plane was also determined. In 88 per cent of cases, the pylorus was located in the right cranioventral abdomen with 63 per cent positioned at the 9-10 o'clock position. The overall distance between the pylorus and right abdominal wall (RAW) at the 13th rib 10 o'clock position was equivalent to 29 per cent of ventral abdominal length, significantly greater than the median overall distance of ∼14 per cent of ventral abdominal length between the pylorus and RAW at the 9th or 10th rib 10 o'clock position (P<0.0001). Common gastropexy locations may result in considerable displacement of the pylorus relative to its natural anatomic location. Further case-control studies are required to assess the clinical significance of this finding. British Veterinary Association.

Ultrasound and anatomical assessment of the infraspinatus tendon through anterosuperolateral approach.

PubMed

Michelin, Paul; Kasprzak, Kevin; Dacher, Jean Nicolas; Lefebvre, Valentin; Duparc, Fabrice

2015-08-01

In the literature, shoulder ultrasound (US) protocols rely on the widely accepted anatomical concept of the infraspinatus tendon (IST) running parallel and posterior to the supraspinatus tendon (SST). To assess the IST, authors currently recommend placing the transducer posteroinferior to the acromion; however the examination of the anterosuperior part of the IST remains problematic. The aim of our study was to apply recent anatomical knowledge to propose a simple protocol to assess the IST over its entire width including its anterosuperior margin. Six non-diseased shoulders from four cadavers were assessed in hyperextended internal rotation (HIR) position with US anterosuperolateral approach followed by dissection. Twelve healthy volunteers underwent similar US examination of the shoulder. The IST is a thin, wide, strap-like tendon. The HIR position exposed the largest area of IST beyond the acromion; combined anterosuperolateral US approach enabled imaging of the IST over its entire width with transverse and longitudinal views. The anterosuperior margin of the IST was distinguishable from the SST. The anterosuperolateral US approach in HIR position enables an accurate assessment of the IST including the transverse plane. The limit between the SST and IST appears more clearly. • The hyperextended internal rotation of the shoulder brings the infraspinatus tendon forward. • The infraspinatus tendon is visible with anterosuperolateral ultrasound approach. • The anterosuperior margin of the infraspinatus tendon is visible with this technique.

The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications

PubMed Central

Golanó, Pau; Sierevelt, Inger N.; van Dijk, C. Niek

2010-01-01

Despite the fact that the superficial peroneal nerve is the only nerve in the human body that can be made visible; iatrogenic damage to this nerve is the most frequently reported complication in anterior ankle arthroscopy. One of the methods to visualize the nerve is combined ankle plantar flexion and inversion. In the majority of cases, the superficial peroneal nerve can be made visible. The portals for anterior ankle arthroscopy are however created with the ankle in the neutral or slightly dorsiflexed position and not in combined plantar flexion and inversion. The purpose of this study was to undertake an anatomical study to the course of the superficial peroneal nerve in different positions of the foot and ankle. We hypothesize that the anatomical localization of the superficial peroneal nerve changes with different foot and ankle positions. In ten fresh frozen ankle specimens, a window, only affecting the skin, was made at the level of the anterolateral portal for anterior ankle arthroscopy in order to directly visualize the superficial peroneal nerve, or if divided, its terminal branches. Nerve movement was assessed from combined 10° plantar flexion and inversion to 5° dorsiflexion, standardized by the Telos stress device. Also for the 4th toe flexion, flexion of all the toes and for skin tensioning possible nerve movement was determined. The mean superficial peroneal nerve movement was 2.4 mm to the lateral side when the ankle was moved from 10° plantar flexion and inversion to the neutral ankle position and 3.6 mm to the lateral side from 10° plantar flexion and inversion to 5° dorsiflexion. Both displacements were significant (P < 0.01). The nerve consistently moves lateral when the ankle is manoeuvred from combined plantar flexion and inversion to the neutral or dorsiflexed position. If visible, it is therefore advised to create the anterolateral portal medial from the preoperative marking, in order to prevent iatrogenic damage to the superficial peroneal nerve. PMID:20224993

Value of a Dixon-based MR/PET attenuation correction sequence for the localization and evaluation of PET-positive lesions.

PubMed

Eiber, Matthias; Martinez-Möller, Axel; Souvatzoglou, Michael; Holzapfel, Konstantin; Pickhard, Anja; Löffelbein, Dennys; Santi, Ivan; Rummeny, Ernst J; Ziegler, Sibylle; Schwaiger, Markus; Nekolla, Stephan G; Beer, Ambros J

2011-09-01

In this study, the potential contribution of Dixon-based MR imaging with a rapid low-resolution breath-hold sequence, which is a technique used for MR-based attenuation correction (AC) for MR/positron emission tomography (PET), was evaluated for anatomical correlation of PET-positive lesions on a 3T clinical scanner compared to low-dose CT. This technique is also used in a recently installed fully integrated whole-body MR/PET system. Thirty-five patients routinely scheduled for oncological staging underwent (18)F-fluorodeoxyglucose (FDG) PET/CT and a 2-point Dixon 3-D volumetric interpolated breath-hold examination (VIBE) T1-weighted MR sequence on the same day. Two PET data sets reconstructed using attenuation maps from low-dose CT (PET(AC_CT)) or simulated MR-based segmentation (PET(AC_MR)) were evaluated for focal PET-positive lesions. The certainty for the correlation with anatomical structures was judged in the low-dose CT and Dixon-based MRI on a 4-point scale (0-3). In addition, the standardized uptake values (SUVs) for PET(AC_CT) and PET(AC_MR) were compared. Statistically, no significant difference could be found concerning anatomical localization for all 81 PET-positive lesions in low-dose CT compared to Dixon-based MR (mean 2.51 ± 0.85 and 2.37 ± 0.87, respectively; p = 0.1909). CT tended to be superior for small lymph nodes, bone metastases and pulmonary nodules, while Dixon-based MR proved advantageous for soft tissue pathologies like head/neck tumours and liver metastases. For the PET(AC_CT)- and PET(AC_MR)-based SUVs (mean 6.36 ± 4.47 and 6.31 ± 4.52, respectively) a nearly complete concordance with a highly significant correlation was found (r = 0.9975, p < 0.0001). Dixon-based MR imaging for MR AC allows for anatomical allocation of PET-positive lesions similar to low-dose CT in conventional PET/CT. Thus, this approach appears to be useful for future MR/PET for body regions not fully covered by diagnostic MRI due to potential time constraints.

Anatomical landmark position--can we trust what we see? Results from an online reliability and validity study of osteopaths.

PubMed

Pattyn, Elise; Rajendran, Dévan

2014-04-01

Practitioners traditionally use observation to classify the position of patients' anatomical landmarks. This information may contribute to diagnosis and patient management. To calculate a) Inter-rater reliability of categorising the sagittal plane position of four anatomical landmarks (lateral femoral epicondyle, greater trochanter, mastoid process and acromion) on side-view photographs (with landmarks highlighted and not-highlighted) of anonymised subjects; b) Intra-rater reliability; c) Individual landmark inter-rater reliability; d) Validity against a 'gold standard' photograph. Online inter- and intra-rater reliability study. Photographed subjects: convenience sample of asymptomatic students; raters: randomly selected UK registered osteopaths. 40 photographs of 30 subjects were used, a priori clinically acceptable reliability was ≥0.4. Inter-rater arm: 20 photographs without landmark highlights plus 10 with highlights; Intra-rater arm: 10 duplicate photographs (non-highlighted landmarks). Validity arm: highlighted landmark scores versus 'gold standard' photographs with vertical line. Research ethics approval obtained. Osteopaths (n = 48) categorised landmark position relative to imagined vertical-line; Gwet's Agreement Coefficient 1 (AC1) calculated and chance-corrected coefficient benchmarked against Landis and Koch's scale; Validity calculation used Kendall's tau-B. Inter-rater reliability was 'fair' (AC1 = 0.342; 95% confidence interval (CI) = 0.279-0.404) for non-highlighted landmarks and 'moderate' (AC1 = 0.700; 95% CI = 0.596-0.805) for highlighted landmarks. Intra-rater reliability was 'fair' (AC1 = 0.522); range was 'poor' (AC1 = 0.160) to 'substantial' (AC1 = 0.896). No differences were found between individual landmarks. Validity was 'low' (TB = 0.327; p = 0.104). Both inter- and intra-rater reliability was 'fair' but below clinically acceptable levels, validity was 'low'. Together these results challenge the clinical practice of using observation to categorise anterio-posterior landmark position. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assessing stapes piston position using computed tomography: a cadaveric study.

PubMed

Hahn, Yoav; Diaz, Rodney; Hartman, Jonathan; Bobinski, Matthew; Brodie, Hilary

2009-02-01

Temporal bone computed tomographic (CT) scanning in the postoperative stapedotomy patient is inaccurate in assessing stapes piston position within the vestibule. Poststapedotomy patients that have persistent vertigo may undergo CT scanning to assess the position of the stapes piston within the vestibule to rule out overly deep insertion. Vertigo is a recognized complication of the deep piston, and CT evaluation is often recommended. The accuracy of CT scan in this setting is unestablished. Stapedotomy was performed on 12 cadaver ears, and stainless steel McGee pistons were placed. The cadaver heads were then scanned using a fine-cut temporal bone protocol. Temporal bone dissection was performed with microscopic measurement of the piston depth in the vestibule. These values were compared with depth of intravestibular penetration measured on CT scan by 4 independent measurements. The intravestibular penetration as assessed by computed tomography was consistently greater than the value found on cadaveric anatomic dissection. The radiographic bias was greater when piston location within the vestibule was shallower. The axial CT scan measurement was 0.53 mm greater, on average, than the anatomic measurement. On average, the coronal CT measurement was 0.68 mm greater than the anatomic measurement. The degree of overestimation of penetration, however, was highly inconsistent. Standard temporal bone CT scan is neither an accurate nor precise examination of stapes piston depth within the vestibule. We found that CT measurement consistently overstated intravestibular piston depth. Computed tomography is not a useful study in the evaluation of piston depth for poststapedectomy vertigo and is of limited value in this setting.

Comparison of the current AJCC-TNM numeric-based with a new anatomical location-based lymph node staging system for gastric cancer: A western experience

PubMed Central

Auricchio, Annamaria; Cardella, Francesca; Mabilia, Andrea; Diana, Anna; Castellano, Paolo; De Vita, Ferdinando; Orditura, Michele

2017-01-01

Background In gastric cancer, the current AJCC numeric-based lymph node staging does not provide information on the anatomical extent of the disease and lymphadenectomy. A new anatomical location-based node staging, proposed by Choi, has shown better prognostic performance, thus soliciting Western world validation. Study design Data from 284 gastric cancers undergoing radical surgery at the Second University of Naples from 2000 to 2014 were reviewed. The lymph nodes were reclassified into three groups (lesser and greater curvature, and extraperigastric nodes); presence of any metastatic lymph node in a given group was considered positive, prompting a new N and TNM stage classification. Receiver-operating-characteristic (ROC) curves for censored survival data and bootstrap methods were used to compare the capability of the two models to predict tumor recurrence. Results More than one third of node positive patients were reclassified into different N and TNM stages by the new system. Compared to the current staging system, the new classification significantly correlated with tumor recurrence rates and displayed improved indices of prognostic performance, such as the Bayesian information criterion and the Harrell C-index. Higher values at survival ROC analysis demonstrated a significantly better stratification of patients by the new system, mostly in the early phase of the follow-up, with a worse prognosis in more advanced new N stages, despite the same current N stage. Conclusions This study suggests that the anatomical location-based classification of lymph node metastasis may be an important tool for gastric cancer prognosis and should be considered for future revision of the TNM staging system. PMID:28380037

Links between Evolution, Development, Human Anatomy, Pathology, and Medicine, with A Proposition of A Re-defined Anatomical Position and Notes on Constraints and Morphological "Imperfections".

PubMed

Diogo, Rui; Molnar, Julia

2016-06-01

Surprisingly the oldest formal discipline in medicine (anatomy) has not yet felt the full impact of evolutionary developmental biology. In medical anatomy courses and textbooks, the human body is still too often described as though it is a "perfect machine." In fact, the study of human anatomy predates evolutionary theory; therefore, many of its conventions continue to be outdated, making it difficult to study, understand, and treat the human body, and to compare it with that of other, nonbipedal animals, including other primates. Moreover, such an erroneous view of our anatomy as "perfect" can be used to fuel nonevolutionary ideologies such as intelligent design. In the section An Evolutionary and Developmental Approach to Human Anatomical Position of this paper, we propose the redefinition of the "human standard anatomical position" used in textbooks to be consistent with human evolutionary and developmental history. This redefined position also simplifies, for students and practitioners of the health professions, the study and learning of embryonic muscle groups (each group including muscles derived from the same/ontogenetically closely related primordium/primordia) and joint movements and highlights the topological correspondence between the upper and lower limbs. Section Evolutionary and Developmental Constraints, "Imperfections" and Sports Pathologies continues the theme by describing examples of apparently "illogical" characteristics of the human body that only make sense when one understands the developmental and evolutionary constraints that have accumulated over millions of years. We focus, in particular, on musculoskeletal functional problems and sports pathologies to emphasize the links with pathology and medicine. These examples demonstrate how incorporating evolutionary theory into anatomy education can be helpful for medical students, teachers, researchers, and physicians, as well as for anatomists, functional morphologists, and evolutionary and developmental biologists. © 2016 Wiley Periodicals, Inc.

Anatomical study of the left superior mediastinal lymphatics for tracheal branches of left recurrent laryngeal nerve-preserving mediastinoscope-assisted surgery in esophageal cancer.

PubMed

Nakajima, Yutaka; Tokairin, Yutaka; Nakajima, Yasuaki; Kawada, Kenro; Nagai, Kagami; Yamaguchi, Kumiko; Akita, Keiichi; Kawano, Tatsuyuki

2018-03-01

Curative treatment of esophageal cancer requires meticulous superior mediastinal lymphadenectomy, in addition to esophagectomy, because superior mediastinal lymph node metastases are common in esophageal cancer. When preserving the tracheal branches of the left recurrent laryngeal nerve (RLN), good anatomical understanding is required for confirmation of the positional relationships between the courses of lymphatic vessels, lymph node distribution, and the left RLN and its tracheal branches. We performed a detailed anatomical examination of these relationships. Macroscopic anatomical observation and histological examination was performed on cadavers. In addition to hematoxylin and eosin staining, immunostaining using antipodoplanin antibody D2-40 (podoplanin) was performed to identify the lymphatic vessels. The tracheal branches of the left RLN were clearly observed, but no lymphatic vessels crossing the ventral or dorsal side of the branches were identified either macro-anatomically or histologically. No complex lymphatic network structure straddling the plane composed of tracheal branches of the left RLN was found in the left superior mediastinum. This suggests that dissection of the lymph nodes around the left RLN via the pneumomediastinum method using the left cervical approach may allow preservation of the tracheal branches of the left RLN by maintaining dissection accuracy.

Comparison of anatomical, functional and regression methods for estimating the rotation axes of the forearm.

PubMed

Fraysse, François; Thewlis, Dominic

2014-11-07

Numerous methods exist to estimate the pose of the axes of rotation of the forearm. These include anatomical definitions, such as the conventions proposed by the ISB, and functional methods based on instantaneous helical axes, which are commonly accepted as the modelling gold standard for non-invasive, in-vivo studies. We investigated the validity of a third method, based on regression equations, to estimate the rotation axes of the forearm. We also assessed the accuracy of both ISB methods. Axes obtained from a functional method were considered as the reference. Results indicate a large inter-subject variability in the axes positions, in accordance with previous studies. Both ISB methods gave the same level of accuracy in axes position estimations. Regression equations seem to improve estimation of the flexion-extension axis but not the pronation-supination axis. Overall, given the large inter-subject variability, the use of regression equations cannot be recommended. Copyright © 2014 Elsevier Ltd. All rights reserved.

Definition of anatomical zero positions for assessing shoulder pose with 3D motion capture during bilateral abduction of the arms.

PubMed

Rettig, Oliver; Krautwurst, Britta; Maier, Michael W; Wolf, Sebastian I

2015-12-09

Surgical interventions at the shoulder may alter function of the shoulder complex. Clinically, the outcome can be assessed by universal goniometry. Marker-based motion capture may not resemble these results due to differing angle definitions. The clinical inspection of bilateral arm abduction for assessing shoulder dysfunction is performed with a marker based 3D optical measurement method. An anatomical zero position of shoulder pose is proposed to determine absolute angles according to the Neutral-0-Method as used in orthopedic context. Static shoulder positions are documented simultaneously by 3D marker tracking and universal goniometry in 8 young and healthy volunteers. Repetitive bilateral arm abduction movements of at least 150° range of motion are monitored. Similarly a subject with gleno-humeral osteoarthritis is monitored for demonstrating the feasibility of the method and to illustrate possible shoulder dysfunction effects. With mean differences of less than 2°, the proposed anatomical zero position results in good agreement between shoulder elevation/depression angles determined by 3D marker tracking and by universal goniometry in static positions. Lesser agreement is found for shoulder pro-/retraction with systematic deviations of up to 6°. In the bilateral arm abduction movements the volunteers perform a common and specific pattern in clavicula-thoracic and gleno-humeral motion with maximum shoulder angles of 32° elevation, 5° depression and 45° protraction, respectively, whereas retraction is hardly reached. Further, they all show relevant out of (frontal) plane motion with anteversion angles of 30° in overhead position (maximum abduction). With increasing arm anteversion the shoulder is increasingly retroverted, with a maximum of 20° retroversion. The subject with gleno-humeral osteoarthritis shows overall less shoulder abduction range of motion but with increased out-of-plane movement during abduction. The proposed anatomical zero definition for shoulder pose fills the missing link for determining absolute joint angles for shoulder elevation/depression and pro-/retraction. For elevation-/depression the accuracy suits clinical expectations very well with mean differences less than 2° and limits of agreement of 8.6° whereas for pro-/retraction the accuracy in individual cases may be inferior with limits of agreement of up to 24.6°. This has critically to be kept in mind when applying this concept to shoulder intervention studies.

Anatomical analysis of thumb opponency movement in the capuchin monkey (Sapajus sp).

PubMed

Aversi-Ferreira, Roqueline A G M F; Souto Maior, Rafael; Aziz, Ashraf; Ziermann, Janine M; Nishijo, Hisao; Tomaz, Carlos; Tavares, Maria Clotilde H; Aversi-Ferreira, Tales Alexandre

2014-01-01

Capuchin monkeys present a wide variety of manipulatory skills and make routine use of tools both in captivity and in the wild. Efficient handling of objects in this genus has led several investigators to assume near-human thumb movements despite the lack of anatomical studies. Here we perform an anatomical analysis of muscles and bones in the capuchin hand. Trapezo-metacarpal joint surfaces observed in capuchins indicate that medial rotation of metacarpal I is either absent or very limited. Overall, bone structural arrangement and thumb position relative to the other digits and the hand's palm suggest that capuchins are unable to perform any kind of thumb opponency, but rather a 'lateral pinch' movement. Although the capuchin hand apparatus bears other features necessary for complex tool use, the lack thumb opposition movements suggests that a developed cognitive and motor nervous system may be even more important for high manipulatory skills than traditionally held.

Soft tissue displacement over pelvic anatomical landmarks during 3-D hip movements.

PubMed

Camomilla, V; Bonci, T; Cappozzo, A

2017-09-06

The position, in a pelvis-embedded anatomical coordinate system, of skin points located over the following anatomical landmarks (AL) was determined while the hip assumed different spatial postures: right and left anterior superior and posterior superior iliac spines, and the sacrum. Postures were selected as occurring during walking and during a flexion-extension and circumduction movement, as used to determine the hip joint centre position (star-arc movement). Five volunteers, characterised by a wide range of body mass indices (22-37), were investigated. Subject-specific MRI pelvis digital bone models were obtained. For each posture, the pose of the pelvis-embedded anatomical coordinate system was determined by registering this bone model with points digitised over bony prominences of the pelvis, using a wand carrying a marker-cluster and stereophotogrammetry. The knowledge of how the position of the skin points varies as a function of the hip posture provided information regarding the soft tissue artefact (STA) that would affect skin markers located over those points during stereophotogrammetric movement analysis. The STA was described in terms of amplitude (relative to the position of the AL during an orthostatic posture), diameter (distance between the positions of the AL which were farthest away from each other), and pelvis orientation. The STA amplitude, exhibited, over all postures, a median [inter-quartile] value of 9[6] and 16[11]mm, for normal and overweight volunteers, respectively. STA diameters were larger for the star-arc than for the walking postures, and the direction was predominantly upwards. Consequent errors in pelvic orientation were in the range 1-9 and 4-11 degrees, for the two groups respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

Local setup errors in image-guided radiotherapy for head and neck cancer patients immobilized with a custom-made device.

PubMed

Giske, Kristina; Stoiber, Eva M; Schwarz, Michael; Stoll, Armin; Muenter, Marc W; Timke, Carmen; Roeder, Falk; Debus, Juergen; Huber, Peter E; Thieke, Christian; Bendl, Rolf

2011-06-01

To evaluate the local positioning uncertainties during fractionated radiotherapy of head-and-neck cancer patients immobilized using a custom-made fixation device and discuss the effect of possible patient correction strategies for these uncertainties. A total of 45 head-and-neck patients underwent regular control computed tomography scanning using an in-room computed tomography scanner. The local and global positioning variations of all patients were evaluated by applying a rigid registration algorithm. One bounding box around the complete target volume and nine local registration boxes containing relevant anatomic structures were introduced. The resulting uncertainties for a stereotactic setup and the deformations referenced to one anatomic local registration box were determined. Local deformations of the patients immobilized using our custom-made device were compared with previously published results. Several patient positioning correction strategies were simulated, and the residual local uncertainties were calculated. The patient anatomy in the stereotactic setup showed local systematic positioning deviations of 1-4 mm. The deformations referenced to a particular anatomic local registration box were similar to the reported deformations assessed from patients immobilized with commercially available Aquaplast masks. A global correction, including the rotational error compensation, decreased the remaining local translational errors. Depending on the chosen patient positioning strategy, the remaining local uncertainties varied considerably. Local deformations in head-and-neck patients occur even if an elaborate, custom-made patient fixation method is used. A rotational error correction decreased the required margins considerably. None of the considered correction strategies achieved perfect alignment. Therefore, weighting of anatomic subregions to obtain the optimal correction vector should be investigated in the future. Copyright © 2011 Elsevier Inc. All rights reserved.

Male characteristics on female mud snails caused by antifouling bottom paints.

PubMed

Smith, B S

1981-02-01

This study continues an investigation of an anatomical abnormality, named 'imposex', which consists of a superimposition of male characteristics on to a functionally normal female reproductive anatomy of the dioecious snail Nassarius obsoletus Say. Imposex is prevalent in natural populations living near yacht basins and rarely found distant from them. In the current study caged snails were transferred between a yacht basin and a distant 'clean' locality where the natural population of snails was normal. Imposex was induced in some normal snails kept at the marina and suppressed, but not lost in abnormal snails kept at the clean locality. A similar positive result was obtained in the laboratory by exposing normal snails to organotin-containing antifouling paints and abnormal snails to clean sea water. Results were negative in parallel tests of various marina-associated materials which did not contain organotin. The laboratory studies have thus identified a causative factor for the anatomical abnormalities common near yacht basins in the natural environment. They also provide a rare, if not unique, example of a chemical agent which causes the appearance of superfluous anatomical features in an animal.

Comparative histology of mouse, rat, and human pelvic ligaments.

PubMed

Iwanaga, Ritsuko; Orlicky, David J; Arnett, Jameson; Guess, Marsha K; Hurt, K Joseph; Connell, Kathleen A

2016-11-01

The uterosacral (USL) and cardinal ligaments (CL) provide support to the uterus and pelvic organs, and the round ligaments (RL) maintain their position in the pelvis. In women with pelvic organ prolapse (POP), the connective tissue, smooth muscle, vasculature, and innervation of the pelvic support structures are altered. Rodents are commonly used animal models for POP research. However, the pelvic ligaments have not been defined in these animals. In this study, we hypothesized that the gross anatomy and histological composition of pelvic ligaments in rodents and humans are similar. We performed an extensive literature search for anatomical and histological descriptions of the pelvic support ligaments in rodents. We also performed anatomical dissections of the pelvis to define anatomical landmarks in relation to the ligaments. In addition, we identified the histological components of the pelvic ligaments and performed quantitative analysis of the smooth muscle bundles and connective tissue of the USL and RL. The anatomy of the USL, CL, and RL and their anatomical landmarks are similar in mice, rats, and humans. All species contain the same cellular components and have similar histological architecture. However, the cervical portion of the mouse USL and RL contain more smooth muscle and less connective tissue compared with rat and human ligaments. The pelvic support structures of rats and mice are anatomically and histologically similar to those of humans. We propose that both mice and rats are appropriate, cost-effective models for directed studies in POP research.

Ultrasonographic identification of the anatomical landmarks that define cervical lymph nodes spaces.

PubMed

Lenghel, Lavinia Manuela; Baciuţ, Grigore; Botar-Jid, Carolina; Vasilescu, Dan; Bojan, Anca; Dudea, Sorin M

2013-03-01

The localization of cervical lymph nodes is extremely important in practice for the positive and differential diagnosis as well as the staging of cervical lymphadenopathies. Ultrasonography represents the first line imaging method in the diagnosis of cervical lymphadenopathies due to its excellent resolution and high diagnosis accuracy. The present paper aims to illustrate the ultrasonographic identification of the anatomical landmarks used for the definition of cervical lymphatic spaces. The application of standardized views allows a delineation of clear anatomical landmarks and an accurate localization of the cervical lymph nodes.

Pelvic incidence: a predictive factor for three-dimensional acetabular orientation-a preliminary study.

PubMed

Boulay, Christophe; Bollini, Gérard; Legaye, Jean; Tardieu, Christine; Prat-Pradal, Dominique; Chabrol, Brigitte; Jouve, Jean-Luc; Duval-Beaupère, Ginette; Pélissier, Jacques

2014-01-01

Acetabular cup orientation (inclination and anteversion) is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter) emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter) could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model. The second aim was to consider the asymmetry between the right and left acetabulae. Twelve pelvic anatomic specimens were measured with an electromagnetic Fastrak system (Polhemus Society) providing 3D position of anatomical landmarks to allow measurement of acetabular and pelvic parameters. Acetabulum and pelvis data were correlated by a Spearman matrix. A robust linear regression analysis provided prediction of acetabulum axes. The orientation of each acetabulum could be predicted by the incidence. The incidence is correlated with the morphology of acetabula. The asymmetry of the acetabular roof was correlated with pelvic incidence. This study allowed analysis of relationships of acetabular orientation and pelvic incidence. Pelvic incidence (morphologic parameter) could determine the safe range of pelvis tilt (positional parameter) for an individual and not a group.

Pelvic Incidence: A Predictive Factor for Three-Dimensional Acetabular Orientation—A Preliminary Study

PubMed Central

Bollini, Gérard; Legaye, Jean; Tardieu, Christine; Prat-Pradal, Dominique; Chabrol, Brigitte; Jouve, Jean-Luc; Duval-Beaupère, Ginette; Pélissier, Jacques

2014-01-01

Acetabular cup orientation (inclination and anteversion) is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter) emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter) could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model. The second aim was to consider the asymmetry between the right and left acetabulae. Twelve pelvic anatomic specimens were measured with an electromagnetic Fastrak system (Polhemus Society) providing 3D position of anatomical landmarks to allow measurement of acetabular and pelvic parameters. Acetabulum and pelvis data were correlated by a Spearman matrix. A robust linear regression analysis provided prediction of acetabulum axes. The orientation of each acetabulum could be predicted by the incidence. The incidence is correlated with the morphology of acetabula. The asymmetry of the acetabular roof was correlated with pelvic incidence. This study allowed analysis of relationships of acetabular orientation and pelvic incidence. Pelvic incidence (morphologic parameter) could determine the safe range of pelvis tilt (positional parameter) for an individual and not a group. PMID:25006461

The anatomical basis for wrinkles.

PubMed

Pessa, Joel E; Nguyen, Hang; John, George B; Scherer, Philipp E

2014-02-01

Light and electron microscopy have not identified a distinct anatomical structure associated with either skin wrinkles or creases, and a histological difference between wrinkled and adjacent skin has not been identified. The authors investigate whether facial wrinkles are related to underlying lymphatic vessels and perilymphatic fat. Lymphatic vessels with a specialized tube of perilymphatic fat were identified beneath palmar creases. Sections of skin, adipose tissue, and muscle were harvested from each of 13 cadavers. Three sites were investigated: the transverse forehead crease, lateral orbicularis oculi wrinkle (crow's feet), and the nasojugal crease. The tissue was paraffin embedded and processed. Two-step indirect immunohistochemistry was performed, and images were examined using laser confocal microscopy. Measurements were taken with software. Every wrinkle examined was found above and within ±1 mm of a major lymphatic vessel and its surrounding tube of adipose tissue. The results satisfied our null hypothesis and were statistically significant. Lymphatic vessels were identified by positive immunofluorescence as well as histological criteria. These findings have been further validated by fluorochrome tracer studies. An anatomical basis for wrinkles was identified among the specimens studied. Lymphatic vessels, along with the surrounding distinct perilymphatic fat, traveled directly beneath wrinkles and creases. Lymphatic dysregulation leads to inflammation, scarring, and fibrosis, but inadvertent injection of these vessels can be avoided with anatomical knowledge.

Use of the rectus abdominis muscle for abdominal stoma sphincter construction: an anatomical feasibility study.

PubMed

Bardoel, J W; Stadelmann, W K; Tobin, G R; Werker, P M; Stremel, R W; Kon, M; Barker, J H

2000-02-01

Permanent fecal abdominal stomas significantly decrease quality of life. Previous attempts to create continent stomas by using dynamic myoplasty procedures have resulted in disappointing outcomes, primarily owing to denervation atrophy of the muscle flap that was used in the creation of the sphincter and because of muscle fatigue resulting from continuous electrical stimulation that is received by the flap to force contraction. On the basis of these problems, we designed two separate studies: an anatomical study addressing flap denervation and a functional study addressing muscle fatigue. The present study addresses the first topic and was designed to develop a rectus abdominis muscle flap into a sphincter that was anatomically situated to create a stoma while preserving as much innervation as possible. In 24 rectus abdominis muscles of human cadavers, the neurovascular anatomy was defined, then the anatomical feasibility of two different muscle flap configurations was considered. The flaps investigated were the peninsula flap and island flap designs, with both using the most caudal segment of the rectus abdominis muscle in construction of the sphincter. Neither flap design required the killing of a nerve for stoma sphincter creation, resulting in minimal muscle denervation. The conclusion of our comparison was that the above, in conjunction with other features of the island flap design, such as muscle overlap after sphincter formation and abdominal wall positioning of the sphincter, made the island flap design better suited to stoma sphincter construction.

Detectability and anatomical correlation of middle ear cholesteatoma using fused thin slice non-echo planar imaging diffusion-weighted image and magnetic resonance cisternography (FTS-nEPID).

PubMed

Kanoto, Masafumi; Sugai, Yukio; Hosoya, Takaaki; Toyoguchi, Yuuki; Konno, Yoshihiro; Watarai, Fumika; Ito, Tsukasa; Watanabe, Tomoo; Kakehata, Seiji

2015-12-01

Cholesteatomas show high intensity in diffusion-weighted imaging (DWI). We performed fused thin slice non-echo planar imaging (EPI) DWI and magnetic resonance cisternography (FTS-nEPID) for cholesteatoma patients to increase the detectability of FTS-nEPID for cholesteatoma. The subjects are 77 consecutive patients who underwent FTS-nEPID as a preoperative study (mean age: 53.3±21.8, 47 men and 30 women). Otorhinolaryngologists performed the operations. We anatomically classified the middle ear into four portions. A radiologist evaluated the images for cholesteatoma and assessed the anatomical invasive range in four portions using only FTS-nEPID. We classified large cholesteatomas that invaded more than three portions and small ones that invaded less than two portions based on the results obtained from surgery, and calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). For all cholesteatomas with an existing diagnosis, the sensitivity, specificity, PPV, and NPV were 71%, 70%, 94%, and 27%, respectively. In anatomical evaluation, the sensitivity, specificity, PPV, and NPV were 49%, 85%, 77%, and 64%, respectively. For large cholesteatomas with an existing diagnosis, the sensitivity was 86%. In anatomical evaluation, the sensitivity, specificity, PPV, and NPV were 51%, 57%, 88%, and 18%, respectively. For small cholesteatomas with an existing diagnosis, the sensitivity, specificity, PPV, and NPV were 59%, 78%, 92%, and 30%, respectively. In anatomical evaluation, the sensitivity, specificity, PPV, and NPV were 40%, 85%, 60%, and 71%, respectively. FTS-nEPID may be useful for diagnosing cholesteatomas. Further research is needed for anatomical evaluation because there were many false-negative results. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation by medical students of the educational value of multi-material and multi-colored three-dimensional printed models of the upper limb for anatomical education.

PubMed

Mogali, Sreenivasulu Reddy; Yeong, Wai Yee; Tan, Heang Kuan Joel; Tan, Gerald Jit Shen; Abrahams, Peter H; Zary, Nabil; Low-Beer, Naomi; Ferenczi, Michael Alan

2018-01-01

For centuries, cadaveric material has been the cornerstone of anatomical education. For reasons of changes in curriculum emphasis, cost, availability, expertise, and ethical concerns, several medical schools have replaced wet cadaveric specimens with plastinated prosections, plastic models, imaging, and digital models. Discussions about the qualities and limitations of these alternative teaching resources are on-going. We hypothesize that three-dimensional printed (3DP) models can replace or indeed enhance existing resources for anatomical education. A novel multi-colored and multi-material 3DP model of the upper limb was developed based on a plastinated upper limb prosection, capturing muscles, nerves, arteries and bones with a spatial resolution of ∼1 mm. This study aims to examine the educational value of the 3DP model from the learner's point of view. Students (n = 15) compared the developed 3DP models with the plastinated prosections, and provided their views on their learning experience using 3DP models using a survey and focus group discussion. Anatomical features in 3DP models were rated as accurate by all students. Several positive aspects of 3DP models were highlighted, such as the color coding by tissue type, flexibility and that less care was needed in the handling and examination of the specimen than plastinated specimens which facilitated the appreciation of relations between the anatomical structures. However, students reported that anatomical features in 3DP models are less realistic compared to the plastinated specimens. Multi-colored, multi-material 3DP models are a valuable resource for anatomical education and an excellent adjunct to wet cadaveric or plastinated prosections. Anat Sci Educ 11: 54-64. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Comparison of the current AJCC-TNM numeric-based with a new anatomical location-based lymph node staging system for gastric cancer: A western experience.

PubMed

Galizia, Gennaro; Lieto, Eva; Auricchio, Annamaria; Cardella, Francesca; Mabilia, Andrea; Diana, Anna; Castellano, Paolo; De Vita, Ferdinando; Orditura, Michele

2017-01-01

In gastric cancer, the current AJCC numeric-based lymph node staging does not provide information on the anatomical extent of the disease and lymphadenectomy. A new anatomical location-based node staging, proposed by Choi, has shown better prognostic performance, thus soliciting Western world validation. Data from 284 gastric cancers undergoing radical surgery at the Second University of Naples from 2000 to 2014 were reviewed. The lymph nodes were reclassified into three groups (lesser and greater curvature, and extraperigastric nodes); presence of any metastatic lymph node in a given group was considered positive, prompting a new N and TNM stage classification. Receiver-operating-characteristic (ROC) curves for censored survival data and bootstrap methods were used to compare the capability of the two models to predict tumor recurrence. More than one third of node positive patients were reclassified into different N and TNM stages by the new system. Compared to the current staging system, the new classification significantly correlated with tumor recurrence rates and displayed improved indices of prognostic performance, such as the Bayesian information criterion and the Harrell C-index. Higher values at survival ROC analysis demonstrated a significantly better stratification of patients by the new system, mostly in the early phase of the follow-up, with a worse prognosis in more advanced new N stages, despite the same current N stage. This study suggests that the anatomical location-based classification of lymph node metastasis may be an important tool for gastric cancer prognosis and should be considered for future revision of the TNM staging system.

The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma.

PubMed

Bennie, George; Vorster, Mariza; Buscombe, John; Sathekge, Mike

2015-01-01

Single-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and radiation burden of these reported benefits remains somewhat uncertain. This study aimed to evaluate the possible added value of SPECT-CT and intra-operative gamma-probe use over planar imaging alone in the South African setting. 80 patients with breast cancer or malignant melanoma underwent both planar and SPECT-CT imaging for SLN mapping. We assessed and compared the number of nodes detected on each study, false positive and negative findings, changes in surgical approach and or patient management. In all cases where a sentinel node was identified, SPECT-CT was more accurate anatomically. There was a significant change in surgical approach in 30 cases - breast cancer (n = 13; P 0.001) and malignant melanoma (n = 17; P 0.0002). In 4 cases a node not identified on planar imaging was seen on SPECT-CT. In 16 cases additional echelon nodes were identified. False positives were excluded by SPECT-CT in 12 cases. The addition of SPECT-CT and use of intra-operative gamma-probe to planar imaging offers important benefits in patients who present with breast cancer and melanoma. These benefits include increased nodal detection, elimination of false positives and negatives and improved anatomical localization that ultimately aids and expedites surgical management. This has been demonstrated in the context of industrialized country previously and has now also been confirmed in the setting of a emerging-market nation.

Alternative body sites for heat stress measurement in milking cows under tropical conditions and their relationship to the thermal discomfort of the animals

NASA Astrophysics Data System (ADS)

Martello, Luciane S.; Savastano Junior, Holmer; Silva, Saulo L.; Balieiro, Júlio Cesar C.

2010-11-01

This study was conducted to determine the relationship among temperatures measured at different anatomical sites of the animal body and their daily pattern as indicative of the thermal stress in lactating dairy cows under tropical conditions. Environmental dry bulb (DBT) and black globe (BGT) temperatures and relative humidity (RH) were recorded. Rectal temperature (RT), respiratory frequency (RF), body surface (BST), internal base of tail (TT), vulva (VT) and auricular temperatures (AT) were collected, from 37 Black and White Holstein cows at 0700, 1300 and 1800 hours. RT showed a moderately and positive correlations with all body temperatures, ranging from 0.59 with TT to 0.64 with BST. Correlations among AT, VT and TT with RF were very similar (from 0.63 to 0.64) and were greater than those observed for RF with RT (0.55) or with BST (0.54). RF and RT were positively correlated to TT (0.63 and 0.59, respectively), AT (r = 0.63 for both) and VT ( r = 0.64 and 0.63, respectively). Positive and very high correlations were observed among AT, VT and TT (from 0.94 to 0.97) indicating good association of temperatures measured in these anatomical sites. Correlations of BST with AT and VT were positive and very similar (0.71 and 0.72, respectively) and lower with TT (0.66). The AT, TT, VT and BST presented similar patterns and follow the variations of DBT through the day. Temperatures measured at different anatomical sites of the animal body have the potential to be used as indicative of the thermal stress in lactating dairy cows.

Development and preliminary evaluation of a new anatomically based prosthetic alignment method for below-knee prosthesis.

PubMed

Tafti, Nahid; Karimlou, Masoud; Mardani, Mohammad Ali; Jafarpisheh, Amir Salar; Aminian, Gholam Reza; Safari, Reza

2018-04-20

The objectives of current study were to a) assess similarities and relationships between anatomical landmark-based angles and distances of lower limbs in unilateral transtibial amputees and b) develop and evaluate a new anatomically based static prosthetic alignment method. First sub-study assessed the anthropometrical differences and relationships between the lower limbs in the photographs taken from amputees. Data were analysed via paired t-test and regression analysis. Results show no significant differences in frontal and transverse planes. In the sagittal plane, the anthropometric parameters of the amputated limb were significantly correlated to the corresponding variables of the sound limb. The results served as bases for the development of a new prosthetic alignment method. The method was evaluated on a single subject study. Prosthetic alignment carried out by an experienced prosthetist was compared with such alignment adjusted by an inexperienced prosthetist but with the use of the developed method. In sagittal and frontal planes, the socket angle was tuned with respect to the shin angle, and the position of the prosthetic foot was tuned in relation to the pelvic landmarks. Further study is needed to assess the proposed method on a larger sample of amputees and prosthetists.

Characterization of midrib vascular bundles of selected medicinal species in Rubiaceae

NASA Astrophysics Data System (ADS)

Nurul-Syahirah, M.; Noraini, T.; Latiff, A.

2016-11-01

An anatomical study was carried out on mature leaves of five selected medicinal species of Rubiaceae from Peninsular Malaysia. The chosen medicinal species were Aidia densiflora, Aidia racemosa, Chasallia chartacea, Hedyotis auricularia and Ixora grandifolia. The objective of this study is to determine the taxonomic value of midrib anatomical characteristics. Leaves samples were collected from Taman Paku Pakis, Universiti Kebangsaan Malaysia, Bangi, Selangor and Kledang Saiong Forest Reserve, Perak, Malaysia. Leaves samples then were fixed in spirit and acetic acid (3:1), the midrib parts then were sectioned using sliding microtome, cleared using Clorox, stained in Safranin and Alcian blue, mounted in Euparal and were observed under light microscope. Findings in this study have shown all species have collateral bundles. The midrib vascular bundles characteristics that can be used as tool to differentiate between species or genus are vascular bundles system (opened or closed), shape and arrangement of main vascular bundles, presence of both additional and medullary vascular bundles, position of additional vascular bundles, shape of medullary vascular bundles, presence of sclerenchyma cells ensheathed the vascular bundles. As a conclusion, midrib anatomical characteristics can be used to identify and discriminate medicinal plants species studied in the Rubiaceae.

The Effect of Anatomical Location of Lymph Node Metastases on Cancer Specific Survival in Patients with Clear Cell Renal Cell Carcinoma.

PubMed

Nini, Alessandro; Larcher, Alessandro; Cianflone, Francesco; Trevisani, Francesco; Terrone, Carlo; Volpe, Alessandro; Regis, Federica; Briganti, Alberto; Salonia, Andrea; Montorsi, Francesco; Bertini, Roberto; Capitanio, Umberto

2018-01-01

Positive nodal status (pN1) is an independent predictor of survival in renal cell carcinoma (RCC) patients. However, no study to date has tested whether the location of lymph node (LN) metastases does affect oncologic outcomes in a population submitted to radical nephrectomy (RN) and extended lymph node dissection (eLND). To describe nodal disease dissemination in clear cell RCC (ccRCC) patients and to assess the effect of the anatomical sites and the number of nodal areas affected on cancer specific mortality (CSM). The study included 415 patients who underwent RN and eLND, defined as the removal of hilar, side-specific (pre/paraaortic or pre/paracaval) and interaortocaval LNs for ccRCC, at two institutions. Descriptive statistics were used to depict nodal dissemination in pN1 patients, stratified according to nodal site and number of involved areas. Multivariable Cox regression analyses and Kaplan-Meier curves were used to explore the relationship between pN1 disease features and survival outcomes. Median number of removed LN was 14 (IQR 9-19); 23% of patients were pN1. Among patients with one involved nodal site, 54 and 26% of patients were positive only in side-specific and interaortocaval station, respectively. The most frequent nodal site was the interaortocaval and side-specific one, for right and left ccRCC, respectively. Interaortocaval nodal positivity (HR 2.3, CI 95%: 1.3-3.9, p < 0.01) represented an independent predictor of CSM. When ccRCC patient harbour nodal disease, its spreading can occur at any nodal station without involving the others. The presence of interoartocaval positive nodes does affect oncologic outcomes. Lymph node invasion in patients with clear cell renal cell carcinoma is not following a fixed anatomical pattern. An extended lymph node dissection, during treatment for primary kidney tumour, would aid patient risk stratification and multimodality upfront treatment.

The role of synovial fluid analysis in the detection of periprosthetic hip and knee infections: a systematic review and meta-analysis.

PubMed

De Fine, Marcello; Giavaresi, Gianluca; Fini, Milena; Illuminati, Andrea; Terrando, Silvio; Pignatti, Giovanni

2018-05-01

This study tried to ascertain (1) the accuracy of synovial fluid white blood cell count and polymorphonucleate percentage in the diagnosis of periprosthetic hip and knee infections, (2) which test yielded superior test performance, and (3) the influence on diagnostic accuracy of study characteristics such as patient number, study design, study level, anatomic site, and threshold value. A systematic search was conducted including papers assessing more effective cutoffs for synovial fluid tests, having comparative design, evaluating an exclusive cohort of hip or knee prostheses, including a clear definition of infected cases, and reporting sufficient data for the calculation of true-positive, false-positive, false-negative, and true-negative. A total of 375 articles were collected and, given the inclusion criteria, ten manuscripts were included. These studies assessed 1155 hip prostheses (276 infected cases) and 1235 knee prostheses (401 infected cases). The specificity of synovial fluid white blood cell count was significantly increased by using the threshold value ≥ 3000 cell/μL (p = 0.006); the sensitivity of polymorphonucleate percentage was significantly higher in detecting knee infections (p = 0.034). Both tests had a high specificity and sensitivity in detecting periprosthetic joint infections, and no clear superiority of one over the other existed. Furthermore, cutoff and anatomic site significantly influenced synovial fluid white blood cell count and polymorphonucleate percentage, respectively. Synovial fluid analysis is adequate in differentiating patients with periprosthetic hip and knee infections. Our data confirms international guidelines suggesting the use of 3000 cell/μL as cutoff threshold for synovial fluid white blood cell count. Since an anatomic site effect has been demonstrated, the goal of future studies will be to identify different cutoffs for hip and knee prostheses.

Reality of the G-spot and its relation to female circumcision and vaginal surgery.

PubMed

Thabet, Saeed Mohamad Ahmad

2009-10-01

To clarify the reality of the G-spot anatomically, functionally and histologically, and to determine the possible effect of female circumcision and anterior vaginal wall surgery on the integrity and function of the G-spot. A controlled descriptive and comparative cohort prospective study was conducted at Kasr El Aini School of Medicine, Cairo University, Cairo, Egypt, of 50 uncircumcised and 125 circumcised women with small to moderate anterior vaginal wall descent. Preoperative sexual examination was performed to map the site of the G-spot and other anatomical landmarks on the anterior vaginal wall and to verify the associated circumcision state. Pre- and postoperative sexual assessment and histological examination of different mapped sites in the anterior vagina were also conducted. Histological findings, results of the anatomical and sexual mapping of the anterior vaginal wall and sexual scores were recorded. The G-spot was proved functionally in 144 (82.3%) of women and anatomically in 95 (65.9%). The latter appeared as two small flaccid balloon-like masses on either side of the lower third of the urethra and were named 'the sexual bodies of the G-spot'. These bodies were significantly detected in all histo-positive cases in the circumcised women and in the uncircumcised women who had small or average clitorises. The G-spot was also proved histologically in 47.4% of all cases and was formed of epithelial, glandular and erectile tissue. Sex scores were significantly higher in the histo-positive cases with sexual bodies but significantly dropped after anterior vaginal wall surgery. In contrast, female circumcision rarely alters the scores. The G-spot is functional reality in 82.3% of women, an anatomical reality in 54.3% and a histological reality in 47.4%. Anterior vaginal wall surgery usually affects the G-spot and female sexuality, but female circumcision rarely affects them.

Fusion of Computed Tomography and PROPELLER Diffusion-Weighted Magnetic Resonance Imaging for the Detection and Localization of Middle Ear Cholesteatoma.

PubMed

Locketz, Garrett D; Li, Peter M M C; Fischbein, Nancy J; Holdsworth, Samantha J; Blevins, Nikolas H

2016-10-01

A method to optimize imaging of cholesteatoma by combining the strengths of available modalities will improve diagnostic accuracy and help to target treatment. To assess whether fusing Periodically Rotated Overlapping Parallel Lines With Enhanced Reconstruction (PROPELLER) diffusion-weighted magnetic resonance imaging (DW-MRI) with corresponding temporal bone computed tomography (CT) images could increase cholesteatoma diagnostic and localization accuracy across 6 distinct anatomical regions of the temporal bone. Case series and preliminary technology evaluation of adults with preoperative temporal bone CT and PROPELLER DW-MRI scans who underwent surgery for clinically suggested cholesteatoma at a tertiary academic hospital. When cholesteatoma was encountered surgically, the precise location was recorded in a diagram of the middle ear and mastoid. For each patient, the 3 image data sets (CT, PROPELLER DW-MRI, and CT-MRI fusion) were reviewed in random order for the presence or absence of cholesteatoma by an investigator blinded to operative findings. If cholesteatoma was deemed present on review of each imaging modality, the location of the lesion was mapped presumptively. Image analysis was then compared with surgical findings. Twelve adults (5 women and 7 men; median [range] age, 45.5 [19-77] years) were included. The use of CT-MRI fusion had greater diagnostic sensitivity (0.88 vs 0.75), positive predictive value (0.88 vs 0.86), and negative predictive value (0.75 vs 0.60) than PROPELLER DW-MRI alone. Image fusion also showed increased overall localization accuracy when stratified across 6 distinct anatomical regions of the temporal bone (localization sensitivity and specificity, 0.76 and 0.98 for CT-MRI fusion vs 0.58 and 0.98 for PROPELLER DW-MRI). For PROPELLER DW-MRI, there were 15 true-positive, 45 true-negative, 1 false-positive, and 11 false-negative results; overall accuracy was 0.83. For CT-MRI fusion, there were 20 true-positive, 45 true-negative, 1 false-positive, and 6 false-negative results; overall accuracy was 0.90. The poor anatomical spatial resolution of DW-MRI makes precise localization of cholesteatoma within the middle ear and mastoid a diagnostic challenge. This study suggests that the bony anatomic detail obtained via CT coupled with the excellent sensitivity and specificity of PROPELLER DW-MRI for cholesteatoma can improve both preoperative identification and localization of disease over DW-MRI alone.

Learning-based stochastic object models for characterizing anatomical variations

NASA Astrophysics Data System (ADS)

Dolly, Steven R.; Lou, Yang; Anastasio, Mark A.; Li, Hua

2018-03-01

It is widely known that the optimization of imaging systems based on objective, task-based measures of image quality via computer-simulation requires the use of a stochastic object model (SOM). However, the development of computationally tractable SOMs that can accurately model the statistical variations in human anatomy within a specified ensemble of patients remains a challenging task. Previously reported numerical anatomic models lack the ability to accurately model inter-patient and inter-organ variations in human anatomy among a broad patient population, mainly because they are established on image data corresponding to a few of patients and individual anatomic organs. This may introduce phantom-specific bias into computer-simulation studies, where the study result is heavily dependent on which phantom is used. In certain applications, however, databases of high-quality volumetric images and organ contours are available that can facilitate this SOM development. In this work, a novel and tractable methodology for learning a SOM and generating numerical phantoms from a set of volumetric training images is developed. The proposed methodology learns geometric attribute distributions (GAD) of human anatomic organs from a broad patient population, which characterize both centroid relationships between neighboring organs and anatomic shape similarity of individual organs among patients. By randomly sampling the learned centroid and shape GADs with the constraints of the respective principal attribute variations learned from the training data, an ensemble of stochastic objects can be created. The randomness in organ shape and position reflects the learned variability of human anatomy. To demonstrate the methodology, a SOM of an adult male pelvis is computed and examples of corresponding numerical phantoms are created.

Distal Extension of the Direct Anterior Approach to the Hip: A Cadaveric Feasibility Study.

PubMed

Ghijselings, Stijn G M; Driesen, Ronald; Simon, Jean-Pierre; Corten, Kristoff

2017-01-01

The direct anterior approach (DAA) is becoming more popular as the standard surgical approach for primary total hip arthroplasty. However, femoral complications of up to 2.8% have been reported. Therefore, it is important for surgeons to understand the periarticular neurovascular anatomy in order to safely deal with intraoperative complications. Anatomic dissections were performed on 20 cadaveric hips. The neurovascular structures anterior to the femur and distal to the intertrochanteric line were dissected and its position was described in relation to anatomic landmarks easily identified through the DAA: anterior superior iliac spine (ASIS), the insertion of the gluteus minimus (GM), and the lesser trochanter (LT). Two clearly distinguishable neurovascular bundles running to the vastus lateralis were seen in 17 of 20 specimens. The average distances to the landmarks were as follows: ASIS-1st bundle = 12.3 cm (range, 9.7-14.5); GM-1st bundle = 3.2 cm (range, 2.2-4); LT-1st bundle = 1.6 cm (range, 0.7-2.8); 1st bundle-2nd bundle = 3.3 cm (range, 1.8-6.1). A consistent pattern of 2 clearly distinguishable neurovascular bundles was seen in 85% of the specimens. Knowledge of the position of these neurovascular bundles in relation to the anatomic landmarks makes distal femoral extension of the DAA feasible. Further clinical studies are needed to confirm the safety of the extensile anterior approach. Copyright © 2016 Elsevier Inc. All rights reserved.

Factors Influencing Student Performance on the Carpal Bone Test as a Preliminary Evaluation of Anatomical Knowledge Retention

ERIC Educational Resources Information Center

Meyer, Amanda J.; Armson, Anthony; Losco, C. Dominique; Losco, Barrett; Walker, Bruce F.

2015-01-01

It has been demonstrated that a positive correlation exists between clinical knowledge and retained concepts in basic sciences. Studies have demonstrated a modest attrition of anatomy knowledge over time, which may be influenced by students' perceived importance of the basic sciences and the learning styles adopted. The aims of this study were to:…

Neuroanatomical Correlates of Intelligence

PubMed Central

Luders, Eileen; Narr, Katherine L.; Thompson, Paul M.; Toga, Arthur W.

2009-01-01

With the advancement of image acquisition and analysis methods in recent decades, unique opportunities have emerged to study the neuroanatomical correlates of intelligence. Traditional approaches examining global measures have been complemented by insights from more regional analyses based on pre-defined areas. Newer state-of-the-art approaches have further enhanced our ability to localize the presence of correlations between cerebral characteristics and intelligence with high anatomic precision. These in vivo assessments have confirmed mainly positive correlations, suggesting that optimally increased brain regions are associated with better cognitive performance. Findings further suggest that the models proposed to explain the anatomical substrates of intelligence should address contributions from not only (pre)frontal regions, but also widely distributed networks throughout the whole brain. PMID:20160919

Heidelberg Retina Tomography Analysis in Optic Disks with Anatomic Particularities

PubMed Central

Alexandrescu, C; Pascu, R; Ilinca, R; Popescu, V; Ciuluvica, R; Voinea, L; Celea, C

2010-01-01

Due to its objectivity, reproducibility and predictive value confirmed by many large scale statistical clinical studies, Heidelberg Retina Tomography has become one of the most used computerized image analysis of the optic disc in glaucoma. It has been signaled, though, that the diagnostic value of Moorfieds Regression Analyses and Glaucoma Probability Score decreases when analyzing optic discs with extreme sizes. The number of false positive results increases in cases of megalopapilllae and the number of false negative results increases in cases of small size optic discs. The present paper is a review of the aspects one should take into account when analyzing a HRT result of an optic disc with anatomic particularities. PMID:21254731

The soleus syndrome. A cause of medial tibial stress (shin splints).

PubMed

Michael, R H; Holder, L E

1985-01-01

Radionuclide bone scans have demonstrated linear uptake along the posterior medial border of the tibia in patients with shin splints. This area was investigated by anatomical dissection (14 human cadavers), electromyographic (EMG) and muscle stimulation studies (10 patients), and open biopsy (1 patient). Histologically, the increased metabolic activity manifested on the radionuclide scan is due to a periostitis with new bone formation. The soleus muscle and its investing fascia are anatomically and biomechanically implicated in the production of these stress changes, particularly when the heel is in the pronated position. The soleus muscle and fascia form a tough "soleus bridge" over the deep compartment which is thought to be important in patients requiring surgical decompression.

Reasonable classical concepts in human lower limb anatomy from the viewpoint of the primitive persistent sciatic artery and twisting human lower limb.

PubMed

Kawashima, Tomokazu; Sasaki, Hiroshi

2010-11-01

The main aim of this review is (1) to introduce the two previous studies we published human lower limb anatomy based on the conventional macroscopic anatomical [corrected] criteria with hazardous recognition of this description, (2) to activate the discussion whether the limb homology exists, and (3) to contribute to future study filling the gap between the gross anatomy and embryology. One of the topics we discussed was the human persistent sciatic artery. To date, numerous human cases of persistent sciatic artery have been reported in which the anomalous artery was present in the posterior compartment of the thigh alongside the sciatic nerve. As one of the important criteria for assessing the human primitive sciatic artery, its ventral arterial position with respect to the sciatic nerve is reasonable based on the initial positional relationship between ventral arterial and dorsal nervous systems and comparative anatomical findings. We also discuss ways of considering the topography of muscles of the lower limb and their innervations compared to those of the upper limb. We propose a schema of the complex anatomical characteristics of the lower limb based on the vertebrate body plan. According to this reasonable schema, the twisted anatomy of the lower limb can be understood more easily. These two main ideas discussed in this paper will be useful for further understanding of the anatomy of the lower limb and as a first step for future. We hope that the future study in lower limb will be further developed by both viewpoints of the classical gross anatomy and recent embryology.

Comparison of mechanical energy profiles of passive and active below-knee prostheses: a case study.

PubMed

Takahashi, Kota Z; Horne, John R; Stanhope, Steven J

2015-04-01

With the recent technological advancements of prosthetic lower limbs, there is currently a great desire to objectively evaluate existing prostheses. Using a novel biomechanical analysis, the purpose of this case study was to compare the mechanical energy profiles of anatomical and two disparate prostheses: a passive prosthesis and an active prosthesis. An individual with a transtibial amputation who customarily wears a passive prosthesis (Elation, Össur) and an active prosthesis (BiOM, iWalk, Inc.) and 11 healthy subjects participated in an instrumented gait analysis. The total mechanical power and work of below-knee structures during stance were quantified using a unified deformable segment power analysis. Active prosthesis generated greater peak power and total positive work than passive prosthesis and healthy anatomical limbs. The case study will enhance future efforts to objectively evaluate prosthetic functions during gait in individuals with transtibial amputations. A prosthetic limb should closely replicate the mechanical energy profiles of anatomical limbs. The unified deformable (UD) analysis may be valuable to facilitate future clinical prescription and guide fine adjustments of prosthetic componentry to optimize gait outcomes. © The International Society for Prosthetics and Orthotics 2014.

A systematic review of single- versus double-bundle ACL reconstruction using the anatomic anterior cruciate ligament reconstruction scoring checklist.

PubMed

Desai, Neel; Alentorn-Geli, Eduard; van Eck, Carola F; Musahl, Volker; Fu, Freddie H; Karlsson, Jón; Samuelsson, Kristian

2016-03-01

The aim of this systematic review was to apply the anatomic ACL reconstruction scoring checklist (AARSC) and to evaluate the degree to which clinical studies comparing single-bundle (SB) and double-bundle (DB) ACL reconstructions are anatomic. A systematic electronic search was performed using the databases PubMed (MEDLINE), EMBASE and Cochrane Library. Studies published from January 1995 to January 2014 comparing SB and DB ACL reconstructions with clinical outcome measurements were included. The items from the AARSC were recorded for both the SB and DB groups in each study. Eight-thousand nine-hundred and ninety-four studies were analysed, 77 were included. Randomized clinical trials (29; 38%) and prospective comparative studies (29; 38%) were the most frequent study type. Most studies were published in 2011 (19; 25%). The most commonly reported items for both SB and DB groups were as follows: graft type (152; 99%), femoral and tibial fixation method (149; 97% respectively), knee flexion angle during graft tensioning (124; 8%) and placement of the tibial tunnel at the ACL insertion site (101; 66%). The highest level of documentation used for ACL tunnel position for both groups was often one dimensional, e.g. drawing, operative notes or o'clock reference. The DB reconstruction was in general more thoroughly reported. The means for the AARSC were 6.9 ± 2.8 for the SB group and 8.3 ± 2.8 for the DB group. Both means were below a proposed required minimum score of 10 for anatomic ACL reconstruction. There was substantial underreporting of surgical data for both the SB and DB groups in clinical studies. This underreporting creates difficulties when analysing, comparing and pooling results of scientific studies on this subject.

A pilot study on objective quantification and anatomical modelling of in vivo head and neck positions commonly applied in training and competition of sport horses.

PubMed

Elgersma, A E; Wijnberg, I D; Sleutjens, J; van der Kolk, J H; van Weeren, P R; Back, W

2010-11-01

Head and neck positions (HNP) in sport horses are under debate in the equine community, as they could interfere with equine welfare. HNPs have not been quantified objectively and no information is available on their head and neck loading. To quantify in vivo HNPs in sport horses and develop o a model to estimate loading on the cervical vertebrae in these positions. Videos were taken of 7 Warmbloods at walk on a straight line in 5 positions, representing all HNPs during Warmblood training and competition. Markers were glued at 5 anatomical landmarks. Two-dimensional angles and distances were determined from video frames for the 5 HNPs and statistically compared (P < 0.05). A new simulation model was developed to estimate nuchal ligament cervical loading at these HNPs. The mean angles were significantly different between the 5 HNPs for the line between C1 and T6 with the horizontal and for the line connecting the facial crest (CF) and C1 with the vertical, while the vertical distance from CF to the lateral styloid process of the radius (PS) was significantly different between all 5 positions (P < 0.05). The estimated nuchal ligament loading appeared to be largest at the origin of C2 for all HNPs, except for the 'hyperextended' HNP5; the 'hyperflexed' HNP4 showed the largest loading values on the nuchal ligament origins at all locations. HNPs can be accurately quantified in the sagittal plane from angles and distances based on standard anatomical landmarks and home-video captured images. Nuchal ligament loading showed the largest estimated values at its origin on C2 in hyperflexion (HNP4). Modelling opens further perspectives to eventually estimate loading for individual horses and thus ergonomically optimise their HNP, which may improve the welfare of the sport horse during training and competition. © 2010 EVJ Ltd.

Anatomical Analysis of Thumb Opponency Movement in the Capuchin Monkey (Sapajus sp)

PubMed Central

Aversi-Ferreira, Roqueline A. G. M. F.; Maior, Rafael Souto; Aziz, Ashraf; Ziermann, Janine M.; Nishijo, Hisao; Tomaz, Carlos; Tavares, Maria Clotilde H.; Aversi-Ferreira, Tales Alexandre

2014-01-01

Capuchin monkeys present a wide variety of manipulatory skills and make routine use of tools both in captivity and in the wild. Efficient handling of objects in this genus has led several investigators to assume near-human thumb movements despite the lack of anatomical studies. Here we perform an anatomical analysis of muscles and bones in the capuchin hand. Trapezo-metacarpal joint surfaces observed in capuchins indicate that medial rotation of metacarpal I is either absent or very limited. Overall, bone structural arrangement and thumb position relative to the other digits and the hand’s palm suggest that capuchins are unable to perform any kind of thumb opponency, but rather a ‘lateral pinch’ movement. Although the capuchin hand apparatus bears other features necessary for complex tool use, the lack thumb opposition movements suggests that a developed cognitive and motor nervous system may be even more important for high manipulatory skills than traditionally held. PMID:24498307

Patients’ satisfaction with anatomic polyurethane implants

PubMed Central

2017-01-01

This paper presents patients satisfaction using anatomical polyurethane breast implants. We performed surgery on 525 patients, 370 of which were primary and 155 were secondary to various causes such as capsular contracture, ruptured implants, volume changes, and incorrect positioning of the implant. The advantages of silicone polyurethane covers shown high level of patient satisfaction, low incidence of capsular contracture, and absence of implant rotation, and late seroma. PMID:28497022

Computed Intranasal Spray Penetration: Comparisons Before and After Nasal Surgery

PubMed Central

Frank, Dennis O.; Kimbell, Julia S.; Cannon, Daniel; Rhee, John S.

2012-01-01

Background Quantitative methods for comparing intranasal drug delivery efficiencies pre- and postoperatively have not been fully utilized. The objective of this study is to use computational fluid dynamics techniques to evaluate aqueous nasal spray penetration efficiencies before and after surgical correction of intranasal anatomic deformities. Methods Ten three-dimensional models of the nasal cavities were created from pre- and postoperative computed tomography scans in five subjects. Spray simulations were conducted using a particle size distribution ranging from 10–110μm, a spray speed of 3m/s, plume angle of 68°, and with steady state, resting inspiratory airflow present. Two different nozzle positions were compared. Statistical analysis was conducted using Student T-test for matched pairs. Results On the obstructed side, posterior particle deposition after surgery increased by 118% and was statistically significant (p-value=0.036), while anterior particle deposition decreased by 13% and was also statistically significant (p-value=0.020). The fraction of particles that by-passed the airways either pre- or post-operatively was less than 5%. Posterior particle deposition differences between obstructed and contralateral sides of the airways were 113% and 30% for pre- and post-surgery, respectively. Results showed that nozzle positions can influence spray delivery. Conclusions Simulations predicted that surgical correction of nasal anatomic deformities can improve spray penetration to areas where medications can have greater effect. Particle deposition patterns between both sides of the airways are more evenly distributed after surgery. These findings suggest that correcting anatomic deformities may improve intranasal medication delivery. For enhanced particle penetration, patients with nasal deformities may explore different nozzle positions. PMID:22927179

Is anatomic acetabular orientation related to pelvic morphology? CT analysis of 150 healthy pelvises.

PubMed

Sautet, P; Giorgi, H; Chabrand, P; Tropiano, P; Argenson, J-N; Parratte, S; Blondel, B

2018-05-01

Links between sagittal spinal alignment and acetabular orientation attract considerable research attention with the goal of optimising prosthetic cup position. However, whether pelvic incidence (PI) is related to anatomic acetabular orientation remains unknown. We therefore conducted a radiological study with the following objectives: to look for correlations between PI and anatomic acetabular parameters; to describe the sacro-pubic angle (SPA), defined by fixed bony pelvic landmarks, and its relations with acetabular anteversion; and to determine whether anatomical parameters (PI and SPA) correlate with demographic characteristics. PI correlates with anatomical acetabular parameters. We conducted a computed tomography (CT) study of the pelvises of 150 patients free of degenerative disease. Three parameters were measured: anatomic acetabular orientation in the Lewinnek reference plane, PI, and the SPA subtended by the line connecting the midpoint of the sacral endplate to the pubic symphysis and the anterior pelvic plane. Statistical tests were performed to look for correlations among these parameters. Intra-observer and inter-observer reproducibility was considered highly satisfactory (inter-class correlation coefficient, >86% and >82%, respectively). Mean PI was 58.6°±10.2° (range, 32.8°-97.6°), with no significant differences between genders or across age groups. Mean SPA was 34.7°±5.5° (range, 18.3°-49.8°). Mean anatomic acetabular anteversion (AAA) was greater in females (23.4°; range, 11.5°-34.5°) than in males (20°; range, 7.5°-34.5°) (P<0.001). PI did not correlate with any of the acetabular parameters (PI/AAA, r=0.8 and P=0.33; PI/acetabular inclination on the horizontal, r=-0.96 and P=0.24). SPA correlated significantly with both PI (r=0.33 and P<0.001) and AAA (r=0.33 and P<0.001). This CT study of normal pelvises showed that AAA was significantly greater in females and that SPA correlated significantly with both PI and acetabular anteversion. SPA could serve to define the "theoretical" AAA of each individual patient and could thus be incorporated into surgical planning protocols or intra-operative guidance methods for hip replacement surgery. IV, retrospective study with no control group. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Biomechanical consequences of a nonanatomic posterior medial meniscal root repair.

PubMed

LaPrade, Christopher M; Foad, Abdullah; Smith, Sean D; Turnbull, Travis Lee; Dornan, Grant J; Engebretsen, Lars; Wijdicks, Coen A; LaPrade, Robert F

2015-04-01

Posterior medial meniscal root tears have been reported to extrude with the meniscus becoming adhered posteromedially along the posterior capsule. While anatomic repair has been reported to restore tibiofemoral contact mechanics, it is unknown whether nonanatomic positioning of a meniscal root repair to a posteromedial location would restore the loading profile of the knee joint. The purpose of this study was to compare the tibiofemoral contact mechanics of a nonanatomic posterior medial meniscal tear with that of the intact knee or anatomic repair. It was hypothesized that a nonanatomic root repair would not restore the tibiofemoral contact pressures and areas to that of the intact or anatomic repair state. Controlled laboratory study. Tibiofemoral contact mechanics were recorded in 6 male human cadaveric knee specimens (average age, 45.8 years) using pressure sensors. Each knee underwent 5 testing conditions for the posterior medial meniscal root: (1) intact knee; (2) root tear; (3) anatomic transtibial pull-out repair; (4) nonanatomic transtibial pull-out repair, placed 5 mm posteromedially along the edge of the articular cartilage; and (5) root tear concomitant with an ACL tear. Knees were loaded with a 1000-N axial compressive force at 4 flexion angles (0°, 30°, 60°, 90°), and contact area, mean contact pressure, and peak contact pressure were calculated. Contact area was significantly lower after nonanatomic repair than for the intact knee at all flexion angles (mean = 44% reduction) and significantly higher for anatomic versus nonanatomic repair at all flexion angles (mean = 27% increase). At 0° and 90°, and when averaged across flexion angles, the nonanatomic repair significantly increased mean contact pressures in comparison to the intact knee or anatomic repair. When averaged across flexion angles, the peak contact pressures after nonanatomic repair were significantly higher than the intact knee but not the anatomic repair. In contrast, when averaged across all flexion angles, the anatomic repair resulted in a 17% reduction in contact area and corresponding increases in mean and peak contact pressures of 13% and 26%, respectively, compared with the intact knee. For most testing conditions, the nonanatomic repair did not restore the contact area or mean contact pressures to that of the intact knee or anatomic repair. However, the anatomic repair produced near-intact contact area and resulted in relatively minimal increases in mean and peak contact pressures compared with the intact knee. Results emphasize the importance of ensuring an anatomic posterior medial meniscal root repair by releasing the extruded menisci from adhesions and the posteromedial capsule. Similar caution toward preventing displacement of the meniscal root repair construct should be emphasized. © 2015 The Author(s).

[Application of acupoint anatomy localization method with colorful tube in education of acupoint anatomy].

PubMed

Song, Shi-Lin

2013-04-01

To seek a precise and simple method for localization of acupoint in anatomical experiment teaching. Medical bone needles were inserted into acupoints. Then, self-mode copper probe needles were thrust along the center of the bone needles to open the inner structures of acuppoints. And probe needles were replaced by colored plastic tubes. Finally, bone needles were withdrawn so as to fix the plastic tubes into the acupoints to facilitate the later cutting. This method for acupoint anatomic positioning is of low cost with accurate positioning and simple manipulation, which has advantages in strong experimental and innovative values.

Muscle magnetic resonance imaging sensitivity does not decrease in chronic, mild, or proximal lower limb neuropathies.

PubMed

Deroide, Nicolas; Bousson, Valérie; Daguet, Edouard; Dumurgier, Julien; Tin, Sophie Ng Wing; Hannouche, Didier; Richette, Pascal; Beaudreuil, Johann; Lioté, Frédéric; Lévy, Bernard; Vicaut, Eric; Laredo, Jean Denis; Kubis, Nathalie

2012-05-01

Muscle magnetic resonance imaging (MRI) is an innovative tool for exploring focal neuropathies. However, its usefulness in mild, proximal, or chronic lesions, when electromyography (EMG), the current "gold standard" sensitivity is inadequate, has yet to be studied. Clinical, MRI, and EMG examinations were performed in 113 muscles of 17 consecutive patients with clinically diagnosed lower limb focal neuropathies. The sensitivity and specificity of MRI and EMG were evaluated in relation to disease duration, severity, and anatomical location. Muscle MRI was highly sensitive for the detection of denervated muscle, and, unlike EMG, its sensitivity did not decrease regardless of the anatomical location, duration, or severity of the neuropathy. Five MRI false positives were noted, including three in the thigh muscles. Muscle MRI is an alternative tool to EMG in proximal, mild, or chronic clinical diagnoses of lower limb focal neuropathies. However, it also seems prone to false-positive results, particularly in proximal muscles. Copyright © 2012 Wiley Periodicals, Inc.

Anatomical placement of the human eyeball in the orbit--validation using CT scans of living adults and prediction for facial approximation.

PubMed

Guyomarc'h, Pierre; Dutailly, Bruno; Couture, Christine; Coqueugniot, Hélène

2012-09-01

Accuracy of forensic facial approximation and superimposition techniques relies on the knowledge of anatomical correlations between soft and hard tissues. Recent studies by Stephan and collaborators (6,8,10) reviewed traditional guidelines leading to a wrong placement of the eyeball in the orbit. As those statements are based on a small cadaver sample, we propose a validation of these findings on a large database (n = 375) of living people. Computed tomography scans of known age and sex subjects were used to collect landmarks on three-dimensional surfaces and DICOM with TIVMI. Results confirmed a more superior and lateral position of the eyeball relatively to the orbital rims. Orbital height and breadth were used to compute regression formulae and proportional placement using percentages to find the most probable position of the eyeball in the orbit. A size-related sexual dimorphism was present but did not impact on the prediction accuracy. © 2012 American Academy of Forensic Sciences.

Anatomically correct visualization of the human upper airway using a high-speed long range optical coherence tomography system with an integrated positioning sensor

NASA Astrophysics Data System (ADS)

Jing, Joseph C.; Chou, Lidek; Su, Erica; Wong, Brian J. F.; Chen, Zhongping

2016-12-01

The upper airway is a complex tissue structure that is prone to collapse. Current methods for studying airway obstruction are inadequate in safety, cost, or availability, such as CT or MRI, or only provide localized qualitative information such as flexible endoscopy. Long range optical coherence tomography (OCT) has been used to visualize the human airway in vivo, however the limited imaging range has prevented full delineation of the various shapes and sizes of the lumen. We present a new long range OCT system that integrates high speed imaging with a real-time position tracker to allow for the acquisition of an accurate 3D anatomical structure in vivo. The new system can achieve an imaging range of 30 mm at a frame rate of 200 Hz. The system is capable of generating a rapid and complete visualization and quantification of the airway, which can then be used in computational simulations to determine obstruction sites.

Automatic anatomical segmentation of the liver by separation planes

NASA Astrophysics Data System (ADS)

Boltcheva, Dobrina; Passat, Nicolas; Agnus, Vincent; Jacob-Da, Marie-Andrée, , Col; Ronse, Christian; Soler, Luc

2006-03-01

Surgical planning in oncological liver surgery is based on the location of the 8 anatomical segments according to Couinaud's definition and tumors inside these structures. The detection of the boundaries between the segments is then the first step of the preoperative planning. The proposed method, devoted to binary images of livers segmented from CT-scans, has been designed to delineate these segments. It automatically detects a set of landmarks using a priori anatomical knowledge and differential geometry criteria. These landmarks are then used to position the Couinaud's segments. Validations performed on 7 clinical cases tend to prove that the method is reliable for most of these separation planes.

Sulfur hexafluoride (SF6) versus perfluoropropane (C3F8) tamponade and short term face-down position for macular hole repair: a randomized prospective study.

PubMed

Casini, Giamberto; Loiudice, Pasquale; De Cillà, Stefano; Radice, Paolo; Nardi, Marco

2016-01-01

To compare early visual and anatomical outcomes after either sulfur hexafluoride (SF 6 ) or perfluoropropane (C 3 F 8 ) tamponade for macular hole repair. 147 eyes affected by primary full-thickness macular hole underwent pars plana vitrectomy with dye assisted removal of the internal limiting membrane and gas tamponade. Prone position was prescribed for 48 h after surgery. All patients were divided into 3 groups depending on the size of the hole: small (<250 µm), medium (>250-<400 µm) or large (>400 µm). Eyes within the same group randomly received either SF 6 (70 eyes) or C 3 F 8 (77 eyes). A complete ophthalmic evaluation, including best corrected visual acuity and anatomic status of the macular holes, was conducted preoperatively, at 1 week and 1 month after surgery. Macular hole volume was calculated using optical coherence tomography scans. The Wilcoxon Signed Ranks Test, the Mann-Whitney Test, the Spearman's rank-order correlation coefficient and the study of variance for repeated measures were used for statistical analysis. Mean best-corrected visual acuity improved from 0.92 logMAR to 0.28 logMAR (P < 0.001). A reduction of the dimensions of macular holes was observed in all cases, with a total repair of 90 % (63/70 eyes) in the SF 6 group and 91 % in the C 3 F 8 group (70/77 eyes). There was a negative correlation between the initial minor diameter, the volume of the hole and the rate of anatomic success. Short-term anatomical and visual outcomes were similar in eyes treated with either SF 6 or C 3 F 8 , independently of the stage of the macular hole. The initial volume and the minor diameter of the hole may be considered as valid tools for predicting surgical success. Age and gender did not appear to have influenced the prognosis.

Validation of a novel technique for creating simulated radiographs using computed tomography datasets.

PubMed

Mendoza, Patricia; d'Anjou, Marc-André; Carmel, Eric N; Fournier, Eric; Mai, Wilfried; Alexander, Kate; Winter, Matthew D; Zwingenberger, Allison L; Thrall, Donald E; Theoret, Christine

2014-01-01

Understanding radiographic anatomy and the effects of varying patient and radiographic tube positioning on image quality can be a challenge for students. The purposes of this study were to develop and validate a novel technique for creating simulated radiographs using computed tomography (CT) datasets. A DICOM viewer (ORS Visual) plug-in was developed with the ability to move and deform cuboidal volumetric CT datasets, and to produce images simulating the effects of tube-patient-detector distance and angulation. Computed tomographic datasets were acquired from two dogs, one cat, and one horse. Simulated radiographs of different body parts (n = 9) were produced using different angles to mimic conventional projections, before actual digital radiographs were obtained using the same projections. These studies (n = 18) were then submitted to 10 board-certified radiologists who were asked to score visualization of anatomical landmarks, depiction of patient positioning, realism of distortion/magnification, and image quality. No significant differences between simulated and actual radiographs were found for anatomic structure visualization and patient positioning in the majority of body parts. For the assessment of radiographic realism, no significant differences were found between simulated and digital radiographs for canine pelvis, equine tarsus, and feline abdomen body parts. Overall, image quality and contrast resolution of simulated radiographs were considered satisfactory. Findings from the current study indicated that radiographs simulated using this new technique are comparable to actual digital radiographs. Further studies are needed to apply this technique in developing interactive tools for teaching radiographic anatomy and the effects of varying patient and tube positioning. © 2013 American College of Veterinary Radiology.

Development of new anatomy reconstruction software to localize cardiac isochrones to the cardiac surface from the 12 lead ECG.

PubMed

van Dam, Peter M; Gordon, Jeffrey P; Laks, Michael M; Boyle, Noel G

2015-01-01

Non-invasive electrocardiographic imaging (ECGI) of the cardiac muscle can help the pre-procedure planning of the ablation of ventricular arrhythmias by reducing the time to localize the origin. Our non-invasive ECGI system, the cardiac isochrone positioning system (CIPS), requires non-intersecting meshes of the heart, lungs and torso. However, software to reconstruct the meshes of the heart, lungs and torso with the capability to check and prevent these intersections is currently lacking. Consequently the reconstruction of a patient specific model with realistic atrial and ventricular wall thickness and incorporating blood cavities, lungs and torso usually requires additional several days of manual work. Therefore new software was developed that checks and prevents any intersections, and thus enables the use of accurate reconstructed anatomical models within CIPS. In this preliminary study we investigated the accuracy of the created patient specific anatomical models from MRI or CT. During the manual segmentation of the MRI data the boundaries of the relevant tissues are determined. The resulting contour lines are used to automatically morph reference meshes of the heart, lungs or torso to match the boundaries of the morphed tissue. Five patients were included in the study; models of the heart, lungs and torso were reconstructed from standard cardiac MRI images. The accuracy was determined by computing the distance between the segmentation contours and the morphed meshes. The average accuracy of the reconstructed cardiac geometry was within 2mm with respect to the manual segmentation contours on the MRI images. Derived wall volumes and left ventricular wall thickness were within the range reported in literature. For each reconstructed heart model the anatomical heart axis was computed using the automatically determined anatomical landmarks of the left apex and the mitral valve. The accuracy of the reconstructed heart models was well within the accuracy of the used medical image data (pixel size <1.5mm). For the lungs and torso the number of triangles in the mesh was reduced, thus decreasing the accuracy of the reconstructed mesh. A novel software tool has been introduced, which is able to reconstruct accurate cardiac anatomical models from MRI or CT within only a few hours. This new anatomical reconstruction tool might reduce the modeling errors within the cardiac isochrone positioning system and thus enable the clinical application of CIPS to localize the PVC/VT focus to the ventricular myocardium from only the standard 12 lead ECG. Copyright © 2015 Elsevier Inc. All rights reserved.

Biomechanical benefits of anterior offsetting of humeral head component in posteriorly unstable total shoulder arthroplasty: A cadaveric study.

PubMed

Kim, Hyun-Min Mike; Chacon, Alexander C; Andrews, Seth H; Roush, Evan P; Cho, Edward; Conaway, William K; Kunselman, Allen R; Lewis, Gregory S

2016-04-01

Restoration of joint stability during total shoulder arthroplasty can be challenging in the face of severe glenoid retroversion. A novel technique of humeral head component anterior-offsetting has been proposed to address posterior instability. We evaluated the biomechanical benefits of this technique in cadaveric specimens. Total shoulder arthroplasty was performed in 14 cadaveric shoulders from 7 donors. Complementary shoulders were assigned to either 10° or 20° glenoid retroversion, with retroversion created by eccentric reaming. Two humeral head component offset positions were tested in each specimen: The anatomic (posterior) and anterior (reverse). With loads applied to the rotator cuff and deltoid, joint contact pressures and the force and energy required for posterior humeral head translation were measured. The force and energy required to displace the humeral head posteriorly increased significantly with the anterior offset position compared to the anatomic offset position. The joint contact pressures were significantly shifted anteriorly, and the joint contact area significantly increased with the anterior offset position. Anterior offsetting of the humeral head component increased the resistance to posterior humeral head translation, shifted joint contact pressures anteriorly, and increased joint contact area, thus, potentially increasing the joint stability in total shoulder arthroplasty with simulated glenoid retroversion. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Orientation of handle for successful prosthetic treatment in patients with an anatomic compromise after a maxillectomy.

PubMed

Sumita, Yuka I; Hattori, Mariko; Elbashti, Mahmoud E; Taniguchi, Hisashi

2017-05-01

This clinical technique provides a key procedure for successful prosthetic treatment in patients with an anatomical compromise after a maxillectomy. When making a preliminary impression, the clinician must keep the handle of the stock tray parallel to the patient's interpupillary line extraorally to maintain the correct position of the tray and to make a record of the inclination of the occlusal plane. This simple consideration during this first step of making a preliminary impression can be an important guide for both dentists and dental technicians. Information about the correct positioning of the tray and the inclination of the occlusal plane obtained by using a stock tray handle will greatly reduce the stress experienced by dentists, dental technicians, and patients during the fabrication of the prosthesis and will ultimately lead to successful prosthetic treatment in patients with anatomic compromise resulting from a maxillectomy. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

SU-G-JeP3-05: Geometry Based Transperineal Ultrasound Probe Positioning for Image Guided Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Camps, S; With, P de; Verhaegen, F

2016-06-15

Purpose: The use of ultrasound (US) imaging in radiotherapy is not widespread, primarily due to the need for skilled operators performing the scans. Automation of probe positioning has the potential to remove this need and minimize operator dependence. We introduce an algorithm for obtaining a US probe position that allows good anatomical structure visualization based on clinical requirements. The first application is on 4D transperineal US images of prostate cancer patients. Methods: The algorithm calculates the probe position and orientation using anatomical information provided by a reference CT scan, always available in radiotherapy workflows. As initial test, we apply themore » algorithm on a CIRS pelvic US phantom to obtain a set of possible probe positions. Subsequently, five of these positions are randomly chosen and used to acquire actual US volumes of the phantom. Visual inspection of these volumes reveal if the whole prostate, and adjacent edges of bladder and rectum are fully visualized, as clinically required. In addition, structure positions on the acquired US volumes are compared to predictions of the algorithm. Results: All acquired volumes fulfill the clinical requirements as specified in the previous section. Preliminary quantitative evaluation was performed on thirty consecutive slices of two volumes, on which the structures are easily recognizable. The mean absolute distances (MAD) between actual anatomical structure positions and positions predicted by the algorithm were calculated. This resulted in MAD of 2.4±0.4 mm for prostate, 3.2±0.9 mm for bladder and 3.3±1.3 mm for rectum. Conclusion: Visual inspection and quantitative evaluation show that the algorithm is able to propose probe positions that fulfill all clinical requirements. The obtained MAD is on average 2.9 mm. However, during evaluation we assumed no errors in structure segmentation and probe positioning. In future steps, accurate estimation of these errors will allow for better evaluation of the achieved accuracy.« less

Whole-body and local RF absorption in human models as a function of anatomy and position within 1.5T MR body coil.

PubMed

Murbach, Manuel; Neufeld, Esra; Kainz, Wolfgang; Pruessmann, Klaas P; Kuster, Niels

2014-02-01

Radiofrequency energy deposition in magnetic resonance imaging must be limited to prevent excessive heating of the patient. Correlations of radiofrequency absorption with large-scale anatomical features (e.g., height) are investigated in this article. The specific absorption rate (SAR), as the pivotal parameter for quantifying absorbed radiofrequency, increases with the radial dimension of the patient and therefore with the large-scale anatomical properties. The absorbed energy in six human models has been modeled in different Z-positions (head to knees) within a 1.5T bodycoil. For a fixed B1+ incident field, the whole-body SAR can be up to 2.5 times higher (local SAR up to seven times) in obese adult models compared to children. If the exposure is normalized to 4 W/kg whole-body SAR, the local SAR can well-exceed the limits for local transmit coils and shows intersubject variations of up to a factor of three. The correlations between anatomy and induced local SAR are weak for normalized exposure, but strong for a fixed B1+ field, suggesting that anatomical properties could be used for fast SAR predictions. This study demonstrates that a representative virtual human population is indispensable for the investigation of local SAR levels. Copyright © 2013 Wiley Periodicals, Inc.

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.

Anatomic, histologic, and two-dimensional-echocardiographic evaluation of mitral valve anatomy in dogs.

PubMed

Borgarelli, Michele; Tursi, Massimiliano; La Rosa, Giuseppe; Savarino, Paolo; Galloni, Marco

2011-09-01

To compare echocardiographic variables of dogs with postmortem anatomic measurements and histologic characteristics of the mitral valve (MV). 21 cardiologically normal dogs. The MV was measured echocardiographically by use of the right parasternal 5-chamber long-axis view. Dogs were euthanized, and anatomic measurements of the MV annulus (MVa) were performed at the level of the left circumflex coronary artery. Mitral valve leaflets (MVLs) and chordae tendineae were measured. Structure of the MVLs was histologically evaluated in 3 segments (proximal, middle, and distal). Echocardiographic measurements of MVL length did not differ significantly from anatomic measurements. A positive correlation was detected between body weight and MVa area. There was a negative correlation between MVa area and the percentage by which the MVL area exceeded the MVa area. Anterior MVLs had a significantly higher number of chordae tendineae than did posterior MVLs. Histologically, layering of MVLs was less preserved in the distal segment, whereas the muscular component and adipose tissue were significantly more diffuse in the proximal and middle segments. The MV in cardiologically normal dogs had wide anatomic variability. Anatomic measurements of MVL length were correlated with echocardiographic measurements.

Cross-sectional anatomy, computed tomography and magnetic resonance imaging of the head of common dolphin (Delphinus delphis) and striped dolphin (Stenella coeruleoalba).

PubMed

Alonso-Farré, J M; Gonzalo-Orden, M; Barreiro-Vázquez, J D; Barreiro-Lois, A; André, M; Morell, M; Llarena-Reino, M; Monreal-Pawlowsky, T; Degollada, E

2015-02-01

Computed tomography (CT) and low-field magnetic resonance imaging (MRI) were used to scan seven by-caught dolphin cadavers, belonging to two species: four common dolphins (Delphinus delphis) and three striped dolphins (Stenella coeruleoalba). CT and MRI were obtained with the animals in ventral recumbency. After the imaging procedures, six dolphins were frozen at -20°C and sliced in the same position they were examined. Not only CT and MRI scans, but also cross sections of the heads were obtained in three body planes: transverse (slices of 1 cm thickness) in three dolphins, sagittal (5 cm thickness) in two dolphins and dorsal (5 cm thickness) in two dolphins. Relevant anatomical structures were identified and labelled on each cross section, obtaining a comprehensive bi-dimensional topographical anatomy guide of the main features of the common and the striped dolphin head. Furthermore, the anatomical cross sections were compared with their corresponding CT and MRI images, allowing an imaging identification of most of the anatomical features. CT scans produced an excellent definition of the bony and air-filled structures, while MRI allowed us to successfully identify most of the soft tissue structures in the dolphin's head. This paper provides a detailed anatomical description of the head structures of common and striped dolphins and compares anatomical cross sections with CT and MRI scans, becoming a reference guide for the interpretation of imaging studies. © 2014 Blackwell Verlag GmbH.

Active shape models incorporating isolated landmarks for medical image annotation

NASA Astrophysics Data System (ADS)

Norajitra, Tobias; Meinzer, Hans-Peter; Stieltjes, Bram; Maier-Hein, Klaus H.

2014-03-01

Apart from their robustness in anatomic surface segmentation, purely surface based 3D Active Shape Models lack the ability to automatically detect and annotate non-surface key points of interest. However, annotation of anatomic landmarks is desirable, as it yields additional anatomic and functional information. Moreover, landmark detection might help to further improve accuracy during ASM segmentation. We present an extension of surface-based 3D Active Shape Models incorporating isolated non-surface landmarks. Positions of isolated and surface landmarks are modeled conjoint within a point distribution model (PDM). Isolated landmark appearance is described by a set of haar-like features, supporting local landmark detection on the PDM estimates using a kNN-Classi er. Landmark detection was evaluated in a leave-one-out cross validation on a reference dataset comprising 45 CT volumes of the human liver after shape space projection. Depending on the anatomical landmark to be detected, our experiments have shown in about 1/4 up to more than 1/2 of all test cases a signi cant improvement in detection accuracy compared to the position estimates delivered by the PDM. Our results encourage further research with regard to the combination of shape priors and machine learning for landmark detection within the Active Shape Model Framework.

Reducing 4D CT artifacts using optimized sorting based on anatomic similarity.

PubMed

Johnston, Eric; Diehn, Maximilian; Murphy, James D; Loo, Billy W; Maxim, Peter G

2011-05-01

Four-dimensional (4D) computed tomography (CT) has been widely used as a tool to characterize respiratory motion in radiotherapy. The two most commonly used 4D CT algorithms sort images by the associated respiratory phase or displacement into a predefined number of bins, and are prone to image artifacts at transitions between bed positions. The purpose of this work is to demonstrate a method of reducing motion artifacts in 4D CT by incorporating anatomic similarity into phase or displacement based sorting protocols. Ten patient datasets were retrospectively sorted using both the displacement and phase based sorting algorithms. Conventional sorting methods allow selection of only the nearest-neighbor image in time or displacement within each bin. In our method, for each bed position either the displacement or the phase defines the center of a bin range about which several candidate images are selected. The two dimensional correlation coefficients between slices bordering the interface between adjacent couch positions are then calculated for all candidate pairings. Two slices have a high correlation if they are anatomically similar. Candidates from each bin are then selected to maximize the slice correlation over the entire data set using the Dijkstra's shortest path algorithm. To assess the reduction of artifacts, two thoracic radiation oncologists independently compared the resorted 4D datasets pairwise with conventionally sorted datasets, blinded to the sorting method, to choose which had the least motion artifacts. Agreement between reviewers was evaluated using the weighted kappa score. Anatomically based image selection resulted in 4D CT datasets with significantly reduced motion artifacts with both displacement (P = 0.0063) and phase sorting (P = 0.00022). There was good agreement between the two reviewers, with complete agreement 34 times and complete disagreement 6 times. Optimized sorting using anatomic similarity significantly reduces 4D CT motion artifacts compared to conventional phase or displacement based sorting. This improved sorting algorithm is a straightforward extension of the two most common 4D CT sorting algorithms.

Anatomical and spatial matching in imitation: Evidence from left and right brain-damaged patients.

PubMed

Mengotti, Paola; Ripamonti, Enrico; Pesavento, Valentina; Rumiati, Raffaella Ida

2015-12-01

Imitation is a sensorimotor process whereby the visual information present in the model's movement has to be coupled with the activation of the motor system in the observer. This also implies that greater the similarity between the seen and the produced movement, the easier it will be to execute the movement, a process also known as ideomotor compatibility. Two components can influence the degree of similarity between two movements: the anatomical and the spatial component. The anatomical component is present when the model and imitator move the same body part (e.g., the right hand) while the spatial component is present when the movement of the model and that of the imitator occur at the same spatial position. Imitation can be achieved by relying on both components, but typically the model's and imitator's movements are matched either anatomically or spatially. The aim of this study was to ascertain the contribution of the left and right hemisphere to the imitation accomplished either with anatomical or spatial matching (or with both). Patients with unilateral left and right brain damage performed an ideomotor task and a gesture imitation task. Lesions in the left and right hemispheres gave rise to different performance deficits. Patients with lesions in the left hemisphere showed impaired imitation when anatomical matching was required, and patients with lesions in the right hemisphere showed impaired imitation when spatial matching was required. Lesion analysis further revealed a differential involvement of left and right hemispheric regions, such as the parietal opercula, in supporting imitation in the ideomotor task. Similarly, gesture imitation seemed to rely on different regions in the left and right hemisphere, such as parietal regions in the left hemisphere and premotor, somatosensory and subcortical regions in the right hemisphere. Copyright © 2015 Elsevier Ltd. All rights reserved.

Can virtual reality improve anatomy education? A randomised controlled study of a computer-generated three-dimensional anatomical ear model.

PubMed

Nicholson, Daren T; Chalk, Colin; Funnell, W Robert J; Daniel, Sam J

2006-11-01

The use of computer-generated 3-dimensional (3-D) anatomical models to teach anatomy has proliferated. However, there is little evidence that these models are educationally effective. The purpose of this study was to test the educational effectiveness of a computer-generated 3-D model of the middle and inner ear. We reconstructed a fully interactive model of the middle and inner ear from a magnetic resonance imaging scan of a human cadaver ear. To test the model's educational usefulness, we conducted a randomised controlled study in which 28 medical students completed a Web-based tutorial on ear anatomy that included the interactive model, while a control group of 29 students took the tutorial without exposure to the model. At the end of the tutorials, both groups were asked a series of 15 quiz questions to evaluate their knowledge of 3-D relationships within the ear. The intervention group's mean score on the quiz was 83%, while that of the control group was 65%. This difference in means was highly significant (P < 0.001). Our findings stand in contrast to the handful of previous randomised controlled trials that evaluated the effects of computer-generated 3-D anatomical models on learning. The equivocal and negative results of these previous studies may be due to the limitations of these studies (such as small sample size) as well as the limitations of the models that were studied (such as a lack of full interactivity). Given our positive results, we believe that further research is warranted concerning the educational effectiveness of computer-generated anatomical models.

Skeletotopy of the gall bladder in American mink (Mustela vision (Brisson, 1756)).

PubMed

Gościcka, D; Flisiński, P

1994-01-01

Using anatomical and radiological methods, the projection of the gall bladder was studied in relation to the vertebral column in fifty adult minks of both sexes. The gall bladder was found to be in three positions when in relation to: 1) the longitudinal axis of the vertebral column, 2) the numerical order of the vertebrae.

Posture and posturology, anatomical and physiological profiles: overview and current state of art.

PubMed

Carini, Francesco; Mazzola, Margherita; Fici, Chiara; Palmeri, Salvatore; Messina, Massimo; Damiani, Provvidenza; Tomasello, Giovanni

2017-04-28

posture is the position of the body in the space, and is controlled by a set of anatomical structures. The maintenance and the control of posture are a set of interactions between muscle-skeletal, visual, vestibular, and skin system. Lately there are numerous studies that correlate the muscle-skeletal and the maintenance of posture. In particular, the correction of defects and obstruction of temporomandibular disorders, seem to have an impact on posture. The aim of this work is to collect information in literature on posture and the influence of the stomatognathic system on postural system. Comparison of the literature on posture and posturology by consulting books and scientific sites. the results obtained from the comparison of the literature show a discrepancy between the thesis. Some studies support the correlation between stomatognathic system and posture, while others deny such a correlation. further studies are necessary to be able to confirm one or the other argument.

Oral human Papillomavirus DNA detection in HIV-positive men: prevalence, predictors, and co-occurrence at anal site.

PubMed

Vergori, Alessandra; Garbuglia, Anna Rosa; Piselli, Pierluca; Del Nonno, Franca; Sias, Catia; Lupi, Federico; Lapa, Daniele; Baiocchini, Andrea; Cimaglia, Claudia; Gentile, Marco; Antinori, Andrea; Capobianchi, Maria; Ammassari, Adriana

2018-01-08

HIV-positive patients carry an increased risk of HPV infection and associated cancers. Therefore, prevalence and patterns of HPV infection at different anatomical sites, as well as theoretical protection of nonavalent vaccine should be investigated. Aim was to describe prevalence and predictors of oral HPV detection in HIV-positive men, with attention to nonavalent vaccine-targeted HPV types. Further, co-occurrence of HPV DNA at oral cavity and at anal site was assessed. This cross-sectional, clinic-based study included 305 HIV-positive males (85.9% MSM; median age 44.7 years; IQR: 37.4-51.0), consecutively observed within an anal cancer screening program, after written informed consent. Indication for anal screening was given by the HIV physician during routine clinic visit. Paired oral rinse and anal samples were processed for the all HPV genotypes with QIASYMPHONY and a PCR with MY09/MY11 primers for the L1 region. At the oral cavity, HPV DNA was detected in 64 patients (20.9%), and in 28.1% of these cases multiple HPV infections were found. Prevalence of oral HPV was significantly lower than that observed at the anal site (p < 0.001), where HPV DNA was found in 199 cases (85.2%). Oral HPV tended to be more frequent in patients with detectable anal HPV than in those without (p = 0.08). Out of 265 HPV DNA-positive men regardless anatomic site, 59 cases (19.3%) had detectable HPV at both sites, and 51 of these showed completely different HPV types. At least one nonavalent vaccine-targeted HPV type was found in 17/64 (26.6%) of patients with oral and 199/260 (76.5%) with anal infection. At multivariable analysis, factors associated with positive oral HPV were: CD4 cells <200/μL (versus CD4 cells >200/μL, p = 0.005) and >5 sexual partners in the previous 12 months (versus 0-1 partner, p = 0.008). In this study on Italian HIV-positive men (predominantly MSM), oral HPV DNA was detected in approximately one fifth of tested subjects, but prevalence was significantly lower than that observed at anal site. Low CD4 cell count and increasing number of recent sexual partners significantly increased the odds of positive oral HPV. The absence of co-occurrence at the two anatomical sites may suggest different routes or timing of infection.

Use of Mobile Apps Among Medical and Nursing Students in Iran.

PubMed

Sheikhtaheri, Abbas; Kermani, Farzaneh

2018-01-01

Mobile technologies have a positive impact on patient care and cause to improved decision making, reduced medical errors and improved communication in care team. The purpose of this study was to investigate the use of mobile technologies by medical and nursing students and their tendency in future. This study was conducted among 372 medical and nursing students of Tehran University of Medical Science. Respectively, 60.8% and 62.4% of medical and nursing students use smartphone. The most commonly used apps among medical students were medical dictionary, drug apps, medical calculators and anatomical atlases and among nursing students were medical dictionary, anatomical atlases and nursing care guides. Also, the use of decision support systems, remote monitoring, patient imagery and remote diagnosis, patient records documentation, diagnostic guidelines and laboratory tests will be increased in the future.

Shape, Position and Dimension of the Nipple Areola Complex in the Ideal Male Chest: A Quick and Simple Operating Room Technique.

PubMed

Tanini, Sara; Lo Russo, Giulia

2018-04-11

The anatomical features of the chest identify an individual as male or female and even the smallest details of these features determine the appropriate appearance for each gender. In female-to-male patients, the creation of an aesthetically pleasing male chest is the most important step. Incorrect positioning of the nipple areola complex (NAC) on the chest wall and suboptimal shaping and sizing of the NAC are common pitfalls in male NAC creation. We have analyzed the anatomical chest features of 26 water polo players, to verify our hypothesis of the relationship between the pectoralis major muscle and NAC and to create a method for repositioning the NAC that is applicable in the operating room, is easy, practical and reproducible without the use of formulas and based on an easily identifiable landmark. In our reference group, the NAC has a constant relationship with the pectoralis major muscle, positioned on average 3 cm medial to the lateral border of the pectoralis muscle and 2.5 cm above the inferior pectoralis major insertion. This supports our hypothesis and our surgical technique. We use the index finger to find a vertical axis and a line 2.5 cm above the inferior pectoralis shadow to find the horizontal axis. We also introduce a modification to the receiving site to recreate an oval areola more similar to that of an ideal male chest. Our anatomical study and statistical analysis support a consistent relationship between the position and shape of the NAC and the borders of the pectoral muscle. We have used this relationship to develop our "trick," which is easily applicable in the operating room to find the NAC position without using formulas and numbers. This method allowed us to place the NAC in a position very close to that of a typical male subject, and it permitted us to reduce the surgery time. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

HPV Prevalence in Multiple Anatomical Sites among Men Who Have Sex with Men in Peru

PubMed Central

Blas, Magaly M.; Brown, Brandon; Menacho, Luis; Alva, Isaac E.; Silva-Santisteban, Alfonso; Carcamo, Cesar

2015-01-01

Background Human Papilloma Virus (HPV) infection is the most common sexually transmitted viral infection worldwide. HPV is highly prevalent in sexually active men who have sex with men (MSM) and has been associated with anal cancer, penile cancer, and oropharyngeal cancer. Methods From March to September 2011, we conducted a cross-sectional study of HPV prevalence among MSM above age 18 years. Participants were recruited using respondent driven sampling at Clinica Cayetano Heredia. All participants provided anal, genital, and oral samples for HPV DNA testing, and blood for HIV and HPV antibody testing. Results A total of 200 MSM were recruited in the study. The mean age was 34 years (range 18–59 years, SD = 9.4) and101 participants were HIV negative (99 HIV positive). HPV 6/11/16/18 or quadrivalent HPV vaccine (HPV4) genotype seroprevalence among HIV negative and positive MSM was 64.3% (55%-75.9%) and 93.8% (87.6%-99.2%) respectively (p<0.001). HIV positivity was associated with a higher prevalence of HPV4 and HPV 16/18 DNA at external genital sites and the anal canal. HPV4 DNA prevalence at external genital sites among HIV negative and positive MSM was 14.9% and 28.7% (p = 0.02) respectively, at anal canal was 50.9% and 79.0% (p = 0.001), and at the oral cavity was 9.9% and 8.5% (p = 0.6). Conclusions HPV4 seroprevalence was high in our study among both HIV positives and negatives, with HPV DNA prevalence much lower, and the anal canal being the anatomical site with the highest HPV DNA prevalence. HPV prevention interventions are needed among MSM at high-risk for HIV infection. PMID:26437318

HPV Prevalence in Multiple Anatomical Sites among Men Who Have Sex with Men in Peru.

PubMed

Blas, Magaly M; Brown, Brandon; Menacho, Luis; Alva, Isaac E; Silva-Santisteban, Alfonso; Carcamo, Cesar

2015-01-01

Human Papilloma Virus (HPV) infection is the most common sexually transmitted viral infection worldwide. HPV is highly prevalent in sexually active men who have sex with men (MSM) and has been associated with anal cancer, penile cancer, and oropharyngeal cancer. From March to September 2011, we conducted a cross-sectional study of HPV prevalence among MSM above age 18 years. Participants were recruited using respondent driven sampling at Clinica Cayetano Heredia. All participants provided anal, genital, and oral samples for HPV DNA testing, and blood for HIV and HPV antibody testing. A total of 200 MSM were recruited in the study. The mean age was 34 years (range 18-59 years, SD = 9.4) and101 participants were HIV negative (99 HIV positive). HPV 6/11/16/18 or quadrivalent HPV vaccine (HPV4) genotype seroprevalence among HIV negative and positive MSM was 64.3% (55%-75.9%) and 93.8% (87.6%-99.2%) respectively (p<0.001). HIV positivity was associated with a higher prevalence of HPV4 and HPV 16/18 DNA at external genital sites and the anal canal. HPV4 DNA prevalence at external genital sites among HIV negative and positive MSM was 14.9% and 28.7% (p = 0.02) respectively, at anal canal was 50.9% and 79.0% (p = 0.001), and at the oral cavity was 9.9% and 8.5% (p = 0.6). HPV4 seroprevalence was high in our study among both HIV positives and negatives, with HPV DNA prevalence much lower, and the anal canal being the anatomical site with the highest HPV DNA prevalence. HPV prevention interventions are needed among MSM at high-risk for HIV infection.

Magnetic resonance imaging of the ankle in female ballet dancers en pointe.

PubMed

Russell, Jeffrey A; Shave, Ruth M; Yoshioka, Hiroshi; Kruse, David W; Koutedakis, Yiannis; Wyon, Matthew A

2010-07-01

Ballet dancers require extreme range of motion of the ankle, especially weight-bearing maximum plantar flexion (en pointe). In spite of a high prevalence of foot and ankle injuries in ballet dancers, the anatomy and pathoanatomy of this position have not been sufficiently studied in weight-bearing. Magnetic resonance imaging (MRI) is a beneficial method for such study. To develop an MRI method of evaluating the ankles of female ballet dancers standing en pointe and to assess whether pathological findings from the MR images were associated with ankle pain reported by the subjects. Nine female ballet dancers (age, 21+/-2.9 years; dance experience, 16+/-4.1 years; en pointe dance experience, 7+/-4.9 years) completed an ankle pain visual analog scale questionnaire and underwent T1- and T2-weighted scans using a 0.25 T open MRI device. The ankle was scanned in three positions: supine with full plantar flexion, standing with the ankle in anatomical position, and standing en pointe. Obtaining MR images of the ballet dancers en pointe was successful in spite of limitations imposed by the difficulty of remaining motionless in the en pointe position during scanning. MRI signs of ankle pathology and anatomical variants were observed. Convergence of the posterior edge of the tibial plafond, posterior talus, and superior calcaneus was noted in 100% of cases. Widened anterior joint congruity and synovitis/joint effusion were present in 71% and 67%, respectively. Anterior tibial and/or talar spurs and Stieda's process were each seen in 44%. However, clinical signs did not always correlate with pain reported by the subjects. This study successfully established an ankle imaging technique for ballet dancers en pointe that can be used in the future to assess the relationship between en pointe positioning and ankle pathoanatomy in ballet dancers.

Influence of the middle ear anatomy on the performance of a membrane sensor in the incudostapedial joint gap.

PubMed

Koch, Martin; Seidler, Hannes; Hellmuth, Alexander; Bornitz, Matthias; Lasurashvili, Nikoloz; Zahnert, Thomas

2013-07-01

There is a great demand for implantable microphones for future generations of implantable hearing aids, especially Cochlea Implants. An implantable middle ear microphone based on a piezoelectric membrane sensor for insertion into the incudostapedial gap is investigated. The sensor is designed to measure the sound-induced forces acting on the center of the membrane. The sensor mechanically couples to the adjacent ossicles via two contact areas, the sensor membrane and the sensor housing. The sensing element is a piezoelectric single crystal bonded on a titanium membrane. The sensor allows a minimally invasive and reversible implantation without removal of ossicles and without additional sensor fixation in the tympanic cavity. This study investigates the implantable microphone sensor and its implantation concept. It intends to quantify the influence of the sensor's insertion position on the achievable microphone sensitivity. The investigation considers anatomical and pathological variations of the middle ear geometry and its space limitations. Temporal bone experiments on a laboratory model show that anatomical and pathological variations of the middle ear geometry can prevent the sensor from being placed optimally within the incudostapedial joint. Beyond scattering of transfer functions due to anatomic variations of individual middle ears there is the impact of variations in the sensor position within the ossicular chain that has a considerable effect on the transfer characteristics of the middle ear microphone. The centering of the sensor between incus and stapes, the direction of insertion (membrane to stapes or to incus) and the effect of additional contact points with surrounding anatomic structures affect the signal yield of the implanted sensor. The presence of additional contact points has a considerably impact on the sensitivity, yet the microphone sensitivity is quite robust against small changes in the positioning of the incus on the sensor. Signal losses can be avoided by adjusting the position of the sensor within the joint. The findings allow the development of an improved surgical insertion technique to ensure maximally achievable signal yield of the membrane sensor in the ISJ and provides valuable knowledge for a future design considerations including sensor miniaturization and geometry. Measurements of the implanted sensor in temporal bone specimens showed a microphone sensitivity in the order of 1 mV/Pa. This article is part of a special issue entitled "MEMRO 2012". Copyright © 2012 Elsevier B.V. All rights reserved.

Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects.

PubMed

Park, Pona; Kim, Jinil; Song, Yoon Jae; Lim, Jae Hyun; Cho, Sung Woo; Won, Tae-Bin; Han, Doo Hee; Kim, Dong-Young; Rhee, Chae Seo; Kim, Hyun Jik

2017-12-01

Although continuous positive airway pressure (CPAP) is the most effective treatment modality, poor adherence still remains a problem for obstructive sleep apnea (OSA) treatment and there is little evidence regarding how this might be improved. This study aims to analyze the anatomic and clinical factors of OSA subjects who failed to comply with CPAP therapy.The medical records of 47 OSA subjects who received CPAP therapy as a first-line treatment modality were retrospectively reviewed. The medical records were reviewed for demographic and polysomnographic data and anatomic findings of the nasal cavity and oropharynx.24 patients who adhered to CPAP therapy and 23 patients who were nonadherent were enrolled in the study. There were no statistically significant differences in sleep parameters between CPAP-adherent patients and CPAP nonadherent subjects. Mean body mass index of CPAP nonadherent group was significantly higher than CPAP adherent group. Higher grades of septal deviation and hypertrophic change of the inferior turbinate were observed more in the CPAP nonadherent group. In addition, CPAP nonadherent subjects showed considerably bigger tonsils and higher grade palatal position comparing with the CPAP adherent subjects. Subjective discomfort including inconvenience, mouth dryness, and chest discomfort were the main problems for OSA subjects who did not comply with CPAP therapy.Excessive upper airway blockage in the nasal cavity and oropharynx was predominant in CPAP nonadherent subjects, which might cause the reported subjective discomfort that reduces CPAP compliance. Therefore, resolution of these issues is needed to enhance CPAP compliance for control of OSA. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects

PubMed Central

Park, Pona; Kim, Jinil; Song, Yoon Jae; Lim, Jae Hyun; Cho, Sung Woo; Won, Tae-Bin; Han, Doo Hee; Kim, Dong-Young; Rhee, Chae Seo; Kim, Hyun Jik

2017-01-01

Abstract Although continuous positive airway pressure (CPAP) is the most effective treatment modality, poor adherence still remains a problem for obstructive sleep apnea (OSA) treatment and there is little evidence regarding how this might be improved. This study aims to analyze the anatomic and clinical factors of OSA subjects who failed to comply with CPAP therapy. The medical records of 47 OSA subjects who received CPAP therapy as a first-line treatment modality were retrospectively reviewed. The medical records were reviewed for demographic and polysomnographic data and anatomic findings of the nasal cavity and oropharynx. 24 patients who adhered to CPAP therapy and 23 patients who were nonadherent were enrolled in the study. There were no statistically significant differences in sleep parameters between CPAP-adherent patients and CPAP nonadherent subjects. Mean body mass index of CPAP nonadherent group was significantly higher than CPAP adherent group. Higher grades of septal deviation and hypertrophic change of the inferior turbinate were observed more in the CPAP nonadherent group. In addition, CPAP nonadherent subjects showed considerably bigger tonsils and higher grade palatal position comparing with the CPAP adherent subjects. Subjective discomfort including inconvenience, mouth dryness, and chest discomfort were the main problems for OSA subjects who did not comply with CPAP therapy. Excessive upper airway blockage in the nasal cavity and oropharynx was predominant in CPAP nonadherent subjects, which might cause the reported subjective discomfort that reduces CPAP compliance. Therefore, resolution of these issues is needed to enhance CPAP compliance for control of OSA. PMID:29390419

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.

The mid-sternal length, a practical anatomical landmark for optimal positioning of long-term central venous catheters

PubMed Central

Salimi, Fereshte; Imani, Mohammad Reza; Ghasemi, Navab; Keshavarzian, Amir; Jazi, Amir Hosein Davarpanah

2013-01-01

Background: Long-term tunneled catheters are used for the hemodialysis or chemotherapy in many patients. Proper placement of the catheter tip could reduce early and late catheter related complications. Aim of the present study was to evaluate a new formula for proper placement of tunneled hemodialysis or infusion port device by using an external anatomic landmark. Materials and Methods: A total of 64 adult patients undergoing elective placement of tunneled Central Venous Catheter (CVC) requiring hemodialysis or chemotherapy were enrolled in this prospective study during 2011-2012 in the university hospital. The catheter length to be inserted in the right internal jugular vein (IJV) was calculated by adding two measurements (the shortest straight length between the insertion point of the needle and the suprasternal notch plus and half of sternal length). The catheter position was considered correct if the tip was positioned in the right atrium (RA) or Superior vena cava (SVC)-RA junction. Results: The patients were 55.28 ± 19.85 years of age, weighed 5.78 ± 16.62 kg and were 166.07 ± 10.27 cm tall. Catheters were inserted successfully in 88% of patients (n = 56). Catheter tip positions in the failures were SVC (n = 5), tricuspid valve (n = 2), and right ventricle (n = 1) in our patients. Conclusion: Long-term hemodialysis or port CVC could easily insert in the right IJV by using half of the sternal length as an external land marks among adult patients. PMID:24174941

What Is the Rate of Incomplete Fetal Anatomic Surveys During a Second-Trimester Scan? Retrospective Observational Study of 4000 Nonobese Pregnant Women.

PubMed

Padula, Francesco; Gulino, Ferdinando Antonio; Capriglione, Stella; Giorlandino, Maurizio; Cignini, Pietro; Mastrandrea, Maria Luisa; D'Emidio, Laura; Giorlandino, Claudio

2015-12-01

The purpose of this study was to estimate the rate of incomplete fetal anatomic surveys during a second-trimester scan due to an unfavorable fetal position in a nonobese population. All pregnant women who came to the Altamedica Fetal-Maternal Medical Center, a specialized center for prenatal diagnosis, for a routine second-trimester scan between January 2012 and April 2013 were retrospectively included in the analysis. Patients with a body mass index higher than 30.0 kg/m(2) or anterior fibroids larger than 5 cm were not included in the study. Of 4000 pregnant women admitted for a second-trimester scan, 169 (4.2%) came back within 2 weeks to complete the examination because of an unfavorable fetal position. In particular, 104 (2.6%) needed visualization of only 1 view, and 65 (1.6%) needed more than 1 view. The most difficult organ to visualize was the corpus callosum, in 73 cases (1.8%); the face was not visualized in 69 cases (1.7%); the cerebellar vermis was not seen in 47 fetuses (1.1%); and the heart could not be completely examined in 40 fetuses (1.0%). Of the 4000 women, 169 (4.2%) had a nonexhaustive scan; 149 (3.7%) needed a second scan to complete the second-trimester survey; 14 (0.35%) needed a third scan; and 2 (0.05%) remained with a not completely exhaustive scan. There is always a small percentage of incomplete fetal anatomic surveys during a second-trimester scan, which cannot be modified by the sonographer's skill or by technical sonographic innovations. © 2015 by the American Institute of Ultrasound in Medicine.

Preoperative (3-dimensional) computed tomography lung reconstruction before anatomic segmentectomy or lobectomy for stage I non-small cell lung cancer.

PubMed

Chan, Ernest G; Landreneau, James R; Schuchert, Matthew J; Odell, David D; Gu, Suicheng; Pu, Jiantao; Luketich, James D; Landreneau, Rodney J

2015-09-01

Accurate cancer localization and negative resection margins are necessary for successful segmentectomy. In this study, we evaluate a newly developed software package that permits automated segmentation of the pulmonary parenchyma, allowing 3-dimensional assessment of tumor size, location, and estimates of surgical margins. A pilot study using a newly developed 3-dimensional computed tomography analytic software package was performed to retrospectively evaluate preoperative computed tomography images of patients who underwent segmentectomy (n = 36) or lobectomy (n = 15) for stage 1 non-small cell lung cancer. The software accomplishes an automated reconstruction of anatomic pulmonary segments of the lung based on bronchial arborization. Estimates of anticipated surgical margins and pulmonary segmental volume were made on the basis of 3-dimensional reconstruction. Autosegmentation was achieved in 72.7% (32/44) of preoperative computed tomography images with slice thicknesses of 3 mm or less. Reasons for segmentation failure included local severe emphysema or pneumonitis, and lower computed tomography resolution. Tumor segmental localization was achieved in all autosegmented studies. The 3-dimensional computed tomography analysis provided a positive predictive value of 87% in predicting a marginal clearance greater than 1 cm and a 75% positive predictive value in predicting a margin to tumor diameter ratio greater than 1 in relation to the surgical pathology assessment. This preoperative 3-dimensional computed tomography analysis of segmental anatomy can confirm the tumor location within an anatomic segment and aid in predicting surgical margins. This 3-dimensional computed tomography information may assist in the preoperative assessment regarding the suitability of segmentectomy for peripheral lung cancers. Published by Elsevier Inc.

Impact of a joint labor-management ergonomics program on upper extremity musculoskeletal symptoms among garment workers.

PubMed

Herbert, R; Dropkin, J; Warren, N; Sivin, D; Doucette, J; Kellogg, L; Bardin, J; Kass, D; Zoloth, S

2001-10-01

This study evaluated the effect of an ergonomics intervention program on the prevalence and intensity of symptoms of upper extremity work-related musculoskeletal disorders among 36 garment workers performing an operation called spooling. Adjustable chairs were introduced and workers were trained in their use. Symptom surveys were administered prior to and 6 months after introduction of adjustable chairs. Quantitative pre- and post-intervention measurement of joint position was performed utilizing videotapes among a subgroup of nineteen. Eighty nine percent of the cohort reported pain in either the neck or at least one upper extremity anatomic site prior to the adjustable chair intervention. Among subjects reporting pain at baseline, there were significantly decreased pain levels in 10 of 11 anatomic sites after the intervention. Among all subjects, the proportion reporting pain decreased for each anatomic site following the intervention, with statistically significant decreases in 3 sites. However, there were only modest declines in awkward posture among the videotaped subgroup. This study suggests that introduction of an ergonomics program focused on education and introduction of an adjustable chair may diminish musculoskeletal symptomatology in apparel manufacturing workers.

An image guidance system for positioning robotic cochlear implant insertion tools

NASA Astrophysics Data System (ADS)

Bruns, Trevor L.; Webster, Robert J.

2017-03-01

Cochlear implants must be inserted carefully to avoid damaging the delicate anatomical structures of the inner ear. This has motivated several approaches to improve the safety and efficacy of electrode array insertion by automating the process with specialized robotic or manual insertion tools. When such tools are used, they must be positioned at the entry point to the cochlea and aligned with the desired entry vector. This paper presents an image guidance system capable of accurately positioning a cochlear implant insertion tool. An optical tracking system localizes the insertion tool in physical space while a graphical user interface incorporates this with patient- specific anatomical data to provide error information to the surgeon in real-time. Guided by this interface, novice users successfully aligned the tool with an mean accuracy of 0.31 mm.

Radio-guided sentinel lymph node identification by lymphoscintigraphy fused with an anatomical vector profile: clinical applications.

PubMed

Niccoli Asabella, A; Antonica, F; Renna, M A; Rubini, D; Notaristefano, A; Nicoletti, A; Rubini, G

2013-12-01

To develop a method to fuse lymphoscintigraphic images with an adaptable anatomical vector profile and to evaluate its role in the clinical practice. We used Adobe Illustrator CS6 to create different vector profiles, we fused those profiles, using Adobe Photoshop CS6, with lymphoscintigraphic images of the patient. We processed 197 lymphoscintigraphies performed in patients with cutaneous melanomas, breast cancer or delayed lymph drainage. Our models can be adapted to every patient attitude or position and contain different levels of anatomical details ranging from external body profiles to the internal anatomical structures like bones, muscles, vessels, and lymph nodes. If needed, more new anatomical details can be added and embedded in the profile without redrawing them, saving a lot of time. Details can also be easily hidden, allowing the physician to view only relevant information and structures. Fusion times are about 85 s. The diagnostic confidence of the observers increased significantly. The validation process showed a slight shift (mean 4.9 mm). We have created a new, practical, inexpensive digital technique based on commercial software for fusing lymphoscintigraphic images with built-in anatomical reference profiles. It is easily reproducible and does not alter the original scintigraphic image. Our method allows a more meaningful interpretation of lymphoscintigraphies, an easier recognition of the anatomical site and better lymph node dissection planning.

A Lymph Node Staging System for Gastric Cancer: A Hybrid Type Based on Topographic and Numeric Systems.

PubMed

Choi, Yoon Young; An, Ji Yeong; Katai, Hitoshi; Seto, Yasuyuki; Fukagawa, Takeo; Okumura, Yasuhiro; Kim, Dong Wook; Kim, Hyoung-Il; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon

2016-01-01

Although changing a lymph node staging system from an anatomically based system to a numerically based system in gastric cancer offers better prognostic performance, several problems can arise: it does not offer information on the anatomical extent of disease and cannot represent the extent of lymph node dissection. The purpose of this study was to discover an alternative lymph node staging system for gastric cancer. Data from 6025 patients who underwent gastrectomy for primary gastric cancer between January 2000 and December 2010 were reviewed. The lymph node groups were reclassified into lesser-curvature, greater-curvature, and extra-perigastric groups. Presence of any metastatic lymph node in one group was considered positive. Lymph node groups were further stratified into four (new N0-new N3) according to the number of positive lymph node groups. Survival outcomes with this new N staging were compared with those of the current TNM system. For validation, two centers in Japan (large center, n = 3443; medium center, n = 560) were invited. Even among the same pN stages, the more advanced new N stage showed worse prognosis, indicating that the anatomical extent of metastatic lymph nodes is important. The prognostic performance of the new staging system was as good as that of the current TNM system for overall advanced gastric cancer as well as lymph node-positive gastric cancer (Harrell C-index was 0.799, 0.726, and 0.703 in current TNM and 0.799, 0.727, and 0.703 in new TNM stage). Validation sets supported these outcomes. The new N staging system demonstrated prognostic performance equal to that of the current TNM system and could thus be used as an alternative.

Do modern total knee replacements improve tibial coverage?

PubMed

Meier, Malin; Webb, Jonathan; Collins, Jamie E; Beckmann, Johannes; Fitz, Wolfgang

2018-01-25

The purpose of the present study is to compare newer designs of various symmetric and asymmetric tibial components and measure tibial bone coverage using the rotational safe zone defined by two commonly utilized anatomic rotational landmarks. Computed tomography scans (CT scans) of one hundred consecutive patients scheduled for total knee arthroplasty were obtained pre-operatively. A virtual proximal tibial cut was performed and two commonly used rotational axes were added for each image: the medio-lateral axis (ML-axis) and the medial 1/3 tibial tubercle axis (med-1/3-axis). Different symmetric and asymmetric implant designs were then superimposed in various rotational positions for best cancellous and cortical coverage. The images were imported to a public domain imaging software, and cancellous and cortical bone coverage was computed for each image, with each implant design in various rotational positions. One single implant type could not be identified that provided the best cortical and cancellous coverage of the tibia, irrespective of using the med-1/3-axis or the ML-axis for rotational alignment. However, it could be confirmed that the best bone coverage was dependent on the selected rotational landmark. Furthermore, improved bone coverage was observed when tibial implant positions were optimized between the two rotational axes. Tibial coverage is similar for symmetric and asymmetric designs, but depends on the rotational landmark for which the implant is designed. The surgeon has the option to improve tibial coverage by optimizing placement between the two anatomic rotational alignment landmarks, the medial 1/3 and the ML-axis. Surgeons should be careful assessing intraoperative rotational tibial placement using the described anatomic rotational landmarks to optimize tibial bony coverage without compromising patella tracking. III.

Can we safely deform a plate to fit every bone? Population-based fit assessment and finite element deformation of a distal tibial plate.

PubMed

Harith, Hazreen; Schmutz, Beat; Malekani, Javad; Schuetz, Michael A; Yarlagadda, Prasad K

2016-03-01

Anatomically precontoured plates are commonly used to treat periarticular fractures. A well-fitting plate can be used as a tool for anatomical reduction of the fractured bone. Recent studies highlighted that some plates fit poorly for many patients due to considerable shape variations between bones of the same anatomical site. While it is impossible to design one shape that fits all, it is also burdensome for the manufacturers and hospitals to produce, store and manage multiple plate shapes without the certainty of utilization by a patient population. In this study, we investigated the number of shapes required for maximum fit within a given dataset, and if they could be obtained by manually deforming the original plate. A distal medial tibial plate was automatically positioned on 45 individual tibiae, and the optimal deformation was determined iteratively using finite element analysis simulation. Within the studied dataset, we found that: (i) 89% fit could be achieved with four shapes, (ii) 100% fit was impossible through mechanical deformation, and (iii) the deformations required to obtain the four plate shapes were safe for the stainless steel plate for further clinical use. The proposed framework is easily transferable to other orthopaedic plates. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

The Effect of Anatomical Location of Lymph Node Metastases on Cancer Specific Survival in Patients with Clear Cell Renal Cell Carcinoma

PubMed Central

Nini, Alessandro; Larcher, Alessandro; Cianflone, Francesco; Trevisani, Francesco; Terrone, Carlo; Volpe, Alessandro; Regis, Federica; Briganti, Alberto; Salonia, Andrea; Montorsi, Francesco; Bertini, Roberto; Capitanio, Umberto

2018-01-01

Background Positive nodal status (pN1) is an independent predictor of survival in renal cell carcinoma (RCC) patients. However, no study to date has tested whether the location of lymph node (LN) metastases does affect oncologic outcomes in a population submitted to radical nephrectomy (RN) and extended lymph node dissection (eLND). Objective To describe nodal disease dissemination in clear cell RCC (ccRCC) patients and to assess the effect of the anatomical sites and the number of nodal areas affected on cancer specific mortality (CSM). Design, setting and partecipants The study included 415 patients who underwent RN and eLND, defined as the removal of hilar, side-specific (pre/paraaortic or pre/paracaval) and interaortocaval LNs for ccRCC, at two institutions. Outcome measurement and statistical analysis Descriptive statistics were used to depict nodal dissemination in pN1 patients, stratified according to nodal site and number of involved areas. Multivariable Cox regression analyses and Kaplan-Meier curves were used to explore the relationship between pN1 disease features and survival outcomes. Results and limitations Median number of removed LN was 14 (IQR 9–19); 23% of patients were pN1. Among patients with one involved nodal site, 54 and 26% of patients were positive only in side-specific and interaortocaval station, respectively. The most frequent nodal site was the interaortocaval and side-specific one, for right and left ccRCC, respectively. Interaortocaval nodal positivity (HR 2.3, CI 95%: 1.3–3.9, p < 0.01) represented an independent predictor of CSM. Conclusions When ccRCC patient harbour nodal disease, its spreading can occur at any nodal station without involving the others. The presence of interoartocaval positive nodes does affect oncologic outcomes. Patient summary Lymph node invasion in patients with clear cell renal cell carcinoma is not following a fixed anatomical pattern. An extended lymph node dissection, during treatment for primary kidney tumour, would aid patient risk stratification and multimodality upfront treatment. PMID:29740587

Use of an Anatomical Scalar to Control for Sex-Based Size Differences in Measures of Hyoid Excursion during Swallowing

ERIC Educational Resources Information Center

Molfenter, Sonja M.; Steele, Catriona M.

2014-01-01

Purpose: Traditional methods for measuring hyoid excursion from dynamic videofluoroscopy recordings involve calculating changes in position in absolute units (mm). This method shows a high degree of variability across studies but agreement that greater hyoid excursion occurs inmen than in women. Given that men are typically taller than women, the…

Evaluation of the optimal visceral branch configuration in open thoracoabdominal aortic repair by computed tomography.

PubMed

Kamohara, Keiji; Furukawa, Kojiro; Itoh, Manabu; Morokuma, Hiroyuki; Tanaka, Hideya; Hayashi, Nagi; Morita, Shigeki

2015-01-01

In thoracoabdominal aneurysm (TAAA) repair, our technical modification of visceral reconstruction using longer cut pre-sewn side branches has provided good surgical outcomes. Here, we assessed the long-term durability and patency of revascularized branches using computed tomography (CT) to confirm the validity of our approach. Early and late CT evaluations were performed in 11 TAAA patients (males: 5; mean age: 60.6 years) using the Coselli graft to evaluate the position of main graft and the diverging pattern and patency of side branches. Seven of 11 were sutured in an extra-anatomical fashion using longer cut side branches. In Anatomical (n = 4) and Extra-anatomical (n = 7) groups, the early patency of side branches was not significantly different. Although the late patency of right renal artery (RA) was 100% in both groups, the one of left RA was 60% in Extra-anatomical, while 100% in Anatomical. Furthermore, the main graft in Extra-anatomical was significantly posterior and leftward to the spine with left RA side branch diverging at an acute angle. When a pre-sewn branched graft designed for TAAA is used, the graft should be sutured in a fashion similar to normal patient anatomy to minimize the possibility of kinking of RA side branch for the patency.

Anatomical image-guided fluorescence molecular tomography reconstruction using kernel method

PubMed Central

Baikejiang, Reheman; Zhao, Yue; Fite, Brett Z.; Ferrara, Katherine W.; Li, Changqing

2017-01-01

Abstract. 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. PMID:28464120

Optic radiation structure and anatomy in the normally developing brain determined using diffusion MRI and tractography.

PubMed

Dayan, Michael; Munoz, Monica; Jentschke, Sebastian; Chadwick, Martin J; Cooper, Janine M; Riney, Kate; Vargha-Khadem, Faraneh; Clark, Chris A

2015-01-01

The optic radiation (OR) is a component of the visual system known to be myelin mature very early in life. Diffusion tensor imaging (DTI) and its unique ability to reconstruct the OR in vivo were used to study structural maturation through analysis of DTI metrics in a cohort of 90 children aged 5-18 years. As the OR is at risk of damage during epilepsy surgery, we measured its position relative to characteristic anatomical landmarks. Anatomical distances, DTI metrics and volume of the OR were investigated for age, gender and hemisphere effects. We observed changes in DTI metrics with age comparable to known trajectories in other white matter tracts. Left lateralization of DTI metrics was observed that showed a gender effect in lateralization. Sexual dimorphism of DTI metrics in the right hemisphere was also found. With respect to OR dimensions, volume was shown to be right lateralised and sexual dimorphism demonstrated for the extent of the left OR. The anatomical results presented for the OR have potentially important applications for neurosurgical planning.

Variability of the inclination of anatomic horizontal reference planes of the craniofacial complex in relation to the true horizontal line in orthognathic patients.

PubMed

Zebeib, Ameen M; Naini, Farhad B

2014-12-01

The purpose of this study was to assess the reliability of the Frankfort horizontal (FH), sella-nasion horizontal, and optic planes in terms of their variabilities in relation to a true horizontal line in orthognathic surgery patients. Thirty-six consecutive presurgical orthognathic patients (13 male, 23 female; age range, 16-35 years; 30 white, 6 African Caribbean) had lateral cephalometric radiographs taken in natural head position, with a plumb line orientating the true vertical line, and the true horizontal line perpendicular to the true vertical. The inclinations of the anatomic reference planes were compared with the true horizontal. The FH plane was found to be on average closest to the true horizontal, with a mean of -1.6° (SD, 3.4°), whereas the sella-nasion horizontal and the optic plane had means of 2.1° (SD, 5.1°) and 3.2° (SD, 4.7°), respectively. The FH showed the least variability of the 3 anatomic planes. The ranges of variability were high for all anatomic planes: -8° to 8° for the FH, -8° to 15° for the sella-nasion horizontal, and -6° to 13° for the optic plane. No significant differences were found in relation to patients' sex, skeletal patterns, or ethnic backgrounds. The clinically significant variability in the inclinations of anatomic reference planes in relation to the true horizontal plane makes their use unreliable in orthognathic patients. Copyright © 2014 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Assessing the impact of the Graduate Certificate in Anatomical Sciences Instruction: A post-degree survey.

PubMed

Richardson-Hatcher, April; MacPherson, Brian; Gould, Douglas; Brueckner-Collins, Jennifer

2018-03-26

There are few graduate programs available for pursuing a doctorate in anatomy where students gain specific training in gross anatomy dissection and the responsibilities of a medical educator. In light of this fact, the University of Kentucky created a Graduate Certificate in Anatomical Sciences Instruction in 2006. This 12-credit hour curriculum includes detailed training in gross anatomy and/or neuroscience courses, practicum experiences, a seminar class in pedagogical literature, and a course in educational strategies for the anatomical sciences. The award of certificate completion affirms that the candidate has demonstrated faculty-supervised proficiency in anatomy dissection, instruction in anatomy topics, and teaching strategies for anatomy. Seventeen graduate students have earned the certificate since its inception; nine students accepted teaching positions in anatomy following their graduate training and currently nine certificate graduates have assistant (six) or associate (three) professor positions in academia. In 2016, an anonymous survey including Likert-style and open-ended questions was emailed to all certificate graduates. Graduates favorably responded (each question averaged 4.4 or greater out of 5) that the certificate increased their awareness of teaching-faculty responsibilities, adequately prepared them for teaching-related duties, and positively contributed toward their first employment. Graduates indicated that the lecturing and dissection experience, awareness of faculty responsibilities, and job preparation (e.g., teaching philosophy development) were the most helpful aspects of the certificate. These results indicate that the Graduate Certificate in Anatomical Sciences Instruction is viewed by its graduates and their employers as a valuable teaching credential that can be attained alongside a basic science degree. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

[Muscle efficiency in total shoulder prosthesis implantation: dependence on position of the humeral head and rotator cuff function].

PubMed

Klages, A; Hurschler, C; Wülker, N; Windhagen, H

2001-09-01

Modern shoulder prostheses permit an anatomic reconstruction of the joint, although the biomechanical advantages are not proven. The goal of this study was to investigate the relationship between position of the humeral head and function of the shoulder prosthesis (muscle efficiency). Shoulder elevation-motion and rotator cuff defects were simulated in vitro in a robot-assisted shoulder simulator. The EPOCA Custom Offset shoulder prosthesis (Argomedical AG, Cham, CH) was implanted in seven normal shoulders (77 +/- 20 kg, 55 +/- 14 years). Active elevation was simulated by hydraulic cylinders, and scapulothoratic motion by a specially programmed industrial robot. Muscle efficiency (elevation-angle/muscle-force of the deltoid muscle) was measured in anatomic (ANA), medialised (MED) and lateralised (LAT) positions of the humeral head, with or without rotator cuff muscle deficiency. Medialisation increased efficiency by 0.03 +/- 0.04 deg/N (p = 0.022), lateralisation decreased it by 0.04 +/- 0.06 deg/N (p = 0.009). Supraspinatus muscle deficiency increased the deltoid force required to elevate the arm, and thus decreased efficiency (ANA p = 0.091, MED p = 0.018, LAT p = 0.028). The data confirm that the position of the humeral head affects the mechanics of total shoulder arthroplasty. Medialisation increases efficiency of the deltoid muscle and may prove useful in compensating isolated supraspinatus muscle deficiency. Lateralisation, in contrast, leads to an unfavorable situation.

A descriptive study of potential effect of anterior tibial translation, femoral tunnel and anterior cruciate ligament graft inclination on clinical outcome and degenerative changes.

PubMed

Snoj, Žiga; Zupanc, Oskar; Stražar, Klemen; Salapura, Vladka

2017-04-01

There is no evidence that anatomically correct anterior cruciate ligament reconstruction (ACLR) offers lower rate of degenerative changes development or that it would lead to a better outcome. The significance and understanding of the abnormal anterior tibial translation (ATT) in ACLR patients is yet to be established. Sixty subjects (40 patients at 5.9 years after ACLR, 20 healthy controls) underwent 3 T MRI. Quantitative cartilage T2 mapping and morphological whole organ magnetic resonance imaging score (WORMS) evaluation was performed. Self-reported questionnaires were used for subjective clinical evaluation. Correlations were calculated with the following MRI measurements; femoral tunnel inclination, ACL graft inclination, lateral and medial compartment ATT. In the ACLR group positive correlation was found between the patellar cartilage T2 values and sagittal ACL graft inclination. In the ACLR group lateral compartment ATT showed negative correlation with ACL graft inclination and subjective clinical evaluation, and positive correlation with morphological degenerative changes. Femoral tunnel showed positive correlation with ACL graft inclination in the same plane. Increased ATT offers worse clinical outcome and increased rate of degenerative changes. Furthermore, ATT is affected by the ACL inclination. Inclination of the drilling tunnel affects ACL graft inclination; thereby independent drilling techniques provide superior results of anatomical ACL graft positioning.

Role of targeted magnetic resonance imaging sequences in the surgical management of anterior skull base pathology.

PubMed

Chawla, S; Bowman, J; Gandhi, M; Panizza, B

2017-01-01

The skull base is a highly complex anatomical region that provides passage for important nerves and vessels as they course into and out of the cranial cavity. Key to the management of pathology in this region is a thorough understanding of the anatomy, with its variations, and the relationship of various neurovascular structures to the pathology in question. Targeted high-resolution magnetic resonance imaging on high field strength magnets can enable the skull base surgeon to understand this intricate relationship and deal with the pathology from a position of relative advantage. With the help of case studies, this paper illustrates the application of specialised magnetic resonance techniques to study pathology of the orbital apex in particular. The fine anatomical detail provided gives surgeons the ability to design an endonasal endoscopic procedure appropriate to the anatomy of the pathology.

Astragalar Morphology of Selected Giraffidae.

PubMed

Solounias, Nikos; Danowitz, Melinda

2016-01-01

The artiodactyl astragalus has been modified to exhibit two trochleae, creating a double pullied structure allowing for significant dorso-plantar motion, and limited mediolateral motion. The astragalus structure is partly influenced by environmental substrates, and correspondingly, morphometric studies can yield paleohabitat information. The present study establishes terminology and describes detailed morphological features on giraffid astragali. Each giraffid astragalus exhibits a unique combination of anatomical characteristics. The giraffid astragalar morphologies reinforce previously established phylogenetic relationships. We find that the enlargement of the navicular head is a feature shared by all giraffids, and that the primitive giraffids possess exceptionally tall astragalar heads in relation to the total astragalar height. The sivatheres and the okapi share a reduced notch on the lateral edge of the astragalus. We find that Samotherium is more primitive in astragalar morphologies than Palaeotragus, which is reinforced by tooth characteristics and ossicone position. Diagnostic anatomical characters on the astragalus allow for giraffid species identifications and a better understanding of Giraffidae.

Dynamic MRI evaluation of urethral hypermobility post-radical prostatectomy.

PubMed

Suskind, Anne M; DeLancey, John O L; Hussain, Hero K; Montgomery, Jeffrey S; Latini, Jerilyn M; Cameron, Anne P

2014-03-01

One postulated cause of post-prostatectomy incontinence is urethral and bladder neck hypermobility. The objective of this study was to determine the magnitude of anatomical differences of urethral and bladder neck position at rest and with valsalva in continent and incontinent men post-prostatectomy based on dynamic MRI. All subjects underwent a dynamic MRI protocol with valsalva and non-valsalva images and a standard urodynamic evaluation. MRI measurements were taken at rest and with valsalva, including (1) bladder neck to sacrococcygeal inferior pubic point line (SCIPP), (2) urethra to pubis, and (3) bulbar urethra to SCIPP. Data were analyzed in SAS using two-tailed t tests. A total of 21 subjects (13 incontinent and 8 continent) had complete data and were included in the final analysis. The two groups had similar demographic characteristics. On MRI, there were no statistically significant differences in anatomic position of the bladder neck or urethra either at rest or with valsalva. The amount of hypermobility ranged from 0.8 to 2 mm in all measures. There were also no differences in the amount of hypermobility (position at rest minus position at valsalva) between groups. We found no statistically significant differences in bladder neck and urethral position or mobility on dynamic MRI evaluation between continent and incontinent men status post-radical prostatectomy. A more complex mechanism for post-prostatectomy incontinence needs to be modeled in order to better understand the continence mechanism in this select group of men. © 2013 Wiley Periodicals, Inc.

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.

Flexible Ultrathin Endoscope Integrated with Irrigation Suction Apparatus for Assisting Microneurosurgery.

PubMed

Otani, Naoki; Morimoto, Yuji; Fujii, Kazuya; Toyooka, Terushige; Wada, Kojiro; Mori, Kentaro

2017-12-01

Endoscopy can observe the anatomical components in a deeply located and/or hidden area during neurosurgical procedures under the operating microscope. We have newly developed a flexible ultrathin endoscope integrated with irrigation suction apparatus (FUEISA) to visualize deeply located and/or hidden areas for assisting microneurosurgery. The present study investigated the usefulness of the FUEISA system for direct clipping surgery of cerebral aneurysms. Twenty-one patients underwent microneurosurgery assisted with the FUEISA system for direct clipping of cerebral aneurysms. The flexible ultrathin endoscope (outer diameter 0.75mm) consists of an image guide (6000 dpi) and a light guide, integrated with the irrigation suction apparatus. This endoscopic system was inserted before and after clipping to observe the anatomical conditions surrounding the lesions. In all cases, handling and operation of the FUEISA was technically successful during the surgical procedure. The ultrathin endoscope was adequately integrated with the irrigation suction apparatus in all cases. General anatomy visualization including the lenticulostriate arteries, medial striate arteries, and/or internal carotid artery perforators was possible, and the correct clip positioning and vessel conditions were easily checked. The endoscope revealed that the clip had been positioned incorrectly in one case. No complications associated with the endoscopic system occurred. The FUEISA system can be applied with safe manipulation, which was remarkably useful for confirmation of the presence of perforators and cranial nerves behind the lesions, particularly anatomical components located in deep and/or hidden areas during clipping of cerebral aneurysms. Copyright © 2017 Elsevier Inc. All rights reserved.

Monitoring blood-flow in the mouse cochlea using an endoscopic laser speckle contrast imaging system

PubMed Central

Yu, Sunkon; Jung, Byungjo; Choi, Jin Sil

2018-01-01

Laser speckle contrast imaging (LSCI) enables continuous high-resolution assessment of microcirculation in real-time. We applied an endoscope to LSCI to measure cochlear blood-flow in an ischemia–reperfusion mouse model. We also explored whether using xenon light in combination with LSCI facilitates visualization of anatomical position. Based on a previous preliminary study, the appropriate wavelength for penetrating the thin bony cochlea was 830 nm. A 2.7-mm-diameter endoscope was used, as appropriate for the size of the mouse cochlea. Our endoscopic LSCI system was used to illuminate the right cochlea after dissection of the mouse. We observed changes in the speckle signals when we applied the endoscopic LSCI system to the ischemia-reperfusion mouse model. The anatomical structure of the mouse cochlea and surrounding structures were clearly visible using the xenon light. The speckle signal of the cochlea was scattered, with an intensity that varied between that of the stapes (with the lowest signal), the negative control, and the stapedial artery (with the highest signal), the positive control. In the cochlear ischemia–reperfusion mouse model, the speckle signal of the cochlea decreased during the ischemic phase, and increased during the reperfusion phase, clearly reflecting cochlear blood-flow. The endoscopic LSCI system generates high-resolution images in real-time, allowing visualization of blood-flow and its changes in the mouse cochlea. Anatomical structures were clearly matched using LSCI along with visible light. PMID:29489849

Monitoring blood-flow in the mouse cochlea using an endoscopic laser speckle contrast imaging system.

PubMed

Kong, Tae Hoon; Yu, Sunkon; Jung, Byungjo; Choi, Jin Sil; Seo, Young Joon

2018-01-01

Laser speckle contrast imaging (LSCI) enables continuous high-resolution assessment of microcirculation in real-time. We applied an endoscope to LSCI to measure cochlear blood-flow in an ischemia-reperfusion mouse model. We also explored whether using xenon light in combination with LSCI facilitates visualization of anatomical position. Based on a previous preliminary study, the appropriate wavelength for penetrating the thin bony cochlea was 830 nm. A 2.7-mm-diameter endoscope was used, as appropriate for the size of the mouse cochlea. Our endoscopic LSCI system was used to illuminate the right cochlea after dissection of the mouse. We observed changes in the speckle signals when we applied the endoscopic LSCI system to the ischemia-reperfusion mouse model. The anatomical structure of the mouse cochlea and surrounding structures were clearly visible using the xenon light. The speckle signal of the cochlea was scattered, with an intensity that varied between that of the stapes (with the lowest signal), the negative control, and the stapedial artery (with the highest signal), the positive control. In the cochlear ischemia-reperfusion mouse model, the speckle signal of the cochlea decreased during the ischemic phase, and increased during the reperfusion phase, clearly reflecting cochlear blood-flow. The endoscopic LSCI system generates high-resolution images in real-time, allowing visualization of blood-flow and its changes in the mouse cochlea. Anatomical structures were clearly matched using LSCI along with visible light.

Overlapping reactivations of herpes simplex virus type 2 in the genital and perianal mucosa.

PubMed

Tata, Sunitha; Johnston, Christine; Huang, Meei-Li; Selke, Stacy; Magaret, Amalia; Corey, Lawrence; Wald, Anna

2010-02-15

Genital shedding of herpes simplex virus (HSV) type 2 occurs frequently. Anatomic patterns of genital HSV-2 reactivation have not been intensively studied. Four HSV-2-seropositive women with symptomatic genital herpes attended a clinic daily during a 30-day period. Daily samples were collected from 7 separate genital sites. Swab samples were assayed for HSV DNA by quantitative polymerase chain reaction. Anatomic sites of clinical HSV-2 recurrences were recorded. HSV was detected on 44 (37%) of 120 days and from 136 (16%) of 840 swab samples. Lesions were documented on 35 (29%) of 120 days. HSV was detected at >1 anatomic site on 25 (57%) of 44 days with HSV shedding (median, 2 sites; range, 1-7), with HSV detected bilaterally on 20 (80%) of the 25 days. The presence of a lesion was significantly associated with detectable HSV from any genital site (incident rate ratio [IRR], 5.41; 95% confidence interval [CI], 1.24-23.50; P= .02) and with the number of positive sites (IRR, 1.19; 95% CI, 1. 01-1.40; P=.03). The maximum HSV copy number detected was associated with the number of positive sites (IRR, 1.62; 95% CI, 1.44-1.82; P<.001). HSV-2 reactivation occurs frequently at widely spaced regions throughout the genital tract. To prevent HSV-2 reactivation, suppressive HSV-2 therapy must control simultaneous viral reactivations from multiple sacral ganglia.

Joint detection of anatomical points on surface meshes and color images for visual registration of 3D dental models

NASA Astrophysics Data System (ADS)

Destrez, Raphaël.; Albouy-Kissi, Benjamin; Treuillet, Sylvie; Lucas, Yves

2015-04-01

Computer aided planning for orthodontic treatment requires knowing occlusion of separately scanned dental casts. A visual guided registration is conducted starting by extracting corresponding features in both photographs and 3D scans. To achieve this, dental neck and occlusion surface are firstly extracted by image segmentation and 3D curvature analysis. Then, an iterative registration process is conducted during which feature positions are refined, guided by previously found anatomic edges. The occlusal edge image detection is improved by an original algorithm which follows Canny's poorly detected edges using a priori knowledge of tooth shapes. Finally, the influence of feature extraction and position optimization is evaluated in terms of the quality of the induced registration. Best combination of feature detection and optimization leads to a positioning average error of 1.10 mm and 2.03°.

Real-time "x-ray vision" for healthcare simulation: an interactive projective overlay system to enhance intubation training and other procedural training.

PubMed

Samosky, Joseph T; Baillargeon, Emma; Bregman, Russell; Brown, Andrew; Chaya, Amy; Enders, Leah; Nelson, Douglas A; Robinson, Evan; Sukits, Alison L; Weaver, Robert A

2011-01-01

We have developed a prototype of a real-time, interactive projective overlay (IPO) system that creates augmented reality display of a medical procedure directly on the surface of a full-body mannequin human simulator. These images approximate the appearance of both anatomic structures and instrument activity occurring within the body. The key innovation of the current work is sensing the position and motion of an actual device (such as an endotracheal tube) inserted into the mannequin and using the sensed position to control projected video images portraying the internal appearance of the same devices and relevant anatomic structures. The images are projected in correct registration onto the surface of the simulated body. As an initial practical prototype to test this technique we have developed a system permitting real-time visualization of the intra-airway position of an endotracheal tube during simulated intubation training.

[Biased objectivity--images of women in 19th century German neuroscience].

PubMed

Schröter, A; Riha, O; Steinberg, H

2012-09-01

At the beginning of the 19 (th) century German scholars wanted to differentiate men and women on the basis of anatomic brain or cerebrum particularities. With the help of scientific criteria such as the weight of the brain they aimed not only to prove pre-postulated intellectual differences, but also to find scientific justification for the inferiority of women in general and their inferior position and treatment in society. This paper presents insights into and excerpts from studies written by renowned scientists such as S. T. von Soemmerring, J. F. Ackermann, K. F. Burdach, F. Tiedemann, E. Huschke, H. Schaaffhausen, or P. J. Möbius. Covering the years from 1780 to 1900, these materials show how at the beginning the interest was primarily in comparative anatomic studies and results, but was soon mingled with sociological intentions. Hence this study gives insights into the history of modern gender studies of neurosciences. © Georg Thieme Verlag KG Stuttgart · New York.

Computerized detection of unruptured aneurysms in MRA images: reduction of false positives using anatomical location features

NASA Astrophysics Data System (ADS)

Uchiyama, Yoshikazu; Gao, Xin; Hara, Takeshi; Fujita, Hiroshi; Ando, Hiromichi; Yamakawa, Hiroyasu; Asano, Takahiko; Kato, Hiroki; Iwama, Toru; Kanematsu, Masayuki; Hoshi, Hiroaki

2008-03-01

The detection of unruptured aneurysms is a major subject in magnetic resonance angiography (MRA). However, their accurate detection is often difficult because of the overlapping between the aneurysm and the adjacent vessels on maximum intensity projection images. The purpose of this study is to develop a computerized method for the detection of unruptured aneurysms in order to assist radiologists in image interpretation. The vessel regions were first segmented using gray-level thresholding and a region growing technique. The gradient concentration (GC) filter was then employed for the enhancement of the aneurysms. The initial candidates were identified in the GC image using a gray-level threshold. For the elimination of false positives (FPs), we determined shape features and an anatomical location feature. Finally, rule-based schemes and quadratic discriminant analysis were employed along with these features for distinguishing between the aneurysms and the FPs. The sensitivity for the detection of unruptured aneurysms was 90.0% with 1.52 FPs per patient. Our computerized scheme can be useful in assisting the radiologists in the detection of unruptured aneurysms in MRA images.

The application of 3D image processing to studies of the musculoskeletal system

NASA Astrophysics Data System (ADS)

Hirsch, Bruce Elliot; Udupa, Jayaram K.; Siegler, Sorin; Winkelstein, Beth A.

2009-10-01

Three dimensional renditions of anatomical structures are commonly used to improve visualization, surgical planning, and patient education. However, such 3D images also contain information which is not readily apparent, and which can be mined to elucidate, for example, such parameters as joint kinematics, spacial relationships, and distortions of those relationships with movement. Here we describe two series of experiments which demonstrate the functional application of 3D imaging. The first concerns the joints of the ankle complex, where the usual description of motions in the talocrural joint is shown to be incomplete, and where the roles of the anterior talofibular and calcaneofibular ligaments are clarified in ankle sprains. Also, the biomechanical effects of two common surgical procedures for repairing torn ligaments were examined. The second series of experiments explores changes in the anatomical relationships between nerve elements and the cervical vertebrae with changes in neck position. They provide preliminary evidence that morphological differences may exist between asymptomatic subjects and patients with radiculopathy in certain positions, even when conventional imaging shows no difference.

Anatomic aspects of tibiotalocalcaneal nail arthrodesis.

PubMed

Hyer, Christopher F; Cheney, Nick

2013-01-01

During the past 15 years, tibiotalocalcaneal nail arthrodesis has become an established procedure for the treatment of specific disorders of the hindfoot and ankle. However, controversy exists regarding the proper starting point for obtaining and maintaining the correct hindfoot position to allow successful fusion. One of the challenges with this procedure is aligning the tibial canal with the central talus and calcaneus for placement of the intramedullary nail. We performed a cadaver study to evaluate the radiographic and anatomic position of the tibial canal and the central talus as it relates to placement of a retrograde tibiotalocalcaneal nail. In our subjects, guide wires directed in an antegrade fashion down the tibial canal were more likely to enter lateral to the midline of the talus and miss the calcaneal body medially. These data have revealed a mismatch among the central axis of the tibia, talus, and calcaneus. Surgeons must pay careful attention to wire placement across these 3 bone segments during retrograde tibiotalocalcaneal nailing. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

[Plain radiographs of the spine: static and relationships between spine and pelvis].

PubMed

Morvan, G; Wybier, M; Mathieu, P; Vuillemin, V; Guerini, H

2008-05-01

Man, with his erect posture, evolves in a world subject to the laws of gravity. His spine reflects these constraints. The morphology and static of human spine and biomechanical relationships between spine and pelvis are in direct relation with bipedia. Owing to this position the pelvis widened and straightened, characteristic sagittal spinal curves appeared and the perispinal muscles were deeply reorganized. Each pelvis is characterized by an important anatomical landmark: the pelvic incidence that reflects the sagittal morphology of the pelvis. Based on this anatomical characteristic, a chain of reactions determines the more efficient equilibrium of the whole body in the sagittal plane in term of energy consumption. Incidence affects the sacral slope, which determines lumbar lordosis, which itself influences pelvic tilt, thoracic kyphosis, and even hip and knee position. All these landmarks can easily be studied on a sagittal radiograph. Knowledge of these functional relationships is essential to understand the origin of low back pain, sagittal imbalance and above all before surgical treatment of spine disorders especially when arthrodesis is considered.

SU-C-210-05: Evaluation of Robustness: Dosimetric Effects of Anatomical Changes During Fractionated Radiation Treatment of Pancreatic Cancer Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Horst, A van der; Houweling, A C; Bijveld, M M C

2015-06-15

Purpose: Pancreatic tumors show large interfractional position variations. In addition, changes in gastrointestinal air volume and body contour take place during treatment. We aim to investigate the robustness of the clinical treatment plans by quantifying the dosimetric effects of these anatomical changes. Methods: Calculations were performed for up to now 3 pancreatic cancer patients who had intratumoral fiducials for daily CBCT-based positioning during their 3-week treatment. For each patient, deformable image registration of the planning CT was used to assign Hounsfield Units to each of the 13—15 CBCTs; air volumes and body contour were copied from CBCT. The clinical treatmentmore » plan was used (CTV-PTV margin = 10 mm; 36Gy; 10MV; 1 arc VMAT). Fraction dose distributions were calculated and accumulated. The V95% of the clinical target volume (CTV) and planning target volume (PTV) were analyzed, as well as the dose to stomach, duodenum and liver. Dose accumulation was done for patient positioning based on the fiducials (as clinically used) as well as for positioning based on bony anatomy. Results: For all three patients, the V95% of the CTV remained 100%, for both fiducial- and bony anatomy-based positioning. For fiducial-based positioning, dose to duodenum en stomach showed no discernable differences with planned dose. For bony anatomy-based positioning, the PTV V95% of the patient with the largest systematic difference in tumor position (patient 1) decreased to 85%; the liver Dmax increased from 33.5Gy (planned) to 35.5Gy. Conclusion: When using intratumoral fiducials, CTV dose coverage was only mildly affected by the daily anatomical changes. When using bony anatomy for patient positioning, we found a decline in PTV dose coverage due to the interfractional tumor position variations. Photon irradiation treatment plans for pancreatic tumors are robust to variations in body contour and gastrointestinal gas, but the use of fiducial-based daily position verification is imperative. This work was supported by the foundation Bergh in het Zadel through the Dutch Cancer Society (KWF Kankerbestrijding) project No. UVA 2011-5271.« less

Numerical compliance testing of human exposure to electromagnetic radiation from smart-watches.

PubMed

Hong, Seon-Eui; Lee, Ae-Kyoung; Kwon, Jong-Hwa; Pack, Jeong-Ki

2016-10-07

In this study, we investigated the electromagnetic dosimetry for smart-watches. At present, the standard for compliance testing of body-mounted and handheld devices specifies the use of a flat phantom to provide conservative estimates of the peak spatial-averaged specific absorption rate (SAR). This means that the estimated SAR using a flat phantom should be higher than the SAR in the exposure part of an anatomical human-body model. To verify this, we numerically calculated the SAR for a flat phantom and compared it with the numerical calculation of the SAR for four anatomical human-body models of different ages. The numerical analysis was performed using the finite difference time domain method (FDTD). The smart-watch models were used in the three antennas: the shorted planar inverted-F antenna (PIFA), loop antenna, and monopole antenna. Numerical smart-watch models were implemented for cellular commutation and wireless local-area network operation at 835, 1850, and 2450 MHz. The peak spatial-averaged SARs of the smart-watch models are calculated for the flat phantom and anatomical human-body model for the wrist-worn and next to mouth positions. The results show that the flat phantom does not provide a consistent conservative SAR estimate. We concluded that the difference in the SAR results between an anatomical human-body model and a flat phantom can be attributed to the different phantom shapes and tissue structures.

Numerical compliance testing of human exposure to electromagnetic radiation from smart-watches

NASA Astrophysics Data System (ADS)

Hong, Seon-Eui; Lee, Ae-Kyoung; Kwon, Jong-Hwa; Pack, Jeong-Ki

2016-10-01

In this study, we investigated the electromagnetic dosimetry for smart-watches. At present, the standard for compliance testing of body-mounted and handheld devices specifies the use of a flat phantom to provide conservative estimates of the peak spatial-averaged specific absorption rate (SAR). This means that the estimated SAR using a flat phantom should be higher than the SAR in the exposure part of an anatomical human-body model. To verify this, we numerically calculated the SAR for a flat phantom and compared it with the numerical calculation of the SAR for four anatomical human-body models of different ages. The numerical analysis was performed using the finite difference time domain method (FDTD). The smart-watch models were used in the three antennas: the shorted planar inverted-F antenna (PIFA), loop antenna, and monopole antenna. Numerical smart-watch models were implemented for cellular commutation and wireless local-area network operation at 835, 1850, and 2450 MHz. The peak spatial-averaged SARs of the smart-watch models are calculated for the flat phantom and anatomical human-body model for the wrist-worn and next to mouth positions. The results show that the flat phantom does not provide a consistent conservative SAR estimate. We concluded that the difference in the SAR results between an anatomical human-body model and a flat phantom can be attributed to the different phantom shapes and tissue structures.

Does flexible tunnel drilling affect the femoral tunnel angle measurement after anterior cruciate ligament reconstruction?

PubMed

Muller, Bart; Hofbauer, Marcus; Atte, Akere; van Dijk, C Niek; Fu, Freddie H

2015-12-01

To quantify the mean difference in femoral tunnel angle (FTA) as measured on knee radiographs between rigid and flexible tunnel drilling after anatomic anterior cruciate ligament (ACL) reconstruction. Fifty consecutive patients that underwent primary anatomic ACL reconstruction with a single femoral tunnel drilled with a flexible reamer were included in this study. The control group was comprised of 50 patients all of who underwent primary anatomic ACL reconstruction with a single femoral tunnel drilled with a rigid reamer. All femoral tunnels were drilled through a medial portal to ensure anatomic tunnel placement. The FTA was determined from post-operative anterior-to-posterior (AP) radiographs by two independent observers. A 5° difference between the two mean FTA was considered clinically significant. The average FTA, when drilled with a rigid reamer, was 42.0° ± 7.2°. Drilling with a flexible reamer resulted in a mean FTA of 44.7° ± 7.0°. The mean difference of 2.7° was not statistically significant. The intraclass correlation coefficient for inter-tester reliability was 0.895. The FTA can be reliably determined from post-operative AP radiographs and provides a useful and reproducible metric for characterizing femoral tunnel position after both rigid and flexible femoral tunnel drilling. This has implications for post-operative evaluation and preoperative treatment planning for ACL revision surgery. IV.

Towards the resolution of a long-standing evolutionary question: muscle identity and attachments are mainly related to topological position and not to primordium or homeotic identity of digits.

PubMed

Diogo, Rui; Walsh, Sean; Smith, Christopher; Ziermann, Janine M; Abdala, Virginia

2015-06-01

Signaling for limb bone development usually precedes that for muscle development, such that cartilage is generally present before muscle formation. It remains obscure, however, if: (i) tetrapods share a general, predictable spatial correlation between bones and muscles; and, if that is the case, if (ii) such a correlation would reflect an obligatory association between the signaling involved in skeletal and muscle morphogenesis. We address these issues here by using the results of a multidisciplinary analysis of the appendicular muscles of all major tetrapod groups integrating dissections, muscle antibody stainings, regenerative and ontogenetic analyses of fluorescently-labeled (GFP) animals, and studies of non-pentadactyl human limbs related to birth defects. Our synthesis suggests that there is a consistent, surprising anatomical pattern in both normal and abnormal phenotypes, in which the identity and attachments of distal limb muscles are mainly related to the topological position, and not to the developmental primordium (anlage) or even the homeotic identity, of the digits to which they are attached. This synthesis is therefore a starting point towards the resolution of a centuries-old question raised by authors such as Owen about the specific associations between limb bones and muscles. This question has crucial implications for evolutionary and developmental biology, and for human medicine because non-pentadactyly is the most common birth defect in human limbs. In particular, this synthesis paves the way for future developmental experimental and mechanistic studies, which are needed to clarify the processes that may be involved in the elaboration of the anatomical patterns described here, and to specifically test the hypothesis that distal limb muscle identity/attachment is mainly related to digit topology. © 2015 Anatomical Society.

Comparison of radiographic and anatomic femoral varus angle measurements in normal dogs.

PubMed

Swiderski, Jennifer K; Radecki, Steven V; Park, Richard D; Palmer, Ross H

2008-01-01

To determine if the clinically practiced method of radiographic femoral varus angle (R-FVA) measurement is repeatable, reproducible, and accurate. Radiographic and anatomic study. ANIMALS/SAMPLE POPULATION: Normal Walker hound cadavers (n=5) and femora (n=10). Cadavers were held in dorsally-recumbent and torso-elevated positions as 3 craniocaudal radiographs were made of each femur, by each of 2 different technicians. Femora were then harvested for direct measurement of anatomic femoral varus angle (A-FVA). R-FVA was measured on each radiograph by each of 3 examiners on 3 separate occasions. Intra-observer (repeatability) and inter-observer (reproducibility) variance in R-FVA measurement and the strength of relationship between R-FVA and A-FVA (accuracy) were determined. Mean (+/-SD) A-FVA was 5.2+/-2.1 degrees (range, 2.4-8.2 degrees). Mean (+/-SD) R-FVA was 5.8+/-1.0 degrees (range, 2.7-9.6 degrees). Intra-observer variance (range: 11-16%) and inter-observer variance (16%) were acceptable. The strength of relationship between measured R-FVA and A-FVA (maximum adjusted R(2)<0) was unacceptably low regardless of observer, patient position, or radiographic technician. R-FVA measurement was repeatable and reproducible, but not statistically accurate in predicting A-FVA in these 5 normal Walker hounds. The detected inaccuracy may be real or the result of a selection bias for normal dogs obscuring the true relationship. R-FVA may not be an accurate method of femoral varus measurement in dogs with A-FVA<10 degrees. Using Slocum's criteria for distal femoral osteotomy (R-FVA>10 degrees), the procedure would not have been erroneously performed in any of the normal dogs of this study.

Radiographic identification of the anterior and posterior root attachments of the medial and lateral menisci.

PubMed

James, Evan W; LaPrade, Christopher M; Ellman, Michael B; Wijdicks, Coen A; Engebretsen, Lars; LaPrade, Robert F

2014-11-01

Anatomic root placement is necessary to restore native meniscal function during meniscal root repair. Radiographic guidelines for anatomic root placement are essential to improve the accuracy and consistency of anatomic root repair and to optimize outcomes after surgery. To define quantitative radiographic guidelines for identification of the anterior and posterior root attachments of the medial and lateral menisci on anteroposterior (AP) and lateral radiographic views. Descriptive laboratory study. The anterior and posterior roots of the medial and lateral menisci were identified in 12 human cadaveric specimens (average age, 51.3 years; age range, 39-65 years) and labeled using 2-mm radiopaque spheres. True AP and lateral radiographs were obtained, and 2 raters independently measured blinded radiographs in relation to pertinent landmarks and radiographic reference lines. On AP radiographs, the anteromedial and posteromedial roots were, on average, 31.9 ± 5.0 mm and 36.3 ± 3.5 mm lateral to the edge of the medial tibial plateau, respectively. The anterolateral and posterolateral roots were, on average, 37.9 ± 5.2 mm and 39.3 ± 3.8 mm medial to the edge of the lateral tibial plateau, respectively. On lateral radiographs, the anteromedial and anterolateral roots were, on average, 4.8 ± 3.7 mm and 20.5 ± 4.3 mm posterior to the anterior margin of the tibial plateau, respectively. The posteromedial and posterolateral roots were, on average, 18.0 ± 2.8 mm and 19.8 ± 3.5 mm anterior to the posterior margin of the tibial plateau, respectively. The intrarater and interrater intraclass correlation coefficients (ICCs) were >0.958, demonstrating excellent reliability. The meniscal root attachment sites were quantitatively and reproducibly defined with respect to anatomic landmarks and superimposed radiographic reference lines. The high ICCs indicate that the measured radiographic relationships are a consistent means for evaluating meniscal root positions. This study demonstrated consistent and reproducible radiographic guidelines for the location of the meniscal roots. These measurements may be used to assess root positions on intraoperative fluoroscopy and postoperative radiographs. © 2014 The Author(s).

Local tissue air ratio in an anatomic phantom for 60Co total body irradiation.

PubMed

Vrtar, M; Purisić, A

1991-07-01

Tissue-air ratio (TAR), as the basic dosimetric function, is not ideally applicable to all important locations in total body irradiation (TBI) dosimetry because it generally refers to central ray measurements. We therefore introduced the local TAR which depends on the specific distribution of the scattering centres around the location of interest. Local TAR measurements were performed in an anatomic water phantom, produced by a sculptor, representing a patient during TBI in the real treatment position. A comparison has been made between TAR values, defined on the beam's ray at different locations in the anatomic phantom and cubic phantoms of different size. The local TAR values in the anatomic phantom, having more realistic outer surface curvatures, are lower by a few percent in most locations. We consider these values more accurate and better applicable to TBI conditions than those obtained in cubic water phantoms, even if the volume of the phantom is adapted to the particular side of the body.

Evaluating the distance between the femoral tunnel centers in anatomic double-bundle anterior cruciate ligament reconstruction using a computer simulation

PubMed Central

Tashiro, Yasutaka; Okazaki, Ken; Iwamoto, Yukihide

2015-01-01

Purpose We aimed to clarify the distance between the anteromedial (AM) bundle and posterolateral (PL) bundle tunnel-aperture centers by simulating the anatomical femoral tunnel placement during double-bundle anterior cruciate ligament reconstruction using 3-D computer-aided design models of the knee, in order to discuss the risk of tunnel overlap. Relationships between the AM to PL center distance, body height, and sex difference were also analyzed. Patients and methods The positions of the AM and PL tunnel centers were defined based on previous studies using the quadrant method, and were superimposed anatomically onto the 3-D computer-aided design knee models from 68 intact femurs. The distance between the tunnel centers was measured using the 3-D DICOM software package. The correlation between the AM–PL distance and the subject’s body height was assessed, and a cutoff height value for a higher risk of overlap of the AM and PL tunnel apertures was identified. Results The distance between the AM and PL centers was 10.2±0.6 mm in males and 9.4±0.5 mm in females (P<0.01). The AM–PL center distance demonstrated good correlation with body height in both males (r=0.66, P<0.01) and females (r=0.63, P<0.01). When 9 mm was defined as the critical distance between the tunnel centers to preserve a 2 mm bony bridge between the two tunnels, the cutoff value was calculated to be a height of 160 cm in males and 155 cm in females. Conclusion When AM and PL tunnels were placed anatomically in simulated double-bundle anterior cruciate ligament reconstruction, the distance between the two tunnel centers showed a strong positive correlation with body height. In cases with relatively short stature, the AM and PL tunnel apertures are considered to be at a higher risk of overlap when surgeons choose the double-bundle technique. PMID:26170727

PI3Kbeta Inhibitor AZD8186 and Docetaxel in Treating Patients Advanced Solid Tumors With PTEN or PIK3CB Mutations That Are Metastatic or Cannot Be Removed by Surgery

ClinicalTrials.gov

2018-05-16

Advanced Malignant Solid Neoplasm; Anatomic Stage III Breast Cancer AJCC v8; Anatomic Stage IIIA Breast Cancer AJCC v8; Anatomic Stage IIIB Breast Cancer AJCC v8; Anatomic Stage IIIC Breast Cancer AJCC v8; Anatomic Stage IV Breast Cancer AJCC v8; Castration-Resistant Prostate Carcinoma; Estrogen Receptor Negative; Estrogen Receptor Positive; HER2/Neu Negative; Metastatic Malignant Solid Neoplasm; Metastatic Prostate Carcinoma; PIK3CB Gene Mutation; Progesterone Receptor Negative; Prognostic Stage III Breast Cancer AJCC v8; Prognostic Stage IIIA Breast Cancer AJCC v8; Prognostic Stage IIIB Breast Cancer AJCC v8; Prognostic Stage IIIC Breast Cancer AJCC v8; Prognostic Stage IV Breast Cancer AJCC v8; PTEN Gene Mutation; PTEN Loss; Stage III Prostate Cancer AJCC v8; Stage IIIA Prostate Cancer AJCC v8; Stage IIIB Prostate Cancer AJCC v8; Stage IIIC Prostate Cancer AJCC v8; Stage IV Prostate Cancer AJCC v8; Stage IVA Prostate Cancer AJCC v8; Stage IVB Prostate Cancer AJCC v8; Triple-Negative Breast Carcinoma; Unresectable Solid Neoplasm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Van de Velde, Joris, E-mail: joris.vandevelde@ugent.be; Department of Radiotherapy, Ghent University, Ghent; Audenaert, Emmanuel

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 validatedmore » 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.« less

HPV-relatedness definitions for classifying HPV-related oropharyngeal cancer patient do impact on TNM classification and patients' survival.

PubMed

Taberna, Miren; Mena, Marisa; Tous, Sara; Pavón, Miquel Angel; Oliva, Marc; León, Xavier; Garcia, Jacinto; Guix, Marta; Hijano, Rafael; Bonfill, Teresa; Aguilà, Antón; Alemany, Laia; Mesía, Ricard

2018-01-01

Given the different nature and better outcomes of oropharyngeal carcinoma (OPC) associated with human papillomavirus (HPV) infection, a novel clinical stage classification for HPV-related OPC has been accepted for the 8th edition AJCC TNM (ICON-S model). However, it is still unclear the HPV-relatedness definition with best diagnostic accuracy and prognostic value. The aim of this study was to compare different staging system models proposed for HPV-related OPC patients: 7th edition AJCC TNM, RPA stage with non-anatomic factors (Princess Margaret), RPA with N categories for nasopharyngeal cancer (MD-Anderson) and AHR-new (ICON-S), according to different HPV-relatedness definitions: HPV-DNA detection plus an additional positive marker (p16INK4a or HPV-mRNA), p16INK4a positivity alone or the combination of HPV-DNA/p16INK4a positivity as diagnostic tests. A total of 788 consecutive OPC cases diagnosed from 1991 to 2013 were considered eligible for the analysis. Of these samples, 66 (8.4%) were positive for HPV-DNA and (p16INK4a or HPV-mRNA), 83 (10.5%) were p16INK4a positive and 58 (7.4%) were double positive for HPV-DNA/p16INK4a. ICON-S model was the staging system, which performed better in our series when using at least two biomarkers to define HPV-causality. When the same analysis was performed considering only p16INK4a-positivity, RPA stage with non-anatomic factors (Princess Margaret) has the best classification based on AIC criteria. HPV-relatedness definition for classifying HPV-related OPC patient do impact on TNM classification and patients' survival. Further studies assessing HPV-relatedness definitions are warranted to better classify HPV-related OPC patients in the era of de-escalation clinical trials.

HPV-relatedness definitions for classifying HPV-related oropharyngeal cancer patient do impact on TNM classification and patients’ survival

PubMed Central

Mena, Marisa; Tous, Sara; Pavón, Miquel Angel; Oliva, Marc; León, Xavier; Garcia, Jacinto; Guix, Marta; Hijano, Rafael; Bonfill, Teresa; Aguilà, Antón; Alemany, Laia; Mesía, Ricard

2018-01-01

Background Given the different nature and better outcomes of oropharyngeal carcinoma (OPC) associated with human papillomavirus (HPV) infection, a novel clinical stage classification for HPV-related OPC has been accepted for the 8th edition AJCC TNM (ICON-S model). However, it is still unclear the HPV-relatedness definition with best diagnostic accuracy and prognostic value. Material and methods The aim of this study was to compare different staging system models proposed for HPV-related OPC patients: 7th edition AJCC TNM, RPA stage with non-anatomic factors (Princess Margaret), RPA with N categories for nasopharyngeal cancer (MD-Anderson) and AHR-new (ICON-S), according to different HPV-relatedness definitions: HPV-DNA detection plus an additional positive marker (p16INK4a or HPV-mRNA), p16INK4a positivity alone or the combination of HPV-DNA/p16INK4a positivity as diagnostic tests. Results A total of 788 consecutive OPC cases diagnosed from 1991 to 2013 were considered eligible for the analysis. Of these samples, 66 (8.4%) were positive for HPV-DNA and (p16INK4a or HPV-mRNA), 83 (10.5%) were p16INK4a positive and 58 (7.4%) were double positive for HPV-DNA/p16INK4a. ICON-S model was the staging system, which performed better in our series when using at least two biomarkers to define HPV-causality. When the same analysis was performed considering only p16INK4a-positivity, RPA stage with non-anatomic factors (Princess Margaret) has the best classification based on AIC criteria. Conclusion HPV-relatedness definition for classifying HPV-related OPC patient do impact on TNM classification and patients’ survival. Further studies assessing HPV-relatedness definitions are warranted to better classify HPV-related OPC patients in the era of de-escalation clinical trials. PMID:29664911

Do small changes in rotation affect measurements of lower extremity limb alignment?

PubMed

Jamali, Amir A; Meehan, John P; Moroski, Nathan M; Anderson, Matthew J; Lamba, Ramit; Parise, Carol

2017-05-22

The alignment of the lower extremity has important implications in the development of knee arthritis. The effect of incremental rotations of the limb on common parameters of alignment has not been studied. The purpose of the study was to (1) determine the standardized neutral position measurements of alignment and (2) determine the effect of rotation on commonly used measurements of alignment. Eighty-seven full length CT angiography studies (49 males and 38 females, average age 66 years old) were included. Three-dimensional models were created using a rendering software program and placed on a virtual plane. An image of the extremity was obtained. Thirty scans were randomly selected, and those models were rotated in 3° intervals around the longitudinal axis and additional images were obtained. In the neutral position, the mechanical lateral distal femoral articular angle (mLDFA) was 85.6 ± 2.3°, medial proximal tibial angle (MPTA) was 86.1 ± 2.8°, and mechanical tibiofemoral angle (mTFA) was -0.7 ± 3.1°. Females had a more valgus alignment with a mTFA of 0.5 ± 2.9° while males had a more varus alignment with a mTFA of -1.7 ± 2.9°. The anatomic tibiofemoral angle (aTFA) was 4.8 ± 2.6°, the anatomic lateral distal femoral angle (aLDFA) measured 80.2 ± 2.2°, and the anatomical-mechanical angle (AMA) was 5.4 ± 0.7°. The prevalence of constitutional varus was 18%. The effect of rotation on the rotated scans led to statistically significant differences relative to the 0° measurement for all measurements. These effects may be small, and their clinical importance is unknown. This study provides new information on standardized measures of lower extremity alignment and the relationship between discreet axial rotations of the entire lower extremity and these parameters.

The biomechanical analysis of three-dimensional distal radius fracture model with different fixed splints.

PubMed

Hua, Zhen; Wang, Jian-Wei; Lu, Zhen-Fei; Ma, Jian-Wei; Yin, Heng

2018-01-01

The distal radius fracture is one of the common clinical fractures. At present, there are no reports regarding application of the finite element method in studying the mechanism of Colles fracture and the biomechanical behavior when using splint fixation. To explore the mechanism of Colles fracture and the biomechanical behavior when using different fixed splints. Based on the CT scanning images of forearm for a young female volunteer, by using model construction technology combined with RPOE and ANSYS software, a 3-D distal radius fracture forearm finite element model with a real shape and bioactive materials is built. The material tests are performed to obtain the mechanical properties of the paper-based splint, the willow splint and the anatomical splint. The numerical results are compared with the experimental results to verify the correctness of the presented model. Based on the verified model, the stress distribution of different tissues are analyzed. Finally, the clinical tests are performed to observe and verify that the anatomical splint is the best fit for human body. Using the three kinds of splints, the transferred bone stress focus on the distal radius and ulna, which is helpful to maintain the stability of fracture. Also the stress is accumulated in the distal radius which may be attributed to flexion position. Such stress distribution may be helpful to maintain the ulnar declination. By comparing the simulation results with the experimental observations, the anatomical splint has the best fitting to the limb, which can effectively avoid the local compression. The anatomical splint is the most effective for fixing and curing the fracture. The presented model can provide theoretical basis and technical guide for further investigating mechanism of distal radius fracture and clinical application of anatomical splint.

Round and Oval Window Anatomic Variability: Its Implication for the Vibroplasty Technique.

PubMed

Mancheño, Marta; Aristegui, Miguel; Sañudo, Jose Ramon

2017-06-01

The objective of this study is to evaluate the anatomical variability of round and oval window regions and its relationship with their closest structures, to determine its implication on the fitting and stabilization of the middle ear implant Vibrant Soundbridge. Variations of the anatomy of round and oval window regions were assessed in a total of 85 human dissected temporal bones. Afterward, we evaluated the adaptation and subsequent stabilization of the floating mass transducer (FMT) of the Vibrant Soundbridge in 67 cases in round window (RW) and in 22 cases in oval window (OW), and the influence that the variability of the different anatomical features examined had on this stabilization. We also assessed access and surgeon's view of the RW niche through the facial recess approach. Stabilization of the FMT in the RW was achieved in 53 (79%) of the 67 cases; we found that the less favorable anatomical conditions for stabilization were: membrane smaller than 1.5 mm, presence of a high jugular bulb and a narrow or very narrow RW niche. Frequently, two or more of these conditions happened simultaneously. In seven cases (22%) access to the RW through facial recess approach did not allow positioning the FMT in place. OW stabilization succeeded in 18 (82%) of the 22 cases. Round and oval window vibroplasty are difficult surgical techniques. To place the FMT directly on the OW may be easier as we do not have to drill the niche. In both regions there are some anatomical conditions that hinder fitting the FMT and even make it impossible. Once fitted, the main problem is to achieve good stabilization of the device.

Anatomical and Physiological Responses of Citrus Trees to Varying Boron Availability Are Dependent on Rootstock.

PubMed

Mesquita, Geisa L; Zambrosi, Fernando C B; Tanaka, Francisco A O; Boaretto, Rodrigo M; Quaggio, José A; Ribeiro, Rafael V; Mattos, Dirceu

2016-01-01

In Citrus, water, nutrient transport and thereby fruit production, are influenced among other factors, by the interaction between rootstock and boron (B) nutrition. This study aimed to investigate how B affects the anatomical structure of roots and leaves as well as leaf gas exchange in sweet orange trees grafted on two contrasting rootstocks in response to B supply. Plants grafted on Swingle citrumelo or Sunki mandarin were grown in a nutrient solution of varying B concentration (deficient, adequate, and excessive). Those grafted on Swingle were more tolerant to both B deficiency and toxicity than those on Sunki, as revealed by higher shoot and root growth. In addition, plants grafted on Sunki exhibited more severe anatomical and physiological damages under B deficiency, showing thickening of xylem cell walls and impairments in whole-plant leaf-specific hydraulic conductance and leaf CO2 assimilation. Our data revealed that trees grafted on Swingle sustain better growth under low B availablitlity in the root medium and still respond positively to increased B levels by combining higher B absorption and root growth as well as better organization of xylem vessels. Taken together, those traits improved water and B transport to the plant canopy. Under B toxicity, Swingle rootstock would also favor plant growth by reducing anatomical and ultrastructural damage to leaf tissue and improving water transport compared with plants grafted on Sunki. From a practical point of view, our results highlight that B management in citrus orchards shall take into account rootstock varieties, of which the Swingle rootstock was characterized by its performance on regulating anatomical and ultrastructural damages, improving water transport and limiting negative impacts of B stress conditions on plant growth.

Motion representation of the long fingers: a proposal for the definitions of new anatomical frames.

PubMed

Coupier, Jérôme; Moiseev, Fédor; Feipel, Véronique; Rooze, Marcel; Van Sint Jan, Serge

2014-04-11

Despite the availability of the International Society of Biomechanics (ISB) recommendations for the orientation of anatomical frames, no consensus exists about motion representations related to finger kinematics. This paper proposes novel anatomical frames for motion representation of the phalangeal segments of the long fingers. A three-dimensional model of a human forefinger was acquired from a non-pathological fresh-frozen hand. Medical imaging was used to collect phalangeal discrete positions. Data processing was performed using a customized software interface ("lhpFusionBox") to create a specimen-specific model and to reconstruct the discrete motion path. Five examiners virtually palpated two sets of landmarks. These markers were then used to build anatomical frames following two methods: a reference method following ISB recommendations and a newly-developed method based on the mean helical axis (HA). Motion representations were obtained and compared between examiners. Virtual palpation precision was around 1mm, which is comparable to results from the literature. The comparison of the two methods showed that the helical axis method seemed more reproducible between examiners especially for secondary, or accessory, motions. Computed Root Mean Square distances comparing methods showed that the ISB method displayed a variability 10 times higher than the HA method. The HA method seems to be suitable for finger motion representation using discrete positions from medical imaging. Further investigations are required before being able to use the methodology with continuous tracking of markers set on the subject's hand. Copyright © 2014 Elsevier Ltd. All rights reserved.

Analysis of the dynamic relationships between the lingual artery and lingual markers in patients with obstructive sleep apnea.

PubMed

Hou, Tie-ning; Shao, Jinyan; Wang, Gaofeng; Ren, Hong; Cheng, Bing

2013-09-01

To determine the relationships between the lingual artery and the lingual markers in tongue resting and extended positions in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) for the clinical application of functional tongue surgery. Computed tomography angiography (CTA) of the lingual artery was performed on 30 OSAHS patients using a 16-slice spiral CT scanner. The anatomical relationships between the lingual artery and the lingual markers were analyzed with the tongue in resting and extended positions using the CTA images. The course of the lingual artery resembled the configuration of the Big Dipper constellation when the tongue was in a resting position. When the tongue was in a full-extended position, the majority of the lingual artery moved forward and upward with the hyoid and formed a "√" fashion. The positions of the tip of the greater horn of the hyoid changed with the tongue positions. While the relationship between the main lingual artery and the tip of the greater horn of the hyoid, as well as the distances between bilateral lingual arteries, remained constant in both tongue positions. In conditions of dynamic tongue movement, the tip of the great horn of the hyoid and the lingual midline are constant anatomical markers to indicate the course of the lingual artery.

Intraoperative Localization of Tantalum Markers for Proton Beam Radiation of Choroidal Melanoma by an Opto-Electronic Navigation System: A Novel Technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Amstutz, Christoph A., E-mail: christoph.amstutz@usz.ch; Bechrakis, Nikolaos E.; Foerster, Michael H.

2012-03-15

Purpose: External beam proton radiation therapy has been used since 1975 to treat choroidal melanoma. For tumor location determination during proton radiation treatment, surgical tantalum clips are registered with image data. This report introduces the intraoperative application of an opto-electronic navigation system to determine with high precision the position of the tantalum markers and their spatial relationship to the tumor and anatomical landmarks. The application of the technique in the first 4 patients is described. Methods and Materials: A navigated reference base was attached noninvasively to the eye, and a navigated pointer device was used to record the spatial positionmore » of the tantalum markers, the tumor, and anatomical landmarks. Measurement accuracy was assessed on ex vivo porcine eye specimen by repetitive recording of the tantalum marker positions. The method was applied intraoperatively on 4 patients undergoing routine tantalum clip surgery. The spatial position information delivered by the navigation system was compared to the geometric data generated by the EYEPLAN software. Results: In the ex vivo experiments, the maximum repetition error was 0.34 mm. For the intraoperative application, the root mean square error of paired-points matching of the marker positions from the navigation system and from the EYEPLAN software was 0.701-1.25 mm. Conclusions: Navigation systems are a feasible tool for accurate localization of tantalum markers and anatomic landmarks. They can provide additional geometric information, and therefore have the potential to increase the reliability and accuracy of external beam proton radiation therapy for choroidal melanoma.« less

Automatic transperineal ultrasound probe positioning based on CT scan for image guided radiotherapy

NASA Astrophysics Data System (ADS)

Camps, S. M.; Verhaegen, F.; Paiva Fonesca, G.; de With, P. H. N.; Fontanarosa, D.

2017-03-01

Image interpretation is crucial during ultrasound image acquisition. A skilled operator is typically needed to verify if the correct anatomical structures are all visualized and with sufficient quality. The need for this operator is one of the major reasons why presently ultrasound is not widely used in radiotherapy workflows. To solve this issue, we introduce an algorithm that uses anatomical information derived from a CT scan to automatically provide the operator with a patient-specific ultrasound probe setup. The first application we investigated, for its relevance to radiotherapy, is 4D transperineal ultrasound image acquisition for prostate cancer patients. As initial test, the algorithm was applied on a CIRS multi-modality pelvic phantom. Probe setups were calculated in order to allow visualization of the prostate and adjacent edges of bladder and rectum, as clinically required. Five of the proposed setups were reproduced using a precision robotic arm and ultrasound volumes were acquired. A gel-filled probe cover was used to ensure proper acoustic coupling, while taking into account possible tilted positions of the probe with respect to the flat phantom surface. Visual inspection of the acquired volumes revealed that clinical requirements were fulfilled. Preliminary quantitative evaluation was also performed. The mean absolute distance (MAD) was calculated between actual anatomical structure positions and positions predicted by the CT-based algorithm. This resulted in a MAD of (2.8±0.4) mm for prostate, (2.5±0.6) mm for bladder and (2.8±0.6) mm for rectum. These results show that no significant systematic errors due to e.g. probe misplacement were introduced.

Sports injuries in an America's Cup yachting crew: A 4-year epidemiological study covering the 2007 challenge.

PubMed

Hadała, Michał; Barrios, Carlos

2009-05-01

The aim of this study was to describe the injuries sustained by an America's Cup crew during eight preparatory competitions of the 32nd America's Cup 2007 and the Louis Vuitton Cup (from October 2004 to June 2007). The anatomical location, type of injury, and mechanism of injury were recorded. The injuries were categorized based on each sailor's position on the boat according to three intensities of physical demands. The injury rates per sailor and per 1000 h of competition were determined. In total, 90 injuries were registered. The overall incidence was 10 injuries per 1000 competition hours. Overuse injuries accounted for 76.6% of all lesions. The most common anatomical location of injuries was the upper limb (36.6%), followed by the upper dorsal and cervical spine (34.4%). Frequency of injury was related to the sailor's position on the boat, being higher in the group with more demanding activities (grinder, bowman, and mastman). Most injuries (67%) were sustained by this group of sailors. The most common injuries in this group were muscle contractures of the quadratus lumborum (11), trapezius (8), and rhomboid (7). There were eight cases of elbow epicondylitis, four cases of tendinopathy of the supraspinous tendon, and three cases of tendinopathy of the biceps brachii. An America's Cup yachting crew is exposed to a high risk of overuse injuries, especially those sailors whose boat position involves high-intensity activity.

Comparative evaluation between anatomic and non-anatomic lateral ligament reconstruction techniques in the ankle joint: A computational study.

PubMed

Purevsuren, Tserenchimed; Batbaatar, Myagmarbayar; Khuyagbaatar, Batbayar; Kim, Kyungsoo; Kim, Yoon Hyuk

2018-03-12

Biomechanical studies have indicated that the conventional non-anatomic reconstruction techniques for lateral ankle sprain (LAS) tend to restrict subtalar joint motion compared to intact ankle joints. Excessive restriction in subtalar motion may lead to chronic pain, functional difficulties, and development of osteoarthritis. Therefore, various anatomic surgical techniques to reconstruct both the anterior talofibular and calcaneofibular ligaments have been introduced. In this study, ankle joint stability was evaluated using multibody computational ankle joint model to assess two new anatomic reconstruction and three popular non-anatomic reconstruction techniques. An LAS injury, three popular non-anatomic reconstruction models (Watson-Jones, Evans, and Chrisman-Snook), and two common types of anatomic reconstruction models were developed based on the intact ankle model. The stability of ankle in both talocrural and subtalar joint were evaluated under anterior drawer test (150 N anterior force), inversion test (3 Nm inversion moment), internal rotational test (3 Nm internal rotation moment), and the combined loading test (9 Nm inversion and internal moment as well as 1800 N compressive force). Our overall results show that the two anatomic reconstruction techniques were superior to the non-anatomic reconstruction techniques in stabilizing both talocrural and subtalar joints. Restricted subtalar joint motion, which mainly observed in Watson-Jones and Chrisman-Snook techniques, was not shown in the anatomical reconstructions. Evans technique was beneficial for subtalar joint as it does not restrict subtalar motion, though Evans technique was insufficient for restoring talocrural joint inversion. The anatomical reconstruction techniques best recovered ankle stability.

Multi-modal anatomical optical coherence tomography and CT for in vivo dynamic upper airway imaging

NASA Astrophysics Data System (ADS)

Balakrishnan, Santosh; Bu, Ruofei; Price, Hillel; Zdanski, Carlton; Oldenburg, Amy L.

2017-02-01

We describe a novel, multi-modal imaging protocol for validating quantitative dynamic airway imaging performed using anatomical Optical Coherence Tomography (aOCT). The aOCT system consists of a catheter-based aOCT probe that is deployed via a bronchoscope, while a programmable ventilator is used to control airway pressure. This setup is employed on the bed of a Siemens Biograph CT system capable of performing respiratory-gated acquisitions. In this arrangement the position of the aOCT catheter may be visualized with CT to aid in co-registration. Utilizing this setup we investigate multiple respiratory pressure parameters with aOCT, and respiratory-gated CT, on both ex vivo porcine trachea and live, anesthetized pigs. This acquisition protocol has enabled real-time measurement of airway deformation with simultaneous measurement of pressure under physiologically relevant static and dynamic conditions- inspiratory peak or peak positive airway pressures of 10-40 cm H2O, and 20-30 breaths per minute for dynamic studies. We subsequently compare the airway cross sectional areas (CSA) obtained from aOCT and CT, including the change in CSA at different stages of the breathing cycle for dynamic studies, and the CSA at different peak positive airway pressures for static studies. This approach has allowed us to improve our acquisition methodology and to validate aOCT measurements of the dynamic airway for the first time. We believe that this protocol will prove invaluable for aOCT system development and greatly facilitate translation of OCT systems for airway imaging into the clinical setting.

Attained height, sex, and risk of cancer at different anatomic sites in the NIH-AARP diet and health study.

PubMed

Kabat, Geoffrey C; Kim, Mimi Y; Hollenbeck, Albert R; Rohan, Thomas E

2014-12-01

To examine the association of adult height with risk of cancer at different anatomic sites in a cohort of men and women. The association of self-reported height with subsequent cancer risk was assessed in 288,683 men and 192,514 women enrolled in the National Institutes of Health-AARP Diet and Health Study. After a median follow-up of 10.5 years, incident cancer was diagnosed in 51,139 men and 23,407 women. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) for the association of height with cancer risk. After adjustment for covariates, height was positively associated with increased risk of all cancers combined in both men [HR10 cm increase = 1.05 (95 % CI 1.04-1.06)] and women [HR10 cm increase = 1.08 (95 % CI 1.06-1.10)]. Several sites common to men and women showed significant positive associations with height: colon, rectum, kidney, melanoma, and non-Hodgkin's lymphoma. For other shared sites, the association differed by sex. For still other sites, there was no clear association with height. Positive associations were also observed with cancers of the breast, endometrium, and prostate. Different patterns were observed in the height-cancer association by sex. Studies investigating the biological mechanisms underlying the association of height with cancer risk should focus on those sites that show a reproducible association with attained height.

Reanalyzing the "far medial" (transcondylar-transtubercular) approach based on three anatomical vectors: the ventral posterolateral corridor.

PubMed

Chakravarthi, Srikant; Monroy-Sosa, Alejandro; Gonen, Lior; Fukui, Melanie; Rovin, Richard; Kojis, Nathaniel; Lindsay, Mark; Khalili, Sammy; Celix, Juanita; Corsten, Martin; Kassam, Amin B

2018-06-01

Endoscopic endonasal access to the jugular foramen and occipital condyle - the transcondylar-transtubercular approach - is anatomically complex and requires detailed knowledge of the relative position of critical neurovascular structures, in order to avoid inadvertent injury and resultant complications. However, access to this region can be confusing as the orientation and relationships of osseous, vascular, and neural structures are very much different from traditional dorsal approaches. This review aims at providing an organizational construct for a more understandable framework in accessing the transcondylar-transtubercular window. The region can be conceptualized using a three-vector coordinate system: vector 1 represents a dorsal or ventral corridor, vector 2 represents the outer and inner circumferential anatomical limits; in an "onion-skin" fashion, key osseous, vascular, and neural landmarks are organized based on a 360-degree skull base model, and vector 3 represents the final core or target of the surgical corridor. The creation of an organized "global-positioning system" may better guide the surgeon in accessing the far-medial transcondylar-transtubercular region, and related pathologies, and help understand the surgical limits to the occipital condyle and jugular foramen - the ventral posterolateral corridor - via the endoscopic endonasal approach.

Decreased long- and short-range functional connectivity at rest in drug-naive major depressive disorder.

PubMed

Guo, Wenbin; Liu, Feng; Chen, Jindong; Wu, Renrong; Zhang, Zhikun; Yu, Miaoyu; Xue, Zhimin; Zhao, Jingping

2016-08-01

Abnormal functional connectivity has been observed in major depressive disorder. Anatomical distance may affect functional connectivity in patients with major depressive disorder. However, whether and how anatomical distance affects functional connectivity at rest remains unclear in drug-naive patients with major depressive disorder. Forty-four patients with major depressive disorder, as well as 44 age-, sex- and education-matched healthy controls, underwent resting-state functional magnetic resonance imaging scanning. Regional functional connectivity strength was calculated for each voxel in the whole brain, which was further divided into short- and long-range functional connectivity strength. The patients showed decreased long-range positive functional connectivity strength in the right inferior parietal lobule, as well as decreased short-range positive functional connectivity strength in the right insula and right superior temporal gyrus relative to those of the controls. No significant correlations existed between abnormal functional connectivity strength and the clinical variables of the patients. The findings revealed that anatomical distance decreases long- and short-range functional connectivity strength in patients with major depressive disorder, which may underlie the neurobiology of major depressive disorder. © The Royal Australian and New Zealand College of Psychiatrists 2015.

The effects of ethanol on insulin-like growth factor-I immunoreactive neurons in the central nervous system.

PubMed

Dalcik, Cannur; Yildirim, Guler K; Dalcik, Hakki

2009-08-01

To evaluate the effect of chronically ethanol treatment on insulin-like growth factor-I (IGF-I) synthesis in various adult brain regions using immunocytochemistry. We performed this study at the Faculty of Medicine, Kocaeli University, Kocaeli, Turkey from March 2006 to October 2007. The vascular perfusion was utilized to fix the adult rat brains (10 for each group). After applying the routine histological techniques, the tissues were embedded in the paraffin. The immunohistochemical protocol was applied to the 10 um thick sections and the expression of IGF-I positive cells were observed in the neuro-anatomic areas. The distribution of IGF-I immunoreactive cells differed between the layers of the normal cerebral cortex and in the thalamic areas. In the alcoholic brain, the amount of IGF-I immunoreactive cells were decreased compared to the similar neuro-anatomical areas examined in the normal brains. The presence of IGF-I immunoreactivity in the neurons of the various neuro-anatomic areas demonstrates clearly that, these particular neurons are active in IGF-I synthesis. The decrease in the immunoreactivity of IGF-I in the chronically ethanol treated adult rat brain areas, show clearly that, ethanol effects negatively on the IGF-I synthesis.

Anatomical departments in Bavaria and the corpses of executed victims of National Socialism.

PubMed

Noack, Thorsten

2012-06-01

While it is known that the bodies of executed victims of National Socialism (NS) were used for anatomical research and teaching, detailed studies are still missing for many anatomical departments. This analysis focuses on the institutes in Bavaria. From 1933 on the institutes of Munich, Würzburg and Erlangen were actively involved in and competed over the procurement of bodies of NS victims, particularly between 1937 and 1941. While the body supply was sufficient thereafter it became again critical in the first years after the war. During that period, anatomists complained about a lack of bodies for dissection courses and tended to use the corpses remaining from the NS-period for teaching purposes. Their position was supported by the popular view that resistance fighters were seen as traitors to the Fatherland and not as honorable political victims. At the same time, relatives and aid organizations were in search of the dead victims of German terror. These conflicting interests created a situation full of tension, in which Philipp Auerbach, state commissioner for religious, political and racial victims of the Nazis in Bavaria, played a crucial role. Copyright © 2012 Elsevier GmbH. All rights reserved.

Patient specific anatomy: the new area of anatomy based on computer science illustrated on liver.

PubMed

Soler, Luc; Mutter, Didier; Pessaux, Patrick; Marescaux, Jacques

2015-01-01

Over the past century, medical imaging has brought a new revolution: internal anatomy of a patient could be seen without any invasive technique. This revolution has highlighted the two main limits of current anatomy: the anatomical description is physician dependent, and the average anatomy is more and more frequently insufficient to describe anatomical variations. These drawbacks can sometimes be so important that they create mistakes but they can be overcome through the use of 3D patient-specific surgical anatomy. In this article, we propose to illustrate such improvement of standard anatomy on liver. We first propose a general scheme allowing to easily compare the four main liver anatomical descriptions by Takasaki, Goldsmith and Woodburne, Bismuth and Couinaud. From this general scheme we propose four rules to apply in order to correct these initial anatomical definitions. Application of these rules allows to correct usual vascular topological mistakes of standard anatomy. We finally validate such correction on a database of 20 clinical cases compared to the 111 clinical cases of a Couinaud article. Out of the 20 images of the database, we note a revealing difference in 14 cases (70%) on at least one important branch of the portal network. Only six cases (30%) do not present a revealing difference between both labellings. We also show that the right portal fissure location on our 20 cases defined between segment V and VI of our anatomical definition is well correlated with the real position described by Couinaud on 111 cases, knowing that the theoretical position was only found in 46 cases out of 111, i.e., 41.44% of cases with the non-corrected Couinaud definition. We have proposed a new anatomical segmentation of the liver based on four main rules to apply in order to correct topological errors of the four main standard segmentations. Our validation clearly illustrates that this new definition corrects the large amount of mistakes created by the current standard definitions, increased by physician interpretation that can vary from one case to another.

Patient specific anatomy: the new area of anatomy based on computer science illustrated on liver

PubMed Central

Mutter, Didier; Pessaux, Patrick; Marescaux, Jacques

2015-01-01

Background Over the past century, medical imaging has brought a new revolution: internal anatomy of a patient could be seen without any invasive technique. This revolution has highlighted the two main limits of current anatomy: the anatomical description is physician dependent, and the average anatomy is more and more frequently insufficient to describe anatomical variations. These drawbacks can sometimes be so important that they create mistakes but they can be overcome through the use of 3D patient-specific surgical anatomy. Methods In this article, we propose to illustrate such improvement of standard anatomy on liver. We first propose a general scheme allowing to easily compare the four main liver anatomical descriptions by Takasaki, Goldsmith and Woodburne, Bismuth and Couinaud. From this general scheme we propose four rules to apply in order to correct these initial anatomical definitions. Application of these rules allows to correct usual vascular topological mistakes of standard anatomy. We finally validate such correction on a database of 20 clinical cases compared to the 111 clinical cases of a Couinaud article. Results Out of the 20 images of the database, we note a revealing difference in 14 cases (70%) on at least one important branch of the portal network. Only six cases (30%) do not present a revealing difference between both labellings. We also show that the right portal fissure location on our 20 cases defined between segment V and VI of our anatomical definition is well correlated with the real position described by Couinaud on 111 cases, knowing that the theoretical position was only found in 46 cases out of 111, i.e., 41.44% of cases with the non-corrected Couinaud definition. Conclusions We have proposed a new anatomical segmentation of the liver based on four main rules to apply in order to correct topological errors of the four main standard segmentations. Our validation clearly illustrates that this new definition corrects the large amount of mistakes created by the current standard definitions, increased by physician interpretation that can vary from one case to another. PMID:29075611

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.

MRI analysis of tibial PCL attachment in a large population of adult patients: reference data for anatomic PCL reconstruction.

PubMed

Teng, Yuanjun; Guo, Laiwei; Wu, Meng; Xu, Tianen; Zhao, Lianggong; Jiang, Jin; Sheng, Xiaoyun; Xu, Lihu; Zhang, Bo; Ding, Ning; Xia, Yayi

2016-09-05

Consistent reference data used for anatomic posterior cruciate ligament (PCL) reconstruction is not well defined. Quantitative guidelines defining the location of PCL attachment would aid in performing anatomic PCL reconstruction. The purpose was to characterize anatomic parameters of the PCL tibial attachment based on magnetic resonance imaging (MRI) in a large population of adult knees. The PCL tibial attachment site was examined in 736 adult knees with an intact PCL using 3.0-T proton density-weighted sagittal MRI. The outcomes measured were the anterior-posterior diameter (APD) of the tibial plateau; angle between the tibial plateau and the posterior tibial 'shelf' (the slope where the PCL tibial attachment site was) (PTS); length of the PTS; proximal, central, and distal PCL attachment positions as well as the width of the PCL attachment site; and vertical dimension of the PCL attachment site inferior from the tibial plateau. The average APD of the tibia plateau was 33.6 ± 3.5 mm, yielding significant differences between males (35.5 ± 3.0 mm) and females (31.6 ± 2.7 mm), P <.05, and there was a significantly decreasing trend with increasing age in males (P <.05). Mean angle between the tibial plateau and the PTS was 122.4° ± 8.1°, and subgroup analysis showed that the young group had a differently smaller angle (120.9° ± 7.5°) than the middle-aged (123.7° ± 8.2°) and the old (123.4° ± 7.7°) in males population, while there were no significant differences between sexes (P >.05). The proximal, central positions and width of the PCL attachment site were 13.4 ± 3.0 mm, 17.8 ± 3.0 mm and 9.6 ± 2.4 mm along the PTS, with significant differences between males and females (P <.05), and accounted for 60.0 % ± 9.1 %, 80.0 % ± 4.6 % and 43.3 % ± 9.7 % of the PTS respectively, with no significant differences between sexes and among age groups (all P >.05). This study provides reference data of the tibial PCL attachment based on MRI in the sagittal orientation. In analysis of retrospective data from a large population of adult patients, the quantitative values can be used as references to define the inserted angle and depth of the drill guide, and the exact position and size of the tibial PCL tunnel for performing arthroscopic anatomic PCL reconstruction.

Dynamic Computed Tomography Angiography: Role in the Evaluation of Popliteal Artery Entrapment Syndrome

DOE Office of Scientific and Technical Information (OSTI.GOV)

Anil, Gopinathan, E-mail: ivyanil10@gmail.com; Tay, Kiang-Hiong; Howe, Tse-Chiang

2011-04-15

This study reviews our experience with dynamic computed tomographic angiography (CTA) as an imaging modality in the evaluation of popliteal artery entrapment syndrome (PAES). Eight patients with surgically proven PAES were included in this study. Dynamic CTA studies performed with the feet in neutral and plantar flexed positions were reviewed for the detailed anatomy of the region and to define the location and extent of the stenosis, occlusions and collateral circulation. These findings were compared with intraoperative observations. CTA provided adequate angiographic and anatomic information required to arrive at the diagnosis and make a surgical decision. Thirteen limbs were affectedmore » in eight patients. There was popliteal artery occlusion in four limbs, stenosis at rest that was accentuated on stress imaging in two limbs, and patent popliteal artery with marked stenosis on stress imaging in seven limbs. Long-segment stenosis was seen in functional entrapment compared to short-segment stenosis in anatomic PAES. Anteroposterior compression of the popliteal artery in anatomic PAES unlike the side-to-side compression in functional PAES was a unique observation in this study. The CTA and surgical characterisation and classification of PAES matched in all the patients, except for misinterpretation of compressing fibrous bands as accessory slips of muscles in three limbs. In conclusion, dynamic CTA is a robust diagnostic tool that provides clinically relevant information and serves as a rapidly performed and easily available 'one-stop-shop' imaging modality in the management of PAES.« less

Correlation among ultrasound, cross-sectional anatomy, and histology of the sciatic nerve: a review.

PubMed

Moayeri, Nizar; van Geffen, Geert J; Bruhn, Jörgen; Chan, Vincent W; Groen, Gerbrand J

2010-01-01

Efficient identification of the sciatic nerve (SN) requires a thorough knowledge of its topography in relation to the surrounding structures. Anatomic cross sections in similar oblique planes as observed during SN ultrasonography are lacking. A survey of sonoanatomy matched with ultrasound views of the major SN block sites will be helpful in pattern recognition, especially when combined with images that show the internal architecture of the nerve. From 1 cadaver, consecutive parts of the upper leg corresponding to the 4 major blocks sites were sectioned and deeply frozen. Using cryomicrotomy, consecutive transverse sections were acquired and photographed at 78-microm intervals, along with histologic sections at 5-mm intervals. Multiplanar reformatting was done to reconstruct the optimal planes for an accurate comparison of ultrasonography and gross anatomy. The anatomic and histologic images were matched with ultrasound images that were obtained from 2 healthy volunteers. By simulating the exact position and angulation as in the ultrasonographic images, detailed anatomic overviews of SN and adjacent structures were reconstructed in the gluteal, subgluteal, midfemoral, and popliteal regions. Throughout its trajectory, SN contains numerous fascicles with connective and adipose tissues. In this study, we provide an optimal matching between histology, anatomic cross sections, and short-axis ultrasound images of SN. Reconstructing ultrasonographic planes with this high-resolution digitized anatomy not only enables an overview but also shows detailed views of the architecture of internal SN. The undulating course of the nerve fascicles within SN may explain its varying echogenic appearance during probe manipulation.

Interlead distance and left ventricular lead electrical delay predict reverse remodeling during cardiac resynchronization therapy.

PubMed

Merchant, Faisal M; Heist, E Kevin; Nandigam, K Veena; Mulligan, Lawrence J; Blendea, Dan; Riedl, Lindsay; McCarty, David; Orencole, Mary; Picard, Michael H; Ruskin, Jeremy N; Singh, Jagmeet P

2010-05-01

Both anatomic interlead separation and left ventricle lead electrical delay (LVLED) have been associated with outcomes following cardiac resynchronization therapy (CRT). However, the relationship between interlead distance and electrical delay in predicting CRT outcomes has not been defined. We studied 61 consecutive patients undergoing CRT for standard clinical indications. All patients underwent intraprocedural measurement of LVLED. Interlead distances in the horizontal (HD), vertical (VD), and direct (DD) dimensions were measured from postprocedure chest radiographs (CXR). Remodeling indices [percent change in left ventricle (LV) ejection fraction, end-diastolic, end-systolic dimensions] were assessed by transthoracic echocardiogram. There was a positive correlation between corrected LVLED and HD on lateral CXR (r = 0.361, P = 0.004) and a negative correlation between LVLED and VD on posteroanterior (PA) CXR (r =-0.281, P = 0.028). To account for this inverse relationship, we developed a composite anatomic distance (defined as: lateral HD-PA VD), which correlated most closely with LVLED (r = 0.404, P = 0.001). Follow-up was available for 48 patients. At a mean of 4.1 +/- 3.2 months, patients with optimal values for both corrected LVLED (>or=75%) and composite anatomic distance (>or=15 cm) demonstrated greater reverse LV remodeling than patients with either one or neither of these optimized values. We identified a significant correlation between LV-right ventricular interlead distance and LVLED; additionally, both parameters act synergistically in predicting LV anatomic reverse remodeling. Efforts to optimize both interlead distance and electrical delay may improve CRT outcomes.

Macroscopic anatomy of the heart of the ringed seal (Phoca hispida).

PubMed

Smodlaka, H; Henry, R W; Schumacher, J; Reed, R B

2008-02-01

Anatomical properties of the ringed seal (Phoca hispida) heart and associated blood vessels reveal adaptations related to requirements for diving. Seven adult ringed seals were embalmed and dissected to document the gross anatomical features of the heart. Computed tomography images of the thoracic cavity were taken on one seal prior to dissection. The shape and position of the heart is different from the typical carnivore heart. The most notable difference is its dorsoventral flattened appearance with its right and left sides positioned, respectively, within the thoracic cavity. The long axis of the heart is positioned horizontally, parallel to the sternum. The right ventricle is spacious with thin walls which extend caudally to the apex of the heart such that the apex is comprised of both right and left ventricles. The cusps of the left atrioventricular valve of the ringed seal heart resemble an uninterrupted, circular curtain making it challenging to distinguish the divisions into parietal and septal cusps.

Catheter tracking using continuous radial MRI.

PubMed

Rasche, V; Holz, D; Köhler, J; Proksa, R; Röschmann, P

1997-06-01

The guidance of minimally invasive procedures may become a very important future application of MRI. The guidance of interventions requires images of the anatomy as well as the information of the position of invasive devices used. This paper introduces continuous radial MRI for the simultaneous acquisition of the anatomic MR image and the position of one or more small RF-coils (mu-coils), which can be mounted on invasive devices such as catheters or biopsy needles. This approach allows the in-plane tracking of an invasive device without any prolongation of the overall acquisition time. The extension to three-dimensional position tracking is described. Phantom studies are presented demonstrating the capability of this technique for real-time automatic adjustment of the slice position to the current catheter position with a temporal resolution of 100 ms. Simultaneously the in-plane catheter position is depicted in the actually acquired MR image during continuous scanning.

A Bayesian approach to the creation of a study-customized neonatal brain atlas

PubMed Central

Zhang, Yajing; Chang, Linda; Ceritoglu, Can; Skranes, Jon; Ernst, Thomas; Mori, Susumu; Miller, Michael I.; Oishi, Kenichi

2014-01-01

Atlas-based image analysis (ABA), in which an anatomical “parcellation map” is used for parcel-by-parcel image quantification, is widely used to analyze anatomical and functional changes related to brain development, aging, and various diseases. The parcellation maps are often created based on common MRI templates, which allow users to transform the template to target images, or vice versa, to perform parcel-by-parcel statistics, and report the scientific findings based on common anatomical parcels. The use of a study-specific template, which represents the anatomical features of the study population better than common templates, is preferable for accurate anatomical labeling; however, the creation of a parcellation map for a study-specific template is extremely labor intensive, and the definitions of anatomical boundaries are not necessarily compatible with those of the common template. In this study, we employed a Volume-based Template Estimation (VTE) method to create a neonatal brain template customized to a study population, while keeping the anatomical parcellation identical to that of a common MRI atlas. The VTE was used to morph the standardized parcellation map of the JHU-neonate-SS atlas to capture the anatomical features of a study population. The resultant “study-customized” T1-weighted and diffusion tensor imaging (DTI) template, with three-dimensional anatomical parcellation that defined 122 brain regions, was compared with the JHU-neonate-SS atlas, in terms of the registration accuracy. A pronounced increase in the accuracy of cortical parcellation and superior tensor alignment were observed when the customized template was used. With the customized atlas-based analysis, the fractional anisotropy (FA) detected closely approximated the manual measurements. This tool provides a solution for achieving normalization-based measurements with increased accuracy, while reporting scientific findings in a consistent framework. PMID:25026155

Automated anatomical description of pleural thickening towards improvement of its computer-assisted diagnosis

NASA Astrophysics Data System (ADS)

Chaisaowong, Kraisorn; Jiang, Mingze; Faltin, Peter; Merhof, Dorit; Eisenhawer, Christian; Gube, Monika; Kraus, Thomas

2016-03-01

Pleural thickenings are caused by asbestos exposure and may evolve into malignant pleural mesothelioma. An early diagnosis plays a key role towards an early treatment and an increased survival rate. Today, pleural thickenings are detected by visual inspection of CT data, which is time-consuming and underlies the physician's subjective judgment. A computer-assisted diagnosis system to automatically assess pleural thickenings has been developed, which includes not only a quantitative assessment with respect to size and location, but also enhances this information with an anatomical description, i.e. lung side (left, right), part of pleura (pars costalis, mediastinalis, diaphragmatica, spinalis), as well as vertical (upper, middle, lower) and horizontal (ventral, dorsal) position. For this purpose, a 3D anatomical model of the lung surface has been manually constructed as a 3D atlas. Three registration sub-steps including rigid, affine, and nonrigid registration align the input patient lung to the 3D anatomical atlas model of the lung surface. Finally, each detected pleural thickening is assigned a set of labels describing its anatomical properties. Through this added information, an enhancement to the existing computer-assisted diagnosis system is presented in order to assure a higher precision and reproducible assessment of pleural thickenings, aiming at the diagnosis of the pleural mesothelioma in its early stage.

Anatomical terminology, then and now.

PubMed

O'Rahilly, R

1989-01-01

Anatomical terminology, which had become chaotic by the nineteenth century, was codified in the BNA of 1895, when some 5,000 terms were carefully selected from among approximately 50,000 names. The BNA and its three major revisions (BR, INA, PNA) are here reviewed and placed in historical perspective. It is emphasized that many anatomical terms are very ancient and that the various nomenclatures are not 'new terminologies' but rather, for the most part, selections of already existing names. This can be seen clearly in the naming of the cranial nerves. Another example, the carpal and tarsal bones, is analysed in detail. Of the 8 carpal bones, for instance, the current names for 7 of them are those proposed by Henle in 1855. All the nomenclatures are, as they should be, in Latin, but it is understood that translations of many terms into other languages are necessary. Although views pro and con have been expressed, current usage favours the erect posture and the anatomical position as a basis, as well as the elimination of eponyms. In both teaching and research, the Nomina has been of great benefit in reducing drastically the number of unnecessary synonyms and in providing a coherent, internationally accepted system that is now the standard in anatomical textbooks. Hence, further use of the Nomina should be encouraged.

Does the Position of the Aorta Change With the Altered Body Position in Ankylosing Spondylitis Patients With Thoracolumbar Kyphosis?: A Magnetic Resonance Imaging Investigation.

PubMed

Qu, Zhe; Bang-Ping, Qian; Qiu, Yong; Shi, Ben-Long; Ji, Ming-Liang; Wang, Bin; Yu, Yang; Zhu, Ze-Zhang

2017-08-01

A prospective magnetic resonance imaging study. To quantitatively explore the differences in the anatomic position of the aorta relative to the spine between supine and prone positions in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis. Aortic complications may occur during the lumbar spine osteotomy in correcting thoracolumbar kyphosis secondary to AS, and a clear understanding of the spatial relationship between the aorta and the vertebrae is essential to prevent these iatrogenic complications. However, previous anatomic study was performed with AS patients in the supine position, which was different from the prone position adopted in surgery. To date, no report has been published to investigate the mobility of the aorta relative to the vertebrae between supine and prone positions in AS patients with thoracolumbar kyphosis. From March 2013 to September 2014, 22 AS patients (21 males, 1 female) with thoracolumbar kyphosis with a mean age of 30.7 years (range, 19-46 y) were recruited. Magnetic resonance imaging examinations from T9 to L3 in both the supine and prone positions were performed, and the left pedicle-aorta (LtP-Ao) angle and LtP-Ao distance were measured at each level. The differences of these parameters between the 2 positions were compared by the paired sample t test, and the relationships between the shifting of the aorta and the change of global kyphosis and lumbar lordosis were evaluated by the Pearson correlation coefficient. The level of significance (α) was set at 0.05. At T9-L3 levels, no significant difference was noted in LtP-Ao distances (43.78 vs. 44.42 mm; P=0.077) and LtP-Ao angles (0.82 vs. 0.22 degrees; P=0.053) between supine and prone positions. The correlation analysis also revealed no remarkable correlation between the change of LtP-Ao angle and increase of global kyphosis and lumbar lordosis in the prone position. There is no significant change of the relative positions between the aorta and the vertebrae at T9-L3 levels after the patient turned to a prone position, which implied that the mobility and range of motion of the aorta is limited in advanced stage of AS.

Anatomical sciences: A foundation for a solid learning experience in dental technology and dental prosthetics.

PubMed

Bakr, Mahmoud M; Thompson, C Mark; Massadiq, Magdalena

2017-07-01

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 10: 395-404. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

Outcomes of total knee arthroplasty in relation to preoperative patient-reported and radiographic measures: data from the osteoarthritis initiative.

PubMed

Kahn, Timothy L; Soheili, Aydin; Schwarzkopf, Ran

2013-12-01

Total knee arthroplasty (TKA) is the preferred surgical treatment for end-stage osteoarthritis. However, substantial numbers of patients still experience poor outcomes. Consequently, it is important to identify which patient characteristics are predictive of outcomes in order to guide clinical decisions. Our hypothesis is that preoperative patient-reported outcome measures and radiographic measures may help to predict TKA outcomes. Using cohort data from the Osteoarthritis Initiative, we studied 172 patients who underwent TKA. For each patient, we compiled pre- and postoperative Western Ontario and McMaster University Arthritis Index (WOMAC) scores. Radiographs were measured for knee joint angles, femorotibial angles, anatomical lateral distal femoral angles, and anatomical medial proximal tibial angles; Kellgren and Lawrence (KL) grades were assigned to each compartment of the knee. All studied measurements were compared to WOMAC outcomes. Preoperative WOMAC disability, pain, and total scores were positively associated with postoperative WOMAC total scores (P = .010, P = .010, and P = .009, respectively) and were associated with improvement in WOMAC total scores (P < .001, P < .001, and P < .001, respectively). For radiographic measurements, preoperative joint angles were positively associated with improvements in postoperative WOMAC total scores (P = .044). Combined KL grades (medial and lateral compartments) were negatively correlated with postoperative WOMAC disability and pain scores (P = .045 and P = .044) and were positively correlated with improvements in WOMAC total scores (P = .001). All preoperative WOMAC scores demonstrated positive associations with postoperative WOMAC scores, while among the preoperative radiographic measurements only combined KL grades and joint angles showed any correlation with postoperative WOMAC scores. Higher preoperative KL grades and joint angles were associated with better (lower) postoperative WOMAC scores, demonstrating an inverse correlation.

Arthroscopy Up to Date: Anterior Cruciate Ligament Anatomy.

PubMed

Schillhammer, Carl K; Reid, John B; Rister, Jamie; Jani, Sunil S; Marvil, Sean C; Chen, Austin W; Anderson, Chris G; D'Agostino, Sophia; Lubowitz, James H

2016-01-01

To categorize and summarize up-to-date anterior cruciate ligament (ACL) research published in Arthroscopy and The American Journal of Sports Medicine and systematically review each subcategory, beginning with ACL anatomy. After searching for "anterior cruciate ligament" OR "ACL" in Arthroscopy and The American Journal of Sports Medicine from January 2012 through December 2014, we excluded articles more pertinent to ACL augmentation; open growth plates; and meniscal, chondral, or multiligamentous pathology. Studies were subcategorized for data extraction. We included 212 studies that were classified into 8 categories: anatomy; basic science and biomechanics; tunnel position; graft selection; graft fixation; injury risk and rehabilitation; practice patterns and outcomes; and complications. Anatomic risk factors for ACL injury and post-reconstruction graft failure include a narrow intercondylar notch, low native ACL volume, and increased posterior slope. Regarding anatomic footprints, the femoral attachment is 43% of the proximal-to-distal lateral femoral condylar length whereas the posterior border of the tendon is 2.5 mm from the articular margin. The tibial attachment of the ACL is two-fifths of the medial-to-lateral interspinous distance and 15 mm anterior to the posterior cruciate ligament. Anatomic research using radiology and computed tomography to evaluate ACL graft placement shows poor interobserver and intraobserver reliability. With a mind to improving outcomes, surgeons should be aware of anatomic risk factors (stenotic femoral notch, low ligament volume, and increased posterior slope) for ACL graft failure, have a precise understanding of arthroscopic landmarks identifying femoral and tibial footprint locations, and understand that imaging to evaluate graft placement is unreliable. Level III, systematic review of Level III evidence. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Preservation of three-dimensional anatomy in phosphatized fossil arthropods enriches evolutionary inference.

PubMed

Schwermann, Achim H; Dos Santos Rolo, Tomy; Caterino, Michael S; Bechly, Günter; Schmied, Heiko; Baumbach, Tilo; van de Kamp, Thomas

2016-02-05

External and internal morphological characters of extant and fossil organisms are crucial to establishing their systematic position, ecological role and evolutionary trends. The lack of internal characters and soft-tissue preservation in many arthropod fossils, however, impedes comprehensive phylogenetic analyses and species descriptions according to taxonomic standards for Recent organisms. We found well-preserved three-dimensional anatomy in mineralized arthropods from Paleogene fissure fillings and demonstrate the value of these fossils by utilizing digitally reconstructed anatomical structure of a hister beetle. The new anatomical data facilitate a refinement of the species diagnosis and allowed us to reject a previous hypothesis of close phylogenetic relationship to an extant congeneric species. Our findings suggest that mineralized fossils, even those of macroscopically poor preservation, constitute a rich but yet largely unexploited source of anatomical data for fossil arthropods.

[Parameters of cardiac muscle repolarization on the electrocardiogram when changing anatomical and electric position of the heart].

PubMed

Chaĭkovskiĭ, I A; Baum, O V; Popov, L A; Voloshin, V I; Budnik, N N; Frolov, Iu A; Kovalenko, A S

2014-01-01

While discussing the diagnostic value of the single channel electrocardiogram a set of theoretical considerations emerges inevitably, one of the most important among them is the question about dependence of the electrocardiogram parameters from the direction of electrical axis of heart. In other words, changes in what of electrocardiogram parameters are in fact liable to reflect pathological processes in myocardium, and what ones are determined by extracardiac factors, primarily by anatomic characteristics of patients. It is arguable that while analyzing electrocardiogram it is necessary to orient to such physiologically based informative indexes as ST segment displacement. Also, symmetry of the T wave shape is an important parameter which is independent of patients anatomic features. The results obtained are of interest for theoretical and applied aspects of the biophysics of the cardiac electric field.

Anatomical versus non-anatomical single bundle anterior cruciate ligament reconstruction: a cadaveric study of comparison of knee stability.

PubMed

Lim, Hong-Chul; Yoon, Yong-Cheol; Wang, Joon-Ho; Bae, Ji-Hoon

2012-12-01

The purpose of this study was to compare the initial stability of anatomical and non-anatomical single bundle anterior cruciate ligament (ACL) reconstruction and to determine which would better restore intact knee kinematics. Our hypothesis was that the initial stability of anatomical single bundle ACL reconstruction would be superior to that of non-anatomical single bundle ACL reconstruction. Anterior tibial translation (ATT) and internal rotation of the tibia were measured with a computer navigation system in seven pairs of fresh-frozen cadaveric knees under two testing conditions (manual maximum anterior force, and a manual maximum anterior force combined with an internal rotational force). Tests were performed at 0, 30, 60, and 90 degrees of flexion with the ACL intact, the ACL transected, and after reconstruction of one side of a pair with either anatomical or non-anatomical single bundle ACL reconstruction. Under manual maximal anterior force, both reconstruction techniques showed no significant difference of ATT when compared to ACL intact knee state at 30° of knee flexion (p > 0.05). Under the combined anterior and internal rotatory force, non-anatomical single-bundle ACL reconstruction showed significant difference of ATT compared to those in ACL intact group (p < 0.05). In contrast, central anatomical single bundle ACL reconstruction showed no significant difference of ATT compared to those in ACL intact group (p > 0.05). Internal rotation of the tibia showed no significant difference in the ACL intact, the ACL transected, non-anatomical reconstructed and anatomical reconstructed knees. Anatomical single bundle ACL reconstruction restored the initial stability closer to the native ACL under combined anterior and internal rotational forces when compared to non-anatomical ACL single bundle reconstruction.

Diversity of beta-papillomavirus at anogenital and oral anatomic sites of men: The HIM Study.

PubMed

Nunes, Emily Montosa; Sudenga, Staci L; Gheit, Tarik; Tommasino, Massimo; Baggio, Maria Luiza; Ferreira, Silvaneide; Galan, Lenice; Silva, Roberto C; Pierce Campbell, Christine M; Lazcano-Ponce, Eduardo; Giuliano, Anna R; Villa, Luisa L; Sichero, Laura

2016-08-01

Our goal was to describe prevalence of β-HPVs at three anatomic sites among 717 men from Brazil, Mexico and US enrolled in the HPV Infection in Men (HIM) Study. β-HPVs were genotyped using Luminex technology. Overall, 77.7%, 54.3% and 29.3% men were positive for any β-HPV at the genitals, anal canal, and oral cavity, respectively. Men from US and Brazil were significantly less likely to have β-HPV at the anal canal than men from Mexico. Older men were more likely to have β-HPV at the anal canal compared to younger men. Prevalence of β-HPV at the oral cavity was significantly associated with country of origin and age. Current smokers were significantly less likely to have β-HPV in the oral cavity than men who never smoked. Lack of associations between β-HPV and sexual behaviors may suggest other routes of contact such as autoinoculation which need to be explored further. Copyright © 2016 Elsevier Inc. All rights reserved.

Astragalar Morphology of Selected Giraffidae

PubMed Central

2016-01-01

The artiodactyl astragalus has been modified to exhibit two trochleae, creating a double pullied structure allowing for significant dorso-plantar motion, and limited mediolateral motion. The astragalus structure is partly influenced by environmental substrates, and correspondingly, morphometric studies can yield paleohabitat information. The present study establishes terminology and describes detailed morphological features on giraffid astragali. Each giraffid astragalus exhibits a unique combination of anatomical characteristics. The giraffid astragalar morphologies reinforce previously established phylogenetic relationships. We find that the enlargement of the navicular head is a feature shared by all giraffids, and that the primitive giraffids possess exceptionally tall astragalar heads in relation to the total astragalar height. The sivatheres and the okapi share a reduced notch on the lateral edge of the astragalus. We find that Samotherium is more primitive in astragalar morphologies than Palaeotragus, which is reinforced by tooth characteristics and ossicone position. Diagnostic anatomical characters on the astragalus allow for giraffid species identifications and a better understanding of Giraffidae. PMID:27028515

Significance of localization of mandibular foramen in an inferior alveolar nerve block.

PubMed

Thangavelu, K; Kannan, R; Kumar, N Senthil; Rethish, E; Sabitha, S; Sayeeganesh, N

2012-07-01

The mandibular foramen (MF) is an opening on the internal surface of the ramus for divisions of the mandibular vessels and nerve to pass. The aim of this study is to determine the position of the MF from various anatomical landmarks in several dry adult mandibles. A total of 102 human dry mandibles were examined, of which 93 were of dentulous and 9 were of edentulous. The measurements were taken from the anterior border of the ramus (coronoid notch) to the midportion of the MF and then from the midportion of the MF to the other landmarks such as internal oblique ridge, inferior border, sigmoid notch, and condyle were measured and recorded. The data were compared using Student's t-test. The MF is positioned at a mean distance of 19 mm (with SD 2.34) from coronoid notch of the anterior border of the ramus. Superio-inferiorly from the condyle to the inferior border MF is situated 5 mm inferior to the midpoint of condyle to the inferior border distance (ramus height). We conclude that failures in the anesthesia of the inferior alveolar nerve are due to the operator error and not due to the anatomical variation.

Multimodality localization of epileptic foci

NASA Astrophysics Data System (ADS)

Desco, Manuel; Pascau, Javier; Pozo, M. A.; Santos, Andres; Reig, Santiago; Gispert, Juan D.; Garcia-Barreno, Pedro

2001-05-01

This paper presents a multimodality approach for the localization of epileptic foci using PET, MRI and EEG combined without the need of external markers. Mutual Information algorithm is used for MRI-PET registration. Dipole coordinates (provided by BESA software) are projected onto the MRI using a specifically developed algorithm. The four anatomical references used for electrode positioning (nasion, inion and two preauricular points) are located on the MRI using a triplanar viewer combined with a surface-rendering tool. Geometric transformation using deformation of the ideal sphere used for dipole calculations is then applied to match the patient's brain size and shape. Eight treatment-refractory epileptic patients have been studied. The combination of the anatomical information from the MRI, hipoperfusion areas in PET and dipole position and orientation helped the physician in the diagnosis of epileptic focus location. Neurosurgery was not indicated for patients where PET and dipole results were inconsistent; in two cases it was clinically indicated despite the mismatch, showing a negative follow up. The multimodality approach presented does not require external markers for dipole projection onto the MRI, this being the main difference with previous methods. The proposed method may play an important role in the indication of surgery for treatment- refractory epileptic patients.

[Functional anatomy of the male continence mechanism].

PubMed

Schwalenberg, T; Neuhaus, J; Dartsch, M; Weissenfels, P; Löffler, S; Stolzenburg, J-U

2010-04-01

The basic structures and organs contributing to continence in men are far less well investigated than in women. This concerns anatomical and functional aspects as well. Especially the cooperation of single components and the dynamic anchoring in the pelvic floor require further investigation. An improved anatomical-functional interpretation is needed to generate therapeutic concepts orientated at the physiology of the bladder neck.Therefore, the focus of anatomical investigations should be on the external sphincter which is the main muscle responsible for urethral closure as well as on the connective tissue, smooth muscular and neuronal structures in the pelvis. The smooth muscular structures involved are the internal sphincter, the inner parts of the external sphincter, the urethral longitudinal musculature, and parts of the centrum perinei and of the ventral suspension apparatus which fixes the position of the bladder neck and seems to be vital for continence and initiation of micturition. These new findings imply an integral concept for men as was developed for women. A first step in this regard would be a consistent and updated anatomical nomenclature.

Spread of activation and deactivation in the brain: does age matter?

PubMed Central

Gordon, Brian A.; Tse, Chun-Yu; Gratton, Gabriele; Fabiani, Monica

2014-01-01

Cross-sectional aging functional MRI results are sometimes difficult to interpret, as standard measures of activation and deactivation may confound variations in signal amplitude and spread, which however, may be differentially affected by age-related changes in various anatomical and physiological factors. To disentangle these two types of measures, here we propose a novel method to obtain independent estimates of the peak amplitude and spread of the BOLD signal in areas activated (task-positive) and deactivated (task-negative) by a Sternberg task, in 14 younger and 28 older adults. The peak measures indicated that, compared to younger adults, older adults had increased activation of the task-positive network, but similar levels of deactivation in the task-negative network. Measures of signal spread revealed that older adults had an increased spread of activation in task-positive areas, but a starkly reduced spread of deactivation in task-negative areas. These effects were consistent across regions within each network. Further, there was greater variability in the anatomical localization of peak points in older adults, leading to reduced cross-subject overlap. These results reveal factors that may confound the interpretation of studies of aging. Additionally, spread measures may be linked to local connectivity phenomena and could be particularly useful to analyze age-related deactivation patterns, complementing the results obtained with standard peak and region of interest analyses. PMID:25360115

An evaluation of the use of oral contrast media in abdominopelvic CT.

PubMed

Buttigieg, Erica Lauren; Grima, Karen Borg; Cortis, Kelvin; Soler, Sandro Galea; Zarb, Francis

2014-11-01

To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdominopelvic CT examinations performed for follow-up general oncological indications. The objectives were to establish anatomical image quality criteria for abdominopelvic CT; use these criteria to evaluate and compare image quality using positive OCM, neutral OCM and no OCM; and evaluate possible benefits for the medical imaging department. Forty-six adult patients attending a follow-up abdominopelvic CT for general oncological indications and who had a previous abdominopelvic CT with positive OCM (n = 46) were recruited and prospectively placed into either the water (n = 25) or no OCM (n = 21) group. Three radiologists performed absolute visual grading analysis (VGA) to assess image quality by grading the fulfilment of 24 anatomical image quality criteria. Visual grading characteristics (VGC) analysis of the data showed comparable image quality with regards to reproduction of abdominal structures, bowel discrimination, presence of artefacts, and visualization of the amount of intra-abdominal fat for the three OCM protocols. All three OCM protocols provided similar image quality for follow-up abdominopelvic CT for general oncological indications. • Positive oral contrast media are routinely used for abdominopelvic multidetector computed tomography • Experimental study comparing image quality using three different oral contrast materials • Three different oral contrast materials result in comparable CT image quality • Benefits for patients and medical imaging department.

Post-operative 3D CT feedback improves accuracy and precision in the learning curve of anatomic ACL femoral tunnel placement.

PubMed

Sirleo, Luigi; Innocenti, Massimo; Innocenti, Matteo; Civinini, Roberto; Carulli, Christian; Matassi, Fabrizio

2018-02-01

To evaluate the feedback from post-operative three-dimensional computed tomography (3D-CT) on femoral tunnel placement in the learning process, to obtain an anatomic anterior cruciate ligament (ACL) reconstruction. A series of 60 consecutive patients undergoing primary ACL reconstruction using autologous hamstrings single-bundle outside-in technique were prospectively included in the study. ACL reconstructions were performed by the same trainee-surgeon during his learning phase of anatomic ACL femoral tunnel placement. A CT scan with dedicated tunnel study was performed in all patients within 48 h after surgery. The data obtained from the CT scan were processed into a three-dimensional surface model, and a true medial view of the lateral femoral condyle was used for the femoral tunnel placement analysis. Two independent examiners analysed the tunnel placements. The centre of femoral tunnel was measured using a quadrant method as described by Bernard and Hertel. The coordinates measured were compared with anatomic coordinates values described in the literature [deep-to-shallow distance (X-axis) 28.5%; high-to-low distance (Y-axis) 35.2%]. Tunnel placement was evaluated in terms of accuracy and precision. After each ACL reconstruction, results were shown to the surgeon to receive an instant feedback in order to achieve accurate correction and improve tunnel placement for the next surgery. Complications and arthroscopic time were also recorded. Results were divided into three consecutive series (1, 2, 3) of 20 patients each. A trend to placing femoral tunnel slightly shallow in deep-to-shallow distance and slightly high in high-to-low distance was observed in the first and the second series. A progressive improvement in tunnel position was recorded from the first to second series and from the second to the third series. Both accuracy (+52.4%) and precision (+55.7%) increased from the first to the third series (p < 0.001). Arthroscopic time decreased from a mean of 105 min in the first series to 57 min in the third series (p < 0.001). After 50 ACL reconstructions, a satisfactory anatomic femoral tunnel was reached. Feedback from post-operative 3D-CT is effective in the learning process to improve accuracy and precision of femoral tunnel placement in order to obtain anatomic ACL reconstruction and helps to reduce also arthroscopic time and learning curve. For clinical relevance, trainee-surgeons should use feedback from post-operative 3DCT to learn anatomic ACL femoral tunnel placement and apply it appropriately. Consecutive case series, Level IV.

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. (c) 2006 Wiley-Liss, Inc.

Clinical Outcomes of Retinal Detachment Surgery following Cytomegalovirus Retinitis in Patients on Highly Active Anti-retroviral Therapy for Acquired Immune Deficiency Syndrome.

PubMed

Mathur, Gaurav; Ratra, Dhanashree; Bhuibhar, Sagar Sudhakar; Roy, Rupak

2015-01-01

The objective of this study is to describe the surgical outcomes of patients of HIV on HAART who underwent surgery for CMV retinitis related retinal detachment. A retrospective analysis of the medical records of 40 eyes of 35 consecutive HIV positive patients who underwent surgical repair for CMV retinitis associated rhegmatogenous retinal detachment between January 2000 to August 2010 was done. All patients had an adequate follow up of atleast 6 months. Favourable anatomical outcome was achieved in 78 % of eyes with the eyes having a attached retina, clear media and controlled intraocular pressure.Favourable functional outcome (vision >3/60) was achieved in 56%. Though anatomical outcomes have not changed from the pre HAART era but there has been an increase in favorable functional outcomes possibly due to effects of antiretroviral therapy.

The effects of organic chromium on adipose anatomical parts, using pig as experimental model.

PubMed

Untea, A E; Varzaru, I; Ropota, M; Panaite, T D; Cornescu, G M

2016-01-01

The aim of this study was to evaluate the influence of chromium supplements on the quality of protein and lipids of adipose anatomical parts using pig as experimental modelfor humans. An experiment was conducted on 18 fattening castrated TOPIGS male pigs, for 4 weeks, under experimental farm conditions. The source of Cr(III) was chromium . picolinate, a food supplement used in human nutrition, 200 µg.Cr per kg diet (El) and 400 µg.Cr per kg diet (E2). The analytic.data showed an improvement of the amino acids profile in belly and in ham samples. A significant decrease of fatty acids concentrations in belly samples was noticed. In conclusion, we observed a positive effect associated with the essential amino acids deposition and decreasing of fatty acids concentrations in tissues with high content offat, thus in human nutrition, chromium is used as a nutritional supplement most recommended in impaired carbohydrate metabolism.

Position des lignes temporales sur le cranium de «Mrs » Ples (A.africanus) : une attribution sexuelle est-elle possible ?Possible position of the temporal lines on the cranium of 'Mrs' Ples (A. africanus): is sexual determination possible?

NASA Astrophysics Data System (ADS)

Prat, Sandrine; Thackeray, John Francis

2001-03-01

The cranium and associated matrix of Sts 5, a cranium of Australopithecus africanus is re-examined in the context of an unfused sagittal suture and the position of the temporal lines. These lines are not developed as a sagittal crest although they are close to the mid-sagittal line. A comparative study of the presence of sagittal crests in male, female, juvenile and adult specimens of extant great apes ( Gorilla, Pan, Pongo) suggests that the existence of a sagittal crest is influenced to a greater extent by anatomical age rather than by the sex of the individuals.

The mediodorsal thalamic nucleus and schizophrenia

PubMed Central

Alelú-Paz, Raúl; Giménez-Amaya, José Manuel

2008-01-01

The mediodorsal nucleus of the human thalamus is in a crucial position that allows it to establish connections with diverse cerebral structures, particularly the prefrontal cortex. The present review examines existing neurobiologic studies of the brains of people with and without schizophrenia that indicate a possible involvement of the mediodorsal nucleus in this psychiatric disorder. Studies at synaptic and cellular levels of the neurobiology of the mediodorsal nucleus, together with a better anatomic understanding of this diencephalic structure owing to neuroimaging studies, should help to establish a more deep and solid pathophysiologic model of schizophrenia. PMID:18982171

Vocal Tract Morphology in Inhaling Singing: An MRI-Based Study.

PubMed

Moerman, Mieke; Vanhecke, Françoise; Van Assche, Lieven; Vercruysse, Johan; Daemers, Kristin; Leman, Marc

2016-07-01

Inhaling singing is a recently developed singing technique explored by the soprano singer Françoise Vanhecke. It is based on an inspiratory airflow instead of an expiratory airflow. This article describes the anatomical structural differences of the vocal tract between inhaling and exhaling singing. We hypothesize that the vocal tract alters significantly in inhaling singing, especially concerning the configuration of the anatomical structures in the oral cavity and the subglottal region. This is a prospective study. A professional singer (F.V.) performed sustained tones from F5 chromatically rising up to Bb5 on the vowel /a/. Vocal tract anatomy is assessed by magnetic resonance imaging. Wilcoxon directional testing demonstrates (1) that the vocal tract volume above the glottal region does not differ statistically in contrast to the subglottal region and (2) significant changes in the configuration of the tongue, the upright position of the epiglottis, the length of the floor of mouth, and the distance between the teeth. The narrowing of the subglottis is considered to be secondary to suction forces used in the inhaling singing technique. The changes in the anatomical structures above the vocal folds possibly suggest a valve-like function controlling the air inlet together with the regulator function of the resonator capacities of the vocal tract. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

A Low-Cost Simulator for Training in Endoscopic-Assisted Transaxillary Dual-Plane Breast Augmentation.

PubMed

Wang, Chenglong; Chen, Lin; Mu, Dali; Xin, Minqiang; Luan, Jie

2017-12-01

Endoscopic-assisted transaxillary dual-plane (EATD) technique is a popular procedure for breast augmentation, especially for Chinese women. However, frustration is often expressed by plastic surgeons when first attempting EATD surgery. Simulation-based teaching is beneficial for EATD training, but it is expensive. This study presents a low-cost simulator to help plastic surgeons exercise psychomotor skills during EATD surgery. The low-cost simulator was invented by Dr Jie Luan (the senior author) and made of some easily available materials including a mannequin, a T-shirt printed the bottom anatomical structure of the chest, the order of dissection, and the potential bleeding spot, and an elastic compression garment printed the upper anatomical structure and the cut-off position to sever the pectoralis major muscle. The first-year residents of plastic surgery assessed their improvement by completing a 5-item evaluation questionnaire at the beginning and at the end of the simulation. Fifty participants enrolled in this study. There was a significant difference (P < 0.05) before and after the training regarding candidate confidence, anatomical awareness, and endoscope control including the dexterity and hand-to-eye coordination. The low-cost and simple maintenance simulator may help plastic surgeons, especially those in developing countries, to improve gradually their EATD breast augmentation skills with no risks in a way. Further randomized controlled trials are needed to test its validity and reliability.

The intertarsal joint of the ostrich (Struthio camelus): Anatomical examination and function of passive structures in locomotion

PubMed Central

Schaller, Nina U; Herkner, Bernd; Villa, Rikk; Aerts, Peter

2009-01-01

The ostrich (Struthio camelus) is the largest extant biped. Being flightless, it exhibits advanced cursorial abilities primarily evident in its characteristic speed and endurance. In addition to the active musculoskeletal complex, its powerful pelvic limbs incorporate passive structures wherein ligaments interact with joint surfaces, cartilage and other connective tissue in their course of motion. This arrangement may enable energy conservation by providing joint stabilisation, optimised limb segment orientation and automated positioning of ground contact elements independently of direct muscle control. The intertarsal joint is of particular interest considering its position near the mid-point of the extended limb and its exposure to high load during stance with significant inertial forces during swing phase. Functional-anatomical analysis of the dissected isolated joint describes the interaction of ligaments with intertarsal joint contours through the full motion cycle. Manual manipulation identified a passive engage-disengage mechanism (EDM) that establishes joint extension, provides bi-directional resistance prior to a transition point located at 115° and contributes to rapid intertarsal flexion at toe off and full extension prior to touch down. This effect was subsequently quantified by measurement of intertarsal joint moments in prepared anatomical specimens in a neutral horizontal position and axially-loaded vertical position. Correlation with kinematic analyses of walking and running ostriches confirms the contribution of the EDM in vivo. We hypothesise that the passive EDM operates in tandem with a stringently coupled multi-jointed muscle-tendon system to conserve the metabolic cost of locomotion in the ostrich, suggesting that a complete understanding of terrestrial locomotion across extinct and extant taxa must include functional consideration of the ligamentous system. PMID:19538629

Standard Anatomic Terminologies: Comparison for Use in a Health Information Exchange–Based Prior Computed Tomography (CT) Alerting System

PubMed Central

Lowry, Tina; Vreeman, Daniel J; Loo, George T; Delman, Bradley N; Thum, Frederick L; Slovis, Benjamin H; Shapiro, Jason S

2017-01-01

Background A health information exchange (HIE)–based prior computed tomography (CT) alerting system may reduce avoidable CT imaging by notifying ordering clinicians of prior relevant studies when a study is ordered. For maximal effectiveness, a system would alert not only for prior same CTs (exams mapped to the same code from an exam name terminology) but also for similar CTs (exams mapped to different exam name terminology codes but in the same anatomic region) and anatomically proximate CTs (exams in adjacent anatomic regions). Notification of previous same studies across an HIE requires mapping of local site CT codes to a standard terminology for exam names (such as Logical Observation Identifiers Names and Codes [LOINC]) to show that two studies with different local codes and descriptions are equivalent. Notifying of prior similar or proximate CTs requires an additional mapping of exam codes to anatomic regions, ideally coded by an anatomic terminology. Several anatomic terminologies exist, but no prior studies have evaluated how well they would support an alerting use case. Objective The aim of this study was to evaluate the fitness of five existing standard anatomic terminologies to support similar or proximate alerts of an HIE-based prior CT alerting system. Methods We compared five standard anatomic terminologies (Foundational Model of Anatomy, Systematized Nomenclature of Medicine Clinical Terms, RadLex, LOINC, and LOINC/Radiological Society of North America [RSNA] Radiology Playbook) to an anatomic framework created specifically for our use case (Simple ANatomic Ontology for Proximity or Similarity [SANOPS]), to determine whether the existing terminologies could support our use case without modification. On the basis of an assessment of optimal terminology features for our purpose, we developed an ordinal anatomic terminology utility classification. We mapped samples of 100 random and the 100 most frequent LOINC CT codes to anatomic regions in each terminology, assigned utility classes for each mapping, and statistically compared each terminology’s utility class rankings. We also constructed seven hypothetical alerting scenarios to illustrate the terminologies’ differences. Results Both RadLex and the LOINC/RSNA Radiology Playbook anatomic terminologies ranked significantly better (P<.001) than the other standard terminologies for the 100 most frequent CTs, but no terminology ranked significantly better than any other for 100 random CTs. Hypothetical scenarios illustrated instances where no standard terminology would support appropriate proximate or similar alerts, without modification. Conclusions LOINC/RSNA Radiology Playbook and RadLex’s anatomic terminologies appear well suited to support proximate or similar alerts for commonly ordered CTs, but for less commonly ordered tests, modification of the existing terminologies with concepts and relations from SANOPS would likely be required. Our findings suggest SANOPS may serve as a framework for enhancing anatomic terminologies in support of other similar use cases. PMID:29242174

Anatomically ordered tapping interferes more with one-digit addition than two-digit addition: a dual-task fMRI study.

PubMed

Soylu, Firat; Newman, Sharlene D

2016-02-01

Fingers are used as canonical representations for numbers across cultures. In previous imaging studies, it was shown that arithmetic processing activates neural resources that are known to participate in finger movements. Additionally, in one dual-task study, it was shown that anatomically ordered finger tapping disrupts addition and subtraction more than multiplication, possibly due to a long-lasting effect of early finger counting experiences on the neural correlates and organization of addition and subtraction processes. How arithmetic task difficulty and tapping complexity affect the concurrent performance is still unclear. If early finger counting experiences have bearing on the neural correlates of arithmetic in adults, then one would expect anatomically and non-anatomically ordered tapping to have different interference effects, given that finger counting is usually anatomically ordered. To unravel these issues, we studied how (1) arithmetic task difficulty and (2) the complexity of the finger tapping sequence (anatomical vs. non-anatomical ordering) affect concurrent performance and use of key neural circuits using a mixed block/event-related dual-task fMRI design with adult participants. The results suggest that complexity of the tapping sequence modulates interference on addition, and that one-digit addition (fact retrieval), compared to two-digit addition (calculation), is more affected from anatomically ordered tapping. The region-of-interest analysis showed higher left angular gyrus BOLD response for one-digit compared to two-digit addition, and in no-tapping conditions than dual tapping conditions. The results support a specific association between addition fact retrieval and anatomically ordered finger movements in adults, possibly due to finger counting strategies that deploy anatomically ordered finger movements early in the development.

Validation of a technique for accurate fine-wire electrode placement into posterior gluteus medius using real-time ultrasound guidance.

PubMed

Hodges, P W; Kippers, V; Richardson, C A

1997-01-01

Fine-wire electromyography is primarily utilised for the recording of activity of the deep musculature, however, due to the location of these muscles, accurate electrode placement is difficult. Real-time ultrasound imaging (RTUI) of muscle tissue has been used for the guidance of the needle insertion for the placement of electrodes into the muscles of the abdominal wall. The validity of RTUI guidance of needle insertion into the deep muscles has not been determined. A cadaveric study was conducted to evaluate the accuracy with which RTUI can be used to guide fine-wire electrode placement using the posterior fibres of gluteus medius (PGM) as an example. Pilot studies revealed that the ultrasound resolution of cadaveric tissue is markedly reduced making it impossible to directly evaluate the technique, therefore, three studies were conducted. An initial study involved the demarcation of the anatomical boundaries of PGM using RTUI to define a technique based on an anatomical landmark that was consisent with the in vivo RTUI guided needle placement technique. This anatomical landmark was then used as the guide for the cadaveric needle insertion. Once the needle was positioned 0.05 ml of dye was introduced and the specimen dissected. The dye was accurately placed in PGM in 100% of the specimens. Finally, fine-wire electrodes were inserted into the PGM of five volunteers and manoeuvres performed indicating the accuracy of placement. This study supports the use of ultrasound imaging for the accurate guidance of needle insertion for fine-wire and needle EMG electrodes.

Anatomical study of the proximal origin of hamstring muscles.

PubMed

Sato, Kengo; Nimura, Akimoto; Yamaguchi, Kumiko; Akita, Keiichi

2012-09-01

It is relatively well accepted that the long head of the biceps femoris and the semitendinosus both originate from the ischial tuberosity as a common tendon. However, it is also widely known that the biceps femoris is consistently injured more than the semitendinosus. The purpose of this study was to examine the origins of the hamstring muscles, to find an anatomic basis for diagnosis and treatment of injuries of the posterior thigh regions. Twenty-eight hips of fourteen adult Japanese cadavers were used in this study. In twenty hips of ten cadavers, the positional relationships among the origins on the ischial tuberosity were examined. In eight hips of four cadavers, histological examination of the origins of the hamstrings was also performed. The origin of the long head of the biceps femoris adjoined that of the semitendinosus. In the proximal regions of these muscles, the long head consisted of the tendinous part; however, the semitendinosus mainly consisted of the muscular part. Some of the fibers of the biceps tendon extended to fuse with the sacrotuberous ligament. The semimembranosus muscle broadly originated from the lateral surface of the ischial tuberosity. The origins of the long head of the biceps femoris and the semitendinosus are found to be almost independent, and the tendon of the long head is partly fused with the sacrotuberous ligament. The high incidence of injuries to the long head of the biceps femoris could be explained by these anatomical configurations.

Only-child and non-only-child exhibit differences in creativity and agreeableness: evidence from behavioral and anatomical structural studies.

PubMed

Yang, Junyi; Hou, Xin; Wei, Dongtao; Wang, Kangcheng; Li, Yadan; Qiu, Jiang

2017-04-01

Different family composition and size inevitably make only-children different from non-only-children. Previous studies have focused on the differences in behaviors, such as cognitive function and personality traits, between the only-child and the non-only-child. However, there are few studies that have focused on the topic of whether different family environments influence children's brain structural development and whether behavior differentially has its neural basis between only-child and non-only-child status. Thus, in the present study, we investigated the differences in cognition (e.g., intelligence and creativity) and personality and the anatomical structural differences of gray matter volume (GMV) using voxel-based morphometry (VBM) between only-children and non-only-children. The behavioral results revealed that only-children exhibited higher flexibility scores (a dimension of creativity) and lower agreeableness scores (a dimension of personality traits) than non-only-children. Most importantly, the GMV results revealed that there were significant differences in the GMV between only-children and non-only-children that occurred mainly in the brain regions of the supramarginal gyrus, which was positively correlated with flexibility scores; the medial prefrontal cortex (mPFC), which was positively correlated with agreeableness scores; and the parahippocampal gyrus. These findings may suggest that family environment (i.e., only-child vs. non-only-child), may play important roles in the development of the behavior and brain structure of individuals.

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.

ACL Fibers Inserting on the Lateral Intercondylar Ridge Carry the Greatest Loads - Are Modern Anatomic Femoral Tunnel Positions Too Low?

PubMed Central

Nawabi, Danyal H.; Imhauser, Carl; Tucker, Scott; Nguyen, Joseph; Wickiewicz, Thomas L.; Pearle, Andrew

2014-01-01

Objectives: Histological studies have shown that the ACL has a direct and indirect insertion on the femur [1]. The direct insertion is located along the lateral intercondylar ridge and the indirect insertion is located ‘lower’ on the lateral wall of the notch. The trend towards anatomic ACL reconstruction using the anteromedial (AM) portal technique has resulted in ‘lower’ non-isometric femoral tunnel positions and increased graft failures [2]. To our knowledge, the load transfer properties of the direct and indirect ACL insertions have not been studied. This information may help in understanding the increased failures reported with AM portal drilling. The purpose of this study was, 1) to compare the load transferred across the native ACL at the direct and indirect femoral insertions and, 2) to determine the strain behavior of ACL grafts placed at different tunnel locations within the direct and indirect insertions. Methods: Ten fresh-frozen cadaveric knees (mean age, 52.5 years; range, 29-65) were mounted to a six degree of freedom robot. A 134N anterior load at 30 and 90° flexion and a combined valgus (8Nm) and internal (4Nm) rotational moment at 15° flexion were applied. The ACL was subsequently sectioned at the femoral footprint by detaching either the direct or indirect insertion (partially sectioned state), followed by the remainder of the ACL (completely sectioned state) (Figure 1). The kinematics of the intact knee were replayed after each stage of sectioning to determine the loads transferred across the direct and indirect ACL fibers. Loads were expressed as a percentage of the total load borne by the ACL. Strain behaviour was tested by generating 3D models of the femur and tibia from CT scans of each knee. Three tunnel locations (anteromedial bundle [AM], center [C], posterolateral bundle [PL]) each were selected for the direct and indirect insertions and a virtual ACL graft was inserted. The isometry of the virtual graft was calculated through a flexion path of 0 to 90°. Results: Under an anterior tibial load at 30° flexion, the direct insertion carried 83.9% of the total ACL load compared to 16.1% in the indirect insertion (p<0.001). The direct insertion also carried more load at 90° flexion (95.2% vs 4.8%; p<0.001). Under a combined rotatory load at 15° flexion, the direct insertion carried 84.2% of the total ACL load compared to 15.8% in the indirect insertion (p<0.001). A virtual ACL graft placed at the AM position in the direct insertion demonstrated the best strain behaviour with a mean 10.9% change in length. This value was significantly lower (p<0.001) than the isometry at all 3 tunnel positions in the indirect insertion (AM = 18.5%; C = 24.9%; PL = 30.9%). Conclusion: Fibers in the direct insertion of the ACL carry more load than fibers in the indirect insertion. Virtual ACL grafts placed in the ‘higher’ direct location are more isometric than in the ‘lower’ indirect location during range of motion testing. Clinical Relevance: ‘Low’ ACL grafts in the indirect ACL insertion, resulting from AM portal drilling techniques, may experience higher loads in-vivo due to unfavorable biomechanics. With the current shift towards anatomic ACL reconstruction, it may be beneficial to create a ‘higher’ femoral tunnel within the direct insertion at the lateral intercondylar ridge. This position remains anatomical but may also be biomechanically favorable.

Standardised anatomical alignment of the head in a clinical photography studio. A comparison between the Frankfort Horizontal and the natural head position.

PubMed

Capon, Thomas

The Frankfort Horizontal (FH) is used by clinical photographers as a reference plane to help maintain Standardised Representational Photography (SRP) when photographing a patients head. A comparative method of alignment is the Natural Head Position (NHP). For this study a survey was created that asked consultants and clinical photographers which method of alignment they considered to be the most effective. The survey found that 77% of respondents thought the FH was the most effective method of alignment. This high figure is due to some confirmation bias as the FH is the industry standard.

Correlation Between Echodefecography and 3-Dimensional Vaginal Ultrasonography in the Detection of Perineal Descent in Women With Constipation Symptoms.

PubMed

Murad-Regadas, Sthela M; Pinheiro Regadas, Francisco Sergio; Rodrigues, Lusmar V; da Silva Vilarinho, Adjra; Buchen, Guilherme; Borges, Livia Olinda; Veras, Lara B; da Cruz, Mariana Murad

2016-12-01

Defecography is an established method of evaluating dynamic anorectal dysfunction, but conventional defecography does not allow for visualization of anatomic structures. The purpose of this study was to describe the use of dynamic 3-dimensional endovaginal ultrasonography for evaluating perineal descent in comparison with echodefecography (3-dimensional anorectal ultrasonography) and to study the relationship between perineal descent and symptoms and anatomic/functional abnormalities of the pelvic floor. This was a prospective study. The study was conducted at a large university tertiary care hospital. Consecutive female patients were eligible if they had pelvic floor dysfunction, obstructed defecation symptoms, and a score >6 on the Cleveland Clinic Florida Constipation Scale. Each patient underwent both echodefecography and dynamic 3-dimensional endovaginal ultrasonography to evaluate posterior pelvic floor dysfunction. Normal perineal descent was defined on echodefecography as puborectalis muscle displacement ≤2.5 cm; excessive perineal descent was defined as displacement >2.5 cm. Of 61 women, 29 (48%) had normal perineal descent; 32 (52%) had excessive perineal descent. Endovaginal ultrasonography identified 27 of the 29 patients in the normal group as having anorectal junction displacement ≤1 cm (mean = 0.6 cm; range, 0.1-1.0 cm) and a mean anorectal junction position of 0.6 cm (range, 0-2.3 cm) above the symphysis pubis during the Valsalva maneuver and correctly identified 30 of the 32 patients in the excessive perineal descent group. The κ statistic showed almost perfect agreement (κ = 0.86) between the 2 methods for categorization into the normal and excessive perineal descent groups. Perineal descent was not related to fecal or urinary incontinence or anatomic and functional factors (sphincter defects, pubovisceral muscle defects, levator hiatus area, grade II or III rectocele, intussusception, or anismus). The study did not include a control group without symptoms. Three-dimensional endovaginal ultrasonography is a reliable technique for assessment of perineal descent. Using this technique, excessive perineal descent can be defined as displacement of the anorectal junction >1 cm and/or its position below the symphysis pubis on Valsalva maneuver.

Quantitation of maxillary remodeling. 2. Masking of remodeling effects when an "anatomical" method of superimposition is used in the absence of metallic implants.

PubMed

Baumrind, S; Korn, E L; Ben-Bassat, Y; West, E E

1987-06-01

We report the results of a study aimed at quantifying the differences in the perceived pattern of maxillary remodeling that are observed when different methods are used to superimpose maxillary images in roentgenographic cephalometrics. In a previous article, we reported cumulative changes in the positions of anterior nasal spine (ANS), posterior nasal spine (PNS), and Point A for a sample of 31 subjects with maxillary metallic implants. Measurements had been made on lateral cephalograms taken at annual intervals relative to superimposition on the implants. In the present article, we quantify the differences in the perceived displacement of the same landmarks in the same sample when a standard "anatomical best bit" rule was used in lieu of superimposition on the implants. The anatomical best fit superimposition as herein defined was found in this sample to lose important information on the downward remodeling of the superior surface of the maxilla that had been detected when the implant superimposition was used. In fact, we observed a small artifactual upward displacement of the ANS-PNS line. In the anteroposterior direction, the tendency toward backward displacement of skeletal landmarks through time that had been detected with the implant superimposition was replaced by a small forward displacement of ANS and Point A together with reduced backward displacement of PNS. To the extent that the implant superimposition is to be considered the true and correct one, the anatomical best fit superimposition appears to understate the true downward remodeling of the palate by an average of about 0.3 and 0.4 mm per year, although this value differs at different ages and timepoints. The anatomical best fit superimposition also misses entirely the small mean tendency toward backward remodeling that was observed when the implant superimposition was used. In situations in which there are no implants, clinicians and research workers must necessarily continue to use anatomically based superimpositions with definitions more or less similar to that of the anatomical best fit superimposition used here. When they do so, some systematic errors will be incurred. For grouped data, we believe that the best currently available estimates of the mean errors involved in using the anatomical best fit superimposition to approximate an implant superimposition are the "bias" values included in Table IIC. The secondary implications of these differences to the perceived displacements of the maxillary teeth will be considered in our next article.

Comparative anatomical study of the kidney position in amniotes using the origin of the renal artery as a landmark.

PubMed

Yokota, Eri; Kawashima, Tomokazu; Ohkubo, Fumie; Sasaki, Hiroshi

2005-03-01

The anatomical relationship between the kidney position and its arterial supply was investigated in 21 mammals, 1 bird, and 3 reptiles (n = 1 for each species) and in 43 human cadavers. The following observations were made. (1) Although the right kidney was located caudal to the left kidney in 29 out of 43 human cadavers (67.4%), the origin of the right renal artery from the aorta was located cranial to the origin of the left renal artery in 36 human cadavers (83.7%). Therefore, the relative positions of the kidneys do not correspond with the relative origins of the renal arteries in humans. (2) Among the mammals that were examined, the position of the kidney and the branching level of the renal artery on the right side were usually cranial to those on the left side. (3) In the bird and most reptiles that were examined, kidneys were typically located in the pelvic region and were supplied by segmental arterial branches. These results suggest that the right kidney and its arterial supply are generally located cranial to the left kidney in phylogeny of mammals. While the presence of a human accessory renal artery in 9 out of 86 sides (10.5%) and a cranial origin of the left renal artery relative to the right renal artery in 7 out of 43 cadavers (16.3%), shows some variation in the arterial supply to the kidneys, the origin of the renal arteries can generally be used as phylogenetic landmarks indicating the relative positions of the kidneys. Hence, from an ontological perspective, the human right kidney may be initially situated cranial to the left kidney during the early stages of development. Thereafter, the human right kidney may shift downwards secondary.

Computational design and engineering of polymeric orthodontic aligners.

PubMed

Barone, S; Paoli, A; Razionale, A V; Savignano, R

2016-10-05

Transparent and removable aligners represent an effective solution to correct various orthodontic malocclusions through minimally invasive procedures. An aligner-based treatment requires patients to sequentially wear dentition-mating shells obtained by thermoforming polymeric disks on reference dental models. An aligner is shaped introducing a geometrical mismatch with respect to the actual tooth positions to induce a loading system, which moves the target teeth toward the correct positions. The common practice is based on selecting the aligner features (material, thickness, and auxiliary elements) by only considering clinician's subjective assessments. In this article, a computational design and engineering methodology has been developed to reconstruct anatomical tissues, to model parametric aligner shapes, to simulate orthodontic movements, and to enhance the aligner design. The proposed approach integrates computer-aided technologies, from tomographic imaging to optical scanning, from parametric modeling to finite element analyses, within a 3-dimensional digital framework. The anatomical modeling provides anatomies, including teeth (roots and crowns), jaw bones, and periodontal ligaments, which are the references for the down streaming parametric aligner shaping. The biomechanical interactions between anatomical models and aligner geometries are virtually reproduced using a finite element analysis software. The methodology allows numerical simulations of patient-specific conditions and the comparative analyses of different aligner configurations. In this article, the digital framework has been used to study the influence of various auxiliary elements on the loading system delivered to a maxillary and a mandibular central incisor during an orthodontic tipping movement. Numerical simulations have shown a high dependency of the orthodontic tooth movement on the auxiliary element configuration, which should then be accurately selected to maximize the aligner's effectiveness. Copyright © 2016 John Wiley & Sons, Ltd.

Ultrasound scans and dual energy CT identify tendons as preferred anatomical location of MSU crystal depositions in gouty joints.

PubMed

Yuan, Yuan; Liu, Chang; Xiang, Xi; Yuan, Tong-Ling; Qiu, Li; Liu, Yi; Luo, Yu-Bin; Zhao, Y; Herrmann, Martin

2018-05-01

The present study was performed to localize the articular deposition of monosodium urate (MSU) crystal in joints. We compare the detection efficiencies of dual-energy CT (DECT) and ultrasound scans. Analyses by DECT and ultrasound were performed with 184 bilateral joints of the lower limbs of 54 consecutive gout patients. All joints were categorized into (1) knee, (2) ankle, (3) MTP1, and (4) MTP2, and sorted into those with and those without detectable MSU deposition. The comparison of the positive rate between DECT and ultrasound and the agreement was performed using the McNemar test and the Cohen's κ coefficient, respectively. Next, we listed the MSU crystal deposition as assessed by ultrasound between the DECT-positive and -negative joints according to their interior structure. We included tendons, synovia, cartilage, subcutaneous tissue, etc. RESULTS: Among all joints, the percentages with MSU crystal deposition detected by DECT (99/184, 53.8%) and ultrasound (106/184, 57.6%) were comparable (P = 0.530 > 0.05). For MTP1 (21/34, 61.8%; 12/34, 35.3%; P < 0.05) and MTP2-5 (17/34, 50.0%; 10/34, 29.4%, P < 0.05), ultrasound and DECT were more efficient, respectively. The data concordance in 46 of 50 joints (92.00%; κ = 0.769, P < 0.05) for knee; and 27 of 34 joints (79.41%; κ = 0.588, P < 0.05) for MTP2-5 and suggested that tendons were the most frequent anatomical location of MSU crystal deposition. The tendons are the most frequent anatomical location of MSU crystal depositions. The concordance rate of knee joints and MTP2-5 joints shows good agreement between DECT and ultrasound depending on the location.

A systematic review of variations of the recurrent laryngeal nerve.

PubMed

Ling, Xing Yao; Smoll, Nicolas Roydon

2016-01-01

With thyroid cancer fast becoming one of the most common endocrine cancers, the frequency of thyroid surgery has increased. A common and debilitating concern with thyroid surgery is recurrent laryngeal nerve (RLN) paralysis leading to glottal obstruction and airway compromise. A systematic review regarding the anatomical variation of the recurrent laryngeal nerve was performed to determine the position of anatomical variants of the RLN in relation to the inferior thyroid artery (ITA) as well as the prevalence of nonrecurrent laryngeal nerve (NRLN). MEDLINE, Web of Science, MEDITEXT, AMED, CINAHL, Cochrane, ProQuest, Pubmed, and ScienceDirect. Databases were searched using the search terms "inferior thyroid artery," "recurrent laryngeal nerve," "nonrecurrent laryngeal nerve," and "anatomical variation." The reference sections of the articles found were searched for additional reports. The references of all articles were searched to find articles missed in the database search. A total of 8,655 RLN sides were included in this study. One thousand eight hundred and thirteen (20.95%; 95% confidence interval (CI) 20.09, 2,182) showed a Type A configuration of RLN in relation to the ITA, 2,432 (28.10%; 95% CI 27.15, 29.06) showed a Type B configuration and 4,410 (50.95%; 95% CI 49.89, 52.01) showed a Type C configuration between the RLN and the ITA. The second search returned with 38,568 recurrent laryngeal sides and only 221 (0.57%; 95%CI 0.5, 0.65) NRLN documented. The RLN is most commonly found in the posterior position, relative to the ITA. The incidence of the NRLN is low, only occurring in 0.57% of people. © 2015 Wiley Periodicals, Inc.

Physical examination of dizziness in athletes after a concussion: A descriptive study.

PubMed

Reneker, Jennifer C; Cheruvu, Vinay K; Yang, Jingzhen; James, Mark A; Cook, Chad E

2018-04-01

Dizziness is commonly reported after concussion. With the forces experienced at the time of the injury, several anatomical locations may have been altered, causing dizziness. Describe an objective examination and the types of impairment/dysfunction implicated by the results of clinical examination tests in subjects with dizziness after a concussion. Cross-Sectional. Athletes between ages 10-23 were enrolled with a diagnosis of concussion. An examination was completed to identify areas potentially contributing to dizziness, including tests of oculomotor control, the vestibular system, neuromotor control, and musculoskeletal components of the cervical spine. Descriptive analyses were completed to define the anatomical areas/types of dysfunction identified by positive findings of the examination tests. All (n = 41; 100%) subjects had examination findings consistent with central dysfunction. Of these, 36 (97.8%) had oculomotor control deficits; 29 (70.7%) demonstrated motion sensitivity; and 6 (15%) had central vestibular deficits. Nineteen (46.3%) had peripheral dysfunction, including 18 (43.9%) with unilateral hypofunction, and 2 (4.9%) with Benign Paroxysmal Positional Vertigo. Thirty-four (82.9%) had cervical dysfunction, with 11 (26.8%) presenting with cervicogenic dizziness, and 31 (75.6%) with altered neuromotor control. Functional injury to centrally-mediated pathways, specifically oculomotor control, and afferent and efferent pathways in the cervical spine are commonly identified through clinical examination tests in individuals with a complaint of dizziness post-concussion. According to results presented here, a high majority (90%) of the participants demonstrated dizziness that appeared to be multifactorial in nature and was not attributable to one main type of dysfunction. The common pathways between the systems make it difficult to isolate only one anatomical area as a contributor to dizziness. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of survival outcomes after anatomical resection and non-anatomical resection in patients with hepatocellular carcinoma

PubMed Central

Kim, Seheon; Kim, Seokwhan; Song, Insang

2015-01-01

Backgrounds/Aims Liver resection is a curative procedure performed worldwide for hepatocellular carcinoma (HCC). Deciding on the appropriate resection range for postoperative hepatic function preservation is an important surgical consideration. This study compares survival outcomes of HCC patients who underwent anatomical or non-anatomical resection, to determine which offers the best clinical survival benefit. Methods One hundred and thirty-one patients underwent liver resection with HCC, between January 2007 and February 2015, and were divided into two groups: those who underwent anatomical liver resection (n=88) and those who underwent non-anatomical liver resection (n=43). Kaplan-Meier survival analysis and Cox regressions were used to compare the disease-free survival (DFS) and overall survival (OS) rates between the groups. Results The mean follow-up periods were 27 and 40 months in the anatomical and non-anatomical groups, respectively (p=0.229). The 3- and 5-year DFS rates were 70% and 60% in the anatomical group and 62% and 48% in the non-anatomical group, respectively. The 3 and 5-year OS rates were 94% and 78% in the anatomical group, and 86% and 80% in the non-anatomical group, respectively. The anatomical group tended to show better outcomes, but the findings were not significant. However, a relative risk of OS between the anatomical and non-anatomical group was 0.234 (95% CI, 0.061-0.896; p=0.034), which is statistically significant. Conclusions Although statistical significance was not detected in survival curves, anatomical resection showed better results. In this respect, anatomical resection is more likely to perform in HCC patients with preserve liver function than non-anatomical resection. PMID:26693235

Effects of Axial Torsion on Disc Height Distribution: An In Vivo Study.

PubMed

Espinoza Orías, Alejandro A; Mammoser, Nicole M; Triano, John J; An, Howard S; Andersson, Gunnar B J; Inoue, Nozomu

2016-05-01

Axial rotation of the torso is commonly used during manipulation treatment of low back pain. Little is known about the effect of these positions on disc morphology. Rotation is a three-dimensional event that is inadequately represented with planar images in the clinic. True quantification of the intervertebral gap can be achieved with a disc height distribution. The objective of this study was to analyze disc height distribution patterns during torsion relevant to manipulation in vivo. Eighty-one volunteers were computed tomography-scanned both in supine and in right 50° rotation positions. Virtual models of each intervertebral gap representing the disc were created with the inferior endplate of each "disc" set as the reference surface and separated into 5 anatomical zones: 4 peripheral and 1 central, corresponding to the footprint of the annulus fibrosus and nucleus pulposus, respectively. Whole-disc and individual anatomical zone disc height distributions were calculated in both positions and were compared against each other with analysis of variance, with significance set at P < .05. Mean neutral disc height was 7.32 mm (1.59 mm). With 50° rotation, a small but significant increase to 7.44 mm (1.52 mm) (P < .0002) was observed. The right side showed larger separation in most levels, except at L5/S1. The posterior and right zones increased in height upon axial rotation of the spine (P < .0001), whereas the left, anterior, and central decreased. This study quantified important tensile/compressive changes disc height during torsion. The implications of these mutually opposing changes on spinal manipulation are still unknown. Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Penetrating maxillary sinus injury caused by a construction nail passing through the orbital cavity.

PubMed

Simsek, Tekin; Demir, Bulent; Yosma, Engin; Keles, Musa K; Abdullayev, Asef

2014-03-01

Because of its anatomic position, the orbit is frequently subject to trauma, leading to functional and cosmetic problems. After blunt trauma, orbital fractures can cause functional problems by trapping the periocular tissues without affecting the anatomic integrity of the globe. In comparison, high-energy penetrating injuries can cause serious consequences such as disrupting the lacrimal drainage system and causing loss of vision. In rare cases, however, penetration of the orbit by a foreign body can result in a treatable injury that causes no functional or cosmetic problems.This article presents a patient in whom a nail penetrated the orbit from the inferomedial margin and reached the maxillary sinus without damaging the globe, extraocular muscles, or lacrimal duct system. Reports of similar injuries are reviewed, focusing on the anatomic structures that might be traumatized, to guide the readers in considering the diagnosis and treatment of such injuries.

Preservation of three-dimensional anatomy in phosphatized fossil arthropods enriches evolutionary inference

PubMed Central

Schwermann, Achim H; dos Santos Rolo, Tomy; Caterino, Michael S; Bechly, Günter; Schmied, Heiko; Baumbach, Tilo; van de Kamp, Thomas

2016-01-01

External and internal morphological characters of extant and fossil organisms are crucial to establishing their systematic position, ecological role and evolutionary trends. The lack of internal characters and soft-tissue preservation in many arthropod fossils, however, impedes comprehensive phylogenetic analyses and species descriptions according to taxonomic standards for Recent organisms. We found well-preserved three-dimensional anatomy in mineralized arthropods from Paleogene fissure fillings and demonstrate the value of these fossils by utilizing digitally reconstructed anatomical structure of a hister beetle. The new anatomical data facilitate a refinement of the species diagnosis and allowed us to reject a previous hypothesis of close phylogenetic relationship to an extant congeneric species. Our findings suggest that mineralized fossils, even those of macroscopically poor preservation, constitute a rich but yet largely unexploited source of anatomical data for fossil arthropods. DOI: http://dx.doi.org/10.7554/eLife.12129.001 PMID:26854367

A geometric analysis of semicircular canals and induced activity in their peripheral afferents in the rhesus monkey

NASA Technical Reports Server (NTRS)

Reisine, H.; Simpson, J. I.; Henn, V.

1988-01-01

Experiments were carried out to determine anatomically the planes of the semicircular canals of two juvenile rhesus monkeys, using plastic casts of the semicircular canals, and the anatomical measurements were related to the directional coding of neural signals transmitted by primary afferents innervating the same simicircular canals. In the experiments, animals were prepared for monitoring the eye position by the implantation of silver-silver chloride electrodes into the bony orbit. Following the recording of semicircular canal afferent activity, the animals were sacrificed; plastic casting resin was injected into the bony canals; and, when the temporal bone was demineralized and removed, the coordinates of points spaced along the circumference of the canal casts were measured. A comparison of the sensitivity vectors determined in these experiments and the anatomical measures showed that the average difference between a sensitivity vector and its respective normal vector was 6.3 deg.

[Cor triatriatum. Anatomical forms and surgical treatment of 6 consecutive cases].

PubMed

Bloch, G; Heurtematte, Y; Menu, P; Mesnildrey, P; Casasoprana, A; Magnier, S; Tamari, W; Seurat, M C; Aubry, P; Vernant, P

1988-01-01

Six cases of cor triatriatum documented and operated on at Henri-Mondor hospital between 1980 and 1984 are reported. Ages at the time of surgery ranged from 8 months to 57 years. Four of the 6 patients presented with pulmonary hypertension. Anatomic types consisted of 4 diaphragmatic types and 2 more complex malformations. Associated lesions were present in all but one patients. They consisted mostly of interatrial defects (depending on their position with regard to the intra-atrial membrane, they play a determinant role in the symptomatology) and of a left superior vena cava (which might play a role in the embryogenesis of the malformation). Except for one early postoperative death, results of surgery were excellent for all patients, with a mean follow-up of 5 years. This series, compared with the literature, allows precising the embryologic and anatomic aspects of the malformation and the surgical techniques in complex types.

Augmented reality environment for temporomandibular joint motion analysis.

PubMed

Wagner, A; Ploder, O; Zuniga, J; Undt, G; Ewers, R

1996-01-01

The principles of interventional video tomography were applied for the real-time visualization of temporomandibular joint movements in an augmented reality environment. Anatomic structures were extracted in three dimensions from planar cephalometric radiographic images. The live-image fusion of these graphic anatomic structures with real-time position data of the mandible and the articular fossa was performed with a see-through, head-mounted display and an electromagnetic tracking system. The dynamic fusion of radiographic images of the temporomandibular joint to anatomic temporomandibular joint structures in motion created a new modality for temporomandibular joint motion analysis. The advantages of the method are its ability to accurately examine the motion of the temporomandibular joint in three dimensions without restraining the subject and its ability to simultaneously determine the relationship of the bony temporomandibular joint and supporting structures (ie, occlusion, muscle function, etc) during movement before and after treatment.

Systemic Review of Anatomic Single- Versus Double-Bundle Anterior Cruciate Ligament Reconstruction: Does Femoral Tunnel Drilling Technique Matter?

PubMed

Zhang, Yang; Xu, Caiqi; Dong, Shiqui; Shen, Peng; Su, Wei; Zhao, Jinzhong

2016-09-01

To provide an up-to-date assessment of the difference between anatomic double-bundle anterior cruciate ligament (ACL) reconstruction (DB-ACLR) and anatomic single-bundle ACL reconstruction (SB-ACLR). We hypothesized that anatomic SB-ACLR using independent femoral drilling technique would be able to achieve kinematic stability as with anatomic DB-ACLR. A comprehensive Internet search was performed to identify all therapeutic trials of anatomic DB-ACLR versus anatomic SB-ACLR. Only clinical studies of Level I and II evidence were included. The comparative outcomes were instrument-measured anterior laxity, Lachman test, pivot shift, clinical outcomes including objective/subjective International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner activity scale and complication rates of extension/flexion deficits, graft failure, and early osteoarthritis. Subgroup analyses were performed for femoral tunnel drilling techniques including independent drilling and transtibial (TT) drilling. Twenty-two clinical trials of 2,261 anatomically ACL-reconstructed patients were included in the meta-analysis. Via TT drilling technique, anatomic DB-ACLR led to improved instrument-measured anterior laxity with a standard mean difference (SMD) of -0.42 (95% confidence interval [CI] = -0.81 to -0.02), less rotational instability measured by pivot shift (SMD = 2.76, 95% CI = 1.24 to 6.16), and higher objective IKDC score with odds ratio (OR) of 2.28 (95% CI = 1.19 to 4.36). Via independent drilling technique, anatomic DB-ACLR yielded better pivot shift (SMD = 2.04, 95% CI = 1.36 to 3.05). Anatomic DB-ACLR also revealed statistical significance in subjective IKDC score compared with anatomic SB-ACLR (SMD = 0.27, 95% CI = 0.05 to 0.49). Anatomic DB-ACLR showed better anterior and rotational stability and higher objective IKDC score than anatomic SB-ACLR via TT drilling technique. Via independent drilling technique, however, anatomic DB-ACLR only showed superiority of rotational stability. All clinical function outcomes except subjective IKDC score were not significantly different between anatomic DB-ACLR and SB-ACLR. Level II, meta-analysis of Level I and II studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Medical students call for national standards in anatomical education.

PubMed

Farey, John E; Sandeford, Jonathan C; Evans-McKendry, Greg D

2014-11-01

The diminishing number of hours dedicated to formal instruction in anatomy has led to a debate within medical education as to the level required for safe clinical practice. We provide a review of the current state of anatomical education in Australian medical schools and state the case for national standards. In light of the review presented, council members of the Australian Medical Students' Association voted to affirm that consideration should be given to developing undergraduate learning goals for anatomy, providing a codified medical student position on the teaching of anatomy in Australian medical schools. Crucially, the position states that time-intensive methods of instruction such as dissection should be a rite of passage for medical students in the absence of evidence demonstrating the superiority of modern teaching methods. We believe the bodies with a vested interest in the quality of medical graduates, namely the Australian Medical Council, Medical Deans Australia & New Zealand, and the postgraduate colleges should collaborate and develop clear guidelines that make explicit the core knowledge of anatomy expected of medical graduates at each stage of their career with a view to safe clinical practice. In addition, Australian universities have a role to play in conducting further research into contemporary learning styles and the most efficacious methods of delivering anatomical education. © 2014 Royal Australasian College of Surgeons.

The Imprint of Extreme Climate Events in Century-Long Time Series of Wood Anatomical Traits in High-Elevation Conifers

PubMed Central

Carrer, Marco; Brunetti, Michele; Castagneri, Daniele

2016-01-01

Extreme climate events are of key importance for forest ecosystems. However, both the inherent infrequency, stochasticity and multiplicity of extreme climate events, and the array of biological responses, challenges investigations. To cope with the long life cycle of trees and the paucity of the extreme events themselves, our inferences should be based on long-term observations. In this context, tree rings and the related xylem anatomical traits represent promising sources of information, due to the wide time perspective and quality of the information they can provide. Here we test, on two high-elevation conifers (Larix decidua and Picea abies sampled at 2100 m a.s.l. in the Eastern Alps), the associations among temperature extremes during the growing season and xylem anatomical traits, specifically the number of cells per ring (CN), cell wall thickness (CWT), and cell diameter (CD). To better track the effect of extreme events over the growing season, tree rings were partitioned in 10 sectors. Climate variability has been reconstructed, for 1800–2011 at monthly resolution and for 1926–2011 at daily resolution, by exploiting the excellent availability of very long and high quality instrumental records available for the surrounding area, and taking into account the relationship between meteorological variables and site topographical settings. Summer temperature influenced anatomical traits of both species, and tree-ring anatomical profiles resulted as being associated to temperature extremes. Most of the extreme values in anatomical traits occurred with warm (positive extremes) or cold (negative) conditions. However, 0–34% of occurrences did not match a temperature extreme event. Specifically, CWT and CN extremes were more clearly associated to climate than CD, which presented a bias to track cold extremes. Dendroanatomical analysis, coupled to high-quality daily-resolved climate records, seems a promising approach to study the effects of extreme events on trees, but further investigations are needed to improve our comprehension of the critical role of such elusive events in forest ecosystems. PMID:27242880

Motion correction for radiation therapy of prostate using B-mode ultrasound

NASA Astrophysics Data System (ADS)

Hummel, Johann; Figl, Michael; Schmidbauer, Jörg; Tinzl, Martina; Bergmann, Helmar; Birkfellner, Wolfgang

2007-03-01

The use of intensity modulated radiation therapy promises to spare organs at risk by applying better dose distribution on the tumor. The specific challenge of this methods is the exact positioning of the patient and the localization of the exposured organ. With respect to the filling of rectum and bladder the prostate can move several millimeters up to centimeters. Therefore, the position of the prostate should be determinated and corrected daily before irradiation. We used a B-mode US machine (Ultramark 9, advanced Technology Laboratories, USA) which was calibrated using an optical tracking system (Polaris, NDI, Can). After correct positioning of the patient in the simulation room three anatomical markers (apex prostate, prostate lateral sinister/dexter) were identified and their positions calculated with respect to the coordinate system of the simulator. The same situation is given in the treatment room. Both, simulator and accelerator are registered by a simple point-to-point registration using a block with five drilled holes with known coordinates in the block coordinate system. The block is aligned by means of laser markers. When the patient is placed on the treatment table, the three anatomical landmarks are located on the US images and their positions are calculated with respect to the coordinate system of the treatment room. Applying a point-to-point registration results in a rotation matrix and a translation vector in the desired coordinate system which can be used for repositioning by translating and rotating the patient table. Additionally, a fiducial registration error (FRE) is calculated which gives a dimension of the accuracy the three points were identified. We found an fiducial registration error (FRE) of 2.4 mm +/- 1.2 mm for the point-to-point registration of the anatomical landmarks. The FRE for the point-to-point registration between the block and the optical tracking system was 0.5 mm +/- 0.2 mm. According to the US calibration we found an error of 0.8 mm +/- 0.2 mm.

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.

Does hemipelvis structure and position influence acetabulum orientation?

PubMed

Musielak, Bartosz; Jóźwiak, Marek; Rychlik, Michał; Chen, Brian Po-Jung; Idzior, Maciej; Grzegorzewski, Andrzej

2016-03-16

Although acetabulum orientation is well established anatomically and radiographically, its relation to the innominate bone has rarely been addressed. If explored, it could open the discussion on patomechanisms of such complex disorders as femoroacetabular impingement (FAI). We therefore evaluated the influence of pelvic bone position and structure on acetabular spatial orientation. We describe this relation and its clinical implications. This retrospective study was based on computed tomography scanning of three-dimensional models of 31 consecutive male pelvises (62 acetabulums). All measurements were based on CT spatial reconstruction with the use of highly specialized software (Rhinoceros). Relations between acetabular orientation (inclination, tilt, anteversion angles) and pelvic structure were evaluated. The following parameters were evaluated to assess the pelvic structure: iliac opening angle, iliac tilt angle, interspinous distance (ISD), intertuberous distance (ITD), height of the pelvis (HP), and the ISD/ITD/HP ratio. The linear and nonlinear dependence of the acetabular angles and hemipelvic measurements were examined with Pearson's product - moment correlation and Spearman's rank correlation coefficient. Correlations different from 0 with p < 0.05 were considered statistically significant. Comparison of the axis position with pelvis structure with orientation in the horizontal plane revealed a significant positive correlation between the acetabular anteversion angle and the iliac opening angle (p = 0.041 and 0.008, respectively). In the frontal plane, there was a positive correlation between the acetabular inclination angle and the iliac tilt angle (p = 0.025 and 0.014, respectively) and the acetabular inclination angle and the ISD/ITD/HP ratio (both p = 0.048). There is a significant correlation of the hemipelvic structure and acetabular orientation under anatomic conditions, especially in the frontal and horizontal planes. In the anteroposterior view, the more tilted-down innominate bone causes a more caudally oriented acetabulum axis, whereas in the horizontal view this relation is reversed. This study may serve as a basis for the discussion on the role of the pelvis in common disorders of the hip.

SU-F-J-201: Validation Study of Proton Radiography Against CT Data for Quantitative Imaging of Anatomical Changes in Head and Neck Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hammi, A; Weber, D; Lomax, A

2016-06-15

Purpose: In clinical pencil-beam-scanned (PBS) proton therapy, the advantage of the characteristic sharp dose fall-off after the Bragg Peak (BP) becomes a disadvantage if the BP positions of a plan’s constituent pencil beams are shifted, eg.due to anatomical changes. Thus, for fractionated PBS proton therapy, accurate knowledge of the water equivalent path length (WEPL) of the traversed anatomy is critical. In this work we investigate the feasibility of using 2D proton range maps (proton radiography, PR) with the active-scanning gantry at PSI. Methods: We simulated our approach using Monte Carlo methods (MC) to simulate proton beam interactions in patients usingmore » clinical imaging data. We selected six head and neck cases having significant anatomical changes detected in per-treatment CTs.PRs (two at 0°/90°) were generated from MC simulations of low-dose pencil beams at 230MeV. Each beam’s residual depth-dose was propagated through the patient geometry (from CT) and detected on exiting the patient anatomy in an ideal depth-resolved detector (eg. range telescope). Firstly, to validate the technique, proton radiographs were compared to the ground truth, which was the WEPL from ray-tracing in the patient CT at the pencil beam location. Secondly, WEPL difference maps (per-treatment – planning imaging timepoints) were then generated to locate the anatomical changes, both in the CT (ground truth) and in the PRs. Binomial classification was performed to evaluate the efficacy of the technique relative to CT. Results: Over the projections simulated over all six patients, 70%, 79% and 95% of the grid points agreed with the ground truth proton range to within ±0.5%, ±1%, and ±3% respectively. The sensitivity, specificity, precision and accuracy were high (mean±1σ, 83±8%, 87±13%, 95±10%, 83±7% respectively). Conclusion: We show that proton-based radiographic images can accurately monitor patient positioning and in vivo range verification, while providing equivalent WEPL information to a CT scan, with the advantage of a much lower imaging dose.« less

Automated segmentation and recognition of the bone structure in non-contrast torso CT images using implicit anatomical knowledge

NASA Astrophysics Data System (ADS)

Zhou, X.; Hayashi, T.; Han, M.; Chen, H.; Hara, T.; Fujita, H.; Yokoyama, R.; Kanematsu, M.; Hoshi, H.

2009-02-01

X-ray CT images have been widely used in clinical diagnosis in recent years. A modern CT scanner can generate about 1000 CT slices to show the details of all the human organs within 30 seconds. However, CT image interpretations (viewing 500-1000 slices of CT images manually in front of a screen or films for each patient) require a lot of time and energy. Therefore, computer-aided diagnosis (CAD) systems that can support CT image interpretations are strongly anticipated. Automated recognition of the anatomical structures in CT images is a basic pre-processing of the CAD system. The bone structure is a part of anatomical structures and very useful to act as the landmarks for predictions of the other different organ positions. However, the automated recognition of the bone structure is still a challenging issue. This research proposes an automated scheme for segmenting the bone regions and recognizing the bone structure in noncontrast torso CT images. The proposed scheme was applied to 48 torso CT cases and a subjective evaluation for the experimental results was carried out by an anatomical expert following the anatomical definition. The experimental results showed that the bone structure in 90% CT cases have been recognized correctly. For quantitative evaluation, automated recognition results were compared to manual inputs of bones of lower limb created by an anatomical expert on 10 randomly selected CT cases. The error (maximum distance in 3D) between the recognition results and manual inputs distributed from 3-8 mm in different parts of the bone regions.

The benefits and limitations of using ultrasonography to supplement anatomical understanding.

PubMed

Sweetman, Greg M; Crawford, Gail; Hird, Kathryn; Fear, Mark W

2013-01-01

Anatomical understanding is critical to medical education. With reduced teaching time and limited cadaver availability, it is important to investigate how best to utilize in vivo imaging to supplement anatomical understanding and better prepare medical graduates for the proliferation of point-of-care imaging in the future. To investigate whether using short sessions of in vivo imaging using ultrasonography could benefit students' anatomical knowledge and clinical application, we conducted a 2-hour session on abdominal anatomy using ultrasonography in small groups of five to six students, for both first- and second-year student cohorts. Individual feedback was collected to assess student perceptions. To measure retention and understanding, a short examination containing ultrasound images and questions and performance of a clinical skill (gastrointestinal' tract examination) were assessed. Ultrasonography sessions were highly valued by the students, with 90% of the students reporting their understanding was improved, and over 70% reporting increased confidence in their anatomical knowledge. However, the assessments showed no appreciable impact on skills or understanding related to abdominal anatomy and examination. We conclude that the risk associated with limited exposure increasing confidence without increasing skills remains real and that in vivo imaging is not effective when used as a short adjunct teaching tool. The widespread use of ultrasonography means finding the best way to incorporate ultrasound into medical education remains important. To this end, we are currently implementing an extended program including echocardiography and multiple anatomical sessions that will determine if frequency and repetition of use can positively impact on student performance and understanding. Copyright © 2012 American Association of Anatomists.

Determinants of the electric field during transcranial direct current stimulation.

PubMed

Opitz, Alexander; Paulus, Walter; Will, Susanne; Antunes, Andre; Thielscher, Axel

2015-04-01

Transcranial direct current stimulation (tDCS) causes a complex spatial distribution of the electric current flow in the head which hampers the accurate localization of the stimulated brain areas. In this study we show how various anatomical features systematically shape the electric field distribution in the brain during tDCS. We constructed anatomically realistic finite element (FEM) models of two individual heads including conductivity anisotropy and different skull layers. We simulated a widely employed electrode montage to induce motor cortex plasticity and moved the stimulating electrode over the motor cortex in small steps to examine the resulting changes of the electric field distribution in the underlying cortex. We examined the effect of skull thickness and composition on the passing currents showing that thinner skull regions lead to higher electric field strengths. This effect is counteracted by a larger proportion of higher conducting spongy bone in thicker regions leading to a more homogenous current over the skull. Using a multiple regression model we could identify key factors that determine the field distribution to a significant extent, namely the thicknesses of the cerebrospinal fluid and the skull, the gyral depth and the distance to the anode and cathode. These factors account for up to 50% of the spatial variation of the electric field strength. Further, we demonstrate that individual anatomical factors can lead to stimulation "hotspots" which are partly resistant to electrode positioning. Our results give valuable novel insights in the biophysical foundation of tDCS and highlight the importance to account for individual anatomical factors when choosing an electrode montage. Copyright © 2015 Elsevier Inc. All rights reserved.

Autonomous bone reposition around anatomical landmark for robot-assisted orthognathic surgery.

PubMed

Woo, Sang-Yoon; Lee, Sang-Jeong; Yoo, Ji-Yong; Han, Jung-Joon; Hwang, Soon-Jung; Huh, Kyung-Hoe; Lee, Sam-Sun; Heo, Min-Suk; Choi, Soon-Chul; Yi, Won-Jin

2017-12-01

The purpose of this study was to develop a new method for enabling a robot to assist a surgeon in repositioning a bone segment to accurately transfer a preoperative virtual plan into the intraoperative phase in orthognathic surgery. We developed a robot system consisting of an arm with six degrees of freedom, a robot motion-controller, and a PC. An end-effector at the end of the robot arm transferred the movements of the robot arm to the patient's jawbone. The registration between the robot and CT image spaces was performed completely preoperatively, and the intraoperative registration could be finished using only position changes of the tracking tools at the robot end-effector and the patient's splint. The phantom's maxillomandibular complex (MMC) connected to the robot's end-effector was repositioned autonomously by the robot movements around an anatomical landmark of interest based on the tool center point (TCP) principle. The robot repositioned the MMC around the TCP of the incisor of the maxilla and the pogonion of the mandible following plans for real orthognathic patients. The accuracy of the robot's repositioning increased when an anatomical landmark for the TCP was close to the registration fiducials. In spite of this influence, we could increase the repositioning accuracy at the landmark by using the landmark itself as the TCP. With its ability to incorporate virtual planning using a CT image and autonomously execute the plan around an anatomical landmark of interest, the robot could help surgeons reposition bones more accurately and dexterously. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

[Anatomical key points and operative principle of "two planes and four landmarks" in extralevator abdominoperineal excision].

PubMed

Ye, Yingjiang; Shen, Zhanlong; Wang, Shan

2014-11-01

Abominoperineal resection (APR) is the main approach of lower rectal cancer treatment. Recently, it was found that conventional APR had higher incidence rate of positive circumferential resection margin(CRM) and intraoperative perforation (IOP), which was the crucial reason of local recurrence and worse prognosis. Extralevator abdominoperineal excision(ELAPE) procedure was proposed by European panels including surgeons, radiologist and pathologists, and considered to lower the positive rates of CRM and IOP. Definitive surgical planes and anatomic landmarks are the cores of this procedure, which are the prerequisite for the guarantee of safety and smoothness of surgery. To realize the anatomy of muscles, fascias, blood vessels and nervous of perineal region is the base of carrying out ELAPE procedure. In this paper, we introduce the key anatomy related to ELAPE procedure and summarize the principle of ELAPE procedure as "two planes and four landmarks", which will be beneficial to the popularization and application.

Is the Lecompte technique the last word on transposition of the great arteries repair for all patients? A magnetic resonance imaging study including a spiral technique two decades postoperatively.

PubMed

Rickers, Carsten; Kheradvar, Arash; Sievers, Hans-Hinrich; Falahatpisheh, Ahmad; Wegner, Philip; Gabbert, Dominik; Jerosch-Herold, Michael; Hart, Chris; Voges, Inga; Putman, Léon M; Kristo, Ines; Fischer, Gunther; Scheewe, Jens; Kramer, Hans-Heiner

2016-06-01

To compare the Lecompte technique and the spiral anastomosis (complete anatomic correction) two decades after arterial switch operation (ASO). Nine patients after primary ASO with Lecompte and 6 selected patients after spiral anastomosis were evaluated 20.8 ± 2.1 years after ASO versus matched controls. Blood flow dynamics and flow profiles (e.g. vorticity, helicity) in the great arteries were quantified from time-resolved 3D magnetic resonance imaging (MRI) phase contrast flow measurements (4D flow MR) in addition to a comprehensive anatomical and functional cardiovascular MRI analysis. Compared with spiral reconstruction, patients with Lecompte showed more vortex formation, supranatural helical blood flow (relative helicity in aorta: 0.036 vs 0.089; P < 0.01), a reduced indexed cross-sectional area of the left pulmonary artery (155 vs 85 mm²/m²; P < 0.001) and more semilunar valve dysfunctions (n = 5 vs 1). There was no difference in elastic aortic wall properties, ventricular function, myocardial perfusion and myocardial fibrosis between the two groups. Cross-sectional area of the aortic sinus was larger in patients than in controls (669 vs 411 mm²/m²; P < 0.01). In the spiral group, the pulmonary root was rotated after ASO more towards the normal left position (P < 0.01). In this study, selected patients with spiral anastomoses showed, two decades after ASO, better physiologically adapted blood flow dynamics, and attained a closer to normal anatomical position of their great arteries, as well as less valve dysfunction. Considering the limitations related to the small number of patients and the novel MRI imaging techniques, these data may provoke reconsidering the optimal surgical approaches to transposition of the great arteries repair. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Classical fluoroscopy criteria poorly predict right ventricular lead septal positioning by comparison with echocardiography.

PubMed

Squara, Fabien; Scarlatti, Didier; Riccini, Philippe; Garret, Gauthier; Moceri, Pamela; Ferrari, Emile

2018-03-13

Fluoroscopic criteria have been described for the documentation of septal right ventricular (RV) lead positioning, but their accuracy remains questioned. Consecutive patients undergoing pacemaker or defibrillator implantation were prospectively included. RV lead was positioned using postero-anterior and left anterior oblique 40° incidences, and right anterior oblique 30° to rule out coronary sinus positioning when suspected. RV lead positioning using fluoroscopy was compared to true RV lead positioning as assessed by transthoracic echocardiography (TTE). Precise anatomical localizations were determined with both modalities; then, RV lead positioning was ultimately dichotomized into two simple clinically relevant categories: RV septal or RV free wall. Accuracy of fluoroscopy for RV lead positioning was then assessed by comparison with TTE. We included 100 patients. On TTE, 66/100 had a septal RV lead and 34/100 had a free wall RV lead. Fluoroscopy had moderate agreement with TTE for precise anatomical localization of RV lead (k = 0.53), and poor agreement for septal/free wall localization (k = 0.36). For predicting septal RV lead positioning, classical fluoroscopy criteria had a high sensitivity (95.5%; 63/66 patients having a septal RV lead on TTE were correctly identified by fluoroscopy) but a very low specificity (35.3%; only 12/34 patients having a free wall RV lead on TTE were correctly identified by fluoroscopy). Classical fluoroscopy criteria have a poor accuracy for identifying RV free wall leads, which are most of the time misclassified as septal. This raises important concerns about the efficacy and safety of RV lead positioning using classical fluoroscopy criteria.

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 human pulvinar and extensive topographically organized connectivity with visual cortex. This organization is similar to other nonhuman primates and provides additional support that the general organization of the pulvinar is consistent across the primate phylogenetic tree. These results suggest that the human pulvinar, like other primates, is well positioned to regulate corticocortical communication. PMID:26156987

Greek language: analysis of the cardiologic anatomical etymology: past and present.

PubMed

Bezas, Georges; Werneck, Alexandre Lins

2012-01-01

The Greek language, the root of most Latin anatomical terms, is deeply present in the Anatomical Terminology. Many studies seek to analyze etymologically the terms stemming from the Greek words. In most of these studies, the terms appear defined according to the etymological understanding of the respective authors at the time of its creation. Therefore, it is possible that the terms currently used are not consistent with its origin in ancient Greek words. We selected cardiologic anatomical terms derived from Greek words, which are included in the International Anatomical Terminology. We performed an etymological analysis using the Greek roots present in the earliest terms. We compared the cardiologic anatomical terms currently used in Greece and Brazil to the Greek roots originating from the ancient Greek language. We used morphological decomposition of Greek roots, prefixes, and suffixes. We also verified their use on the same lexicons and texts from the ancient Greek language. We provided a list comprising 30 cardiologic anatomical terms that have their origins in ancient Greek as well as their component parts in the International Anatomical Terminology. We included the terms in the way they were standardized in Portuguese, English, and Modern Greek as well as the roots of the ancient Greek words that originated them. Many works deal with the true origin of words (etymology) but most of them neither returns to the earliest roots nor relate them to their use in texts of ancient Greek language. By comparing the world's greatest studies on the etymology of Greek words, this paper tries to clarify the differences between the true origin of the Greek anatomical terms as well as the origins of the cardiologic anatomical terms more accepted today in Brazil by health professionals.

Use of Eye Tracking as an Innovative Instructional Method in Surgical Human Anatomy.

PubMed

Sánchez-Ferrer, María Luísa; Grima-Murcia, María Dolores; Sánchez-Ferrer, Francisco; Hernández-Peñalver, Ana Isabel; Fernández-Jover, Eduardo; Sánchez Del Campo, Francisco

Tobii glasses can record corneal infrared light reflection to track pupil position and to map gaze focusing in the video recording. Eye tracking has been proposed for use in training and coaching as a visually guided control interface. The aim of our study was to test the potential use of these glasses in various situations: explanations of anatomical structures on tablet-type electronic devices, explanations of anatomical models and dissected cadavers, and during the prosection thereof. An additional aim of the study was to test the use of the glasses during laparoscopies performed on Thiel-embalmed cadavers (that allows pneumoinsufflation and exact reproduction of the laparoscopic surgical technique). The device was also tried out in actual surgery (both laparoscopy and open surgery). We performed a pilot study using the Tobii glasses. Dissection room at our School of Medicine and in the operating room at our Hospital. To evaluate usefulness, a survey was designed for use among students, instructors, and practicing physicians. The results were satisfactory, with the usefulness of this tool supported by more than 80% positive responses to most questions. There was no inconvenience for surgeons and that patient safety was ensured in the real laparoscopy. To our knowledge, this is the first publication to demonstrate the usefulness of eye tracking in practical instruction of human anatomy, as well as in teaching clinical anatomy and surgical techniques in the dissection and operating rooms. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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…

Relationship of the lumbar plexus branches to the lumbar spine: anatomical study with application to lateral approaches.

PubMed

Tubbs, Richard Isaiah; Gabel, Brandon; Jeyamohan, Shiveindra; Moisi, Marc; Chapman, Jens R; Hanscom, R David; Loukas, Marios; Oskouian, Rod J; Tubbs, Richard Shane

2017-07-01

Injuries to the lumbar plexus during lateral approaches to the spine are not uncommon and may result in permanent deficits. However, the literature contains few studies that provide landmarks for avoiding the branches of the lumbar plexus. The present anatomical study was performed to elucidate the course of these nerves in relation to lateral approaches to the lumbar spine. This is a quantitative anatomical cadaveric study. The lumbar plexus and its branches were dissected on 12 cadaveric sides. Metal wires were laid on the nerves along their paths on the posterior abdominal wall. Fluoroscopy was performed in the anteroposterior and lateral positions. The relationships between regional bony landmarks and the branches of the lumbar plexus were observed. When viewed laterally, the greatest concentration of nerves occurred from the posteroinferior aspect of L4, inferior along the posterior one-third of the body of L5, then at the level of the sacral promontory. On the basis of our study, approaches to the anterior two-thirds of the L4 vertebra and anterior third of L5 will result in the lowest chance of lumbar plexus nerve injury. In addition, lateral muscle dissection through the psoas major should be in a superior to inferior direction in order to minimize nerve injury. Laterally, the widest corridor between branches in the abdominal wall was between the subcostal and iliohypogastric nerves. The findings of our cadaveric study provide surgeons who approach the lateral lumbar spine with data that could decrease injuries to the branches of the lumbar plexus, thus lessening patient morbidity. Copyright © 2017 Elsevier Inc. All rights reserved.

Detailed comparative anatomy of the extrinsic cardiac nerve plexus and postnatal reorganization of the cardiac position and innervation in the great apes: orangutans, gorillas, and chimpanzees.

PubMed

Kawashima, Tomokazu; Sato, Fumi

2012-03-01

To speculate how the extrinsic cardiac nerve plexus (ECNP) evolves phyletically and ontogenetically within the primate lineage, we conducted a comparative anatomical study of the ECNP, including an imaging examination in the great apes using 20 sides from 11 bodies from three species and a range of postnatal stages from newborns to mature adults. Although the position of the middle cervical ganglion (MG) in the great apes tended to be relatively lower than that in humans, the morphology of the ECNP in adult great apes was almost consistent with that in adult humans but essentially different from that in the lesser apes or gibbons. Therefore, the well-argued anatomical question of when did the MG acquire communicating branches with the spinal cervical nerves and appear constantly in all sympathetic cardiac nerves during primate evolution is clearly considered to be after the great apes and gibbons split. Moreover, a horizontal four-chambered heart and a lifted cardiac apex with a relatively large volume in newborn great apes rapidly changed its position downward, as seen in humans during postnatal growth and was associated with a reduction in the hepatic volume by imaging diagnosis and gross anatomy. In addition, our observation using a range of postnatal stages exhibits that two sympathetic ganglia, the middle cervical and cervicothoracic ganglia, differed between the early and later postnatal stages. Copyright © 2011 Wiley Periodicals, Inc.

Accuracy of conventional radiography and computed tomography in predicting implant position in relation to the vertebral canal in dogs.

PubMed

Hettlich, Bianca F; Fosgate, Geoffrey T; Levine, Jonathan M; Young, Benjamin D; Kerwin, Sharon C; Walker, Michael; Griffin, Jay; Maierl, Johann

2010-08-01

To compare the accuracy of radiography and computed tomography (CT) in predicting implant position in relation to the vertebral canal in the cervical and thoracolumbar vertebral column. In vitro imaging and anatomic study. Medium-sized canine cadaver vertebral columns (n=12). Steinmann pins were inserted into cervical and thoracolumbar vertebrae based on established landmarks but without predetermination of vertebral canal violation. Radiographs and CT images were obtained and evaluated by 6 individuals. A random subset of pins was evaluated for ability to distinguish left from right pins on radiographs. The ability to correctly identify vertebral canal penetration for all pins was assessed both on radiographs and CT. Spines were then anatomically prepared and visual examination of pin penetration into the canal served as the gold standard. Left/right accuracy was 93.1%. Overall sensitivity of radiographs and CT to detect vertebral canal penetration by an implant were significantly different and estimated as 50.7% and 93.4%, respectively (P<.0001). Sensitivity was significantly higher for complete versus partial penetration and for radiologists compared with nonradiologists for both imaging modalities. Overall specificity of radiographs and CT to detect vertebral canal penetration was 82.9% and 86.4%, respectively (P=.049). CT was superior to radiographic assessment and is the recommended imaging modality to assess penetration into the vertebral canal. CT is significantly more accurate in identifying vertebral canal violation by Steinmann pins and should be performed postoperatively to assess implant position.

Naval Biodynamics Laboratory 1993 Command History

DTIC Science & Technology

1993-01-01

position and alignment, camera optical calibration, photo target position, and standard anatomical coordinate systems based upon X-rays of each HRV...safety range. Before, during, and after each sled run, a physiological data acquisition system is used to collect and analyze physiological measurements ...experimental devices. It is also responsible for the configuring of field data measuring and acquisition systems for use aboard ships or at other field

Effect of body position on vocal tract acoustics: Acoustic pharyngometry and vowel formants.

PubMed

Vorperian, Houri K; Kurtzweil, Sara L; Fourakis, Marios; Kent, Ray D; Tillman, Katelyn K; Austin, Diane

2015-08-01

The anatomic basis and articulatory features of speech production are often studied with imaging studies that are typically acquired in the supine body position. It is important to determine if changes in body orientation to the gravitational field alter vocal tract dimensions and speech acoustics. The purpose of this study was to assess the effect of body position (upright versus supine) on (1) oral and pharyngeal measurements derived from acoustic pharyngometry and (2) acoustic measurements of fundamental frequency (F0) and the first four formant frequencies (F1-F4) for the quadrilateral point vowels. Data were obtained for 27 male and female participants, aged 17 to 35 yrs. Acoustic pharyngometry showed a statistically significant effect of body position on volumetric measurements, with smaller values in the supine than upright position, but no changes in length measurements. Acoustic analyses of vowels showed significantly larger values in the supine than upright position for the variables of F0, F3, and the Euclidean distance from the centroid to each corner vowel in the F1-F2-F3 space. Changes in body position affected measurements of vocal tract volume but not length. Body position also affected the aforementioned acoustic variables, but the main vowel formants were preserved.

Augmented reality-based electrode guidance system for reliable electroencephalography.

PubMed

Song, Chanho; Jeon, Sangseo; Lee, Seongpung; Ha, Ho-Gun; Kim, Jonghyun; Hong, Jaesung

2018-05-24

In longitudinal electroencephalography (EEG) studies, repeatable electrode positioning is essential for reliable EEG assessment. Conventional methods use anatomical landmarks as fiducial locations for the electrode placement. Since the landmarks are manually identified, the EEG assessment is inevitably unreliable because of individual variations among the subjects and the examiners. To overcome this unreliability, an augmented reality (AR) visualization-based electrode guidance system was proposed. The proposed electrode guidance system is based on AR visualization to replace the manual electrode positioning. After scanning and registration of the facial surface of a subject by an RGB-D camera, the AR of the initial electrode positions as reference positions is overlapped with the current electrode positions in real time. Thus, it can guide the position of the subsequently placed electrodes with high repeatability. The experimental results with the phantom show that the repeatability of the electrode positioning was improved compared to that of the conventional 10-20 positioning system. The proposed AR guidance system improves the electrode positioning performance with a cost-effective system, which uses only RGB-D camera. This system can be used as an alternative to the international 10-20 system.

Sinonasal anatomical variations: their relationship with chronic rhinosinusitis and effect on the severity of disease-a computerized tomography assisted anatomical and clinical study.

PubMed

Kaygusuz, Ahmet; Haksever, Mehmet; Akduman, Davut; Aslan, Sündüs; Sayar, Zeynep

2014-09-01

The anatomy of the sinonasal area has a very wide rage of anatomical variations. The significance of these anatomical variations in pathogenesis of rhinosinusitis, which is the commonest disease in the region, is still unclear. The aims of the study were to compare the rate of sinonasal anatomical variations with development and severity of chronic rhinosinusitis patients. CT scan of paranasal sinuses images of 99 individuals were retrospectively reviewed. 65 cases of chronic rhinosinusitis (study group) who had undergone endoscopic sinus surgery were compared with 34 cases without chronic rhinosinusitis (control group). Also in study group Lund-Mackay score of the sinus disease were calculated and compared to the rate of related anatomical variations. There were 74 (74.7 %) males and 25 (25.2 %) females with ages ranging from 13 to 70 years (mean 32.2 years). The anatomical variations recorded were: Septal deviation 47 (72.3) in study and 25 (73.5 %) in control group, concha bullosa 27 (41.5 %) in study and 18 (52.9 %) in control group, overpneumatized ethmoid bulla 17 (26.1 %) in study and 14 (41.1 %) in control group, pneumatized uncinate 3 (4.6 %) in study and 3 (8.8 %) in control group, agger nasi 42 (64.6 %) in study and 19 (55.8 %) in control group, paradoxical middle turbinates 9 (13.8 %) in study and 4 (11.7 %) in control group, Onodi cell 6 (9.2 %) in study and 2 (5.8 %) in control group, Haller's cells (infraorbital ethmoid cell) 9 (13.8 %) in study and 7 (20.5 %) in control group. None of these results were statistically significant between study and control group (p > 0.05). Lund-Mackay score (which was assumed to show the severity of the disease) of the maxillary, ethmoid and frontal sinus were calculated and compared to rate of septal deviation, concha bullosa, agger nasi cells. No significant correlation was conducted (p > 0.05). The results of study showed no statistically significant correlation between sinonasal anatomical variations and pathologies of the paranasal sinus. Also these anatomical variations did not increase the severity of pre-existing sinusitis significantly. This is a retrospective cohort study (2b).

The Science and Politics of Naming: Reforming Anatomical Nomenclature, ca. 1886-1955.

PubMed

Buklijas, Tatjana

2017-04-01

Anatomical nomenclature is medicine's official language. Early in their medical studies, students are expected to memorize not only the bodily geography but also the names for all the structures that, by consensus, constitute the anatomical body. The making and uses of visual maps of the body have received considerable historiographical attention, yet the history of production, communication, and reception of anatomical names-a history as long as the history of anatomy itself-has been studied far less. My essay examines the reforms of anatomical naming between the first modern nomenclature, the 1895 Basel Nomina Anatomica (BNA), and the 1955 Nomina Anatomica Parisiensia (NAP, also known as PNA), which is the basis for current anatomical terminology. I focus on the controversial and ultimately failed attempt to reform anatomical nomenclature, known as Jena Nomina Anatomica (INA), of 1935. Discussions around nomenclature reveal not only how anatomical names are made and communicated, but also the relationship of anatomy with the clinic; disciplinary controversies within anatomy; national traditions in science; and the interplay between international and scientific disciplinary politics. I show how the current anatomical nomenclature, a successor to the NAP, is an outcome of both political and disciplinary tensions that reached their peak before 1945. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Significance of localization of mandibular foramen in an inferior alveolar nerve block

PubMed Central

Thangavelu, K.; Kannan, R.; Kumar, N. Senthil; Rethish, E.; Sabitha, S.; SayeeGanesh, N.

2012-01-01

Background: The mandibular foramen (MF) is an opening on the internal surface of the ramus for divisions of the mandibular vessels and nerve to pass. The aim of this study is to determine the position of the MF from various anatomical landmarks in several dry adult mandibles. Materials and Methods: A total of 102 human dry mandibles were examined, of which 93 were of dentulous and 9 were of edentulous. The measurements were taken from the anterior border of the ramus (coronoid notch) to the midportion of the MF and then from the midportion of the MF to the other landmarks such as internal oblique ridge, inferior border, sigmoid notch, and condyle were measured and recorded. Results: The data were compared using Student's t-test. The MF is positioned at a mean distance of 19 mm (with SD 2.34) from coronoid notch of the anterior border of the ramus. Superio-inferiorly from the condyle to the inferior border MF is situated 5 mm inferior to the midpoint of condyle to the inferior border distance (ramus height). Conclusion: We conclude that failures in the anesthesia of the inferior alveolar nerve are due to the operator error and not due to the anatomical variation. PMID:23225978

Computational tissue volume reconstruction of a peripheral nerve using high-resolution light-microscopy and reconstruct.

PubMed

Gierthmuehlen, Mortimer; Freiman, Thomas M; Haastert-Talini, Kirsten; Mueller, Alexandra; Kaminsky, Jan; Stieglitz, Thomas; Plachta, Dennis T T

2013-01-01

The development of neural cuff-electrodes requires several in vivo studies and revisions of the electrode design before the electrode is completely adapted to its target nerve. It is therefore favorable to simulate many of the steps involved in this process to reduce costs and animal testing. As the restoration of motor function is one of the most interesting applications of cuff-electrodes, the position and trajectories of myelinated fibers in the simulated nerve are important. In this paper, we investigate a method for building a precise neuroanatomical model of myelinated fibers in a peripheral nerve based on images obtained using high-resolution light microscopy. This anatomical model describes the first aim of our "Virtual workbench" project to establish a method for creating realistic neural simulation models based on image datasets. The imaging, processing, segmentation and technical limitations are described, and the steps involved in the transition into a simulation model are presented. The results showed that the position and trajectories of the myelinated axons were traced and virtualized using our technique, and small nerves could be reliably modeled based on of light microscopy images using low-cost OpenSource software and standard hardware. The anatomical model will be released to the scientific community.

Computational Tissue Volume Reconstruction of a Peripheral Nerve Using High-Resolution Light-Microscopy and Reconstruct

PubMed Central

Gierthmuehlen, Mortimer; Freiman, Thomas M.; Haastert-Talini, Kirsten; Mueller, Alexandra; Kaminsky, Jan; Stieglitz, Thomas; Plachta, Dennis T. T.

2013-01-01

The development of neural cuff-electrodes requires several in vivo studies and revisions of the electrode design before the electrode is completely adapted to its target nerve. It is therefore favorable to simulate many of the steps involved in this process to reduce costs and animal testing. As the restoration of motor function is one of the most interesting applications of cuff-electrodes, the position and trajectories of myelinated fibers in the simulated nerve are important. In this paper, we investigate a method for building a precise neuroanatomical model of myelinated fibers in a peripheral nerve based on images obtained using high-resolution light microscopy. This anatomical model describes the first aim of our “Virtual workbench” project to establish a method for creating realistic neural simulation models based on image datasets. The imaging, processing, segmentation and technical limitations are described, and the steps involved in the transition into a simulation model are presented. The results showed that the position and trajectories of the myelinated axons were traced and virtualized using our technique, and small nerves could be reliably modeled based on of light microscopy images using low-cost OpenSource software and standard hardware. The anatomical model will be released to the scientific community. PMID:23785485

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.

Characterization of proximal femoral anatomy in the skeletally-immature patient.

PubMed

Beutel, B G; Girdler, S J; Collins, J A; Otsuka, N Y; Chu, A

2018-04-01

The morphology of the proximal femur has been extensively studied in the adult population. However, no literature providing a comprehensive evaluation of the anatomy in paediatric patients exists. The current study aims to characterize such anatomy in skeletally-immature patients, examine potential differences between genders, and analyze how these anatomical parameters change with age. Cadaveric femurs from the Hamann-Todd Osteological Collection were examined. Specimens with open physes and no skeletal disease or deformity were included for analysis. Age and gender were recorded for each specimen. Each femur was photographed in standardized modified axial and anteroposterior views. In all, 14 proximal femoral anatomical parameters were measured from these photographs. Comparisons between genders and age were calculated. A total of 43 femurs from ages four to 17 years met inclusion criteria. The majority were female (56%); no difference existed in age between genders (p = 0.62). The specimens had a neutral mean neck-shaft angle (130.7º) and anteversion (12.8º), and the sphericity of the ossified femoral heads was symmetrical. Male specimens had significantly higher alpha angles (p = 0.01), posterior offset (p = 0.02), neck width (p = 0.04) and head-neck length ratio (p = 0.02) values than female specimens. Strong positive correlations exist between length/size parameters and age, while negligible correlations were noted for angular measurements. This study establishes reference values for a comprehensive list of anatomical parameters for the skeletally-immature ossified proximal femur. It highlights gender differences in morphology and demonstrates that angular characteristics remain relatively stable while length parameters generally increase with age. Level III Diagnostic.

Anatomical study of phrenic nerve course in relation to neck dissection.

PubMed

Hamada, Tomohiro; Usami, Akinobu; Kishi, Asuka; Kon, Hideki; Takada, Satoshi

2015-04-01

The present study sought to clarify the course of the phrenic nerve and its correlation with anatomical landmarks in the neck region. We examined 17 cadavers (30 sides). In each, the phrenic nerves was dissected from the lateral side of the neck, and its position within the triangle formed by the mastoid process and sternal and acromial ends of the clavicle was determined. The point where the phrenic nerve arises in the posterior triangle was found to be similar to the point where the cutaneous blanches of the cervical plexus emerge at the middle of the posterior border of the sternocleidomastoid muscle. In the supraclavian triangle, the phrenic nerve crosses the anterior border of the anterior scalene muscle near Erb's point where the superficial point is 2-3 cm superior from the clavicle and posterior border of the sternocleidomastoid muscle. The phrenic nerve arises in the posterior triangle near the nerve point, then descends to the anterior surface of the anterior scalene muscle in the supraclavian triangle. It is necessary to be aware of the supraclavian triangle below Erb's point during neck dissection procedures.

Internal respiratory surrogate in multislice 4D CT using a combination of Fourier transform and anatomical features

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hui, Cheukkai; Suh, Yelin; Robertson, Daniel

Purpose: The purpose of this study was to develop a novel algorithm to create a robust internal respiratory signal (IRS) for retrospective sorting of four-dimensional (4D) computed tomography (CT) images. Methods: The proposed algorithm combines information from the Fourier transform of the CT images and from internal anatomical features to form the IRS. The algorithm first extracts potential respiratory signals from low-frequency components in the Fourier space and selected anatomical features in the image space. A clustering algorithm then constructs groups of potential respiratory signals with similar temporal oscillation patterns. The clustered group with the largest number of similar signalsmore » is chosen to form the final IRS. To evaluate the performance of the proposed algorithm, the IRS was computed and compared with the external respiratory signal from the real-time position management (RPM) system on 80 patients. Results: In 72 (90%) of the 4D CT data sets tested, the IRS computed by the authors’ proposed algorithm matched with the RPM signal based on their normalized cross correlation. For these data sets with matching respiratory signals, the average difference between the end inspiration times (Δt{sub ins}) in the IRS and RPM signal was 0.11 s, and only 2.1% of Δt{sub ins} were more than 0.5 s apart. In the eight (10%) 4D CT data sets in which the IRS and the RPM signal did not match, the average Δt{sub ins} was 0.73 s in the nonmatching couch positions, and 35.4% of them had a Δt{sub ins} greater than 0.5 s. At couch positions in which IRS did not match the RPM signal, a correlation-based metric indicated poorer matching of neighboring couch positions in the RPM-sorted images. This implied that, when IRS did not match the RPM signal, the images sorted using the IRS showed fewer artifacts than the clinical images sorted using the RPM signal. Conclusions: The authors’ proposed algorithm can generate robust IRSs that can be used for retrospective sorting of 4D CT data. The algorithm is completely automatic and requires very little processing time. The algorithm is cost efficient and can be easily adopted for everyday clinical use.« less

Hybrid computational phantoms of the male and female newborn patient: NURBS-based whole-body models

NASA Astrophysics Data System (ADS)

Lee, Choonsik; Lodwick, Daniel; Hasenauer, Deanna; Williams, Jonathan L.; Lee, Choonik; Bolch, Wesley E.

2007-07-01

Anthropomorphic computational phantoms are computer models of the human body for use in the evaluation of dose distributions resulting from either internal or external radiation sources. Currently, two classes of computational phantoms have been developed and widely utilized for organ dose assessment: (1) stylized phantoms and (2) voxel phantoms which describe the human anatomy via mathematical surface equations or 3D voxel matrices, respectively. Although stylized phantoms based on mathematical equations can be very flexible in regard to making changes in organ position and geometrical shape, they are limited in their ability to fully capture the anatomic complexities of human internal anatomy. In turn, voxel phantoms have been developed through image-based segmentation and correspondingly provide much better anatomical realism in comparison to simpler stylized phantoms. However, they themselves are limited in defining organs presented in low contrast within either magnetic resonance or computed tomography images—the two major sources in voxel phantom construction. By definition, voxel phantoms are typically constructed via segmentation of transaxial images, and thus while fine anatomic features are seen in this viewing plane, slice-to-slice discontinuities become apparent in viewing the anatomy of voxel phantoms in the sagittal or coronal planes. This study introduces the concept of a hybrid computational newborn phantom that takes full advantage of the best features of both its stylized and voxel counterparts: flexibility in phantom alterations and anatomic realism. Non-uniform rational B-spline (NURBS) surfaces, a mathematical modeling tool traditionally applied to graphical animation studies, was adopted to replace the limited mathematical surface equations of stylized phantoms. A previously developed whole-body voxel phantom of the newborn female was utilized as a realistic anatomical framework for hybrid phantom construction. The construction of a hybrid phantom is performed in three steps: polygonization of the voxel phantom, organ modeling via NURBS surfaces and phantom voxelization. Two 3D graphic tools, 3D-DOCTOR™ and Rhinoceros™, were utilized to polygonize the newborn voxel phantom and generate NURBS surfaces, while an in-house MATLAB™ code was used to voxelize the resulting NURBS model into a final computational phantom ready for use in Monte Carlo radiation transport calculations. A total of 126 anatomical organ and tissue models, including 38 skeletal sites and 31 cartilage sites, were described within the hybrid phantom using either NURBS or polygon surfaces. A male hybrid newborn phantom was constructed following the development of the female phantom through the replacement of female-specific organs with male-specific organs. The outer body contour and internal anatomy of the NURBS-based phantoms were adjusted to match anthropometric and reference newborn data reported by the International Commission on Radiological Protection in their Publication 89. The voxelization process was designed to accurately convert NURBS models to a voxel phantom with minimum volumetric change. A sensitivity study was additionally performed to better understand how the meshing tolerance and voxel resolution would affect volumetric changes between the hybrid-NURBS and hybrid-voxel phantoms. The male and female hybrid-NURBS phantoms were constructed in a manner so that all internal organs approached their ICRP reference masses to within 1%, with the exception of the skin (-6.5% relative error) and brain (-15.4% relative error). Both hybrid-voxel phantoms were constructed with an isotropic voxel resolution of 0.663 mm—equivalent to the ICRP 89 reference thickness of the newborn skin (dermis and epidermis). Hybrid-NURBS phantoms used to create their voxel counterpart retain the non-uniform scalability of stylized phantoms, while maintaining the anatomic realism of segmented voxel phantoms with respect to organ shape, depth and inter-organ positioning. This work was supported by the National Cancer Institute.

Defining the spatial relationships between eight anatomic planes in the 11+6 to 13+6 weeks fetus: a pilot study.

PubMed

Abu-Rustum, Reem S; Ziade, M Fouad; Abu-Rustum, Sameer E

2012-09-01

Our study aims at investigating the spatial relationships between eight anatomic planes in the 11+6 to 13+6 weeks fetus. This is a retrospective pilot study where three-dimensional and four-dimensional stored data sets were manipulated to retrieve eight anatomic planes starting from the midsagittal plane of the fetus. Standardization of volumes was performed at the level of the transverse abdominal circumference plane. Parallel shift was utilized and the spatial relationships between eight anatomic planes were established. The median and the range were calculated for each of the planes, and they were evaluated as a function of the fetal crown-rump length. P < 0.05 was considered statistically significant. A total of 63 volume data sets were analyzed. The eight anatomic planes were found to adhere to normal distribution curves, and most of the planes were in a definable relationship to each other with statistically significant correlations. To our knowledge, this is the first study to describe the possible spatial relationships between eight two-dimensional anatomic planes in the 11+6 to 13+6 weeks fetus, utilizing a standardized approach. Defining these spatial relationships may serve as the first step for the potential future development of automation software for fetal anatomic assessment at 11+6 to 13+6 weeks. © 2012 John Wiley & Sons, Ltd.

Information processing architecture of functionally defined clusters in the macaque cortex.

PubMed

Shen, Kelly; Bezgin, Gleb; Hutchison, R Matthew; Gati, Joseph S; Menon, Ravi S; Everling, Stefan; McIntosh, Anthony R

2012-11-28

Computational and empirical neuroimaging studies have suggested that the anatomical connections between brain regions primarily constrain their functional interactions. Given that the large-scale organization of functional networks is determined by the temporal relationships between brain regions, the structural limitations may extend to the global characteristics of functional networks. Here, we explored the extent to which the functional network community structure is determined by the underlying anatomical architecture. We directly compared macaque (Macaca fascicularis) functional connectivity (FC) assessed using spontaneous blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) to directed anatomical connectivity derived from macaque axonal tract tracing studies. Consistent with previous reports, FC increased with increasing strength of anatomical connection, and FC was also present between regions that had no direct anatomical connection. We observed moderate similarity between the FC of each region and its anatomical connectivity. Notably, anatomical connectivity patterns, as described by structural motifs, were different within and across functional modules: partitioning of the functional network was supported by dense bidirectional anatomical connections within clusters and unidirectional connections between clusters. Together, our data directly demonstrate that the FC patterns observed in resting-state BOLD-fMRI are dictated by the underlying neuroanatomical architecture. Importantly, we show how this architecture contributes to the global organizational principles of both functional specialization and integration.

Do Open Reduction and Internal Fixation With Articular Disc Anatomical Reduction and Rigid Anchorage Manifest a Promising Prospect in the Treatment of Intracapsular Fractures?

PubMed

Cai, Bo-Lei; Ren, Rong; Yu, Hong-Bo; Liu, Peng-Chao; Shen, Steve G F; Shi, Jun

2018-05-01

In response to the increased attention to soft tissue reduction in the treatment of intracapsular condylar fractures (ICFs), a modified open reduction technique is proposed and its functional and radiographic outcomes were evaluated in this study. This is a retrospective case series study of patients with all ICF types that were treated with open reduction and internal fixation (ORIF) with articular disc anatomic reduction and rigid anchorage. Inclusion and exclusion criteria were strictly applied. Preoperative and postoperative clinical examinations of malocclusion, maximum incisor opening (MIO), laterotrusion, and temporomandibular disorder symptoms were recorded and analyzed. Computed tomography (CT) and magnetic resonance imaging (MRI) were used to assess articular position and condylar morphology and position. Thirty-four patients with ICFs (47 sides) were treated with the modified ORIF technique. At 6 months of follow-up, no malocclusion was found and the MIO considerably expanded to 3.56 ± 0.13 cm. Only 4 patients (12%) had temporomandibular joint discomfort with mouth opening. Interestingly, for unilateral type B ICFs, the laterotrusion distance to the ORIF sides was notably longer than to the non-ORIF sides. Postoperative CT and MRI showed that all fragments were properly reduced and the condyles were in the normal position. Postoperative anterior disc displacement occurred in 4 sides and condylar morphologic abnormalities (slight surface roughening and articular cartilage absorption) occurred in 3 sides (6.4%). This modified ORIF technique, which achieved good outcomes after treatment of all ICF types, shows promise for the treatment of ICFs. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Anatomical characteristics of teats and premilking bacterial counts of teat skin swabs of primiparous cows exposed to different types of bedding.

PubMed

Guarín, J F; Baumberger, C; Ruegg, P L

2017-02-01

Bacterial populations of teat skin are associated with risk of intramammary infection and may be influenced by anatomical characteristics of teats. The objective of this study was to evaluate associations of selected anatomical characteristics of teats with bacterial counts of teat skin of cows exposed to different types of bedding. Primarily primiparous Holstein cows (n = 128) were randomly allocated to 4 pens within a single barn. Each pen contained 1 type of bedding [new sand (NES), recycled sand (RS), deep-bedded manure solids (DBMS), and shallow-bedded manure solids over foam core mattresses (SBMS)]. During a single farm visit udders (n = 112) were scored for hygiene and 1 front (n = 112) and 1 rear teat (n = 111) of each enrolled cow were scored for hyperkeratosis (HK). Teat length, teat barrel diameter, and teat apex diameter were measured and teat skin swabs were systematically collected for microbiological analysis. Linear type evaluation data for udders of each cow were retrieved for each cow. Teat position (front or rear) was associated with occurrence of clinical mastitis during the 12 mo before the farm visit and more cases occurred in front quarters. The proportion of udders that were classified as clean (score 1 or 2) was 68, 82, 54, and 95% for cows housed in pens containing NES, RS, SBMS, and DBMS, respectively. No association was found between HK score and teat position and no association was found between HK score and teat skin bacterial count. Bacterial counts of teat skin swabs from front teats of cows in pens containing RS and SBMS were significantly less than those of rear teats of cows in pens containing DBMS or NES. Teat skin bacterial counts were significantly greater for swabs obtained from teats of cows with udder hygiene scores of 3 and 4 as compared with swabs obtained from cows with cleaner udders. Of all udder conformation traits evaluated, only narrower rear teat placement was positively associated with bacterial counts on teat skin. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Distinct anatomical subtypes of the behavioural variant of frontotemporal dementia: a cluster analysis study.

PubMed

Whitwell, Jennifer L; Przybelski, Scott A; Weigand, Stephen D; Ivnik, Robert J; Vemuri, Prashanthi; Gunter, Jeffrey L; Senjem, Matthew L; Shiung, Maria M; Boeve, Bradley F; Knopman, David S; Parisi, Joseph E; Dickson, Dennis W; Petersen, Ronald C; Jack, Clifford R; Josephs, Keith A

2009-11-01

The behavioural variant of frontotemporal dementia is a progressive neurodegenerative syndrome characterized by changes in personality and behaviour. It is typically associated with frontal lobe atrophy, although patterns of atrophy are heterogeneous. The objective of this study was to examine case-by-case variability in patterns of grey matter atrophy in subjects with the behavioural variant of frontotemporal dementia and to investigate whether behavioural variant of frontotemporal dementia can be divided into distinct anatomical subtypes. Sixty-six subjects that fulfilled clinical criteria for a diagnosis of the behavioural variant of frontotemporal dementia with a volumetric magnetic resonance imaging scan were identified. Grey matter volumes were obtained for 26 regions of interest, covering frontal, temporal and parietal lobes, striatum, insula and supplemental motor area, using the automated anatomical labelling atlas. Regional volumes were divided by total grey matter volume. A hierarchical agglomerative cluster analysis using Ward's clustering linkage method was performed to cluster the behavioural variant of frontotemporal dementia subjects into different anatomical clusters. Voxel-based morphometry was used to assess patterns of grey matter loss in each identified cluster of subjects compared to an age and gender-matched control group at P < 0.05 (family-wise error corrected). We identified four potentially useful clusters with distinct patterns of grey matter loss, which we posit represent anatomical subtypes of the behavioural variant of frontotemporal dementia. Two of these subtypes were associated with temporal lobe volume loss, with one subtype showing loss restricted to temporal lobe regions (temporal-dominant subtype) and the other showing grey matter loss in the temporal lobes as well as frontal and parietal lobes (temporofrontoparietal subtype). Another two subtypes were characterized by a large amount of frontal lobe volume loss, with one subtype showing grey matter loss in the frontal lobes as well as loss of the temporal lobes (frontotemporal subtype) and the other subtype showing loss relatively restricted to the frontal lobes (frontal-dominant subtype). These four subtypes differed on clinical measures of executive function, episodic memory and confrontation naming. There were also associations between the four subtypes and genetic or pathological diagnoses which were obtained in 48% of the cohort. The clusters did not differ in behavioural severity as measured by the Neuropsychiatric Inventory; supporting the original classification of the behavioural variant of frontotemporal dementia in these subjects. Our findings suggest behavioural variant of frontotemporal dementia can therefore be subdivided into four different anatomical subtypes.

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.

Understanding the Anatomic Basis for Obstructive Sleep Apnea Syndrome in Adolescents

PubMed Central

Kim, Christopher; Bagchi, Sheila; Keenan, Brendan T.; Comyn, François-Louis; Wang, Stephen; Tapia, Ignacio E.; Huang, Shirley; Traylor, Joel; Torigian, Drew A.; Bradford, Ruth M.; Marcus, Carole L.

2015-01-01

Rationale: Structural risk factors for obstructive sleep apnea syndrome (OSAS) in adolescents have not been well characterized. Because many adolescents with OSAS are obese, we hypothesized that the anatomic OSAS risk factors would be more similar to those in adults than those in children. Objectives: To investigate the anatomic risk factors in adolescents with OSAS compared with obese and lean control subjects using magnetic resonance imaging (MRI). Methods: Three groups of adolescents (age range: 12–16 yr) underwent MRI: obese individuals with OSAS (n = 49), obese control subjects (n = 38), and lean control subjects (n = 50). Measurements and Main Results: We studied 137 subjects and found that (1) obese adolescents with OSAS had increased adenotonsillar tissue compared with obese and lean control subjects; (2) obese OSAS adolescents had a smaller nasopharyngeal airway than control subjects; (3) the size of other upper airway soft tissue structures (volume of the tongue, parapharyngeal fat pads, lateral walls, and soft palate) was similar between subjects with OSAS and obese control subjects; (4) although there were no major craniofacial abnormalities in most of the adolescents with OSAS, the ratio of soft tissue to craniofacial space surrounding the airway was increased; and (5) there were sex differences in the pattern of lymphoid proliferation. Conclusions: Increased size of the pharyngeal lymphoid tissue, rather than enlargement of the upper airway soft tissue structures, is the primary anatomic risk factor for OSAS in obese adolescents. These results are important for clinical decision making and suggest that adenotonsillectomy should be considered as the initial treatment for OSAS in obese adolescents, a group that has poor continuous positive airway pressure adherence and difficulty in achieving weight loss. PMID:25835282

Investigation of image components affecting the detection of lung nodules in digital chest radiography

NASA Astrophysics Data System (ADS)

Bath, Magnus; Hakansson, Markus; Borjesson, Sara; Hoeschen, Christoph; Tischenko, Oleg; Bochud, Francois O.; Verdun, Francis R.; Ullman, Gustaf; Kheddache, Susanne; Tingberg, Anders; Mansson, Lars Gunnar

2005-04-01

The aim of this work was to investigate and quantify the effects of system noise, nodule location, anatomical noise and anatomical background on the detection of lung nodules in different regions of the chest x-ray. Simulated lung nodules of diameter 10 mm but with varying detail contrast were randomly positioned in four different kinds of images: 1) clinical images collected with a 200 speed CR system, 2) images containing only system noise (including quantum noise) at the same level as the clinical images, 3) clinical images with removed anatomical noise, 4) artificial images with similar power spectrum as the clinical images but random phase spectrum. An ROC study was conducted with 5 observers. The detail contrast needed to obtain an Az of 0.80, C0.8, was used as measure of detectability. Five different regions of the chest x-ray were investigated separately. The C0.8 of the system noise images ranged from only 2% (the hilar regions) to 20% (the lateral pulmonary regions) of those of the clinical images. Compared with the original clinical images, the C0.8 was 16% lower for the de-noised clinical images and 71% higher for the random phase images, respectively, averaged over all five regions. In conclusion, regarding the detection of lung nodules with a diameter of 10 mm, the system noise is of minor importance at clinically relevant dose levels. The removal of anatomical noise and other noise sources uncorrelated from image to image leads to somewhat better detection, but the major component disturbing the detection is the overlapping of recognizable structures, which are, however, the main aspect of an x-ray image.

Hybrid imaging by SPECT/CT for sentinel lymph node detection in patients with cancer of the uterine cervix.

PubMed

Martínez, A; Zerdoud, S; Mery, E; Bouissou, E; Ferron, G; Querleu, D

2010-12-01

Conventional lymphoscintigraphy provides planar images with little spatial information on location of pelvic sentinel lymph nodes (SLN). SPECT has better spatial resolution and, in combination with anatomic accuracy provided by CT improves SLN preoperative localization. The aim of the study was to report on the results of hybrid imaging of SLN in early cervical cancer patients treated at Claudius Regaud Cancer Center. Stages IA-IB1 cervical cancer patients undergoing preoperative SPECT/CT for SLN detection were analysed. Forty-one patients were included. A 100% SLN detection rate was achieved when a combined technique (radiotracer and blue dye) was used. At least one SLN was clearly visualized by SPECT/CT in 39 of 41 patients (95%) and full anatomic concordance with intraoperative anatomical location of SLN was found in 37 of the 39 patients with at least one SLN identified by SPECT/CT (95%). Location of removed SLN included the external and internal iliac area in 88% patients, the common iliac area in 10.5%, and the inframesenteric para-aortic area in 1.5%. No SLN was found in the infrarenal para-aortic region. Lymph node involvement was identified in 5 patients (12.1%). SLN correctly predicted lymph node involvement in all node-positive patients. However, SPECT/CT failed to identify 1 of the 5 metastatic SLN. SPECT/CT accurately detected preoperative SLN topography and enhanced diagnostic sensitivity of SLN imaging, improving surgical approach to patients with cervical cancer staging. Diagnostic quality of anatomic landmarks of CT images of SPECT/CT could be further improved by the use of contrast injected CT. Copyright © 2010 Elsevier Inc. All rights reserved.

Anatomical basis of variation in mesophyll resistance in eastern Australian sclerophylls: news of a long and winding path

PubMed Central

Tosens, Tiina

2012-01-01

In sclerophylls, photosynthesis is particularly strongly limited by mesophyll diffusion resistance from substomatal cavities to chloroplasts (r m), but the controls on diffusion limits by integral leaf variables such as leaf thickness, density, and dry mass per unit area and by the individual steps along the diffusion pathway are imperfectly understood. To gain insight into the determinants of r m in leaves with varying structure, the full CO2 physical diffusion pathway was analysed in 32 Australian species sampled from sites contrasting in soil nutrients and rainfall, and having leaf structures from mesophytic to strongly sclerophyllous. r m was estimated based on combined measurements of gas exchange and chlorophyll fluorescence. In addition, r m was modelled on the basis of detailed anatomical measurements to separate the importance of different serial resistances affecting CO2 diffusion into chloroplasts. The strongest sources of variation in r m were S c/S, the exposed surface area of chloroplasts per unit leaf area, and mesophyll cell wall thickness, t cw. The strong correlation of r m with t cw could not be explained by cell wall thickness alone, and most likely arose from a further effect of cell wall porosity. The CO2 drawdown from intercellular spaces to chloroplasts was positively correlated with t cw, suggesting enhanced diffusional limitations in leaves with thicker cell walls. Leaf thickness and density were poorly correlated with S c/S, indicating that widely varying combinations of leaf anatomical traits occur at given values of leaf integrated traits, and suggesting that detailed anatomical studies are needed to predict r m for any given species. PMID:22888123

Dedicated breast CT: geometric design considerations to maximize posterior breast coverage

NASA Astrophysics Data System (ADS)

Vedantham, Srinivasan; Karellas, Andrew; Emmons, Margaret M.; Moss, Lawrence J.; Hussain, Sarwat; Baker, Stephen P.

2013-06-01

An Institutional Review Board-approved protocol was used to quantify breast tissue inclusion in 52 women, under conditions simulating both craniocaudal (CC) and mediolateral oblique (MLO) views in mammography, dedicated breast CT in the upright subject position, and dedicated breast CT in the prone subject position. Using skin as a surrogate for the underlying breast tissue, the posterior aspect of the breast that is aligned with the chest-wall edge of the breast support in a screen-film mammography system was marked with the study participants positioned for CC and MLO views. The union of skin marks with the study participants positioned for CC and MLO views was considered to represent chest-wall tissue available for imaging with mammography and served as the reference standard. For breast CT, a prone stereotactic breast biopsy unit and a custom-fabricated barrier were used to simulate conditions during prone and upright breast CT, respectively. For the same breast marked on the mammography system, skin marks were made along the breast periphery that was just anterior to the apertures of the prone biopsy unit and the upright barrier. The differences in skin marks between subject positioning simulating breast CT (prone, upright) and mammography were quantified at six anatomic locations. For each location, at least one study participant had a skin mark from breast CT (prone, upright) posterior to mammography. However for all study participants, there was at least one anatomic location where the skin mark from mammography was posterior to that from breast CT (prone, upright) positioning. The maximum amount by which the skin mark from mammography was posterior to breast CT (prone and upright) over all six locations was quantified for each study participant and pair-wise comparison did not exhibit statistically significant difference between prone and upright breast CT (paired t- test, p = 0.4). Quantitatively, for 95% of the study participants the skin mark from mammography was posterior to breast CT (prone or upright) by at the most 9 mm over all six locations. Based on the study observations, geometric design considerations targeting chest-wall coverage with breast CT equivalent to mammography, wherein part of the x-ray beam images through the swale during breast CT are provided. Assuming subjects can extend their chest in to a swale, the optimal swale-depth required to achieve equivalent coverage with breast CT images as mammograms for 95% of the subjects varies in the range of ˜30-50 mm for clinical prototypes and was dependent on the system geometry.

Effect of Medial Patellofemoral Ligament Reconstruction Method on Patellofemoral Contact Pressures and Kinematics.

PubMed

Stephen, Joanna M; Kittl, Christoph; Williams, Andy; Zaffagnini, Stefano; Marcheggiani Muccioli, Giulio Maria; Fink, Christian; Amis, Andrew A

2016-05-01

There remains a lack of evidence regarding the optimal method when reconstructing the medial patellofemoral ligament (MPFL) and whether some graft constructs can be more forgiving to surgical errors, such as overtensioning or tunnel malpositioning, than others. The null hypothesis was that there would not be a significant difference between reconstruction methods (eg, graft type and fixation) in the adverse biomechanical effects (eg, patellar maltracking or elevated articular contact pressure) resulting from surgical errors such as tunnel malpositioning or graft overtensioning. Controlled laboratory study. Nine fresh-frozen cadaveric knees were placed on a customized testing rig, where the femur was fixed but the tibia could be moved freely from 0° to 90° of flexion. Individual quadriceps heads and the iliotibial tract were separated and loaded to 205 N of tension using a weighted pulley system. Patellofemoral contact pressures and patellar tracking were measured at 0°, 10°, 20°, 30°, 60°, and 90° of flexion using pressure-sensitive film inserted between the patella and trochlea, in conjunction with an optical tracking system. The MPFL was transected and then reconstructed in a randomized order using a (1) double-strand gracilis tendon, (2) quadriceps tendon, and (3) tensor fasciae latae allograft. Pressure maps and tracking measurements were recorded for each reconstruction method in 2 N and 10 N of tension and with the graft positioned in the anatomic, proximal, and distal femoral tunnel positions. Statistical analysis was undertaken using repeated-measures analyses of variance, Bonferroni post hoc analyses, and paired t tests. Anatomically placed grafts during MPFL reconstruction tensioned to 2 N resulted in the restoration of intact medial joint contact pressures and patellar tracking for all 3 graft types investigated (P > .050). However, femoral tunnels positioned proximal or distal to the anatomic origin resulted in significant increases in the mean medial joint contact pressure, medial patellar tilt, and medial patellar translation during knee flexion or extension, respectively (P < .050), regardless of graft type, as did tensioning to 10 N. The importance of the surgical technique, specifically correct femoral tunnel positioning and graft tensioning, in restoring normal patellofemoral joint (PFJ) kinematics and articular cartilage contact stresses is evident, and the type of MPFL graft appeared less important. The correct femoral tunnel position and graft tension for restoring normal PFJ kinematics and articular cartilage contact stresses appear to be more important than graft selection during MPFL reconstruction. These findings emphasize the importance of the surgical technique when undertaking this procedure. © 2016 The Author(s).

[The anatomic tradition in Venice].

PubMed

Capitanio, G; Stracca Pansa, V

2000-04-01

Venice had a long tradition and great reputation in the study of anatomical science dating back to the 1300's. The "Serenissima" Republic favoured the study and practice of anatomy as part of medical professional formation. Before the construction of the anatomical theater of San Giacomo dell'Orio, which took place in 1671, anatomical dissections were performed in churches, convents, hospitals and private homes. Even though Venice was not a University seat, it boosted numerous Venetian anatomists, among whom Benedetti, Massa, Santorini, and the medical activity of illustrious professors at the nearby University of Padua such as Vesalio, Falloppio, Spigelio, Vislingio and Morgagni.

Reliability of implant placement after virtual planning of implant positions using cone beam CT data and surgical (guide) templates.

PubMed

Nickenig, Hans-Joachim; Eitner, Stephan

2007-01-01

We assessed the reliability of implant placement after virtual planning of implant positions using cone-beam CT data and surgical guide templates. A total of 102 patients (250 implants, 55.4% mandibular; mean patient age, 40.4 years) who had undergone implant treatment therapy in an armed forces dental clinic (Cologne, Germany) between July 1, 2005 and December 1, 2005. They were treated with a system that allows transfer of virtual planning to surgical guide templates. Only in eight cases the surgical guides were not used because a delayed implant placement was necessary. In four posterior mandibular cases, handling was limited because of reduced interocclusal distance, requiring 50% shortening of the drill guides. The predictability of implant size was high: only one implant was changed to a smaller diameter (because of insufficient bone). In all cases, critical anatomical structures were protected and no complications were detected in postoperative panoramic radiographs. In 58.1% (147) of the 250 implants, a flapless surgery plan was realized. Implant placement after virtual planning of implant positions using cone beam CT data and surgical templates can be reliable for preoperative assessment of implant size, position, and anatomical complications. It is also indicative of cases amenable to flapless surgery.

Maxillary post-traumatic outcome correction literature review and our experience. Part I: maxillary bone non-unions-"poor bone positioning".

PubMed

D'Agostino, A; Toffanetti, G; Scala, R; Trevisiol, L; Ferrari, F

2004-04-01

Still today, there is no classification of non-unions in maxillofacial traumatology. There is a broad spectrum of definitions that simultaneously describe the pathological conditions and functional implications determined by the anatomical location of the fractures and the time factor. In this article the authors describe a literature review about bone non-union classification. Weber, in 1973, introduced the term "pseudo-arthrosis" to describe an altered process of bone healing characterised by the presence of fibrous tissue interposed between the fracture segments, that was lined with cartilaginous tissue and joined by a capsule; Spiessl, in 1988, used the term "non-union" to define any alteration of the bone healing process after a time period of more than 6 months from the initial traumatic event; Rosen, in 1990, proposed a new classification of the modes of altered bone healing in fractures, distinguishing 5 categories: delayed consolidation, non-union, non-union vascular, non union avascular, pseudoarthrosis. The authors also talk about "poor bone positioning". This factor describes the incorrect anatomical position of the bone fragments despite perfectly normal healing according to Gruss. In this article they also discuss about the treatment of non-unions and the treatment of occlusal alterations caused by poor post-traumatic bone positioning.

[3D FSPGR (fast spoiled gradient echo) magnetic resonance imaging in the diagnosis of focal cortical dysplasia in children].

PubMed

Alikhanov, A A; Sinitsyn, V E; Perepelova, E M; Mukhin, K Iu; Demushkina, A A; Omarova, M O; Piliia, S V

2001-01-01

Small dysplastic lesions of the cerebral cortex are often missed by conventional MRI methods. The identification of subtle structural abnormalities by traditional multiplanar rectilinear slices is often limited by the complex convolutional pattern of the brain. We used a method of FSPGR (fast spoiled gradient-echo) of three-dimensional MRI data that improves the anatomical display of the sulcal structure of the hemispheric convexities. It also reduces the asymmetric sampling of gray-white matter that may lead to false-positive results. We present 5 from 12 patients with dysplastic cortical lesions in whom conventional two-dimensional and three-dimensional MRI with multiplanar reformatting was initially considered normal. Subsequent studies using 3D FSPGR identified various types of focal cortical dysplasia in all. These results indicate that an increase in the detection of subtle focal dysplastic lesions may be accomplished when one improves the anatomical display of the brain sulcal structure by performing 3D FSPGR.

Three-dimensional kinematic stress magnetic resonance image analysis shows promise for detecting altered anatomical relationships of tissues in the cervical spine associated with painful radiculopathy.

PubMed

Jaumard, N V; Udupa, J K; Siegler, S; Schuster, J M; Hilibrand, A S; Hirsch, B E; Borthakur, A; Winkelstein, B A

2013-10-01

For some patients with radiculopathy a source of nerve root compression cannot be identified despite positive electromyography (EMG) evidence. This discrepancy hampers the effective clinical management for these individuals. Although it has been well-established that tissues in the cervical spine move in a three-dimensional (3D) manner, the 3D motions of the neural elements and their relationship to the bones surrounding them are largely unknown even for asymptomatic normal subjects. We hypothesize that abnormal mechanical loading of cervical nerve roots during pain-provoking head positioning may be responsible for radicular pain in those cases in which there is no evidence of nerve root compression on conventional cervical magnetic resonance imaging (MRI) with the neck in the neutral position. This biomechanical imaging proof-of-concept study focused on quantitatively defining the architectural relationships between the neural and bony structures in the cervical spine using measurements derived from 3D MR images acquired in neutral and pain-provoking neck positions for subjects: (1) with radicular symptoms and evidence of root compression by conventional MRI and positive EMG, (2) with radicular symptoms and no evidence of root compression by MRI but positive EMG, and (3) asymptomatic age-matched controls. Function and pain scores were measured, along with neck range of motion, for all subjects. MR imaging was performed in both a neutral position and a pain-provoking position. Anatomical architectural data derived from analysis of the 3D MR images were compared between symptomatic and asymptomatic groups, and the symptomatic groups with and without imaging evidence of root compression. Several differences in the architectural relationships between the bone and neural tissues were identified between the asymptomatic and symptomatic groups. In addition, changes in architectural relationships were also detected between the symptomatic groups with and without imaging evidence of nerve root compression. As demonstrated in the data and a case study the 3D stress MR imaging approach provides utility to identify biomechanical relationships between hard and soft tissues that are otherwise undetected by standard clinical imaging methods. This technique offers a promising approach to detect the source of radiculopathy to inform clinical management for this pathology. Copyright © 2013 Elsevier Ltd. All rights reserved.

Mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous vein insufficiency (MESSI trial): study protocol for a randomized controlled trial.

PubMed

Boersma, Doeke; van Eekeren, Ramon R J P; Kelder, Hans J C; Werson, Debora A B; Holewijn, Suzanne; Schreve, Michiel A; Reijnen, Michel M P J; de Vries, Jean Paul P M

2014-10-29

Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used. Prospective studies using MOCA™ in both great and small saphenous veins showed good anatomical and clinical results with fast postoperative recovery. The MESSI trial (Mechanochemical Endovenous ablation versus radiofrequency ablation in the treatment of primary Small Saphenous vein Insufficiency) is a multicenter randomized controlled trial in which a total of 160 patients will be randomized (1:1) to MOCA™ or RFA. Consecutive patients with primary small saphenous vein incompetence, who meet the eligibility criteria, will be invited to participate in this trial. The primary endpoint is anatomic success, defined as occlusion of the treated veins objectified with duplex ultrasonography at 1 year follow-up. Secondary endpoints are post-procedural pain, initial technical success, clinical success, complications and the duration of the procedure. Initial technical success is defined as the ability to position the device adequately, treat the veins as planned and occlude the treated vein directly after the procedure has been proven by duplex ultrasonography. Clinical success is defined as an objective improvement of clinical outcome after treatment, measured with the Venous Clinical Severity Score (VCSS). Power analyses are conducted for anatomical success and post-procedural pain.Both groups will be evaluated on an intention-to-treat principle. The hypothesis of the MESSI trial is that the anatomic success rate of MOCA™ is not inferior to RFA. The second hypothesis is that post-procedural pain is significantly less after MOCA compared to RFA. NTR4613 Date of trial registration: 28 May 2014.

Mucous retention cyst of the soft palate: a case presentation.

PubMed

Ellis, S G; Lee, N J; Peckitt, N S

1995-12-01

This article describes a mucous retention cyst of the soft palate associated with an over-extended complete maxillary denture. The clinical and anatomical relevance of the fovea palatinae are discussed with respect to the posterior palatal seal and post-dam positioning.

Computer aided three-dimensional reconstruction and modeling of the pelvis, by using plastinated cross sections, as a powerful tool for morphological investigations.

PubMed

Sora, Mircea-Constantin; Jilavu, Radu; Matusz, Petru

2012-10-01

The aim of this study was to describe a method of developing a computerized model of the human female pelvis using plastinated slices. Computerized reconstruction of anatomical structures is becoming very useful for developing anatomical teaching, research modules and animations. Although databases consisting of serial sections derived from frozen cadaver material exist, plastination represents an alternative method for developing anatomical data useful for computerized reconstruction. A slice anatomy study, using plastinated transparent pelvis cross sections, was performed to obtain a 3D reconstruction. One female human pelvis used for this study, first plastinated as a block, then sliced into thin slices and in the end subjected to 3D computerized reconstruction using WinSURF modeling system (SURFdriver Software). To facilitate the understanding of the complex pelvic floor anatomy on sectional images obtained through MR imaging, and to make the representation more vivid, a female pelvis computer-aided 3D model was created. Qualitative observations revealed that the morphological features of the model were consistent with those displayed by typical cadaveric specimens. The quality of the reconstructed images appeared distinct, especially the spatial positions and complicated relationships of contiguous structures of the female pelvis. All reconstructed structures can be displayed in groups or as a whole and interactively rotated in 3D space. The utilization of plastinates for generating tissue sections is useful for 3D computerized modeling. The 3D model of the female pelvis presented in this paper provides a stereoscopic view to study the adjacent relationship and arrangement of respective pelvis sections. A better understanding of the pelvic floor anatomy is relevant to gynaecologists, radiologists, surgeons, urologists, physical therapists and all professionals who take care of women with pelvic floor dysfunction.

Integration of prior CT into CBCT reconstruction for improved image quality via reconstruction of difference: first patient studies

NASA Astrophysics Data System (ADS)

Zhang, Hao; Gang, Grace J.; Lee, Junghoon; Wong, John; Stayman, J. Webster

2017-03-01

Purpose: There are many clinical situations where diagnostic CT is used for an initial diagnosis or treatment planning, followed by one or more CBCT scans that are part of an image-guided intervention. Because the high-quality diagnostic CT scan is a rich source of patient-specific anatomical knowledge, this provides an opportunity to incorporate the prior CT image into subsequent CBCT reconstruction for improved image quality. We propose a penalized-likelihood method called reconstruction of difference (RoD), to directly reconstruct differences between the CBCT scan and the CT prior. In this work, we demonstrate the efficacy of RoD with clinical patient datasets. Methods: We introduce a data processing workflow using the RoD framework to reconstruct anatomical changes between the prior CT and current CBCT. This workflow includes processing steps to account for non-anatomical differences between the two scans including 1) scatter correction for CBCT datasets due to increased scatter fractions in CBCT data; 2) histogram matching for attenuation variations between CT and CBCT; and 3) registration for different patient positioning. CBCT projection data and CT planning volumes for two radiotherapy patients - one abdominal study and one head-and-neck study - were investigated. Results: In comparisons between the proposed RoD framework and more traditional FDK and penalized-likelihood reconstructions, we find a significant improvement in image quality when prior CT information is incorporated into the reconstruction. RoD is able to provide additional low-contrast details while correctly incorporating actual physical changes in patient anatomy. Conclusions: The proposed framework provides an opportunity to either improve image quality or relax data fidelity constraints for CBCT imaging when prior CT studies of the same patient are available. Possible clinical targets include CBCT image-guided radiotherapy and CBCT image-guided surgeries.

Contribution of the computed tomography of the anatomical aspects of the sphenoid sinuses to forensic identification.

PubMed

Auffret, Mathieu; Garetier, Marc; Diallo, Idris; Aho, Serge; Ben Salem, Douraied

2016-12-01

Body identification is the cornerstone of forensic investigation. It can be performed using radiographic techniques, if antemortem images are available. This study was designed to assess the value of visual comparison of the computed tomography (CT) anatomical aspects of the sphenoid sinuses, in forensic individual identification, especially if antemortem dental records, fingerprints or DNA samples are not available. This retrospective work took place in a French university hospital. The supervisor of this study randomly selected from the picture archiving and communication system (PACS), 58 patients who underwent one (16 patients) or two (42 patients) head CT in various neurological contexts. To avoid bias, those studies were prepared (anonymized, and all the head structures but the sphenoid sinuses were excluded), and used to constitute two working lists of 50 (42+8) CT studies of the sphenoid sinuses. An anatomical classification system of the sphenoid sinuses anatomical variations was created based on the anatomical and surgical literature. In these two working lists, three blinded readers had to identify, using the anatomical system and subjective visual comparison, 42 pairs of matched studies, and 16 unmatched studies. Readers were blinded from the exact numbers of matching studies. Each reader correctly identified the 42 pairs of CT with a concordance of 100% [97.5% confidence interval: 91-100%], and the 16 unmatched CT with a concordance of 100% [97.5% confidence interval: 79-100%]. Overall accuracy was 100%. Our study shows that establishing the anatomical concordance of the sphenoid sinuses by visual comparison could be used in personal identification. This easy method, based on a frequently and increasingly prescribed exam, still needs to be assessed on a postmortem cohort. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Comparative anatomy of the arm muscles of the Japanese monkey (Macaca fuscata) with some comments on locomotor mechanics and behavior.

PubMed

Aversi-Ferreira, Tales Alexandre; Aversi-Ferreira, Roqueline A G M F; Bretas, Rafael Vieira; Nishimaru, Hiroshi; Nishijo, Hisao

2016-08-01

The anatomical literature on the genus Macaca has focused mainly on the rhesus monkey. However, some aspects in the positional behaviors of the Japanese monkey may be different from those in rhesus monkey, suggesting that the anatomical details of these species are divergent. Four thoracic limbs of Macaca fuscata adults were dissected. The arm muscles in Japanese macaques are more similar to rhesus monkeys and Papio; these characteristics are closer to those of bearded capuchins than apes, indicating more proximity of this genus to New World primates. The anatomical features observed favor quadrupedal locomotor behaviors on the ground and in arboreal environments. Japanese monkeys, rhesus monkeys, and bearded capuchins, which share more primitive characteristics in their arm muscles, present features that favor both arboreal and quadrupedal locomotor behaviors, whereas apes, mainly Pan and Gorilla, which spend more time on the ground, present more quadrupedal specializations. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Sonographic investigation of anatomical specimens of infant hip joints.

PubMed

Falliner, Axel; Hahne, Hans-Jürgen; Hassenpflug, Joachim

2002-07-01

The anatomical foundations of infant hip sonography techniques are ill-defined. We investigated anatomical specimens of infant hip joints in a water bath, with Graf's and Terjesen's methods. Acetabular position was varied in defined increments, with respect to the ultrasound beam. The alpha angles and the femoral head coverage were measured. Plastic acetabular casts were sawn along the sonographic section planes, and the cut sections compared with the sonographic sections. For images to be obtained, which were analysable by the two methods, the ultrasound beam had to intersect with the acetabular inlet plane at defined angles. The acetabular notch had to be anteriorly rotated from the ultrasound beam plane by at least 20 degrees. Beam entry within a 50 degrees sector posterior to the perpendicular on the inlet plane gave analysable images. The alpha angles and femoral head coverage were much affected by coronal-plane transducer tilt. Caudad tilts were associated with lesser values, a fact that should be borne in mind in clinical ultrasound investigations.

In search of a periodic table of the neurons: Axonal-dendritic circuitry as the organizing principle: Patterns of axons and dendrites within distinct anatomical parcels provide the blueprint for circuit-based neuronal classification.

PubMed

Ascoli, Giorgio A; Wheeler, Diek W

2016-10-01

No one knows yet how to organize, in a simple yet predictive form, the knowledge concerning the anatomical, biophysical, and molecular properties of neurons that are accumulating in thousands of publications every year. The situation is not dissimilar to the state of Chemistry prior to Mendeleev's tabulation of the elements. We propose that the patterns of presence or absence of axons and dendrites within known anatomical parcels may serve as the key principle to define neuron types. Just as the positions of the elements in the periodic table indicate their potential to combine into molecules, axonal and dendritic distributions provide the blueprint for network connectivity. Furthermore, among the features commonly employed to describe neurons, morphology is considerably robust to experimental conditions. At the same time, this core classification scheme is suitable for aggregating biochemical, physiological, and synaptic information. © 2016 WILEY Periodicals, Inc.

Prehepatocholedochal proper hepatic artery. Rare anatomical variant. Surgical considerations. Case report.

PubMed

Ardeleanu, V; Chicoş, S; Tutunaru, D; Georgescu, C

2014-01-01

In classical anatomic variants, the proper hepatic artery (PHA)continues the common hepatic artery (CHA) after the gastroduodenal artery (GDA) detaches itself and divides into the right hepatic artery (RHA) and left hepatic artery (LHA), the proper hepatic artery being located to the left of the hepatocholedochal duct (HCD). This paper presents an abnormal positioning of the PHA placed before the HCD with an increased diameter of about 5-7 mm, which could be confused with the HCD. We present the case of a 57 year-old woman diagnosed with acute lithiasic cholecystitis, associated with hypersplenism and hypertension. The literature mentions manifold anatomical variants of arterial liver vascularization,including PHA. For this reason, this paper presents an overview of similar cases that can be found in medical literature. The aforementioned case is a rare topographic anatomy for the PHA that can easily pass for HCD especially during celioscopy, therefore it is crucial for this to be acknowledged by all surgeons. Celsius.

Evaluation of mandibular posterior single implants with two different surfaces: a 5-year comparative study.

PubMed

Jung, Ui-Won; Choi, Jung-Yoo; Kim, Chang-Sung; Cho, Kyoo-Sung; Chai, Jung-Kiu; Kim, Chong-Kwan; Choi, Seong-Ho

2008-10-01

Anatomic and biomechanical limitations can jeopardize successful single implantation in the mandibular posterior area. To overcome the limitations, the design and the surface of the fixtures were modified. This study evaluated the cumulative survival rate (CSR) of mandibular molars replaced with a sand-blasted, large-grit, acid-etched (SLA) single implant or an anodized (ANO) single implant and examined associated factors, such as the surface treatment, position, and length and diameter of the implants. One hundred ninety-three single implants restored with an SLA implant and 112 single implants restored with an ANO implant in the mandibular molar area were selected from subjects who had visited the Department of Periodontology, Dental Hospital of Yonsei University, from March 2001 through June 2006. In the SLA group, 123 and 70 implants were placed in the first and second molar area, respectively. In the ANO group, 55 and 57 implants were placed in the first and second molar area, respectively. The 1- to 6-year CSR of the SLA and ANO groups was calculated using the life-table analysis. In addition, associated factors, such as the surface treatment, position, and length and diameter of the implants, were compared and analyzed using the chi(2) test (P <0.05). Two of 193 implants in the SLA group failed, giving a CSR of 98.96%; four of 112 ANO implants failed, giving a CSR of 96.43%. There were no significant differences with regard to the surface treatment, position, and length and diameter of the implants. Despite the anatomic and biomechanical limitation in the mandibular posterior area, mandibular posterior single implants showed a high CSR during the observation period. Mandibular posterior single implants can be an effective and reliable treatment modality that is not affected by the surface treatment, position, or length and diameter of the implant.

SU-E-J-44: Design a Platform and Phantom Model for Photoacoustic Imaging in Combination with CT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sick, J; Alsanea, F; Rancilio, N

2014-06-01

Purpose: Our (long-term) objective is to develop a US manipulator that will provide in situ radiation response and image-guided therapy for bladder cancer based on photoacoustic molecular imaging. Methods: A platform was devised to provide a reproducible positional frame of reference for targeting anatomic structure between MDCT and US scans, in lieu of CBCT, and to fuse photoacoustic molecular imaging. US and photoacoustic scans are taken of a patient while in the CT scanner and IRMT. Through co-registration, based on anatomical positions, we identified a common coordinate system to be used in Eclipse. A bladder phantom was constructed to validatemore » anatomical tracking via US and photoacoustic imaging. We tested the platform using phantom model to demonstrate validity once moved from the CT couch to the linear accelerator couch. Results: This platform interlocks with Varian exact couch index points for reproducibility of positioning. Construction from low Z material and sized appropriately to fit in CT/IMRT gantry. Error in conversion from cylindrical coordinates of the manipulator to X, Y, Z coordinates of the treatment couch was less than 1mm. We measured the bladder size in 3 different directions in both Eclipse from the CT and Acuson from US. The error was less than 2mm in all directions. CT and US images were co-registered in MATLAB. Co-registration of photoacoustic images is still being developed. Conclusion: For Linear Accelerators without on board imaging, MV portal images are not a viable option for the localization of soft tissue anatomy. We believe our manipulator provides an alternative using US imaging, which will be examined in an upcoming clinical trial. We plan to examine the value of hypoxia guided treatment through photoacoustic imaging during this trial.« less

The Diagnostic Performance of Multiparametric Magnetic Resonance Imaging to Detect Significant Prostate Cancer.

PubMed

Thompson, J E; van Leeuwen, P J; Moses, D; Shnier, R; Brenner, P; Delprado, W; Pulbrook, M; Böhm, M; Haynes, A M; Hayen, A; Stricker, P D

2016-05-01

We assess the accuracy of multiparametric magnetic resonance imaging for significant prostate cancer detection before diagnostic biopsy in men with an abnormal prostate specific antigen/digital rectal examination. A total of 388 men underwent multiparametric magnetic resonance imaging, including T2-weighted, diffusion weighted and dynamic contrast enhanced imaging before biopsy. Two radiologists used PI-RADS to allocate a score of 1 to 5 for suspicion of significant prostate cancer (Gleason 7 with more than 5% grade 4). PI-RADS 3 to 5 was considered positive. Transperineal template guided mapping biopsy of 18 regions (median 30 cores) was performed with additional manually directed cores from magnetic resonance imaging positive regions. The anatomical location, size and grade of individual cancer areas in the biopsy regions (18) as the primary outcome and in prostatectomy specimens (117) as the secondary outcome were correlated to the magnetic resonance imaging positive regions. Of the 388 men who were enrolled in the study 344 were analyzed. Multiparametric magnetic resonance imaging was positive in 77.0% of patients, 62.5% had prostate cancer and 41.6% had significant prostate cancer. The detection of significant prostate cancer by multiparametric magnetic resonance imaging had a sensitivity of 96%, specificity of 36%, negative predictive value of 92% and positive predictive value of 52%. Adding PI-RADS to the multivariate model, including prostate specific antigen, digital rectal examination, prostate volume and age, improved the AUC from 0.776 to 0.879 (p <0.001). Anatomical concordance analysis showed a low mismatch between the magnetic resonance imaging positive regions and biopsy positive regions (4 [2.9%]), and the significant prostate cancer area in the radical prostatectomy specimen (3 [3.3%]). In men with an abnormal prostate specific antigen/digital rectal examination, multiparametric magnetic resonance imaging detected significant prostate cancer with an excellent negative predictive value and moderate positive predictive value. The use of multiparametric magnetic resonance imaging to diagnose significant prostate cancer may result in a substantial number of unnecessary biopsies while missing a minimum of significant prostate cancers. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[Reproducibility of centric relation of the patient with severe dental attrition for oral rehabilitation].

PubMed

Kang, Hong; Chao, Yonglie; Yi, Xinzhu

2003-12-01

Standards for determining mandibular position, especially the centric relation (CR), are in controversy because of anatomical, neurophysiological factors and research methods or instrument. The purpose of this study was to reevaluate the reproducibility of centric relation of the patients with severe dental attrition for oral rehabilitation. Reproducibility of the centric relation of 6 patients with severe occlusal attrition was investigated by using D5A Denar fully adjustable articulator and the Pantronic recording system. 1. In supine position, anterior-posterior(AP) displacement of centric relation (CR) was 0.14 mm and superior-inferior(SI) displacements of CR were between 0.11 mm-0.12 mm. 2. In upright position, anterior-posterior displacement of CR was 0.35 mm and superior-inferior changes of CR were between 0.13 mm-0.20 mm. The CR is the most stable and reproducible position of mandibule in normal stomatological system and is useful as a reference position in occlusal treatment and functional rehabilitation.

Prevalence and Risk Factors of Colonization with Staphylococcus aureus in Healthy Pet Cats Kept in the City Households

PubMed Central

Płoneczka-Janeczko, Katarzyna; Rypuła, Krzysztof

2016-01-01

Staphylococcus aureus, especially methicillin-resistant S. aureus (MRSA), is a significant pathogen in both human medicine and veterinary medicine. The importance of pets as reservoirs of human infections is still poorly understood. This article provides detailed information of a cross-sectional study of a S. aureus colonization in clinically healthy indoor cats. The study systematically assessed a number of different anatomical locations for the S. aureus colonization and the influence of a range of potential risk factors on the value of the final S. aureus colonization rate. The incidence rates observed for cats with at least one site positive for S. aureus or MRSA were 17.5% and 6.63%, respectively. The following risk factors were identified: one or more owners working in the healthcare industry (human or veterinary); dogs being kept with the cat under investigation; treatment of the cat under investigation with antibiotics or chemotherapeutics during the previous year. In conclusion, this study revealed a higher prevalence of MRSA than what has previously been reported in healthy pets. A combination of anatomical locations from which the samples were collected had a major influence on the final value of the S. aureus colonization rate. PMID:27766257

An Anatomical Study of Maxillary-Zygomatic Complex Using Three-Dimensional Computerized Tomography-Based Zygomatic Implantation

PubMed Central

Zhao, Shijie; Liu, Hui; Sun, Zhipeng; Wang, Jianwei

2017-01-01

Objective To obtain anatomical data of maxillary-zygomatic complex based on simulating the zygomatic implantation using cadaver heads and three-dimensional computerized tomography (3D-CT). Methods Simulating zygomatic implantation was performed using seven cadaver heads and 3D-CT images from forty-eight adults. After measuring the maxillary-zygomatic complex, we analyzed the position between the implantation path and the maxillary sinus cavity as well as the distance between the implantation path and the zygomatic nerve. Results The distance from the starting point to the endpoint of the implant was 56.85 ± 5.35 mm in cadaver heads and 58.15 ± 7.37 mm in 3D-CT images. For the most common implantation path (80.20%), the implant went through the maxillary sinus cavity completely. The projecting points of the implant axis (IA) on the surface of zygoma were mainly located in the region of frontal process of zygomatic bone close to the lateral orbital wall. The distances between IA and zygomatic nerve in 53 sides were shorter than 2 mm. Conclusion The simulating zygomatic implantation on cadaver skulls and 3D-CT imaging provided useful anatomical data of the maxillary-zygomatic complex. It is necessary to take care to avoid the zygomatic nerve injury during implantation, because it frequently appears on the route of implantation. PMID:29376077

Divergent hydraulic strategies to cope with freezing in co-occurring temperate tree species with special reference to root and stem pressure generation.

PubMed

Yin, Xiao-Han; Sterck, Frank; Hao, Guang-You

2018-04-23

Some temperate tree species mitigate the negative impacts of frost-induced xylem cavitation by restoring impaired hydraulic function via positive pressures, and may therefore be more resistant to frost fatigue (the phenomenon that post-freezing xylem becomes more susceptible to hydraulic dysfunction) than nonpressure-generating species. We test this hypothesis and investigate underlying anatomical/physiological mechanisms. Using a common garden experiment, we studied key hydraulic traits and detailed xylem anatomical characteristics of 18 sympatric tree species. These species belong to three functional groups, that is, one generating both root and stem pressures (RSP), one generating only root pressure (RP), and one unable to generate such pressures (NP). The three functional groups diverged substantially in hydraulic efficiency, resistance to drought-induced cavitation, and frost fatigue resistance. Most notably, RSP and RP were more resistant to frost fatigue than NP, but this was at the cost of reduced hydraulic conductivity for RSP and reduced resistance to drought-induced cavitation for RP. Our results show that, in environments with strong frost stress: these groups diverge in hydraulic functioning following multiple trade-offs between hydraulic efficiency, resistance to drought and resistance to frost fatigue; and how differences in anatomical characteristics drive such divergence across species. © 2018 The Authors. New Phytologist © 2018 New Phytologist Trust.

The "safe zone" in medial percutaneous calcaneal pin placement.

PubMed

Gamie, Zakareya; Donnelly, Leo; Tsiridis, Eleftherios

2009-05-01

Percutaneous pin insertion into the medial calcaneus places a number of structures at risk. Evidence suggests that the greatest risk is to the medial calcaneal nerve (MCN). The medial calcaneal region of 24 cadavers was dissected to determine the major structures at risk. By using four palpable anatomical landmarks, the inferior tip of the medial malleolus (point A), the posterior superior portion of the calcaneal tuberosity (point B), the navicular tuberosity (point C), and the medial process of the calcaneal tuberosity (point D), we attempted to define the safe zone taking into account all possible variables in our dissections including ankle position, side, gender, and possible anatomical variations of the MCN. The commonest arrangement of the MCN was two MCNs that arose independently, one arising before the bifurcation of the tibial nerve and the other arising from the medial plantar nerve. A zone could be defined posterior to 75% of the distance along the lines AB, CD, AD, and CB which would avoid most structures. The posterior branches of the MCN, however, would still be at risk and placing the pin too far posteriorly risks an avulsion fracture. This is the first study to employ four palpable anatomical landmarks to identify a zone to minimize damage to neurovascular structures. It may not be possible, however, to avoid injury of the MCN and consequent sensory loss to the sole of the foot.

Psychological and emotional concomitants of infertility diagnosis in women with diminished ovarian reserve or anatomical cause of infertility.

PubMed

Nicoloro-SantaBarbara, Jennifer M; Lobel, Marci; Bocca, Silvina; Stelling, James R; Pastore, Lisa M

2017-07-01

To examine the magnitude and predictors of emotional reactions to an infertility diagnosis in two groups of women: those with diminished ovarian reserve (DOR), and those clinically diagnosed with an anatomical cause of infertility (ACI). Cross-sectional study. Academic and private fertility clinics. Women diagnosed with DOR (n = 51) and women diagnosed with ACI (n = 51). Not applicable. Fertility Problem Inventory (infertility distress), Rosenberg Self-Esteem Scale, Health Orientation Scale (emotional reactions to receiving a diagnosis). Women with DOR had statistically significantly higher infertility distress scores than women with ACI and higher scores on subscales assessing distress from social concerns, sexual concerns, and a need for parenthood. In both groups, higher self-esteem was associated with lower infertility distress. Hierarchical multiple regression analyses revealed that for women with DOR and those with ACI lower infertility distress but not self-esteem predicted a more positive emotional reaction toward receiving a fertility diagnosis. Women diagnosed with DOR have greater infertility distress but similar self-esteem and emotional reactions to their diagnosis compared with women who have an anatomical cause of infertility. These results suggest that for both groups distress surrounding infertility itself may influence the way women respond to learning the cause of their infertility. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

A comparative analysis of the dependences of the hemodynamic parameters on changes in ROI's position in perfusion CT scans

NASA Astrophysics Data System (ADS)

Choi, Yong-Seok; Cho, Jae-Hwan; Namgung, Jang-Sun; Kim, Hyo-Jin; Yoon, Dae-Young; Lee, Han-Joo

2013-05-01

This study performed a comparative analysis of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and mean time-to-peak (TTP) obtained by changing the region of interest's (ROI) anatomical positions, during CT brain perfusion. We acquired axial source images of perfusion CT from 20 patients undergoing CT perfusion exams due to brain trauma. Subsequently, the CBV, CBF, MTT, and TTP values were calculated through data-processing of the perfusion CT images. The color scales for the CBV, CBF, MTT, and TTP maps were obtained using the image data. Anterior cerebral artery (ACA) was taken as the standard ROI for the calculations of the perfusion values. Differences in the hemodynamic average values were compared in a quantitative analysis by placing ROI and the dividing axial images into proximal, middle, and distal segments anatomically. By performing the qualitative analysis using a blind test, we observed changes in the sensory characteristics by using the color scales of the CBV, CBF, and MTT maps in the proximal, middle, and distal segments. According to the qualitative analysis, no differences were found in CBV, CBF, MTT, and TTP values of the proximal, middle, and distal segments and no changes were detected in the color scales of the the CBV, CBF, MTT, and TTP maps in the proximal, middle, and distal segments. We anticipate that the results of the study will useful in assessing brain trauma patients using by perfusion imaging.

[Dynamic study of the female levator ani muscle using MRI 3D vectorial modeling].

PubMed

Delmas, Vincent; Ami, Olivier; Iba-Zizen, Marie-Thérèse

2010-06-01

The levator ani muscle has a major role in the female pelvic floor, and is involved in the pathophysiology of pelvic prolapse and stress urinary incontinence. We conducted an anatomical and morphological study of this muscle using dynamic 3D vectorial reconstruction MRI, in order to analyze the contraction of two major components of the levator ani: the iliococcygeus and pubococcygeus. Three volunteer healthy continent nulliparous women aged from 19 to 22 underwent dynamic pelvic MRI. Coronal T2-weighted pelvic images were obtained in the supine position, at rest, holding back, and during Valsalva stress effort. 3D vectorial models were reconstructed by manual segmentation of the source images, and were set up on bony anatomic marks. Iliococcygeus and pubococcygeus volumes were measured in the three positions. Volumetrics, displacement and dynamic morphing changes were analyzed with 3D vectorial animation software. The urogenital hiatus extended more holding back (mean +4.31 mm) than on effort (mean +2.78 mm). The iliococcygeus lowered (mean -3.95 mm) and deviated outward (mean +3.01 mm). The basic tone of the iliococcygeus muscle gives it a dome shape, and its reflex contraction against abdominal strain ensures anal and urinary continence The levator ani is more than a pelvic diaphragm: it is a truly dynamic pelvic floor. Its points of support on the stiff osseous frame allow it to retain the pelvic organs. The levator ani muscle seems to prevent anal prolapse during stress strain.

Revision surgery in anterior cruciate ligament reconstruction: a cohort study of 17,682 patients from the Swedish National Knee Ligament Register.

PubMed

Desai, Neel; Andernord, Daniel; Sundemo, David; Alentorn-Geli, Eduard; Musahl, Volker; Fu, Freddie; Forssblad, Magnus; Samuelsson, Kristian

2017-05-01

To investigate the association between surgical variables and the risk of revision surgery after ACL reconstruction in the Swedish National Knee Ligament Register. This cohort study was based on data from the Swedish National Knee Ligament Register. Patients who underwent primary single-bundle ACL reconstruction with hamstring tendon were included. Follow-up started with primary ACL reconstruction and ended with ACL revision surgery or on 31 December, 2014, whichever occurred first. Details on surgical technique were collected using an online questionnaire. All group comparisons were made in relation to an "anatomic" reference group, comprised of essential AARSC items, defined as utilization of accessory medial portal drilling, anatomic tunnel placement, visualization of insertion sites and pertinent landmarks. Study end-point was revision surgery. A total of 108 surgeons (61.7%) replied to the questionnaire. A total of 17,682 patients were included [n = 10,013 males (56.6%) and 7669 females (43.4%)]. The overall revision rate was 3.1%. Older age as well as cartilage injury evident at index surgery was associated with a decreased risk of revision surgery. The group using transtibial drilling and non-anatomic bone tunnel placement was associated with a lower risk of revision surgery [HR 0.694 (95% CI 0.490-0.984); P = 0.041] compared with the anatomic reference group. The anatomic reference group showed no difference in risk of revision surgery compared with the transtibial drilling groups with partial anatomic [HR 0.759 (95% CI 0.548-1.051), n.s.] and anatomic tunnel placement [HR 0.944 (95% CI 0.718-1.241), n.s.]. The anatomic reference group showed a decreased risk of revision surgery compared with the transportal drilling group with anatomic placement [HR 1.310 (95% CI 1.047-1.640); P = 0.018]. Non-anatomic bone tunnel placement via transtibial drilling resulted in the lowest risk of revision surgery after ACL reconstruction. The risk of revision surgery increased when using transportal drilling. Performing anatomic ACL reconstruction utilizing eight selected essential items from the AARSC lowered the risk of revision surgery associated with transportal drilling and anatomic bone tunnel placement. Detailed knowledge of surgical technique using the AARSC predicts the risk of ACL revision surgery. III.

Anatomical and morphological study of the subcoracoacromial canal.

PubMed

Le Reun, O; Lebhar, J; Mateos, F; Voisin, J L; Thomazeau, H; Ropars, M

2016-12-01

Many clinical anatomy studies have looked into how variations in the acromion, coracoacromial ligament (CAL) and subacromial space are associated with rotator cuff injuries. However, no study up to now had defined anatomically the fibro-osseous canal that confines the supraspinatus muscle in the subcoracoacromial space. Through an anatomical study of the scapula, we defined the bone-related parameters of this canal and its anatomical variations. This study on dry bones involved 71 scapulas. With standardised photographs in two orthogonal views (superior and lateral), the surface area of the subcoracoacromial canal and the anatomical parameters making up this canal were defined and measured using image analysis software. The primary analysis evaluated the anatomical parameters of the canal as a function of three canal surface area groups; the secondary analysis looked into how variations in the canal surface area were related to the type of acromion according to the Bigliani classification. Relative to glenoid width, the group with a large canal surface area (L) had significantly less lateral overhang of the acromion than the group with a small canal surface area (S), with ratios of 0.41±0.23 and 0.58±0.3, respectively (P=0.04). The mean length of the CAL was 46±8mm in the L group and 39±9mm in the S group (P=0.003). The coracoacromial arch angle was 38°±11° in the L group and 34°±9° in the S group; the canal surface area was smaller in specimens with a smaller coracoacromial arch angle (P=0.20). Apart from acromial morphology, there could be innate anatomical features of the scapula that predispose people to extrinsic lesions to the supraspinatus tendon (lateral overhang, coracoacromial arch angle) by reducing the subcoracoacromial canal's surface area. Anatomical descriptive study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Injuries of the Sternoclavicular Joint - An Innovative Approach in the Management of a Rare Injury: Tight Rope Fixation of the Costo-Clavicular Ligament.

PubMed

Unterkofler, Jan; Merschin, David; Langenbach, Andreas; Ekkernkamp, Axel; Schulz-Drost, Stefan

2017-01-01

Background: The costoclavicular ligament (CCL) provides the most tight stability within the sternoclavicular joint (SCJ), followed by the most cited sternoclavicular ligaments (SCL). Their disruption may cause severe instability of the SCJ. Different treatment options, such as the use of plates, wires or autologous tendons are associated with mainly limited functional outcome. Could a stabilization of CCL next to an anatomic fixation of the SCL provide sufficient reconstruction of the SCJ? Methods: A 58-year-old male showed severe anterior and painful instability of the SCJ following a fall on his shoulder 8 weeks ago. The SCJ had been reconstructed in an open procedure with stabilization of the CCL employing 2 tight ropes and anatomical suture of the SCL. Follow-up was carried out 78 weeks after operation. Results: The reduction of the SCJ was successful. X-ray proved the anatomic position of the SCJ. Pain was decreased in between the first 6 weeks. The patient showed uneventful follow-up and returned to work 6 months after the procedureas a hard working farmer. Conclusions: Innovative stabilization of the CCL with tight ropes additional to a suture of the SCL may enable anatomic reconstruction of the SCJ considering cosmetic and functional results. Celsius.

Short communication: Pre- and postmilking anatomical characteristics of teats and their associations with risk of clinical mastitis in dairy cows.

PubMed

Guarín, J F; Ruegg, P L

2016-10-01

The primary objective of this study was to describe and compare anatomical characteristics of teats before and after machine milking adjusted for parity and teat location (front versus rear). The second objective was to determine if selected milking and anatomical characteristics of teats were associated with occurrence of clinical mastitis. To address objective 1, a cross-sectional study was done to describe and compare teat dimensions before and after milking (n=1,751 teats from 445 cows). To fulfill objective 2, a case-control study was performed. Quarters having their first case of clinical mastitis in the current lactation from 2 mo before to 2 mo after the day the teats were measured were selected as cases (n=47), provided no other quarters from that cow were affected by clinical mastitis at that time. Three controls (n=141) were matched with each case; these were selected from quarters that did not experience any case of clinical mastitis during their current lactation. A conditional logistic regression model was used to determine associations between teat dimensions and occurrence of clinical mastitis. Primiparous and multiparous Holstein cows were enrolled in both studies. As compared with premilking dimensions, postmilking teats were longer and narrower at the barrel and the apex. Significant interactions between teat position and parity were identified for premilking teat length and diameter of the teat barrel. Premilking, teats were longer and wider with increasing parity. Front teats were longer and wider than rear teats premilking. Also during premilking, differences between the front and rear teat were less at increasing parity. Teat apex diameter was greater for premilking teats of cows in parity ≥3 and the apexes of front teats were wider than those of rear teats. Teats enrolled in the case-control study had twice as many clinical mastitis cases in front quarters compared with rear quarters. Premilking diameter of the teat apex was positively associated with risk of clinical mastitis (odds ratio=1.20 per 1-mm increase in the diameter of the apex of the teat, 95% confidence interval=1.05-1.37). Milking machine-related changes in teat dimensions had no association with occurrence of clinical mastitis. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Use of Intraoperative Computed Tomography for Revisional Procedures in Patients with Complex Maxillofacial Trauma

PubMed Central

Singh, Mansher; Ricci, Joseph A.

2015-01-01

Background: In patients with panfacial fractures and distorted anatomic landmarks of zygomatic and orbital complex, there is a risk of zygomaticomaxillary complex (ZMC) malpositioning even with the best efforts for surgical repair. This results in increased number of additional procedures to achieve accurate positioning. Methods: We describe the usage of intraoperative C-arm cone-beam computed tomographic (CT) scan for ZMC malpositioning in a representative patient with panfacial fractures. Results: We have successfully used intraoperative CT scan for ZMC malpositioning in 3 patients. The representative patient had ZMC malposition after the initial attempt of surgical repair without any intraoperative imaging. On using intraoperative CT scan during the next attempt, we were able to reposition the ZMC accurately. Conclusions: Intraoperative CT scan might improve the accuracy of ZMC positioning and decrease the chances of potential additional surgeries. In patients with distorted anatomical landmarks and panfacial fractures, it can be especially helpful toward correcting ZMC malposition. PMID:26301152

RPI-AM and RPI-AF, a pair of mesh-based, size-adjustable adult male and female computational phantoms using ICRP-89 parameters and their calculations for organ doses from monoenergetic photon beams

NASA Astrophysics Data System (ADS)

Zhang, Juying; Hum Na, Yong; Caracappa, Peter F.; Xu, X. George

2009-10-01

This paper describes the development of a pair of adult male and adult female computational phantoms that are compatible with anatomical parameters for the 50th percentile population as specified by the International Commission on Radiological Protection (ICRP). The phantoms were designed entirely using polygonal mesh surfaces—a Boundary REPresentation (BREP) geometry that affords the ability to efficiently deform the shape and size of individual organs, as well as the body posture. A set of surface mesh models, from Anatomium™ 3D P1 V2.0, including 140 organs (out of 500 available) was adopted to supply the basic anatomical representation at the organ level. The organ masses were carefully adjusted to agree within 0.5% relative error with the reference values provided in the ICRP Publication 89. The finalized phantoms have been designated the RPI adult male (RPI-AM) and adult female (RPI-AF) phantoms. For the purposes of organ dose calculations using the MCNPX Monte Carlo code, these phantoms were subsequently converted to voxel formats. Monoenergetic photons between 10 keV and 10 MeV in six standard external photon source geometries were considered in this study: four parallel beams (anterior-posterior, posterior-anterior, left lateral and right lateral), one rotational and one isotropic. The results are tabulated as fluence-to-organ-absorbed-dose conversion coefficients and fluence-to-effective-dose conversion coefficients and compared against those derived from the ICRP computational phantoms, REX and REGINA. A general agreement was found for the effective dose from these two sets of phantoms for photon energies greater than about 300 keV. However, for low-energy photons and certain individual organs, the absorbed doses exhibit profound differences due to specific anatomical features. For example, the position of the arms affects the dose to the lung by more than 20% below 300 keV in the lateral source directions, and the vertical position of the testes affects the dose by more than 80% below 150 keV in the PA source direction. The deformability and adjustability of organs and posture in the RPI adult phantoms may prove useful not only for average workers or patients for radiation protection purposes, but also in studies involving anatomical and posture variability that is important in future radiation protection dosimetry.

The Epidemiology of Injuries in Australian Professional Rugby Union 2014 Super Rugby Competition

PubMed Central

Whitehouse, Timothy; Orr, Robin; Fitzgerald, Edward; Harries, Simon; McLellan, Christopher P.

2016-01-01

Background: Rugby union is a collision-based ball sport played at the professional level internationally. Rugby union has one of the highest reported incidences of injury of all team sports. Purpose: To identify the characteristics, incidence, and severity of injuries occurring in Australian professional Super Rugby Union. Design: Descriptive epidemiology study. Methods: The present study was a prospective epidemiology study on a cohort of 180 professional players from 5 Australian Super Rugby teams during the 2014 Super Rugby Union Tournament. Team medical staff collected and submitted daily training and match-play injury data through a secure, web-based electronic platform. The injury data included the main anatomic location of the injury, specific anatomic structure of the injury, injury diagnosis, training or match injury occurrence, main player position, mechanism of injury, and the severity of the injury quantified based on the number of days lost from training and/or competition due to injury. Results: The total combined incidence rate for injury during training and match-play across all Australian Super Rugby Union teams was 6.96 per 1000 hours, with a mean injury severity of 37.45 days lost from training and competition. The match-play injury incidence rate was 66.07 per 1000 hours, with a mean severity of 39.80 days lost from training and competition. No significant differences were observed between forward- and back-playing positions for match or training injury incidence rate or severity. Conclusion: The incidence of injury for the present study was lower during match-play than has previously been reported in professional rugby union; however, the overall time loss was higher compared with previous studies in professional rugby union. The high overall time loss was due fundamentally to a high incidence of injuries with greater than 28 days’ severity. PMID:27069947

Increase of forage dryness induces differentiated anatomical response in the sheep rumen compartments.

PubMed

Scocco, Paola; Mercati, Francesca; Tardella, Federico Maria; Catorci, Andrea

2016-08-01

The aim of this study was to investigate how the Surface Enlargement Factor (SEF) and the epithelial keratinization degree of sheep rumen change in response to phytomass production, and to forage fiber and water content during the pasture vegetative cycle. The study used eighteen sheep nourished with dry hay and cereals during the winter season and with fresh hay during the pasture vegetative cycle. We collected samples from rumen indicative regions for two consecutive years characterized by different rainfall and pasture productivity values. We evaluated the densities (D) of rumen papillae to estimate the rumen SEF, and the keratinization percentage of the epithelial lining; these parameters showed differentiated modifications in the four ruminal analyzed compartments in response to pasture seasonal conditions. In addition, we performed Canonical Redundancy Analysis (RDA) on the "keratinization and SEF" matrix constrained by phytomass, water, and crude fiber contents of pasture at different time in the two considered years to highlight how rumen features answer to pasture conditions. Atrium (A) and ventral sac (VS) keratinization showed a strict positive correlation to crude fiber, while SEF of VS was positively related to phytomass and forage water content. The degree of keratinization of the rumen VS epithelium proved to be a useful parameter for evaluating anatomical variations in the short term period related to pasture features; in addition, its monitoring could be carried out through biopsy, thus avoiding the killing of animals. The study also leads to the application of the 3Rs (Replacement; Reduction; and Refinement). Microsc. Res. Tech. 79:738-743, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

[The interactive neuroanatomical simulation and practical application of frontotemporal transsylvian exposure in neurosurgery].

PubMed

Balogh, Attila; Czigléczki, Gábor; Papal, Zsolt; Preul, Mark C; Banczerowski, Péter

2014-11-30

There is an increased need for new digital education tools in neurosurgical training. Illustrated textbooks offer anatomic and technical reference but do not substitute hands-on experience provided by surgery or cadaver dissection. Due to limited availability of cadaver dissections the need for development of simulation tools has been augmented. We explored simulation technology for producing virtual reality-like reconstructions of simulated surgical approaches on cadaver. Practical application of the simulation tool has been presented through frontotemporal transsylvian exposure. The dissections were performed on two cadaveric heads. Arteries and veins were prepared and injected with colorful silicon rubber. The heads were rigidly fixed in Mayfield headholder. A robotic microscope with two digital cameras in inverted cone method of image acquisition was used to capture images around a pivot point in several phases of dissections. Multilayered, high-resolution images have been built into interactive 4D environment by custom developed software. We have developed the simulation module of the frontotemporal transsylvian approach. The virtual specimens can be rotated or tilted to any selected angles and examined from different surgical perspectives at any stage of dissections. Important surgical issues such as appropriate head positioning or surgical maneuvers to expose deep situated neuroanatomic structures can be simulated and studied by using the module. The simulation module of the frontotemporal transsylvian exposure helps to examine effect of head positioning on the visibility of deep situated neuroanatomic structures and study surgical maneuvers required to achieve optimal exposure of deep situated anatomic structures. The simulation program is a powerful tool to study issues of preoperative planning and well suited for neurosurgical training.

Effects of Axial Torsion on Disc Height Distribution: an In Vivo Study

PubMed Central

Espinoza Orías, Alejandro A.; Mammoser, Nicole M.; Triano, John J.; An, Howard S.; Andersson, Gunnar B.J.; Inoue, Nozomu

2016-01-01

Objectives Axial rotation of the torso is commonly used during manipulation treatment of low back pain. Little is known about the effect of these positons on disc morphology. Rotation is a three-dimensional event that is inadequately represented with planar images in the clinic. True quantification of the intervertebral gap can be achieved with a disc height distribution. The objective of this study was to analyze disc height distribution patterns during torsion relevant to manipulation in vivo. Methods Eighty-one volunteers were CT-scanned both in supine and in right 50° rotation positions. Virtual models of each intervertebral gap representing the disc were created with the inferior endplate of each ‘disc’ set as the reference surface and separated into five anatomical zones: four peripheral and one central, corresponding to the footprint of the annulus fibrosus and nucleus pulposus, respectively. Whole-disc and individual anatomical zone disc height distributions were calculated in both positions, and were compared against each other with ANOVA, with significance set at p < 0.05. Results Mean neutral disc height was 7.32 (1.59) mm. With 50° rotation, a small but significant increase to 7.44 (1.52) mm (p < 0.0002) was observed. The right side showed larger separation in most levels, except at L5/S1. The posterior and right zones increased in height upon axial rotation of the spine (p < 0.0001), while the left, anterior and central decreased. Conclusions This study quantified important tensile/compressive changes disc height during torsion. The implications of these mutually opposing changes on spinal manipulation are still unknown. PMID:27059249

The influence of body position on cerebrospinal fluid pressure gradient and movement in cats with normal and impaired craniospinal communication.

PubMed

Klarica, Marijan; Radoš, Milan; Erceg, Gorislav; Petošić, Antonio; Jurjević, Ivana; Orešković, Darko

2014-01-01

Intracranial hypertension is a severe therapeutic problem, as there is insufficient knowledge about the physiology of cerebrospinal fluid (CSF) pressure. In this paper a new CSF pressure regulation hypothesis is proposed. According to this hypothesis, the CSF pressure depends on the laws of fluid mechanics and on the anatomical characteristics inside the cranial and spinal space, and not, as is today generally believed, on CSF secretion, circulation and absorption. The volume and pressure changes in the newly developed CSF model, which by its anatomical dimensions and basic biophysical features imitates the craniospinal system in cats, are compared to those obtained on cats with and without the blockade of craniospinal communication in different body positions. During verticalization, a long-lasting occurrence of negative CSF pressure inside the cranium in animals with normal cranio-spinal communication was observed. CSF pressure gradients change depending on the body position, but those gradients do not enable unidirectional CSF circulation from the hypothetical site of secretion to the site of absorption in any of them. Thus, our results indicate the existence of new physiological/pathophysiological correlations between intracranial fluids, which opens up the possibility of new therapeutic approaches to intracranial hypertension.

[The anatomy of a reduced skull model--visualisation of Leonardo da Vinci's anthropology].

PubMed

Ahner, E

2008-04-02

The article focuses on a rare example of a miniature skull of unknown origin. The profoundness of the anatomical details, conjoint with outstanding virtuosity, reminds of Leonardo da Vinci's anatomical skull studies and asks for additional interpretation beside the emblematic "memento mori"-character. Following the miscellaneous topics of his skull studies an anatomical-anthropological interpretation is proposed. For such a project the mergence of anthropology, history of medicine and history of art was mandatory. Concerning some discrepancies within the anatomical realism, the depiction of a pathology is discussed and beyond the visualisation of a historic concept of brain function.

Using ring width correlations to study the effects of plantation density on wood density and anatomical properties of red pine (Pinus resinosa Ait.)

Treesearch

J. Y. Zhu; C. T. Scott; K. L. Scallon; G. C. Myers

2006-01-01

This study demonstrated that average ring width (or average annual radial growth rate) is a reliable parameter to quantify the effects of tree plantation ndensity (growth suppression) on wood density and tracheid anatomical properties. The average ring width successfully correlated wood density and tracheid anatomical properties of red pines (Pinus resinosa Ait.) from...

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.

[Radiologic evaluation of the position of the heart and its valves in American mink Mustela vison (Brisson, 1756)].

PubMed

Gościcka, D; Krakowiak, E

1988-01-01

Resorting to anatomical and radiological methods we have examined the position of the heart and the projection of the heart valves. The costotopy and the ortodiagram of the heart was analyzed. Special attention was paid to the difference between the position of the heart in female and male minks. We have found that in the majority of minks the heart is enclosed between 5 and 8 rib; it is situated with is greater part on the left side of the chest, especially in females.

A guide for effective anatomical vascularization studies: useful ex vivo methods for both CT and MRI imaging before dissection.

PubMed

Renard, Yohann; Hossu, Gabriela; Chen, Bailiang; Krebs, Marine; Labrousse, Marc; Perez, Manuela

2018-01-01

The objective of this study was to develop a simple and useful injection protocol for imaging cadaveric vascularization and dissection. Mixtures of contrast agent and cast product should provide adequate contrast for two types of ex vivo imaging (MRI and CT) and should harden to allow gross dissection of the injected structures. We tested the most popular contrast agents and cast products, and selected the optimal mixture composition based on their availability and ease of use. All mixtures were first tested in vitro to adjust dilution parameters of each contrast agent and to fine-tune MR imaging acquisition sequences. Mixtures were then injected in 24 pig livers and one human pancreas for MR and computed tomography (CT) imaging before anatomical dissection. Colorized latex, gadobutrol and barite mixture met the above objective. Mixtures composed of copper sulfate (CuSO 4 ) gadoxetic acid (for MRI) and iodine (for CT) gave an inhomogeneous signal or extravasation of the contrast agent. Agar did not harden sufficiently for gross dissection but appears useful for CT and magnetic resonance imaging (MRI) studies without dissection. Silicone was very hard to inject but achieved the goals of the study. Resin is particularly difficult to use but could replace latex as an alternative for corrosion instead of dissection. This injection protocol allows CT and MRI images to be obtained of cadaveric vascularization and anatomical casts in the same anatomic specimen. Post-imaging processing software allow easy 3D reconstruction of complex anatomical structures using this technique. Applications are numerous, e.g. surgical training, teaching methods, postmortem anatomic studies, pathologic studies, and forensic diagnoses. © 2017 Anatomical Society.

Keeping brains young with making music.

PubMed

Rogenmoser, Lars; Kernbach, Julius; Schlaug, Gottfried; Gaser, Christian

2018-01-01

Music-making is a widespread leisure and professional activity that has garnered interest over the years due to its effect on brain and cognitive development and its potential as a rehabilitative and restorative therapy of brain dysfunctions. We investigated whether music-making has a potential age-protecting effect on the brain. For this, we studied anatomical magnetic resonance images obtained from three matched groups of subjects who differed in their lifetime dose of music-making activities (i.e., professional musicians, amateur musicians, and non-musicians). For each subject, we calculated a so-called BrainAGE score which corresponds to the discrepancy (in years) between chronological age and the "age of the brain", with negative values reflecting an age-decelerating brain and positive values an age-accelerating brain, respectively. The index of "brain age" was estimated using a machine-learning algorithm that was trained in a large independent sample to identify anatomical correlates of brain-aging. Compared to non-musicians, musicians overall had lower BrainAGE scores, with amateur musicians having the lowest scores suggesting that music-making has an age-decelerating effect on the brain. Unlike the amateur musicians, the professional musicians showed a positive correlation between their BrainAGE scores and years of music-making, possibly indicating that engaging more intensely in just one otherwise enriching activity might not be as beneficial than if the activity is one of several that an amateur musician engages in. Intense music-making activities at a professional level could also lead to stress-related interferences and a less enriched environment than that of amateur musicians, possibly somewhat diminishing the otherwise positive effect of music-making.

Comparison of computer assisted surgery with conventional technique for treatment of abaxial distal phalanx fractures in horses: an in vitro study.

PubMed

Rossol, Melanie; Gygax, Diego; Andritzky-Waas, Juliane; Zheng, Guoyan; Lischer, Christoph J; Zhang, Xuan; Auer, Joerg A

2008-01-01

To (1) evaluate and compare computer-assisted surgery (CAS) with conventional screw insertion (conventional osteosynthesis [COS]) for treatment of equine abaxial distal phalanx fractures; (2) compare planned screw position with actual postoperative position; and (3) determine preferred screw insertion direction. Experimental study. Cadaveric equine limbs (n=32). In 8 specimens each, a 4.5 mm cortex bone screw was inserted in lag fashion in dorsopalmar (plantar) direction using CAS or COS. In 2 other groups of 8, the screws were inserted in opposite direction. Precision of CAS was determined by comparison of planned and actual screw position. Preferred screw direction was also assessed for CAS and COS. In 4 of 6 direct comparisons, screw positioning was significantly better with CAS. Results of precision analysis for screw position were similar to studies published in human medicine. None of evaluated criteria identified a preferred direction for screw insertion. For abaxial fractures of the distal phalanx, superior precision in screw position is achieved with CAS technique compared with COS technique. Abaxial fractures of the distal phalanx lend themselves to computer-assisted implantation of 1 screw in a dorsopalmar (plantar) direction. Because of the complex anatomic relationships, and our results, we discourage use of COS technique for repair of this fracture type.

A comprehensive overview of urogenital, anorectal and oropharyngeal Neisseria gonorrhoeae testing and diagnoses among different STI care providers: a cross-sectional study.

PubMed

den Heijer, Casper D J; Hoebe, Christian J P A; van Liere, Geneviève A F S; van Bergen, Jan E A M; Cals, Jochen W L; Stals, Frans S; Dukers-Muijrers, Nicole H T M

2017-04-20

Gonorrhoea, caused by Neisseria gonorrhoeae (NG), can cause reproductive morbidity, is increasingly becoming resistant to antibiotics and is frequently asymptomatic, which shows the essential role of NG test practice. In this study we wanted to compare NG diagnostic testing procedures between different STI care providers serving a defined geographic Dutch region (280,000 inhabitants). Data on laboratory testing and diagnosis of urogenital and extragenital (i.e. anorectal and oropharyngeal) NG were retrieved from general practitioners (GPs), an STI clinic, and gynaecologists (2006-2010). Per provider, we assessed their contribution regarding the total number of tests performed and type of populations tested, the proportion of NG positives re-tested (3-12 months after treatment) and test-of-cure (TOC, within 3 months post treatment). Overall, 17,702 NG tests (48.7% STI clinic, 38.2% GPs, 13.1% gynaecologists) were performed during 15,458 patient visits. From this total number of tests, 2257 (12.7%) were extragenital, of which 99.4% were performed by the STI clinic. Men were mostly tested at the STI clinic (71%) and women by their GP (43%). NG positivity per visit was 1.6%; GP 1.9% (n = 111), STI clinic 1.7% (n = 131) and gynaecology 0.2% (n = 5). NG positivity was associated with Chlamydia trachomatis positivity (OR: 2.06, 95% confidence interval: 1.46-2.92). Per anatomical location, the proportion of NG positives re-tested were: urogenital 20.3% (n = 36), anorectal 43.6% (n = 17) and oropharyngeal 57.1% (n = 20). NG positivity among re-tests was 16.9%. Proportions of NG positives with TOC by anatomical location were: urogenital 10.2% (n = 18), anorectal 17.9% (n = 7) and oropharyngeal 17.1% (n = 6). To achieve best practice in relation to NG testing, we recommend that: 1) GPs test at extragenital sites, especially men who have sex with men (MSM), 2) all care providers consider re-testing 3 to 12 months after NG diagnosis and 3) TOC is performed following oropharyngeal NG diagnosis in settings which provide services to higher-risk men and women (such as STI clinics).

Two- and Three-Dimensional Anatomy of Paranasal Sinuses in Arabian Foals

PubMed Central

BAHAR, Sadullah; BOLAT, Durmus; DAYAN, Mustafa Orhun; PAKSOY, Yahya

2013-01-01

ABSTRACT The 2- and 3-dimensional (3D) anatomy and the morphometric properties of the paranasal sinuses of the foal have received little or no attention in the literature. The aim of this study was to obtain details of the paranasal sinuses using multiplane CT imaging to create 3D models and to determine morphological and morphometric data for the sinuses using the 3D models. The heads of five female foals were used in this study. The heads were scanned using computed tomography (CT) in the rostrocaudal direction. After the heads had been frozen, anatomical sections were obtained in the scan position. The 3D models of sinuses and the skull were prepared using MIMICS®. These models were used to assess the surface area and volume of the sinuses, the width, height and orientation of the apertures connecting these sinuses and finally the planar relation of the sinuses with the skull. The right and left sides of all anatomical structures, except the sphenoid sinuses, had symmetric organization on CT images and anatomical sections. The total sinus surface area and volume on both sides were 214.4 cm2 and 72.9 ml, respectively. The largest and the smallest sinuses were the frontal sinus (41.5 ml) and the middle conchal sinus (0.2 ml), respectively. It was found that the planes bounding the sinuses passed through easily palpable points on the head. In conclusion, 3D modeling in combination with conventional sectional imaging of the paranasal sinuses of the foal may help anatomists, radiologists, clinicians and veterinary students. PMID:24004969

Two- and three-dimensional anatomy of paranasal sinuses in Arabian foals.

PubMed

Bahar, Sadullah; Bolat, Durmus; Dayan, Mustafa Orhun; Paksoy, Yahya

2014-01-01

The 2- and 3-dimensional (3D) anatomy and the morphometric properties of the paranasal sinuses of the foal have received little or no attention in the literature. The aim of this study was to obtain details of the paranasal sinuses using multiplane CT imaging to create 3D models and to determine morphological and morphometric data for the sinuses using the 3D models. The heads of five female foals were used in this study. The heads were scanned using computed tomography (CT) in the rostrocaudal direction. After the heads had been frozen, anatomical sections were obtained in the scan position. The 3D models of sinuses and the skull were prepared using MIMICS(®). These models were used to assess the surface area and volume of the sinuses, the width, height and orientation of the apertures connecting these sinuses and finally the planar relation of the sinuses with the skull. The right and left sides of all anatomical structures, except the sphenoid sinuses, had symmetric organization on CT images and anatomical sections. The total sinus surface area and volume on both sides were 214.4 cm(2) and 72.9 ml, respectively. The largest and the smallest sinuses were the frontal sinus (41.5 ml) and the middle conchal sinus (0.2 ml), respectively. It was found that the planes bounding the sinuses passed through easily palpable points on the head. In conclusion, 3D modeling in combination with conventional sectional imaging of the paranasal sinuses of the foal may help anatomists, radiologists, clinicians and veterinary students.

Boundaries of the thoracic paravertebral space: potential risks and benefits of the thoracic paravertebral block from an anatomical perspective.

PubMed

Bouman, Esther A C; Sieben, Judith M; Balthasar, Andrea J R; Joosten, Elbert A; Gramke, Hans-Fritz; van Kleef, Maarten; Lataster, Arno

2017-10-01

Thoracic paravertebral block (TPVB) may be an alternative to thoracic epidural analgesia. A detailed knowledge of the anatomy of the TPV-space (TPVS), content and adnexa is essential in understanding the clinical consequences of TPVB. The exploration of the posterior TPVS accessibility in this study allows (1) determination of the anatomical boundaries, content and adnexa, (2) description of an ultrasound-guided spread of low and high viscous liquid. In two formalin-fixed specimens, stratification of the several layers and the 3D-architecture of the TPVS were dissected, observed and photographed. In a third unembalmed specimen, ultrasound-guided posterolateral injections at several levels of the TPVS were performed with different fluids. TPVS communicated with all surrounding spaces including the segmental dorsal intercostal compartments (SDICs) and the prevertebral space. TPVS transitions to the SDICs were wide, whereas the SDICs showed narrowed transitions to the lateral intercostal spaces at the costal angle. Internal subdivision of the TPVS in a subendothoracic and an extra-pleural compartment by the endothoracic fascia was not observed. Caudally injected fluids spread posteriorly to the costodiaphragmatic recess, showing segmental intercostal and slight prevertebral spread. Our detailed anatomical study shows that TPVS is a potential space continuous with the SDICs. The separation of the TPVS in a subendothoracic and an extra-pleural compartment by the endothoracic fascia was not observed. Based on the ultrasound-guided liquid spread we conclude that the use of a more lateral approach might increase the probability of intravascular puncture or catheter position.

Intrahepatic venous anastomoses with a focus on the middle hepatic vein anastomoses in normal human livers: anatomical study on liver corrosion casts.

PubMed

Hribernik, Marija; Trotovšek, Blaž

2014-04-01

The aim of this study is to present the anatomical data about intrahepatic venous anastomoses found in normal human livers. The focus is on the middle hepatic vein (MHV) anastomoses, because their existence or non-existence could be of crucial importance in tumour resections as well as in split or living donor liver transplantations. The frequency of livers with intrahepatic venous anastomoses was determined on 164 corrosion casts and the diameter of each anastomosis was measured. Additionally, the type of connection and the position within the liver (liver segment) was determined for each MHV anastomosis. Intrahepatic venous anastomoses were found in 46 % (75/164), whereas MHV anastomoses were found in 28 % (44/164) of liver casts. Most commonly (39/44), MHV had anastomotic connections with the right hepatic vein (RHV), and also with the inferior RHV, the left hepatic vein and the short subhepatic vein. In more than three quarters of liver casts, MHV-RHV anastomoses were found in liver segment 8; in 45 % of cases, there was more than one anastomosis in this liver segment. The diameter of MHV-RHV anastomoses found in segment 8 was ≥1 mm in 90.6 % of cases. As MHV anastomoses were present in more than a quarter of all examined liver casts, we believe that detailed anatomical data presented in this article, together with up to date radiologic technics which enable even 3D reconstruction of venous anastomoses in the liver, could contribute to the clinician's decisions when planning surgical procedures.

A 3D high resolution ex vivo white matter atlas of the common squirrel monkey (saimiri sciureus) based on diffusion tensor imaging

NASA Astrophysics Data System (ADS)

Gao, Yurui; Parvathaneni, Prasanna; Schilling, Kurt G.; Wang, Feng; Stepniewska, Iwona; Xu, Zhoubing; Choe, Ann S.; Ding, Zhaohua; Gore, John C.; Chen, Li min; Landman, Bennett A.; Anderson, Adam W.

2016-03-01

Modern magnetic resonance imaging (MRI) brain atlases are high quality 3-D volumes with specific structures labeled in the volume. Atlases are essential in providing a common space for interpretation of results across studies, for anatomical education, and providing quantitative image-based navigation. Extensive work has been devoted to atlas construction for humans, macaque, and several non-primate species (e.g., rat). One notable gap in the literature is the common squirrel monkey - for which the primary published atlases date from the 1960's. The common squirrel monkey has been used extensively as surrogate for humans in biomedical studies, given its anatomical neuro-system similarities and practical considerations. This work describes the continued development of a multi-modal MRI atlas for the common squirrel monkey, for which a structural imaging space and gray matter parcels have been previously constructed. This study adds white matter tracts to the atlas. The new atlas includes 49 white matter (WM) tracts, defined using diffusion tensor imaging (DTI) in three animals and combines these data to define the anatomical locations of these tracks in a standardized coordinate system compatible with previous development. An anatomist reviewed the resulting tracts and the inter-animal reproducibility (i.e., the Dice index of each WM parcel across animals in common space) was assessed. The Dice indices range from 0.05 to 0.80 due to differences of local registration quality and the variation of WM tract position across individuals. However, the combined WM labels from the 3 animals represent the general locations of WM parcels, adding basic connectivity information to the atlas.

A 3D high resolution ex vivo white matter atlas of the common squirrel monkey (Saimiri sciureus) based on diffusion tensor imaging

PubMed Central

Gao, Yurui; Parvathaneni, Prasanna; Schilling, Kurt G.; Wang, Feng; Stepniewska, Iwona; Xu, Zhoubing; Choe, Ann S.; Ding, Zhaohua; Gore, John C.; Chen, Li Min; Landman, Bennett A.; Anderson, Adam W.

2016-01-01

Modern magnetic resonance imaging (MRI) brain atlases are high quality 3-D volumes with specific structures labeled in the volume. Atlases are essential in providing a common space for interpretation of results across studies, for anatomical education, and providing quantitative image-based navigation. Extensive work has been devoted to atlas construction for humans, macaque, and several non-primate species (e.g., rat). One notable gap in the literature is the common squirrel monkey – for which the primary published atlases date from the 1960’s. The common squirrel monkey has been used extensively as surrogate for humans in biomedical studies, given its anatomical neuro-system similarities and practical considerations. This work describes the continued development of a multi-modal MRI atlas for the common squirrel monkey, for which a structural imaging space and gray matter parcels have been previously constructed. This study adds white matter tracts to the atlas. The new atlas includes 49 white matter (WM) tracts, defined using diffusion tensor imaging (DTI) in three animals and combines these data to define the anatomical locations of these tracks in a standardized coordinate system compatible with previous development. An anatomist reviewed the resulting tracts and the inter-animal reproducibility (i.e., the Dice index of each WM parcel across animals in common space) was assessed. The Dice indices range from 0.05 to 0.80 due to differences of local registration quality and the variation of WM tract position across individuals. However, the combined WM labels from the 3 animals represent the general locations of WM parcels, adding basic connectivity information to the atlas. PMID:27064328

A 3D high resolution ex vivo white matter atlas of the common squirrel monkey (Saimiri sciureus) based on diffusion tensor imaging.

PubMed

Gao, Yurui; Parvathaneni, Prasanna; Schilling, Kurt G; Wang, Feng; Stepniewska, Iwona; Xu, Zhoubing; Choe, Ann S; Ding, Zhaohua; Gore, John C; Chen, Li Min; Landman, Bennett A; Anderson, Adam W

2016-02-27

Modern magnetic resonance imaging (MRI) brain atlases are high quality 3-D volumes with specific structures labeled in the volume. Atlases are essential in providing a common space for interpretation of results across studies, for anatomical education, and providing quantitative image-based navigation. Extensive work has been devoted to atlas construction for humans, macaque, and several non-primate species (e.g., rat). One notable gap in the literature is the common squirrel monkey - for which the primary published atlases date from the 1960's. The common squirrel monkey has been used extensively as surrogate for humans in biomedical studies, given its anatomical neuro-system similarities and practical considerations. This work describes the continued development of a multi-modal MRI atlas for the common squirrel monkey, for which a structural imaging space and gray matter parcels have been previously constructed. This study adds white matter tracts to the atlas. The new atlas includes 49 white matter (WM) tracts, defined using diffusion tensor imaging (DTI) in three animals and combines these data to define the anatomical locations of these tracks in a standardized coordinate system compatible with previous development. An anatomist reviewed the resulting tracts and the inter-animal reproducibility (i.e., the Dice index of each WM parcel across animals in common space) was assessed. The Dice indices range from 0.05 to 0.80 due to differences of local registration quality and the variation of WM tract position across individuals. However, the combined WM labels from the 3 animals represent the general locations of WM parcels, adding basic connectivity information to the atlas.

Anatomical predisposition of the ankle joint for lateral sprain or lateral malleolar fracture evaluated by radiographic measurements.

PubMed

Lee, Kyoung Min; Chung, Chin Youb; Sung, Ki Hyuk; Lee, SeungYeol; Kim, Tae Gyun; Choi, Young; Jung, Ki Jin; Kim, Yeon Ho; Koo, Seung Bum; Park, Moon Seok

2015-01-01

Injury mechanism and the amount of force are important factors determining whether a fracture or sprain occurs at the time of an ankle inversion injury. However, the anatomical differences between the ankle fracture and sprain have not been investigated sufficiently. This study was performed to investigate whether an anatomical predisposition of the ankle joint results in a lateral malleolar fracture or lateral ankle sprain. Two groups of consecutive patients, one with lateral malleolar fracture (274 patients, mean age 49.0 years) and the other with lateral ankle sprain (400 patients, mean age 38.4 years), were evaluated. Ankle radiographs were examined for 7 measures: distal tibial articular surface (DTAS) angle, bimalleolar tilt (BT), medial malleolar relative length (MMRL), lateral malleolar relative length (LMRL), medial malleolar slip angle (MMSA), anterior inclination of tibia (AI), and fibular position (FP). After an interobserver reliability test, the radiographic measurements were compared between the 2 groups. Linear regression analysis was performed to correct for age and sex effects between the groups. The fracture group and the sprain group showed significant differences in BT (P = .001), MMSA (P < .001), AI (P = .023), and FP (P < .001). In multiple regression analysis, after adjusting for age and sex effects, fracture and sprain groups showed a significant difference in BT (P = .001), MMRL (P < .001), MMSA (P < .001), and FP (P < .001). The lateral malleolar fracture group tended to show more bony constraint than that of the lateral ankle sprain group. Further 3-dimensional assessment of the bony structure and subsequent biomechanical studies are needed to elucidate the mechanism of injury according to the various types of ankle fractures and ankle sprain. Level III, retrospective comparative study. © The Author(s) 2014.

Anatomy and Physiology of the Speech Mechanism.

ERIC Educational Resources Information Center

Sheets, Boyd V.

This monograph on the anatomical and physiological aspects of the speech mechanism stresses the importance of a general understanding of the process of verbal communication. Contents include "Positions of the Body,""Basic Concepts Linked with the Speech Mechanism,""The Nervous System,""The Respiratory System--Sound-Power Source,""The…

Virtual reality in rhinology-a new dimension of clinical experience.

PubMed

Klapan, Ivica; Raos, Pero; Galeta, Tomislav; Kubat, Goranka

2016-07-01

There is often a need to more precisely identify the extent of pathology and the fine elements of intracranial anatomic features during the diagnostic process and during many operations in the nose, sinus, orbit, and skull base region. In two case reports, we describe the methods used in the diagnostic workup and surgical therapy in the nose and paranasal sinus region. Besides baseline x-ray, multislice computed tomography, and magnetic resonance imaging, operative field imaging was performed via a rapid prototyping model, virtual endoscopy, and 3-D imaging. Different head tissues were visualized in different colors, showing their anatomic interrelations and the extent of pathologic tissue within the operative field. This approach has not yet been used as a standard preoperative or intraoperative procedure in otorhinolaryngology. In this way, we tried to understand the new, visualized "world of anatomic relations within the patient's head" by creating an impression of perception (virtual perception) of the given position of all elements in a particular anatomic region of the head, which does not exist in the real world (virtual world). This approach was aimed at upgrading the diagnostic workup and surgical therapy by ensuring a faster, safer and, above all, simpler operative procedure. In conclusion, any ENT specialist can provide virtual reality support in implementing surgical procedures, with additional control of risks and within the limits of normal tissue, without additional trauma to the surrounding tissue in the anatomic region. At the same time, the virtual reality support provides an impression of the virtual world as the specialist navigates through it and manipulates virtual objects.

Systemic regulation of leaf anatomical structure, photosynthetic performance, and high-light tolerance in sorghum.

PubMed

Jiang, Chuang-Dao; Wang, Xin; Gao, Hui-Yuan; Shi, Lei; Chow, Wah Soon

2011-03-01

Leaf anatomy of C3 plants is mainly regulated by a systemic irradiance signal. Since the anatomical features of C4 plants are different from that of C3 plants, we investigated whether the systemic irradiance signal regulates leaf anatomical structure and photosynthetic performance in sorghum (Sorghum bicolor), a C4 plant. Compared with growth under ambient conditions (A), no significant changes in anatomical structure were observed in newly developed leaves by shading young leaves alone (YS). Shading mature leaves (MS) or whole plants (S), on the other hand, caused shade-leaf anatomy in newly developed leaves. By contrast, chloroplast ultrastructure in developing leaves depended only on their local light conditions. Functionally, shading young leaves alone had little effect on their net photosynthetic capacity and stomatal conductance, but shading mature leaves or whole plants significantly decreased these two parameters in newly developed leaves. Specifically, the net photosynthetic rate in newly developed leaves exhibited a positive linear correlation with that of mature leaves, as did stomatal conductance. In MS and S treatments, newly developed leaves exhibited severe photoinhibition under high light. By contrast, newly developed leaves in A and YS treatments were more resistant to high light relative to those in MS- and S-treated seedlings. We suggest that (1) leaf anatomical structure, photosynthetic capacity, and high-light tolerance in newly developed sorghum leaves were regulated by a systemic irradiance signal from mature leaves; and (2) chloroplast ultrastructure only weakly influenced the development of photosynthetic capacity and high-light tolerance. The potential significance of the regulation by a systemic irradiance signal is discussed.

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…

Development of an Anatomically Accurate Finite Element Human Ocular Globe Model for Blast-Related Fluid-Structure Interaction Studies

DTIC Science & Technology

2017-02-01

ARL-TR-7945 ● FEB 2017 US Army Research Laboratory Development of an Anatomically Accurate Finite Element Human Ocular Globe...ARL-TR-7945 ● FEB 2017 US Army Research Laboratory Development of an Anatomically Accurate Finite Element Human Ocular Globe Model... Finite Element Human Ocular Globe Model for Blast-Related Fluid-Structure Interaction Studies 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM

Automated Detection, Localization, and Classification of Traumatic Vertebral Body Fractures in the Thoracic and Lumbar Spine at CT

PubMed Central

Burns, Joseph E.; Yao, Jianhua; Muñoz, Hector

2016-01-01

Purpose To design and validate a fully automated computer system for the detection and anatomic localization of traumatic thoracic and lumbar vertebral body fractures at computed tomography (CT). Materials and Methods This retrospective study was HIPAA compliant. Institutional review board approval was obtained, and informed consent was waived. CT examinations in 104 patients (mean age, 34.4 years; range, 14–88 years; 32 women, 72 men), consisting of 94 examinations with positive findings for fractures (59 with vertebral body fractures) and 10 control examinations (without vertebral fractures), were performed. There were 141 thoracic and lumbar vertebral body fractures in the case set. The locations of fractures were marked and classified by a radiologist according to Denis column involvement. The CT data set was divided into training and testing subsets (37 and 67 subsets, respectively) for analysis by means of prototype software for fully automated spinal segmentation and fracture detection. Free-response receiver operating characteristic analysis was performed. Results Training set sensitivity for detection and localization of fractures within each vertebra was 0.82 (28 of 34 findings; 95% confidence interval [CI]: 0.68, 0.90), with a false-positive rate of 2.5 findings per patient. The sensitivity for fracture localization to the correct vertebra was 0.88 (23 of 26 findings; 95% CI: 0.72, 0.96), with a false-positive rate of 1.3. Testing set sensitivity for the detection and localization of fractures within each vertebra was 0.81 (87 of 107 findings; 95% CI: 0.75, 0.87), with a false-positive rate of 2.7. The sensitivity for fracture localization to the correct vertebra was 0.92 (55 of 60 findings; 95% CI: 0.79, 0.94), with a false-positive rate of 1.6. The most common cause of false-positive findings was nutrient foramina (106 of 272 findings [39%]). Conclusion The fully automated computer system detects and anatomically localizes vertebral body fractures in the thoracic and lumbar spine on CT images with a high sensitivity and a low false-positive rate. © RSNA, 2015 Online supplemental material is available for this article. PMID:26172532

A generic, geometric cocalibration method for a combined system of fluorescence molecular tomography and microcomputed tomography with arbitrarily shaped objects.

PubMed

Fu, Jianwei; Yang, Xiaoquan; Wang, Kan; Luo, Qingming; Gong, Hui

2011-12-01

A combined system of fluorescence molecular tomography and microcomputed tomography (FMT&mCT) can provide molecular and anatomical information of small animals in a single study with intrinsically coregistered images. The anatomical information provided by the mCT subsystem is commonly used as a reference to locate the fluorophore distribution or as a priori structural information to improve the performance of FMT. Therefore, the transformation between the coordinate systems of the subsystem needs to be determined in advanced. A cocalibration method for the combined system of FMT&mCT is proposed. First, linear models are adopted to describe the galvano mirrors and the charge-coupled device (CCD) camera in the FMT subsystem. Second, the position and orientation of the galvano mirrors are determined with the input voltages of the galvano mirrors and the markers, whose positions are predetermined. The position, orientation and normalized pixel size of the CCD camera are obtained by analysing the projections of a point-like marker at different positions. Finally, the orientation and position of sources and the corresponding relationship between the detectors and their projections on the image plane are predicted. Because the positions of the markers are acquired with mCT, the registration of the FMT and mCT could be realized by direct image fusion. The accuracy and consistency of this method in the presence of noise is evaluated by computer simulation. Next, a practical implementation for an experimental FMT&mCT system is carried out and validated. The maximum prediction error of the source positions on the surface of a cylindrical phantom is within 0.375 mm and that of the projections of a point-like marker is within 0.629 pixel. Finally, imaging experiments of the fluorophore distribution in a cylindrical phantom and a phantom with a complex shape demonstrate the feasibility of the proposed method. This method is universal in FMT&mCT, which could be performed with no restriction on the system geometry, calibration phantoms or imaging objects.

A generic, geometric cocalibration method for a combined system of fluorescence molecular tomography and microcomputed tomography with arbitrarily shaped objects

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fu Jianwei; Yang Xiaoquan; Wang Kan

2011-12-15

Purpose: A combined system of fluorescence molecular tomography and microcomputed tomography (FMT and mCT) can provide molecular and anatomical information of small animals in a single study with intrinsically coregistered images. The anatomical information provided by the mCT subsystem is commonly used as a reference to locate the fluorophore distribution or as a priori structural information to improve the performance of FMT. Therefore, the transformation between the coordinate systems of the subsystem needs to be determined in advanced. Methods: A cocalibration method for the combined system of FMT and mCT is proposed. First, linear models are adopted to describe themore » galvano mirrors and the charge-coupled device (CCD) camera in the FMT subsystem. Second, the position and orientation of the galvano mirrors are determined with the input voltages of the galvano mirrors and the markers, whose positions are predetermined. The position, orientation and normalized pixel size of the CCD camera are obtained by analysing the projections of a point-like marker at different positions. Finally, the orientation and position of sources and the corresponding relationship between the detectors and their projections on the image plane are predicted. Because the positions of the markers are acquired with mCT, the registration of the FMT and mCT could be realized by direct image fusion. Results: The accuracy and consistency of this method in the presence of noise is evaluated by computer simulation. Next, a practical implementation for an experimental FMT and mCT system is carried out and validated. The maximum prediction error of the source positions on the surface of a cylindrical phantom is within 0.375 mm and that of the projections of a point-like marker is within 0.629 pixel. Finally, imaging experiments of the fluorophore distribution in a cylindrical phantom and a phantom with a complex shape demonstrate the feasibility of the proposed method. Conclusions: This method is universal in FMT and mCT, which could be performed with no restriction on the system geometry, calibration phantoms or imaging objects.« less

Double positivity for HPV-DNA/p16ink4a is the biomarker with strongest diagnostic accuracy and prognostic value for human papillomavirus related oropharyngeal cancer patients.

PubMed

Mena, Marisa; Taberna, Miren; Tous, Sara; Marquez, Sandra; Clavero, Omar; Quiros, Beatriz; Lloveras, Belen; Alejo, Maria; Leon, Xavier; Quer, Miquel; Bagué, Silvia; Mesia, Ricard; Nogués, Julio; Gomà, Montserrat; Aguila, Anton; Bonfill, Teresa; Blazquez, Carmen; Guix, Marta; Hijano, Rafael; Torres, Montserrat; Holzinger, Dana; Pawlita, Michael; Pavon, Miguel Angel; Bravo, Ignacio G; de Sanjosé, Silvia; Bosch, Francesc Xavier; Alemany, Laia

2018-03-01

The etiologic role of human papillomaviruses (HPV) in oropharyngeal cancer (OPC) is well established. Nevertheless, information on survival differences by anatomic sub-site or treatment remains scarce, and it is still unclear the HPV-relatedness definition with best diagnostic accuracy and prognostic value. We conducted a retrospective cohort study of all patients diagnosed with a primary OPC in four Catalonian hospitals from 1990 to 2013. Formalin-fixed, paraffin-embedded cancer tissues were subjected to histopathological evaluation, DNA quality control, HPV-DNA detection, and p16 INK4a /pRb/p53/Cyclin-D1 immunohistochemistry. HPV-DNA positive and a random sample of HPV-DNA negative cases were subjected to HPV-E6*I mRNA detection. Demographic, tobacco/alcohol use, clinical and follow-up data were collected. Multivariate models were used to evaluate factors associated with HPV positivity as defined by four different HPV-relatedness definitions. Proportional-hazards models were used to compare the risk of death and recurrence among HPV-related and non-related OPC. 788 patients yielded a valid HPV-DNA result. The percentage of positive cases was 10.9%, 10.2%, 8.5% and 7.4% for p16 INK4a , HPV-DNA, HPV-DNA/HPV-E6*I mRNA, and HPV-DNA/p16 INK4a , respectively. Being non-smoker or non-drinker was consistently associated across HPV-relatedness definitions with HPV positivity. A suggestion of survival differences between anatomic sub-sites and treatments was observed. Double positivity for HPV-DNA/p16 INK4a showed strongest diagnostic accuracy and prognostic value. Double positivity for HPV-DNA/p16 INK4a , a test that can be easily implemented in the clinical practice, has optimal diagnostic accuracy and prognostic value. Our results have strong clinical implications for patients' classification and handling and also suggest that not all the HPV-related OPC behave similarly. Copyright © 2018 Elsevier Ltd. All rights reserved.

Does Medial Meniscal Allograft Transplantation With the Bone-Plug Technique Restore the Anatomic Location of the Native Medial Meniscus?

PubMed

Kim, Nam-Ki; Bin, Seong-Il; Kim, Jong-Min; Lee, Chang-Rack

2015-12-01

Previous work has shown the importance of restoring the normal structure of the native meniscus with meniscal allograft transplantation. The purpose of this study was to compare the anatomic positions of the anterior horn and posterior horn between the preoperative medial meniscus and the postoperative meniscal allograft after medial meniscal allograft transplantation with the bone-plug technique. The hypothesis was that the bone-plug technique could restore the preoperative structure of the native medial meniscus. Case series; Level of evidence, 4. Between December 1999 and December 2013, a total of 59 patients (49 male, 10 female) underwent medial meniscal allograft transplantation by use of the bone-plug technique. The anatomic positions of both horns in the native medial meniscus and in the meniscal allograft were measured via MRI. The percentage reference method was used to measure the locations of both horns. On coronal MRI, the mean absolute distance of the posterior horn from the lateral border of the tibial plateau changed from 45.2 ± 3.3 to 48.1 ± 4.2 mm (P < .05), and the percentage distance of the posterior horn changed from 59.6% to 63.0% (P < .05). On sagittal MRI, the mean absolute distance of the posterior horn from the anterior reference point changed from 40.3 ± 3.0 to 42.0 ± 3.5 mm (P < .05), and the mean percentage distance of the posterior horn changed from 76.5% to 79.4% (P <.05). On coronal MRI, the mean absolute distance of the anterior horn from the lateral border of the tibial plateau changed from 41.3 ± 4.2 to 48.5 ± 5.6 mm (P < .05), and the mean percentage distance of the anterior horn changed from 54.5% to 63.8% (P < .05). On sagittal MRI, the mean absolute distance of the anterior horn from the anterior reference point changed from 5.5 ± 1.0 to 9.9 ± 2.9 mm (P < .05), and the mean percentage distance of the anterior horn changed from 10.6% to 19.0% (P < .05). Despite attempts to place the meniscal allograft in the same position as the native meniscus, the anatomic locations of both horns were shifted posteromedially compared with those of the native medial meniscus. There were significant differences, attributed to several limitations in the bone-plug technique, between the preoperative and postoperative values of both horns. However, the posterior horn showed a location change of <5 mm, on average, in both the coronal and sagittal planes, whereas the anterior horn showed a location change of ≥ 5 mm in the coronal plane but <5 mm in the sagittal plane. © 2015 The Author(s).

How does climate influence xylem morphogenesis over the growing season? Insights from long-term intra-ring anatomy in Picea abies

PubMed Central

Fonti, Patrick; von Arx, Georg; Carrer, Marco

2017-01-01

Background and Aims During the growing season, the cambium of conifer trees produces successive rows of xylem cells, the tracheids, that sequentially pass through the phases of enlargement and secondary wall thickening before dying and becoming functional. Climate variability can strongly influence the kinetics of morphogenetic processes, eventually affecting tracheid shape and size. This study investigates xylem anatomical structure in the stem of Picea abies to retrospectively infer how, in the long term, climate affects the processes of cell enlargement and wall thickening. Methods Tracheid anatomical traits related to the phases of enlargement (diameter) and wall thickening (wall thickness) were innovatively inspected at the intra-ring level on 87-year-long tree-ring series in Picea abies trees along a 900 m elevation gradient in the Italian Alps. Anatomical traits in ten successive tree-ring sectors were related to daily temperature and precipitation data using running correlations. Key Results Close to the altitudinal tree limit, low early-summer temperature negatively affected cell enlargement. At lower elevation, water availability in early summer was positively related to cell diameter. The timing of these relationships shifted forward by about 20 (high elevation) to 40 (low elevation) d from the first to the last tracheids in the ring. Cell wall thickening was affected by climate in a different period in the season. In particular, wall thickness of late-formed tracheids was strongly positively related to August–September temperature at high elevation. Conclusions Morphogenesis of tracheids sequentially formed in the growing season is influenced by climate conditions in successive periods. The distinct climate impacts on cell enlargement and wall thickening indicate that different morphogenetic mechanisms are responsible for different tracheid traits. Our approach of long-term and high-resolution analysis of xylem anatomy can support and extend short-term xylogenesis observations, and increase our understanding of climate control of tree growth and functioning under different environmental conditions. PMID:28130220

Enhanced cardio vascular image analysis by combined representation of results from dynamic MRI and anatomic CTA

NASA Astrophysics Data System (ADS)

Kuehnel, C.; Hennemuth, A.; Oeltze, S.; Boskamp, T.; Peitgen, H.-O.

2008-03-01

The diagnosis support in the field of coronary artery disease (CAD) is very complex due to the numerous symptoms and performed studies leading to the final diagnosis. CTA and MRI are on their way to replace invasive catheter angiography. Thus, there is a need for sophisticated software tools that present the different analysis results, and correlate the anatomical and dynamic image information. We introduce a new software assistant for the combined result visualization of CTA and MR images, in which a dedicated concept for the structured presentation of original data, segmentation results, and individual findings is realized. Therefore, we define a comprehensive class hierarchy and assign suitable interaction functions. User guidance is coupled as closely as possible with available data, supporting a straightforward workflow design. The analysis results are extracted from two previously developed software assistants, providing coronary artery analysis and measurements, function analysis as well as late enhancement data investigation. As an extension we introduce a finding concept directly relating suspicious positions to the underlying data. An affine registration of CT and MR data in combination with the AHA 17-segment model enables the coupling of local findings to positions in all data sets. Furthermore, sophisticated visualization in 2D and 3D and interactive bull's eye plots facilitate a correlation of coronary stenoses and physiology. The software has been evaluated on 20 patient data sets.

Convolution neural-network-based detection of lung structures

NASA Astrophysics Data System (ADS)

Hasegawa, Akira; Lo, Shih-Chung B.; Freedman, Matthew T.; Mun, Seong K.

1994-05-01

Chest radiography is one of the most primary and widely used techniques in diagnostic imaging. Nowadays with the advent of digital radiology, the digital medical image processing techniques for digital chest radiographs have attracted considerable attention, and several studies on the computer-aided diagnosis (CADx) as well as on the conventional image processing techniques for chest radiographs have been reported. In the automatic diagnostic process for chest radiographs, it is important to outline the areas of the lungs, the heart, and the diaphragm. This is because the original chest radiograph is composed of important anatomic structures and, without knowing exact positions of the organs, the automatic diagnosis may result in unexpected detections. The automatic extraction of an anatomical structure from digital chest radiographs can be a useful tool for (1) the evaluation of heart size, (2) automatic detection of interstitial lung diseases, (3) automatic detection of lung nodules, and (4) data compression, etc. Based on the clearly defined boundaries of heart area, rib spaces, rib positions, and rib cage extracted, one should be able to use this information to facilitate the tasks of the CADx on chest radiographs. In this paper, we present an automatic scheme for the detection of lung field from chest radiographs by using a shift-invariant convolution neural network. A novel algorithm for smoothing boundaries of lungs is also presented.

SAR exposure from UHF RFID reader in adult, child, pregnant woman, and fetus anatomical models.

PubMed

Fiocchi, Serena; Markakis, Ioannis A; Ravazzani, Paolo; Samaras, Theodoros

2013-09-01

The spread of radio frequency identification (RFID) devices in ubiquitous applications without their simultaneous exposure assessment could give rise to public concerns about their potential adverse health effects. Among the various RFID system categories, the ultra high frequency (UHF) RFID systems have recently started to be widely used in many applications. This study addresses a computational exposure assessment of the electromagnetic radiation generated by a realistic UHF RFID reader, quantifying the exposure levels in different exposure scenarios and subjects (two adults, four children, and two anatomical models of women 7 and 9 months pregnant). The results of the computations are presented in terms of the whole-body and peak spatial specific absorption rate (SAR) averaged over 10 g of tissue to allow comparison with the basic restrictions of the exposure guidelines. The SAR levels in the adults and children were below 0.02 and 0.8 W/kg in whole-body SAR and maximum peak SAR levels, respectively, for all tested positions of the antenna. On the contrary, exposure of pregnant women and fetuses resulted in maximum peak SAR(10 g) values close to the values suggested by the guidelines (2 W/kg) in some of the exposure scenarios with the antenna positioned in front of the abdomen and with a 100% duty cycle and 1 W radiated power. Copyright © 2013 Wiley Periodicals, Inc.

Fostering interprofessional teamwork in an academic medical center: Near-peer education for students during gross medical anatomy.

PubMed

Shields, Richard K; Pizzimenti, Marc A; Dudley-Javoroski, Shauna; Schwinn, Debra A

2015-01-01

The purpose of this report is to describe student satisfaction with a near-peer interprofessional education (IPE) session for physical therapy and medical students. Ten senior physical therapy students worked in peer-groups to develop a musculoskeletal anatomy demonstration for first-semester medical students. Together with their classmates, they demonstrated observation, palpation, and musculoskeletal assessment of the shoulder and scapular-thoracic articulation to medical student dissection groups in the Gross Anatomy laboratory. The medical students were encouraged to consider the synergistic function of shoulder structures and the potential impact of a selected pathology: rotator cuff injury. The session provided the medical students with an opportunity to integrate their new anatomical knowledge into a framework for clinical musculoskeletal evaluation. The experience offered senior physical therapy students an opportunity to work in teams with their peers, internalize and adapt to constructive feedback, and seek common ground with members of another profession. Both student groups reported a high degree of satisfaction with the sessions and expressed a desire for further interaction. These positive perceptions by student stakeholders have prompted us to consider additional IPE exchanges for the anatomy course in the upcoming school year. Given the positive outcome of this descriptive study, we now plan to systematically test whether near-peer IPE interactions can enhance the degree that students learn key anatomical concepts. © 2014 American Association of Anatomists.

Accuracy of intensity and inclinometer output of three activity monitors for identification of sedentary behavior and light-intensity activity.

PubMed

Carr, Lucas J; Mahar, Matthew T

2012-01-01

Purpose. To examine the accuracy of intensity and inclinometer output of three physical activity monitors during various sedentary and light-intensity activities. Methods. Thirty-six participants wore three physical activity monitors (ActiGraph GT1M, ActiGraph GT3X+, and StepWatch) while completing sedentary (lying, sitting watching television, sitting using computer, and standing still) light (walking 1.0 mph, pedaling 7.0 mph, pedaling 15.0 mph) intensity activities under controlled settings. Accuracy for correctly categorizing intensity was assessed for each monitor and threshold. Accuracy of the GT3X+ inclinometer function (GT3X+Incl) for correctly identifying anatomical position was also assessed. Percentage agreement between direct observation and the monitor recorded time spent in sedentary behavior and light intensity was examined. Results. All monitors using all thresholds accurately identified over 80% of sedentary behaviors and 60% of light-intensity walking time based on intensity output. The StepWatch was the most accurate in detecting pedaling time but unable to detect pedal workload. The GT3X+Incl accurately identified anatomical position during 70% of all activities but demonstrated limitations in discriminating between activities of differing intensity. Conclusions. Our findings suggest that all three monitors accurately measure most sedentary and light-intensity activities although choice of monitors should be based on study-specific needs.

Development of the ethmoid sinus and extramural migration: the anatomical basis of this paranasal sinus.

PubMed

Márquez, Samuel; Tessema, Belachew; Clement, Peter Ar; Schaefer, Steven D

2008-11-01

Frontal and/or maxillary sinusitis frequently originates with pathologic processes of the ethmoid sinuses. This clinical association is explained by the close anatomical relationship between the frontal and maxillary sinuses and the ethmoid sinus, since developmental trajectories place the ethmoid in a strategic central position within the nasal complex. The advent of optical endoscopes has permitted improved visualization of these spaces, leading to a renaissance in intranasal sinus surgery. Advancing patient care has consequently driven the need for the proper and accurate anatomical description of the paranasal sinuses, regrettably the continuing subject of persistent confusion and ambiguity in nomenclature and terminology. Developmental tracking of the pneumatization of the ethmoid and adjacent bones, and particularly of the extramural cells of the ethmoid, helps to explain the highly variable adult morphology of the ethmoid air sinus system. To fully understand the nature and underlying biology of this sinus system, multiple approaches were employed here. These include CT imaging of living humans (n = 100), examination of dry cranial material (n = 220), fresh tissue and cadaveric anatomical dissections (n = 168), and three-dimensional volume rendering methods that allow digitizing of the spaces of the ethmoid sinus for graphical examination. Results show the ethmoid sinus to be highly variable in form and structure as well as in the quantity of air cells. The endochondral bony origin of the ethmoid sinuses leads to remarkably thin bony contours of their irregular and morphologically unique borders, making them substantially different from the other paranasal sinuses. These investigations allow development of a detailed anatomical template of this region based on observed patterns of morphological diversity, which can initially mask the underlying anatomy. For example, the frontal recess, ethmoid infundibulum, and hiatus semilunaris are key anatomical components of the ethmoid structural complex that are fully documented and explained here on the basis of the template we have developed, as well as being comprehensively illustrated. In addition, an exhaustive 2000-year literature search identified original sources of nomenclature, in order to help clarify the persistent confusions found in the literature. Modified anatomical terms are suggested to permit proper description of the ethmoid region. This clarification of nomenclature will permit better communication in addition to eliminating redundant terminology. The combination of anatomical, evolutionary, and clinical perspectives provides an important strategy for gaining insight into the complexity of these sinuses. Copyright 2008 Wiley-Liss, Inc.

Attachment area of fibres from the horns of lateral meniscus: anatomic study with special reference to the positional relationship of anterior cruciate ligament.

PubMed

Fujishiro, Hitomi; Tsukada, Sachiyuki; Nakamura, Tomomasa; Nimura, Akimoto; Mochizuki, Tomoyuki; Akita, Keiichi

2017-02-01

Although studies support the clinical importance of the fibres from the horns of lateral meniscus (LM), few studies have investigated the detailed anatomy. This anatomic study was conducted to analyse the structural details of LM with special reference to (1) the attachment area of the fibres from the anterior and posterior horns and (2) the positional relationship between these fibres and the anterior cruciate ligament (ACL). A total of 24 cadaveric knees were used in the macroscopic investigation, and six knees were used in the histological investigation. Micro-computed tomography analysis was also performed to assess the anatomy of the posteriormost fibre from the posterior horn of LM. Based on the macroscopic investigations, the outer fibres from the anterior horn of LM extended to ACL and seemed to intermingle with ACL fibres. However, the histological investigations showed a distinct border between the fibres and ACL. The inner fibres from the anterior horn of LM attached to the lateral intercondylar tubercle serving as a lateral margin of ACL attachment. Fibres from the posterior horn of LM were separated into anterolateral and posteromedial crura which attached to the posterior aspect of the lateral and medial intercondylar tubercles, respectively. These two crura formed the posterior margin of the ACL attachment, except for the central part of ACL. The outer fibres from the anterior horn of LM adjoined ACL. The inner fibres from the anterior horn of LM and two crura from the posterior horn of LM formed the border of the attachment area of ACL. The distinctive fibre anatomy from LM could provide a surgical landmark during arthroscopic surgery.

Mental rotation and the human body: Children's inflexible use of embodiment mirrors that of adults.

PubMed

Krüger, Markus; Ebersbach, Mirjam

2017-12-25

Adults' mental rotation performance with body-like stimuli is enhanced if these stimuli are anatomically compatible with a human body, but decreased by anatomically incompatible stimuli. In this study, we investigated these effects for kindergartners and first-graders: When asked to mentally rotate cube configurations attached with human body parts in an anatomically compatible way, allowing for the projection of a human body, children performed better than with pure cube combinations. By contrast, when body parts were attached in an anatomically incompatible way, disallowing the projection of a human body, children performed worse than with pure combinations. This experiment is of specific interest against the background of two different theoretical approaches concerning imagery and the motor system in development: One approach assumes an increasing integration of motor processes and imagery over time that enables older children and adults to requisition motor resources for imagery processes, while the other postulates that imagery stems from early sensorimotor processes in the first place, and is disentangled from it over time. The finding that children of the two age groups tested show exactly the same effects as adults when mentally rotating anatomically compatible and incompatible stimuli is interpreted in favour of the latter approach. Statement of contribution What is already known on this subject? In mental rotation, adults perform better when rotating anatomically possible stimuli as compared to rotating standard cube combinations. Performance is worse when rotating anatomically impossible stimuli. What does this study add? The present study shows that children's mental transformations mirror those of adults in these respects. In case of the anatomically impossible stimuli, this highlights an inflexible use of embodiment in both age groups. This is in line with the Piagetian assumption of imagery being based on sensorimotor processes. © 2017 The British Psychological Society.

The transverse ligament as a landmark for tibial sagittal insertions of the anterior cruciate ligament: a cadaveric study.

PubMed

Kongcharoensombat, Wirat; Ochi, Mitsuo; Abouheif, Mohamed; Adachi, Nobuo; Ohkawa, Shingo; Kamei, Goki; Okuhara, Atushi; Shibuya, Hoyatoshi; Niimoto, Takuya; Nakasa, Tomoyuki; Nakamae, Atsuo; Deie, Masataka

2011-10-01

The purpose of this study was to determine the relation between the position of the transverse ligament, the anterior edge of the anterior cruciate ligament (ACL) tibial footprint, and the center of the ACL tibial insertion. We used arthroscopy for localization of the anatomic landmarks, followed by insertions of guide pins under direct visualization, and then the position of these guide pins was checked on plain lateral radiographs. The transverse ligament and the anterior aspect of the ACL tibial footprint were identified by arthroscopy in 20 unpaired cadaveric knees (10 left and 10 right). Guide pins were inserted with tibial ACL adapter drill guides under direct observation at the transverse ligament, the anterior aspect of the tibial footprint, and the center of tibial insertion of the ACL. Then, plain lateral radiographs of specimens were taken. The Amis and Jakob line was used to define the attachment of the ACL tibial insertion and the transverse ligament. A sagittal percentage of the location of the insertion point was determined and calculated from the anterior margin of the tibia in the anteroposterior direction. The transverse ligament averaged 21.20% ± 4.1%, the anterior edge of the ACL tibial insertion averaged 21.60% ± 4.0%, and the center of the ACL tibial insertion averaged 40.30% ± 4.8%. There were similar percent variations between the transverse ligament and the anterior edge of the ACL tibial insertion, with no significant difference between them (P = .38). Intraobserver and interobserver reliability was high, with small standard errors of measurement. This study shows that the transverse ligament coincides with the anterior edge of the ACL tibial footprint in the sagittal plane. The transverse ligament can be considered as a new landmark for tibial tunnel positioning during anatomic ACL reconstruction. Copyright © 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Variation in stem anatomical characteristics of Campanuloideae species in relation to evolutionary history and ecological preferences.

PubMed

Schweingruber, Fritz Hans; Ríha, Pavel; Doležal, Jiří

2014-01-01

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. 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. 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 of early wood vessels of large diameter, thinner cell-walls and alternate intervessel pits, while the opposite trend was found in small Arctic and alpine taxa. This supports the existing generalization that narrower vessels allow plants to grow in colder places where they can avoid freezing-induced embolism, while taller plants have wider vessels to minimize hydraulic resistance with their greater path lengths.

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 of early wood vessels of large diameter, thinner cell-walls and alternate intervessel pits, while the opposite trend was found in small Arctic and alpine taxa. This supports the existing generalization that narrower vessels allow plants to grow in colder places where they can avoid freezing-induced embolism, while taller plants have wider vessels to minimize hydraulic resistance with their greater path lengths. PMID:24586306

Comparative ecomorphology of the cyathial nectaries in eight European Euphorbia species.

PubMed

Papp, Nóra; Csete, S; Farkas, Agnes

2013-03-01

The morphology and histology of the cyathial nectary were studied in 8 European leafy spurge (Euphorbia) species, revealing that certain histological traits of the glands are in close correlation to each species' habitat, underlining the importance of morphological evidences in determining relevant ecological tolerance spectra of plants.The structure of the cyathial glands was studied in longitudinal sections with light microscopy, and histological parameters were measured and statistically analyzed by appropriate softwares.The nectaries consist of a cuticle-covered epidermis, formed by palisade cells, under which the glandular tissue and parenchyma are composed of isodiametric and anisodiametric cells in all species. Thickness of cuticle, position of nectary stomata and number of rows comprising the glandular tissue vary to a great extent in plants living in xeric, humid or mesic habitats.Although all the studied anatomical features of the nectaries were expected to be in correspondence with the characteristics of habitat types, we have only found the number of glandular cell rows to be in strong correlation with the Ellenberg's ecological indicator values on soil moisture, which varied with species. The recorded anatomical differences among the studied Euphorbia taxa emphasize the ecological significance of glandular tissue in plant adaptation, which can also be relevant for systematic purposes.

Growth Patterns Inferred from Anatomical Records 1

PubMed Central

Silk, Wendy Kuhn; Lord, Elizabeth M.; Eckard, Kathleen J.

1989-01-01

Our objective was to test whether accurate growth analyses can be obtained from anatomical records and some mathematical formulas. Roots of Zea mays L. were grown at one of two temperatures (19°C or 29°C) and were prepared with standard techniques for light microscopy. Positions of cell walls were digitized from micrographs. The digitized data were averaged and smoothed and used in formulas to estimate growth trajectories, Z(t), velocities, v(z), and strain rates, r(z), where Z(t) is the location occupied by the cellular particle at time t; and v(z) and r(z) are, respectively, the fields of growth velocity and strain rate. The relationships tested are: for Z(t), t = n * c; v(z) = l(z) * f; and r(z) = f * (∂/∂z (l(z))). In the formulas, n represents the number of cells between the origin and the position Z(t); l(z) is local cell length; the constant c, named the `cellochron,' denotes the time for successive cells to pass a spatial point distal to the meristem; l(z) is local cell length, and f is cell flux. Growth trajectories and velocity fields from the anatomical method are in good agreement with earlier analyses based on marking experiments at the two different temperatures. Growth strain rate fields show an unexpected oscillation which may be due to numerical artifacts or to a real oscillation in cell production rate. Images Figure 2 PMID:16666832

Does simulation-based training facilitate the integration of human anatomy with surgery? A report of a novel Surgical Anatomy Course.

PubMed

Torres, K; Denisow-Pietrzyk, M; Pietrzyk, Ł; Maciejewski, R; Torres, A

2018-01-01

Knowledge of gross anatomy, as a basic core subject, is fundamental for medical students and essential to medical practitioners, particularly for those intending a surgical career. However, both medical students and clinical teachers have found a significant gap in teaching basic sciences and the transition into clinical skills. The authors present a Surgical Anatomy Course developed to teach the anatomical basis of surgical procedures with particular emphasis on laparo-scopic skills while incorporating medical simulation. An evaluation of the students' satisfaction of the Surgical Anatomy Course was completed using a mix of multiple choice and open-ended questions, and a six-point Likert Scale. Questions were asked about the students' perceived improvement in surgical and laparoscopic skills. Manual skills were assessed using a laparoscopic simulator. Both evaluation of the course structure and the general impression of the course were positive. Most students believed the course should be an integral part of a modern curriculum. The course supported the traditional surgical classes and improved anatomical knowledge and strengthened students' confidentiality and facilitated understanding and taking surgical rotations. A medical course combining the practical learning of anatomy and surgical-based approaches will bring out the best from the students. Medical students positively evaluated the Surgical Anatomy Course as useful and benefi-cial regarding understanding anatomical structure and relationship necessary for further surgical education. (Folia Morphol 2018; 77, 2: 279-285).

Orientation estimation of anatomical structures in medical images for object recognition

NASA Astrophysics Data System (ADS)

Bağci, Ulaş; Udupa, Jayaram K.; Chen, Xinjian

2011-03-01

Recognition of anatomical structures is an important step in model based medical image segmentation. It provides pose estimation of objects and information about "where" roughly the objects are in the image and distinguishing them from other object-like entities. In,1 we presented a general method of model-based multi-object recognition to assist in segmentation (delineation) tasks. It exploits the pose relationship that can be encoded, via the concept of ball scale (b-scale), between the binary training objects and their associated grey images. The goal was to place the model, in a single shot, close to the right pose (position, orientation, and scale) in a given image so that the model boundaries fall in the close vicinity of object boundaries in the image. Unlike position and scale parameters, we observe that orientation parameters require more attention when estimating the pose of the model as even small differences in orientation parameters can lead to inappropriate recognition. Motivated from the non-Euclidean nature of the pose information, we propose in this paper the use of non-Euclidean metrics to estimate orientation of the anatomical structures for more accurate recognition and segmentation. We statistically analyze and evaluate the following metrics for orientation estimation: Euclidean, Log-Euclidean, Root-Euclidean, Procrustes Size-and-Shape, and mean Hermitian metrics. The results show that mean Hermitian and Cholesky decomposition metrics provide more accurate orientation estimates than other Euclidean and non-Euclidean metrics.

Clusia hilariana and Eugenia uniflora as bioindicators of atmospheric pollutants emitted by an iron pelletizing factory in Brazil.

PubMed

da Silva, Luzimar Campos; de Araújo, Talita Oliveira; Siqueira-Silva, Advanio Inácio; Pereira, Tiago Augusto Rodrigues; Castro, Letícia Nalon; Silva, Eduardo Chagas; Oliva, Marco Antonio; Azevedo, Aristéa Alves

2017-12-01

The objectives of this work were to evaluate if the pollution emitted by the pelletizing factory causes visual symptoms and/or anatomical changes in exposed Eugenia uniflora and Clusia hilariana, in active biomonitoring, at different distances from a pelletizing factory. We characterize the symptomatology, anatomical, and histochemistry alterations induced in the two species. There was no difference in the symptomatology in relation to the different distances of the emitting source. The foliar symptoms found in C. hilariana were chlorosis, necrosis, and foliar abscission and, in E. uniflora, were observed necrosis punctuais, purple spots in the leaves, and increase in the emission of new leaves completely purplish. The two species presented formation of a cicatrization tissue. E. uniflora presented reduction in the thickness of leaf. In C. hilariana, it was visualized hyperplasia of the cells and the adaxial epidermis did not appear collapsed due to thick cuticle and cuticular flanges. Leaves of C. hilariana showed positive staining for iron, protein, starch, and phenolic compounds. E. uniflora showed positive staining for total phenolic compounds and starch. Micromorphologically, there was accumulation of particulate matter on the leaf surface, obstruction of the stomata, and scaling of the epicuticular wax in both species. It was concluded that the visual and anatomical symptoms were efficient in the diagnosis of the stress factor. C. hilariana and E. uniflora showed to be good bioindicators of the atmospheric pollutants emitted by the pelletizing factory.

The "G-Spot" Is Not a Structure Evident on Macroscopic Anatomic Dissection of the Vaginal Wall.

PubMed

Hoag, Nathan; Keast, Janet R; O'Connell, Helen E

2017-12-01

Controversy exists in the literature regarding the presence or absence of an anatomic "G-spot." However, few studies have examined the detailed topographic or histologic anatomy of the putative G-spot location. To determine the anatomy of the anterior vaginal wall and present detailed, systematic, accessible findings from female cadaveric dissections to provide anatomic clarity with respect to this location. Systematic anatomic dissections were performed on 13 female cadavers (32-97 years old, 8 fixed and 5 fresh) to characterize the gross anatomy of the anterior vaginal wall. Digital photography was used to document dissections. Dissection preserved the anterior vaginal wall, urethra, and clitoris. In 9 cadavers, the vaginal epithelial layer was reflected to expose the underlying urethral wall and associated tissues. In 4 cadavers, the vaginal wall was left intact before preservation. Once photographed, 8 specimens were transversely sectioned for macroscopic inspection and histologic examination. The presence or absence of a macroscopic anatomic structure at detailed cadaveric pelvis dissection that corresponds to the previously described G-spot and gross anatomic description of the anterior vaginal wall. Deep to the lining epithelium of the anterior vaginal wall is the urethra. There is no macroscopic structure other than the urethra and vaginal wall lining in the location of the putative G-spot. Specifically, there is no apparent erectile or "spongy" tissue in the anterior vaginal wall, except where the urethra abuts the clitoris distally. The absence of an anatomic structure corresponding to the putative G-spot helps clarify the controversy on this subject. Limitations to this study include limited access to specimens immediately after death and potential for observational bias. In addition, age, medical history, and cause of death are not publishable for privacy reasons. However, it is one of the most thorough and complete anatomic evaluations documenting the anatomic detail of the anterior vaginal wall. The G-spot, in its current description, is not identified as a discrete anatomic entity at macroscopic dissection of the urethra or vaginal wall. Further insights could be provided by histologic study. Hoag N, Keast JR, O'Connell HE. The "G-Spot" Is Not a Structure Evident on Macroscopic Anatomic Dissection of the Vaginal Wall. J Sex Med 2017;14:1524-1532. Copyright © 2017. Published by Elsevier Inc.

Consensus-based identification of factors related to false-positives in ultrasound scanning of synovitis and tenosynovitis.

PubMed

Ikeda, Kei; Narita, Akihiro; Ogasawara, Michihiro; Ohno, Shigeru; Kawahito, Yutaka; Kawakami, Atsushi; Ito, Hiromu; Matsushita, Isao; Suzuki, Takeshi; Misaki, Kenta; Ogura, Takehisa; Kamishima, Tamotsu; Seto, Yohei; Nakahara, Ryuichi; Kaneko, Atsushi; Nakamura, Takayuki; Henmi, Mihoko; Fukae, Jun; Nishida, Keiichiro; Sumida, Takayuki; Koike, Takao

2016-01-01

We aimed to identify causes of false-positives in ultrasound scanning of synovial/tenosynovial/bursal inflammation and provide corresponding imaging examples. We first performed systematic literature review to identify previously reported causes of false-positives. We next determined causes of false-positives and corresponding example images for educational material through Delphi exercises and discussion by 15 experts who were an instructor and/or a lecturer in the 2013 advanced course for musculoskeletal ultrasound organized by Japan College of Rheumatology Committee for the Standardization of Musculoskeletal Ultrasonography. Systematic literature review identified 11 articles relevant to sonographic false-positives of synovial/tenosynovial inflammation. Based on these studies, 21 candidate causes of false-positives were identified in the consensus meeting. Of these items, 11 achieved a predefined consensus (≥ 80%) in Delphi exercise and were classified as follows: (I) Gray-scale assessment [(A) non-specific synovial findings and (B) normal anatomical structures which can mimic synovial lesions due to either their low echogenicity or anisotropy]; (II) Doppler assessment [(A) Intra-articular normal vessels and (B) reverberation)]. Twenty-four corresponding examples with 49 still and 23 video images also achieved consensus. Our study provides a set of representative images that can help sonographers to understand false-positives in ultrasound scanning of synovitis and tenosynovitis.

Mixed Reality in Visceral Surgery: Development of a Suitable Workflow and Evaluation of Intraoperative Use-cases.

PubMed

Sauer, Igor M; Queisner, Moritz; Tang, Peter; Moosburner, Simon; Hoepfner, Ole; Horner, Rosa; Lohmann, Rudiger; Pratschke, Johann

2017-11-01

The paper evaluates the application of a mixed reality (MR) headmounted display (HMD) for the visualization of anatomical structures in complex visceral-surgical interventions. A workflow was developed and technical feasibility was evaluated. Medical images are still not seamlessly integrated into surgical interventions and, thus, remain separated from the surgical procedure.Surgeons need to cognitively relate 2-dimensional sectional images to the 3-dimensional (3D) during the actual intervention. MR applications simulate 3D images and reduce the offset between working space and visualization allowing for improved spatial-visual approximation of patient and image. The surgeon's field of vision was superimposed with a 3D-model of the patient's relevant liver structures displayed on a MR-HMD. This set-up was evaluated during open hepatic surgery. A suitable workflow for segmenting image masks and texture mapping of tumors, hepatic artery, portal vein, and the hepatic veins was developed. The 3D model was positioned above the surgical site. Anatomical reassurance was possible simply by looking up. Positioning in the room was stable without drift and minimal jittering. Users reported satisfactory comfort wearing the device without significant impairment of movement. MR technology has a high potential to improve the surgeon's action and perception in open visceral surgery by displaying 3D anatomical models close to the surgical site. Superimposing anatomical structures directly onto the organs within the surgical site remains challenging, as the abdominal organs undergo major deformations due to manipulation, respiratory motion, and the interaction with the surgical instruments during the intervention. A further application scenario would be intraoperative ultrasound examination displaying the image directly next to the transducer. Displays and sensor-technologies as well as biomechanical modeling and object-recognition algorithms will facilitate the application of MR-HMD in surgery in the near future.

Anatomical and/or pathological predictors for the “incorrect” classification of red dot markers on wrist radiographs taken following trauma

PubMed Central

Kranz, R

2015-01-01

Objective: To establish the prevalence of red dot markers in a sample of wrist radiographs and to identify any anatomical and/or pathological characteristics that predict “incorrect” red dot classification. Methods: Accident and emergency (A&E) wrist cases from a digital imaging and communications in medicine/digital teaching library were examined for red dot prevalence and for the presence of several anatomical and pathological features. Binary logistic regression analyses were run to establish if any of these features were predictors of incorrect red dot classification. Results: 398 cases were analysed. Red dot was “incorrectly” classified in 8.5% of cases; 6.3% were “false negatives” (“FNs”)and 2.3% false positives (FPs) (one decimal place). Old fractures [odds ratio (OR), 5.070 (1.256–20.471)] and reported degenerative change [OR, 9.870 (2.300–42.359)] were found to predict FPs. Frykman V [OR, 9.500 (1.954–46.179)], Frykman VI [OR, 6.333 (1.205–33.283)] and non-Frykman positive abnormalities [OR, 4.597 (1.264–16.711)] predict “FNs”. Old fractures and Frykman VI were predictive of error at 90% confidence interval (CI); the rest at 95% CI. Conclusion: The five predictors of incorrect red dot classification may inform the image interpretation training of radiographers and other professionals to reduce diagnostic error. Verification with larger samples would reinforce these findings. Advances in knowledge: All healthcare providers strive to eradicate diagnostic error. By examining specific anatomical and pathological predictors on radiographs for such error, as well as extrinsic factors that may affect reporting accuracy, image interpretation training can focus on these “problem” areas and influence which radiographic abnormality detection schemes are appropriate to implement in A&E departments. PMID:25496373

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 settings. PMID:21233305

Wood Anatomy and Insect Defoliator Systems: Is there an anatomical response to sustained feeding by the western spruce budworm (Choristoneura occidentalis) on Douglas-fir (Pseudotusga menziesii)?

NASA Astrophysics Data System (ADS)

Axelson, Jodi; Gärtner, Holger; Alfaro, René; Smith, Dan

2013-04-01

The western spruce budworm (Choristoneura occidentalis Freeman) is the most widespread and destructive defoliator of coniferous forests in western North America, and has a long-term coexistence with its primary host tree, Douglas-fir (Pseudotsuga menziesii Franco). Western spruce budworm (WSB) outbreaks usually last for several years, and cause reductions in annual growth, stem defects, and regeneration delays. In British Columbia, the WSB is the second most damaging insect after the mountain pine beetle, and sustained and/or severe defoliation can result in the mortality of host trees. Numerous studies have used tree rings to reconstruct WSB outbreaks across long temporal scales, to evaluate losses in stand productivity, and examine isotope ratios. Although some studies have looked at the impacts of artificial defoliation on balsam fir in eastern North America, there has been no prior research on how WSB outbreaks affect the anatomical structure of the stem as described by intra-annual wood density and potential cell size variations. The objective of this study was to anatomically examine the response of Douglas-fir to sustained WSB outbreaks in two regions of southern British Columbia. We hypothesize that the anatomical intra-annual characteristics of the tree rings, such as cell wall thickness, latewood cell size, and/or lumen area changes during sustained WSB outbreaks. To test this hypothesis we sampled four permanent sample plots in coastal and dry interior sites, which had annually resolved defoliation data collected over a 7-12 year period. At each site diameter-at-breast height (cm), height (m), and crown position were recorded and three increment cores were extracted from 25 trees. Increment cores were prepared to permit anatomical and x-ray density analyses. For each tree, a 15µm thick micro section was cut from the radial plane. Digital images of the micro sections were captured and processed. In each annual ring, features such as cell lumen area (µm2), cell wall thickness (µm), lumen diameter (µm), and total cell width (µm) were measured. Preliminary results indicate that earlywood parameters remain quite stable during WSB outbreak, while latewood parameters such as secondary cell wall thickness and cell length undergo step shifts at the beginning and end of outbreaks. These parameters, tree-level data, and annual defoliation data will further be tested to determine if changes in stem wood anatomy during WSB outbreaks were statistically significant.

In vivo estimation of normal amygdala volume from structural MRI scans with anatomical-based segmentation.

PubMed

Siozopoulos, Achilleas; Thomaidis, Vasilios; Prassopoulos, Panos; Fiska, Aliki

2018-02-01

Literature includes a number of studies using structural MRI (sMRI) to determine the volume of the amygdala, which is modified in various pathologic conditions. The reported values vary widely mainly because of different anatomical approaches to the complex. This study aims at estimating of the normal amygdala volume from sMRI scans using a recent anatomical definition described in a study based on post-mortem material. The amygdala volume has been calculated in 106 healthy subjects, using sMRI and anatomical-based segmentation. The resulting volumes have been analyzed for differences related to hemisphere, sex, and age. The mean amygdalar volume was estimated at 1.42 cm 3 . The mean right amygdala volume has been found larger than the left, but the difference for the raw values was within the limits of the method error. No intersexual differences or age-related alterations have been observed. The study provides a method for determining the boundaries of the amygdala in sMRI scans based on recent anatomical considerations and an estimation of the mean normal amygdala volume from a quite large number of scans for future use in comparative studies.

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.

Effects of Instructional Strategies Using Cross Sections on the Recognition of Anatomical Structures in Correlated CT and MR Images

ERIC Educational Resources Information Center

Khalil, Mohammed K.; Paas, Fred; Johnson, Tristan E.; Su, Yung K.; Payer, Andrew F.

2008-01-01

This research is an effort to best utilize the interactive anatomical images for instructional purposes based on cognitive load theory. Three studies explored the differential effects of three computer-based instructional strategies that use anatomical cross-sections to enhance the interpretation of radiological images. These strategies include:…

Determinants of alveolar ridge preservation differ by anatomic location

PubMed Central

Leblebicioglu, Binnaz; Salas, Mabel; Ort, Yirae; Johnson, Ashley; Yildiz, Vedat O.; Kim, Do-Gyoon; Agarwal, Sudha; Tatakis, Dimitris N.

2016-01-01

Aim To investigate and compare outcomes following alveolar ridge preservation (ARP) in posterior maxilla and mandible. Methods Twenty-four patients (54 ± 3 years) with single posterior tooth extraction were included. ARP was performed with freeze-dried bone allograft and collagen membrane. Clinical parameters were recorded at extraction and re-entry. Harvested bone cores were analysed by microcomputed tomography (micro-CT), histomorphometry and immunohistochemistry. Results In both jaws, ARP prevented ridge height loss, but ridge width was significantly reduced by approximately 2.5 mm. Healing time, initial clinical attachment loss and amount of keratinized tissue at extraction site were identified as determinants of ridge height outcome. Buccal plate thickness and tooth root length were identified as determinants of ridge width outcome. In addition, initial ridge width was positively correlated with ridge width loss. Micro-CT revealed greater mineralization per unit volume in new bone compared with existing bone in mandible (p < 0.001). Distributions of residual graft, new cellular bone and immature tissue were similar in both jaws. Conclusion Within the limitations of this study, the results indicate that in different anatomic locations different factors may determine ARP outcomes. Further studies are needed to better understand determinants of ARP outcomes. PMID:23432761

Anatomical study of the pigs temporal bone by microdissection.

PubMed

Garcia, Leandro de Borborema; Andrade, José Santos Cruz de; Testa, José Ricardo Gurgel

2014-01-01

Initial study of the pig`s temporal bone anatomy in order to enable a new experimental model in ear surgery. Dissection of five temporal bones of Sus scrofa pigs obtained from UNIFESP - Surgical Skills Laboratory, removed with hole saw to avoid any injury and stored in formaldehyde 10% for better conservation. The microdissection in all five temporal bone had the following steps: inspection of the outer part, external canal and tympanic membrane microscopy, mastoidectomy, removal of external ear canal and tympanic membrane, inspection of ossicular chain and middle ear. Anatomically it is located at the same position than in humans. Some landmarks usually found in humans are missing. The tympanic membrane of the pig showed to be very similar to the human, separating the external and the middle ear. The middle ear`s appearance is very similar than in humans. The ossicular chain is almost exactly the same, as well as the facial nerve, showing the same relationship with the lateral semicircular canal. The temporal bone of the pigs can be used as an alternative for training in ear surgery, especially due the facility to find it and its similarity with temporal bone of the humans.

Deep sleep divides the cortex into opposite modes of anatomical-functional coupling.

PubMed

Tagliazucchi, Enzo; Crossley, Nicolas; Bullmore, Edward T; Laufs, Helmut

2016-11-01

The coupling of anatomical and functional connectivity at rest suggests that anatomy is essential for wake-typical activity patterns. Here, we study the development of this coupling from wakefulness to deep sleep. Globally, similarity between whole-brain anatomical and functional connectivity networks increased during deep sleep. Regionally, we found differential coupling: during sleep, functional connectivity of primary cortices resembled more the underlying anatomical connectivity, while we observed the opposite in associative cortices. Increased anatomical-functional similarity in sensory areas is consistent with their stereotypical, cross-modal response to the environment during sleep. In distinction, looser coupling-relative to wakeful rest-in higher order integrative cortices suggests that sleep actively disrupts default patterns of functional connectivity in regions essential for the conscious access of information and that anatomical connectivity acts as an anchor for the restoration of their functionality upon awakening.

ArthroBroström Lateral Ankle Stabilization Technique: An Anatomic Study.

PubMed

Acevedo, Jorge I; Ortiz, Cristian; Golano, Pau; Nery, Caio

2015-10-01

Arthroscopic ankle lateral ligament repair techniques have recently been developed and biomechanically as well as clinically validated. Although there has been 1 anatomic study relating suture and anchor proximity to anatomic structures, none has evaluated the ArthroBroström procedure. To evaluate the proximity of anatomic structures for the ArthroBroström lateral ankle ligament stabilization technique and to define ideal landmarks and "safe zones" for this repair. Descriptive laboratory study. Ten human cadaveric ankle specimens (5 matched pairs) were screened for the study. All specimens underwent arthroscopic lateral ligament repair according to the previously described ArthroBroström technique with 2 suture anchors in the fibula. Three cadaveric specimens were used to test the protocol, and 7 were dissected to determine the proximity of anatomic structures. Several distances were measured, including those of different anatomic structures to the suture knots, to determine the "safe zones." Measurements were obtained by 2 separate observers, and statistical analysis was performed. None of the specimens revealed entrapment by either of the suture knots of the critical anatomic structures, including the superficial peroneal nerve (SPN), sural nerve, peroneus tertius tendon, peroneus brevis tendon, or peroneus longus tendon. The internervous safe zone between the intermediate branch of the SPN and sural nerve was a mean of 51 mm (range, 39-64 mm). The intertendinous safe zone between the peroneus tertius and peroneus brevis was a mean of 43 mm (range, 37-49 mm). On average, a 20-mm (range, 8-36 mm) safe distance was maintained from the most medial suture to the intermediate branch of the SPN. The amount of inferior extensor retinaculum (IER) grasped by either suture knot varied from 0 to 12 mm, with 86% of repairs including the retinaculum. The results indicate that there is a relatively wide internervous and intertendinous safe zone when performing the ArthroBroström technique for lateral ankle stabilization. While none of the critical anatomic structures was entrapped by the suture knots, it was evident that the IER was included in a majority of the repairs. This study further defines the proximity of adjacent anatomic structures and establishes the anatomic safe zones for the ArthroBroström lateral ankle stabilization procedure. By defining this relatively risk-free zone, surgeons who are not as experienced with arthroscopic lateral ligament repair techniques may approach arthroscopic suture passage with more confidence. © 2015 The Author(s).

ACL Roof Impingement Revisited: Does the Independent Femoral Drilling Technique Avoid Roof Impingement With Anteriorly Placed Tibial Tunnels?

PubMed

Tanksley, John A; Werner, Brian C; Conte, Evan J; Lustenberger, David P; Burrus, M Tyrrell; Brockmeier, Stephen F; Gwathmey, F Winston; Miller, Mark D

2017-05-01

Anatomic femoral tunnel placement for single-bundle anterior cruciate ligament (ACL) reconstruction is now well accepted. The ideal location for the tibial tunnel has not been studied extensively, although some biomechanical and clinical studies suggest that placement of the tibial tunnel in the anterior part of the ACL tibial attachment site may be desirable. However, the concern for intercondylar roof impingement has tempered enthusiasm for anterior tibial tunnel placement. To compare the potential for intercondylar roof impingement of ACL grafts with anteriorly positioned tibial tunnels after either transtibial (TT) or independent femoral (IF) tunnel drilling. Controlled laboratory study. Twelve fresh-frozen cadaver knees were randomized to either a TT or IF drilling technique. Tibial guide pins were drilled in the anterior third of the native ACL tibial attachment site after debridement. All efforts were made to drill the femoral tunnel anatomically in the center of the attachment site, and the surrogate ACL graft was visualized using 3-dimensional computed tomography. Reformatting was used to evaluate for roof impingement. Tunnel dimensions, knee flexion angles, and intra-articular sagittal graft angles were also measured. The Impingement Review Index (IRI) was used to evaluate for graft impingement. Two grafts (2/6, 33.3%) in the TT group impinged upon the intercondylar roof and demonstrated angular deformity (IRI type 1). No grafts in the IF group impinged, although 2 of 6 (66.7%) IF grafts touched the roof without deformation (IRI type 2). The presence or absence of impingement was not statistically significant. The mean sagittal tibial tunnel guide pin position prior to drilling was 27.6% of the sagittal diameter of the tibia (range, 22%-33.9%). However, computed tomography performed postdrilling detected substantial posterior enlargement in 2 TT specimens. A significant difference in the sagittal graft angle was noted between the 2 groups. TT grafts were more vertical, leading to angular convergence with the roof, whereas IF grafts were more horizontal and universally diverged from the roof. The IF technique had no specimens with roof impingement despite an anterior tibial tunnel position, likely due to a more horizontal graft trajectory and anatomic placement of the ACL femoral tunnel. Roof impingement remains a concern after TT ACL reconstruction in the setting of anterior tibial tunnel placement, although statistical significance was not found. Future clinical studies are planned to develop better recommendations for ACL tibial tunnel placement. Graft impingement due to excessively anterior tibial tunnel placement using a TT drilling technique has been previously demonstrated; however, this may not be a concern when using an IF tunnel drilling technique. There may also be biomechanical advantages to a more anterior tibial tunnel in IF tunnel ACL reconstruction.

Hox control of Drosophila larval anatomy; The Alary and Thoracic Alary-Related Muscles.

PubMed

Bataillé, Laetitia; Frendo, Jean-Louis; Vincent, Alain

2015-11-01

The body plan of arthropods and vertebrates involves the formation of repetitive segments, which subsequently diversify to give rise to different body parts along the antero-posterior/rostro-caudal body axis. Anatomical variations between body segments are crucial for organ function and organismal fitness. Pioneering work in Drosophila has established that Hox transcription factors play key roles both in endowing initially identical segments with distinct identities and organogenesis. The focus of this review is on Alary Muscles (AMs) and the newly discovered Thoracic Alary-Related Muscles (TARMs). AMs and TARMs are thin muscles which together connect the circulatory system and different midgut regions to the exoskeleton, while intertwining with the respiratory tubular network. They were hypothesized to represent a new type of muscles with spring-like properties, maintaining internal organs in proper anatomical positions during larval locomotion. Both the morphology of TARMs relative to AMs, and morphogenesis of connected tissues is under Hox control, emphasizing the key role of Hox proteins in coordinating the anatomical development of the larva. Copyright © 2015 Elsevier B.V. All rights reserved.

Exploring New Frontiers of Microsurgery: From Anatomy to Clinical Methods.

PubMed

Wang, Zeng Tao; Zheng, You Mao; Zhu, Lei; Hao, Li Wen; Zhang, Ya Bin; Chen, Chao; Xia, Li Feng; Liu, Lin Feng

2017-04-01

This article presents the authors' understanding and experience concerning anatomic studies and clinical methods in microsurgical hand reconstruction. The 4 parts of this article include anatomic study of the hand for developing new flaps; application of miniflaps from the hand, including clinical experience with 8 unique flaps in the hand; anatomic and clinical considerations concerning several flaps from other parts of the human body; And our experience with vascularized free toe joint transfer. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of HPV infection on the development of head and neck cancer

PubMed Central

Betiol, J.; Villa, L.L.; Sichero, L.

2013-01-01

Human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC) is considered to be a distinct clinical entity with better prognosis than the classical tobacco- and alcohol-associated tumors. The increasing incidence of this neoplasia during the last decades highlights the need to better understand the role of HPV in the development of these cancers. Although the proportion of HNSCC attributed to HPV varies considerably according to anatomical site, overall approximately 25% of all HNSCC are HPV-DNA positive, and HPV-16 is by far the most prevalent type. In this review we discuss the existing evidence for a causal association between HPV infection and HNSCC at diverse anatomical head and neck subsites. PMID:23532264

A Case Series of Rapid Prototyping and Intraoperative Imaging in Orbital Reconstruction

PubMed Central

Lim, Christopher G.T.; Campbell, Duncan I.; Cook, Nicholas; Erasmus, Jason

2014-01-01

In Christchurch Hospital, rapid prototyping (RP) and intraoperative imaging are the standard of care in orbital trauma and has been used since February 2013. RP allows the fabrication of an anatomical model to visualize complex anatomical structures which is dimensionally accurate and cost effective. This assists diagnosis, planning, and preoperative implant adaptation for orbital reconstruction. Intraoperative imaging involves a computed tomography scan during surgery to evaluate surgical implants and restored anatomy and allows the clinician to correct errors in implant positioning that may occur during the same procedure. This article aims to demonstrate the potential clinical and cost saving benefits when both these technologies are used in orbital reconstruction which minimize the need for revision surgery. PMID:26000080

A case series of rapid prototyping and intraoperative imaging in orbital reconstruction.

PubMed

Lim, Christopher G T; Campbell, Duncan I; Cook, Nicholas; Erasmus, Jason

2015-06-01

In Christchurch Hospital, rapid prototyping (RP) and intraoperative imaging are the standard of care in orbital trauma and has been used since February 2013. RP allows the fabrication of an anatomical model to visualize complex anatomical structures which is dimensionally accurate and cost effective. This assists diagnosis, planning, and preoperative implant adaptation for orbital reconstruction. Intraoperative imaging involves a computed tomography scan during surgery to evaluate surgical implants and restored anatomy and allows the clinician to correct errors in implant positioning that may occur during the same procedure. This article aims to demonstrate the potential clinical and cost saving benefits when both these technologies are used in orbital reconstruction which minimize the need for revision surgery.

Anatomic documentation of the G-spot complex role in the genesis of anterior vaginal wall ballooning.

PubMed

Ostrzenski, Adam

2014-09-01

To expand previous G-spot anatomical and histological investigations; to examine the G-spot complex anatomic role in the anterior vaginal wall ballooning bio-mechanisms; and to determine, which division of autonomic nervous system (sympathetic or parasympathetic) dominates at the time of female sudden death. A prospective-descriptive case series anatomical study on eleven consecutive fresh humane female cadavers was conducted. Anterior vaginal wall stratum-by-stratum macro-dissections were executed in axial, coronal and sagittal plains. Upon G-spot extirpations, micro-dissections were performed. The G-spot tissues were stained with hematoxilin and eosin for histological examinations to authenticate the G-spot anatomical and histological characteristic features. The G-spot complex was identified and present in all subjects on either the distal vaginal left (more often) or on the right side from the lateral margin of the urethra; the G-spot anatomical and microscopic characteristic features have been authenticated; the G-spot complex expansion elevated anterior vaginal walls in each subject; the autonomic parasympathetic nervous system was the dominant division at the time of female subject sudden death. This study advances our anatomical and histological understanding of the G-spot complex and its role in the genesis of anterior vaginal ballooning bio-mechanisms. The G-spot complex is under parasympathetic nervous system domination at the time of female sudden death. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

JenaValve.

PubMed

Treede, Hendrik; Rastan, Ardawan; Ferrari, Markus; Ensminger, Stephan; Figulla, Hans-Reiner; Mohr, Friedrich-Wilhelm

2012-09-01

The JenaValve is a next-generation TAVI device which consists of a well-proven porcine root valve mounted on a low-profile nitinol stent. Feeler guided positioning and clip fixation on the diseased leaflets allow for anatomically correct implantation of the device without rapid pacing. Safety and efficacy of transapical aortic valve implantation using the JenaValve were evaluated in a multicentre prospective study that showed good short and midterm results. The valve was CE-mark released in Europe in September 2011. A post-market registry ensures on-going and prospective data collection in "real-world" patients. The transfemoral JenaValve delivery system will be evaluated in a first-in-man study in the near future.

Anterior hippocampal dysconnectivity in posttraumatic stress disorder: a dimensional and multimodal approach.

PubMed

Abdallah, C G; Wrocklage, K M; Averill, C L; Akiki, T; Schweinsburg, B; Roy, A; Martini, B; Southwick, S M; Krystal, J H; Scott, J C

2017-02-28

The anterior hippocampus (aHPC) has a central role in the regulation of anxiety-related behavior, stress response, emotional memory and fear. However, little is known about the presence and extent of aHPC abnormalities in posttraumatic stress disorder (PTSD). In this study, we used a multimodal approach, along with graph-based measures of global brain connectivity (GBC) termed functional GBC with global signal regression (f-GBCr) and diffusion GBC (d-GBC), in combat-exposed US Veterans with and without PTSD. Seed-based aHPC anatomical connectivity analyses were also performed. A whole-brain voxel-wise data-driven investigation revealed a significant association between elevated PTSD symptoms and reduced medial temporal f-GBCr, particularly in the aHPC. Similarly, aHPC d-GBC negatively correlated with PTSD severity. Both functional and anatomical aHPC dysconnectivity measures remained significant after controlling for hippocampal volume, age, gender, intelligence, education, combat severity, depression, anxiety, medication status, traumatic brain injury and alcohol/substance comorbidities. Depression-like PTSD dimensions were associated with reduced connectivity in the ventromedial and dorsolateral prefrontal cortex. In contrast, hyperarousal symptoms were positively correlated with ventromedial and dorsolateral prefrontal connectivity. We believe the findings provide first evidence of functional and anatomical dysconnectivity in the aHPC of veterans with high PTSD symptomatology. The data support the putative utility of aHPC connectivity as a measure of overall PTSD severity. Moreover, prefrontal global connectivity may be of clinical value as a brain biomarker to potentially distinguish between PTSD subgroups.

Direct visualization of anatomic subfields within the superior aspect of the human lateral thalamus by MRI at 7T.

PubMed

Kanowski, M; Voges, J; Buentjen, L; Stadler, J; Heinze, H-J; Tempelmann, C

2014-09-01

The morphology of the human thalamus shows high interindividual variability. Therefore, direct visualization of landmarks within the thalamus is essential for an improved definition of electrode positions for deep brain stimulation. The aim of this study was to provide anatomic detail in the thalamus by using inversion recovery TSE imaging at 7T. The MR imaging protocol was optimized on 1 healthy subject to segment thalamic nuclei from one another. Final images, acquired with 0.5(2)-mm2 in-plane resolution and 3-mm section thickness, were compared with stereotactic brain atlases to assign visualized details to known anatomy. The robustness of the visualization of thalamic nuclei was assessed with 4 healthy subjects at lower image resolution. Thalamic subfields were successfully delineated in the dorsal aspect of the lateral thalamus. T1-weighting was essential. MR images had an appearance very similar to that of myelin-stained sections seen in brain atlases. Visualized intrathalamic structures were, among others, the lamella medialis, the external medullary lamina, the reticulatum thalami, the nucleus centre médian, the boundary between the nuclei dorso-oralis internus and externus, and the boundary between the nuclei dorso-oralis internus and zentrolateralis intermedius internus. Inversion recovery-prepared TSE imaging at 7T has a high potential to reveal fine anatomic detail in the thalamus, which may be helpful in enhancing the planning of stereotactic neurosurgery in the future. © 2014 by American Journal of Neuroradiology.

Chemical Composition and Activity of Essential Oils of Carissa macrocarpa (Eckl.) A.DC. Cultivated in Tunisia and its Anatomical Features.

PubMed

Souilem, Fedia; El Ayeb, Asma; Djlassi, Brahim; Ayari, Olfa; Chiboub, Wiem; Arbi, Faten; Ascrizzi, Roberta; Flamini, Guido; Harzallah-Skhiri, Fethia

2018-06-15

This is the first study investigating the chemical composition of essential oils (EOs) isolated from different tissues of Carissa macrocarpa (Eckl.)A.DC, their antimicrobial activity and the anatomical characters of the aerial organs and the fruits. The main EO components were pentadecanal and tetradecan-1-ol (31.9 and 16.5% in fresh leaf EO, resp.), (E)-nerolidol and caryophyllene oxide (27.3 and 15.0% in fruit EO, resp.), linalool and hexahydrofarnesyl acetone (30.9 and 24.9% in stem EO, resp.), benzyl benzoate (24.3% in flower EO). The fruit EO was more active against Candida albicans (MIC=0.46 mg/mL) compared to the reference antibiotic (17.66 mg/mL). Furthermore, at this concentration it inhibited all the Gram-positive bacteria. Concerning the anatomical features, it is noteworth the presence of a large cluster of Ca oxalate crystals inside some parenchymatous cells. Large ducts corresponding to non articulated laticifers were identified in the cortex of leaf, stem and fruit pericarp. The laticifers categories and their distribution are taxonomically important to discriminate this species from others acclimated in different countries. Considering the obtained results, EOs of C. macrocarpa can be a good source of antimicrobial compounds, contributing to solve the problem of microbial resistance to antibiotics. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Fast multigrid-based computation of the induced electric field for transcranial magnetic stimulation

NASA Astrophysics Data System (ADS)

Laakso, Ilkka; Hirata, Akimasa

2012-12-01

In transcranial magnetic stimulation (TMS), the distribution of the induced electric field, and the affected brain areas, depends on the position of the stimulation coil and the individual geometry of the head and brain. The distribution of the induced electric field in realistic anatomies can be modelled using computational methods. However, existing computational methods for accurately determining the induced electric field in realistic anatomical models have suffered from long computation times, typically in the range of tens of minutes or longer. This paper presents a matrix-free implementation of the finite-element method with a geometric multigrid method that can potentially reduce the computation time to several seconds or less even when using an ordinary computer. The performance of the method is studied by computing the induced electric field in two anatomically realistic models. An idealized two-loop coil is used as the stimulating coil. Multiple computational grid resolutions ranging from 2 to 0.25 mm are used. The results show that, for macroscopic modelling of the electric field in an anatomically realistic model, computational grid resolutions of 1 mm or 2 mm appear to provide good numerical accuracy compared to higher resolutions. The multigrid iteration typically converges in less than ten iterations independent of the grid resolution. Even without parallelization, each iteration takes about 1.0 s or 0.1 s for the 1 and 2 mm resolutions, respectively. This suggests that calculating the electric field with sufficient accuracy in real time is feasible.

Leonardo da Vinci's "A skull sectioned": skull and dental formula revisited.

PubMed

Gerrits, Peter O; Veening, Jan G

2013-05-01

What can be learned from historical anatomical drawings and how to incorporate these drawings into anatomical teaching? The drawing "A skull sectioned" (RL 19058v) by Leonardo da Vinci (1452-1519), hides more detailed information than reported earlier. A well-chosen section cut explores sectioned paranasal sinuses and ductus nasolacrimalis. A dissected lateral wall of the maxilla is also present. Furthermore, at the level of the foramen mentale, the drawing displays compact and spongious bony components, together with a cross-section through the foramen mentale and its connection with the canalis mandibulae. Leonardo was the first to describe a correct dental formula (6424) and made efforts to place this formula above the related dental elements. However, taking into account, the morphological features of the individual elements of the maxilla, it can be suggested that Leonardo sketched a "peculiar dental element" on the position of the right maxillary premolar in the dental sketch. The fact that the author did not make any comment on that special element is remarkable. Leonardo could have had sufficient knowledge of the precise morphology of maxillary and mandibular premolars, since the author depicted these elements in the dissected skull. The fact that the author also had access to premolars in situ corroborates our suggestion that "something went wrong" in this part of the drawing. The present study shows that historical anatomical drawings are very useful for interactive learning of detailed anatomy for students in medicine and dentistry. Copyright © 2012 Wiley Periodicals, Inc.

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

"Anatomizing" Reversed: Use of Examination Questions that Foster Use of Higher Order Learning Skills by Students

ERIC Educational Resources Information Center

Burns, E. Robert

2010-01-01

"Anatomizing" is a new verb some use to describe the breaking apart of a complex entity such as the human body, into isolated tidbits of information for study, which can never equal the complex, integrated whole. Although popular with first-year medical students, this practice of "tidbitting" anatomical information into easy to memorize facts or…

Visualization of Stereoscopic Anatomic Models of the Paranasal Sinuses and Cervical Vertebrae from the Surgical and Procedural Perspective

ERIC Educational Resources Information Center

Chen, Jian; Smith, Andrew D.; Khan, Majid A.; Sinning, Allan R.; Conway, Marianne L.; Cui, Dongmei

2017-01-01

Recent improvements in three-dimensional (3D) virtual modeling software allows anatomists to generate high-resolution, visually appealing, colored, anatomical 3D models from computed tomography (CT) images. In this study, high-resolution CT images of a cadaver were used to develop clinically relevant anatomic models including facial skull, nasal…

Chemical and anatomical changes in Liquidambar styraciflua L.xylem after long term exposure to elevated CO

Treesearch

Keonhee Kim; Nicole Labbé; Jeffrey M. Warren; Thomas Elder; Timothy G. Rials

2015-01-01

The anatomical and chemical characteristics of sweetgum were studied after 11 years of elevated CO₂(544 ppm, ambient at 391 ppm) exposure. Anatomically, branch xylem cells were larger for elevated CO2 trees, and the cell wall thickness was thinner. Chemically, elevated CO₂ exposure did not...

[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.

Effects of plantation density on wood density and anatomical properties of red pine (Pinus resinosa Ait.)

Treesearch

J. Y. Zhu; C. Tim Scott; Karen L. Scallon; Gary C. Myers

2007-01-01

This study demonstrated that average ring width (or average annual radial growth rate) is a reliable parameter to quantify the effects of tree plantation density (growth suppression) on wood density and tracheid anatomical properties. The average ring width successfully correlated wood density and tracheid anatomical properties of red pines (Pinus resinosa Ait.) from a...

CT of Anatomic Variants of the Paranasal Sinuses and Nasal Cavity: Poor Correlation With Radiologically Significant Rhinosinusitis but Importance in Surgical Planning.

PubMed

Shpilberg, Katya A; Daniel, Simon C; Doshi, Amish H; Lawson, William; Som, Peter M

2015-06-01

The purpose of this study was to determine the incidence of sinonasal anatomic variants and to assess their relation to sinonasal mucosal disease. A retrospective evaluation of 192 sinus CT examinations of patients with a clinical history of rhinosinusitis was conducted. The CT scans were evaluated for the presence of several anatomic variants of the sinonasal cavities, and the prevalence of each variant was calculated. Prevalences of all sinonasal anatomic variants were compared between patients who had minimal to no apparent imaging evidence of rhinosinusitis and those who had radiologic evidence of clinically significant rhinosinusitis. The most common normal variants were nasal septal deviation, Agger nasi cells, and extension of the sphenoid sinuses into the posterior nasal septum. We found no statistically significant difference in the prevalence of any of the studied anatomic variants between patients with minimal and those with clinically significant paranasal sinus or nasal cavity disease. Analysis of every routine CT scan of the paranasal sinuses obtained for sinusitis or rhinitis for the presence of different anatomic variants is of questionable value unless surgery is planned.

Treatment of Crowe Type-IV Hip Dysplasia Using Cementless Total Hip Arthroplasty and Double Chevron Subtrochanteric Shortening Osteotomy: A 5- to 10-Year Follow-Up Study.

PubMed

Li, Xigong; Lu, Yang; Sun, Junying; Lin, Xiangjin; Tang, Tiansi

2017-02-01

The purpose of this study was to evaluate the functional and radiographic results of patients with Crowe type-IV hip dysplasia treated by cementless total hip arthroplasty and double chevron subtrochanteric osteotomy. From January 2000 to February 2006, cementless total hip arthroplasty with a double chevron subtrochanteric shortening osteotomy was performed on 18 patients (22 hips) with Crowe type-IV dysplasia. The acetabular cup was placed in the position of the anatomic hip center, and subtrochanteric femoral shortening osteotomy was performed with the use of a double chevron design. The clinical and radiographic outcomes were reviewed with a mean follow-up of 6.5 years (5-10 years). The mean amount of femoral subtrochanteric shortening was 38 mm (25-60 mm). All osteotomy sites were healed by 3-6 months without complications. The mean Harris Hip Score improved significantly from 47 points (35-65 points) preoperatively to 88 points (75-97 points) at the final follow-up. The Trendelenburg sign was corrected from a positive preoperative status to a negative postoperative status in 12 of 22 hips. No acetabular and femoral components have loosened or required revision during the period of follow-up. Cementless total hip arthroplasty using double chevron subtrochanteric osteotomy allowed for restoration of anatomic hip center with safely functional limb lengthening, achieved correction of preoperative limp, and good functional and radiographic outcomes for 22 Crowe type-IV dislocation hips at the time of the 5- to 10-year follow-up. Copyright © 2016 Elsevier Inc. All rights reserved.

Structural and functional effects of social isolation on the hippocampus of rats with traumatic brain injury.

PubMed

Khodaie, Babak; Lotfinia, Ahmad Ali; Ahmadi, Milad; Lotfinia, Mahmoud; Jafarian, Maryam; Karimzadeh, Fariba; Coulon, Philippe; Gorji, Ali

2015-02-01

Social isolation has significant long-term psychological and physiological consequences. Both social isolation and traumatic brain injury (TBI) alter normal brain function and structure. However, the influence of social isolation on recovery from TBI is unclear. This study aims to evaluate if social isolation exacerbates the anatomical and functional deficits after TBI in young rats. Juvenile male rats were divided into four groups; sham operated control with social contacts, sham control with social isolation, TBI with social contacts, and TBI with social isolation. During four weeks after brain injury in juvenile rats, we evaluated the animal behaviors by T-maze and open-field tests, recorded brain activity with electrocorticograms and assessed structural changes by histological procedures in the hippocampal dentate gyrus, CA1, and CA3 areas. Our findings revealed significant memory impairments and hyperactivity conditions in rats with TBI and social isolation compared to the other groups. Histological assessments showed an increase of the mean number of dark neurons, apoptotic cells, and caspase-3 positive cells in all tested areas of the hippocampus in TBI rats with and without social isolation compared to sham rats. Furthermore, social isolation significantly increased the number of dark cells, apoptotic neurons, and caspase-3 positive cells in the hippocampal CA3 region in rats with TBI. This study indicates the harmful effect of social isolation on anatomical and functional deficits induced by TBI in juvenile rats. Prevention of social isolation may improve the outcome of TBI. Copyright © 2014 Elsevier B.V. All rights reserved.

The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations.

PubMed

Kirkpatrick, Joshua; Yassaie, Omid; Mirjalili, Seyed Ali

2017-06-01

The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and surgery. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. Historically, authors have described the intrinsic muscles of the foot and/or the plantar fascia as attaching to the PCS. In this article we review the relationship between the PCS and surrounding soft tissues as well as examining the histology of the PCS. We identify a number of key associations with PCS, including age, weight, gender, arthritides, plantar fasciitis and foot position; these factors may function as risk factors in PCS formation. The etiology of these spurs is a contentious issue and it has been explained through a number of theories including the degenerative, inflammatory, traction, repetitive trauma, bone-formers and vertical compression theories. We review these and finish by looking clinically at the evidence that PCS causes heel pain. © 2017 Anatomical Society.

Pressure ulcer risk of patient handling sling use.

PubMed

Peterson, Matthew J; Kahn, Julie A; Kerrigan, Michael V; Gutmann, Joseph M; Harrow, Jeffrey J

2015-01-01

Patient handling slings and lifts reduce the risk of musculoskeletal injuries for healthcare providers. However, no published evidence exists of their safety with respect to pressure ulceration for vulnerable populations, specifically persons with spinal cord injury, nor do any studies compare slings for pressure distribution. High-resolution interface pressure mapping was used to describe and quantify risks associated with pressure ulceration due to normal forces and identify at-risk anatomical locations. We evaluated 23 patient handling slings with 4 nondisabled adults. Sling-participant interface pressures were recorded while participants lay supine on a hospital bed and while suspended during typical patient transfers. Sling-participant interface pressures were greatest while suspended for all seated and supine slings and exceeded 200 mm Hg for all seated slings. Interface pressures were greatest along the sling seams (edges), regardless of position or sling type. The anatomical areas most at risk while participants were suspended in seated slings were the posterior upper and lower thighs. For supine slings, the perisacral area, ischial tuberosities, and greater trochanters were most at risk. The duration of time spent in slings, especially while suspended, should be limited.

Distribution of syringomyelia along the entire spinal cord in clinically affected Cavalier King Charles Spaniels.

PubMed

Loderstedt, Shenja; Benigni, Livia; Chandler, Kate; Cardwell, Jacqueline M; Rusbridge, Clare; Lamb, Christopher R; Volk, Holger A

2011-12-01

Chiari-like malformation (CM) and syringomyelia (SM) is an important disease complex in the Cavalier King Charles Spaniel (CKCS) but data about the anatomical distribution of SM along the spinal cord are lacking in veterinary medicine. The objective of this study was to define the anatomic distribution of SM in CKCS clinically affected by CM/SM. Magnetic resonance imaging (MRI) of the brain and the entire spinal cord of 49 dogs was performed and different morphological parameters compared. Syrinx formation was present in the C1-C4 region and in other parts of the spinal cord. The maximal dorsoventral syrinx size can occur in any region of the spinal cord and the total syrinx size was positively correlated with age. Seventy-six per cent of CKCS with a cranial cervical syrinx also have a syrinx affecting more caudal spinal cord regions. MRI restricted to the cervical region may underestimate the extent of SM and the severity of the disease process in the majority of dogs. Copyright © 2010 Elsevier Ltd. All rights reserved.

Liver hanging maneuver for right hemiliver in situ donation--anatomical considerations.

PubMed

Trotovsek, B; Gadzijev, E M; Ravnik, D; Hribernik, M

2006-01-01

An anatomical study was carried out to evaluate the safety of the liver hanging maneuver for the right hemiliver in living donor and in situ splitting transplantation. During this procedure a 4-6 cm blind dissection is performed between the inferior vena cava and the liver. Short subhepatic veins entering the inferior vena cava from segments 1 and 9 could be torn with consequent hemorrhage. One hundred corrosive casts of livers were evaluated to establish the position and diameter of short subhepatic veins and the inferior right hepatic vein. The average distance from the right border of the inferior vena cava to the opening of segment 1 veins was 16.7+/-3.4 mm and to the entrance of segment 9 veins was 5.0+/-0.5 mm. The width of the narrowest point on the route of blind dissection was determined, with the average value being 8.7+/-2.3 mm (range 2-15 mm). The results show that the liver hanging maneuver is a safe procedure. A proposed route of dissection minimizes the risk of disrupting short subhepatic veins (7%).

Descriptive Cadaveric Study Comparing the Accuracy of Ultrasound Versus Fluoroscopic Guidance for First Sacral Transforaminal Injections: A Comparison Study.

PubMed

Thompson, Bradley F; Pingree, Matthew J; Qu, Wenchun; Murthy, Naveen S; Lachman, Nirusha; Hurdle, Mark Friedrich

2018-04-01

Ultrasound is rarely used for guiding lumbosacral epidural steroid injections due to its technical limitations. For example, sonographic imaging lacks the ability to confirm epidural spread and identify vascular uptake. The perceived risk that these limitations pose to human subjects has precluded any large scale clinical trials to date. To compare the accuracy of ultrasound versus fluoroscopic guidance for first sacral transforaminal epidural injections. Cadaveric comparative study using dichotomous outcomes. A fluoroscopy suite and anatomic laboratory at an academic medical center. Four unembalmed adult human cadavers with no history of spinal surgery. Eight sites were injected twice by one interventionalist, using fluoroscopic and ultrasound guidance. In the fluoroscopy arm, contrast spread was assessed using computed tomography. In the ultrasound arm, latex spread was assessed using gross anatomic dissection. Any visible evidence of epidural spread constituted a positive result. Comparison of the success of obtaining epidural contrast flow was the primary outcome measure. Secondary outcome measures included average duration, rate of intravascular uptake, and quantity of intravascular uptake. All injections performed in both the ultrasound arm and the fluoroscopy arm had positive epidural spread. The average duration was 3.03 minutes with fluoroscopy and 4.76 minutes with ultrasound. The rate of intravascular uptake was 37.5% with fluoroscopy and 50% with ultrasound. Within the ultrasound arm, greater intravascular spread and duration variability were recorded. Although ultrasonography can provide reliable image guidance for cannulating the first sacral foramen in cadavers, it would have limited clinical utility due to its inability to visualize relevant neurovascular structures deep to the osseus roof and exclude intravascular uptake. IV. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

BrainMap VBM: An environment for structural meta-analysis.

PubMed

Vanasse, Thomas J; Fox, P Mickle; Barron, Daniel S; Robertson, Michaela; Eickhoff, Simon B; Lancaster, Jack L; Fox, Peter T

2018-05-02

The BrainMap database is a community resource that curates peer-reviewed, coordinate-based human neuroimaging literature. By pairing the results of neuroimaging studies with their relevant meta-data, BrainMap facilitates coordinate-based meta-analysis (CBMA) of the neuroimaging literature en masse or at the level of experimental paradigm, clinical disease, or anatomic location. Initially dedicated to the functional, task-activation literature, BrainMap is now expanding to include voxel-based morphometry (VBM) studies in a separate sector, titled: BrainMap VBM. VBM is a whole-brain, voxel-wise method that measures significant structural differences between or within groups which are reported as standardized, peak x-y-z coordinates. Here we describe BrainMap VBM, including the meta-data structure, current data volume, and automated reverse inference functions (region-to-disease profile) of this new community resource. CBMA offers a robust methodology for retaining true-positive and excluding false-positive findings across studies in the VBM literature. As with BrainMap's functional database, BrainMap VBM may be synthesized en masse or at the level of clinical disease or anatomic location. As a use-case scenario for BrainMap VBM, we illustrate a trans-diagnostic data-mining procedure wherein we explore the underlying network structure of 2,002 experiments representing over 53,000 subjects through independent components analysis (ICA). To reduce data-redundancy effects inherent to any database, we demonstrate two data-filtering approaches that proved helpful to ICA. Finally, we apply hierarchical clustering analysis (HCA) to measure network- and disease-specificity. This procedure distinguished psychiatric from neurological diseases. We invite the neuroscientific community to further exploit BrainMap VBM with other modeling approaches. © 2018 Wiley Periodicals, Inc.

Optimized functional femoral rotation in navigated total knee arthroplasty considering ligament tension.

PubMed

Walde, T A; Bussert, J; Sehmisch, S; Balcarek, P; Stürmer, K M; Walde, H J; Frosch, K H

2010-12-01

Femoral malrotation in total knee arthroplasty is correlated to an increased number of revisions. Anatomic landmarks such as Whiteside line, posterior condyle axis and transepicondylar axis are used for determining femoral component rotation. The femoral rotation achieved with the anatomical landmarks is compared to the femoral rotation achieved by a navigated ligament tension-based tibia-first technique. Ninety-three consecutive patients with gonarthritis were prospectively enrolled. Intraoperatively the anatomical landmarks for femoral rotation and the achieved femoral rotation using a navigated tension-based tibia-first technique were determined and stored for further comparison. A pre- and postoperative functional diagram displaying the extension and flexion and varus or valgus positions was also part of the evaluation. Using anatomical landmarks the rotational errors ranged from 12.2° of internal rotation to 15.5° of external rotation from parallel to the tibial resection surface at 90° flexion. A statistical significant improved femoral rotation was achieved using the ligament tension-based method with a rotational error ranged from 3.0° of internal rotation to 2.4° of external rotation. The functional analyses demonstrated statistical significant lower varus/valgus deviations within the flexion range and an improved maximum varus deviation at 90° flexion using the ligament tension-based method. Compared to the anatomical landmarks a balanced, almost parallel flexion gap was achieved using a navigation technique taking the ligament tension of the knee joint into account. As a result the improved femoral rotation was demonstrated by the functional evaluation. Unilateral overloading of the polyethylene inlay and unilateral instability can thus be avoided. Copyright © 2009 Elsevier B.V. All rights reserved.

Patient ratings of chewing ability from a randomised crossover trial: lingualised vs. first premolar/canine-guided occlusion for complete dentures.

PubMed

Heydecke, Guido; Akkad, Ahmed Shadi; Wolkewitz, Martin; Vogeler, Michael; Türp, Jens C; Strub, Joerg R

2007-06-01

Complex procedures involving a facebow transfer and the use of lingualised teeth are deemed to have a positive influence on the chewing ability with complete dentures. To determine if patients' ratings of their ability to chew depend on the method of complete denture fabrication. Edentulous patients (n = 20) participated in a within-subject crossover trial. Each patient received two sets of new complete dentures. One pair was manufactured based on intraoral tracing of centric relation and facebow transfer; semi-anatomical teeth with lingualised occlusion denture (LOD) were chosen. The second pair was made using a simplified procedure without facebow transfer; jaw relations were recorded with wax occlusion rims, and anatomical teeth with a first premolar/canine-guidance (CGD) were selected. The dentures were delivered in randomised order, and each was worn for 3 months. Three months after delivery, patients' ratings of each new prosthesis were recorded on visual analogue scales for their ability to chew seven index foods. Repeated measurements analysis of variance was performed to investigate possible carry-over effects accounting for confounding by treatment period. When comparing the two treatments, participants rated their ability to chew in general, to masticate carrots, hard sausage, steak and raw apple in particular, was significantly better with the CGD (anatomical teeth) than with the LOD (p < 0.05). Comprehensive methods for the fabrication of complete dentures including semi-anatomical lingualised teeth and a full registration do not seem to influence the perceived chewing ability, when compared with more simple procedures. Chewing ability for tough foods appears to benefit from the use of anatomical teeth.

Functional differentiation of posterior superior temporal sulcus in autism: A functional connectivity MRI study

PubMed Central

Shih, Patricia; Keehn, Brandon; Oram, Jessica K.; Leyden, Kelly M.; Keown, Christopher L.; Müller, Ralph-Axel

2012-01-01

Background Socio-communicative impairments are salient features of autism spectrum disorder (ASD). Abnormal development of posterior superior temporal sulcus (pSTS), a key processing area for language, biological motion, and social context, may play a role in these deficits. Methods Functional connectivity MRI (fcMRI) was used to examine the synchronization of low frequency BOLD fluctuations during continuous performance on a visual search task. Twenty-one children and adolescents with ASD and 26 typically developing (TD) individuals, matched on age, sex, and IQ, participated in the study. Three subregions of pSTS were delineated with a data-driven approach, and differentiation of pSTS was examined by comparing the connectivity of each subregion. Results In TD individuals, differentiation of networks was positively associated with age and anatomical maturation (cortical thinning in pSTS, greater white matter volume). In the ASD group, differentiation of pSTS connectivity was significantly reduced and correlations with anatomical measures were weak or absent. Moreover, pSTS differentiation was inversely correlated with autism symptom severity. Conclusions Atypical maturation of pSTS suggests altered trajectories for functional segregation and integration of networks in ASD, potentially related to impaired cognitive and sensorimotor development. Furthermore, our findings provide a novel explanation for atypically increased connectivity in ASD observed in some fcMRI studies. PMID:21601832

Activation of mTor Signaling by Gene Transduction to Induce Axon Regeneration in the Central Nervous System Following Neural Injury

DTIC Science & Technology

2014-03-01

bundle (MFB); quantification by confocal optical dissection of either GFP-positive axons in the MFB in transgenic TH- GFP mice or of Tomato -positive...axons following transduction with anterograde tracer Tomato -Tau. As anticipated, based on anatomical evidence showing an inability of AAV eIF4E to re...which the axon-targeted fusion protein Tomato -Tau is delivered to SN neurons by AAV and expression is driven by the robust chicken-beta actin promoter

Comparison of face types in Chinese women using three-dimensional computed tomography.

PubMed

Zhou, Rong-Rong; Zhao, Qi-Ming; Liu, Miao

2015-04-01

This study compared inverted triangle and square faces of 21 young Chinese Han women (18-25 years old) using three-dimensional computed tomography images retrieved from a records database. In this study, 11 patients had inverted triangle faces and 10 had square faces. The anatomic features were examined and compared. There were significant differences in lower face width, lower face height, masseter thickness, middle/lower face width ratio, and lower face width/height ratio between the two facial types (p < 0.01). Lower face width was positively correlated with masseter thickness and negatively correlated with gonial angle. Lower face height was positively correlated with gonial angle and negatively correlated with masseter thickness, and gonial angle was negatively correlated with masseter thickness. In young Chinese Han women, inverted triangle faces and square faces differ significantly in masseter thickness and lower face height. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evaluation of Hyoid Position in Children of 7-11 Years Old with Ankyloglossia in Lateral Cephalometic Radiographs.

PubMed

Ardekani, Mohammad Danesh; Tabatabaee, Zohre; Halvani, Niloofar; Tabatabaee, Hossein; Yasaee, Soghra

2016-09-01

Ankyloglossia is an anatomic developmental anomaly determining by thick and short, fi brotic ferenum. Tongue changes have severe eff ects on occlusion and oropharyngeal structures. The aim of this study was to evaluate the position of hyoid in children 7-11 years` old with ankyloglossia in lateral cephalometric radiographs. 30 radiographs of children with ankyloglossia with mean age of 9.8 and 30 radiographs of control group were chosen and matched in terms of age, sex, class of malocclusion and growth pattern. The measurements of hyoid position were done (C3-RGN, C3-H, H-RGN, HP) and analyzed with paired t-test under SPSS-15 software. The means of C3-RGN, C3-H, H-RGN, HP were 66.2, 30.9, 33.4, 3.2 and 7.45, 36.8, 34.1, 68.6 in ankyloglossia and control groups respectively. Lower amount of measurements were statistically signifi cant (p-value<0.05). Size and position of hyoid in children with ankyloglossia show more posterior- superior Position than healthy children.

Automatic anatomical structures location based on dynamic shape measurement

NASA Astrophysics Data System (ADS)

Witkowski, Marcin; Rapp, Walter; Sitnik, Robert; Kujawinska, Malgorzata; Vander Sloten, Jos; Haex, Bart; Bogaert, Nico; Heitmann, Kjell

2005-09-01

New image processing methods and active photonics apparatus have made possible the development of relatively inexpensive optical systems for complex shape and object measurements. We present dynamic 360° scanning method for analysis of human lower body biomechanics, with an emphasis on the analysis of the knee joint. The anatomical structure (of high medical interest) that is possible to scan and analyze, is patella. Tracking of patella position and orientation under dynamic conditions may lead to detect pathological patella movements and help in knee joint disease diagnosis. The processed data is obtained from a dynamic laser triangulation surface measurement system, able to capture slow to normal movements with a scan frequency between 15 and 30 Hz. These frequency rates are enough to capture controlled movements used e.g. for medical examination purposes. The purpose of the work presented is to develop surface analysis methods that may be used as support of diagnosis of motoric abilities of lower limbs. The paper presents algorithms used to process acquired lower limbs surface data in order to find the position and orientation of patella. The algorithms implemented include input data preparation, curvature description methods, knee region discrimination and patella assumed position/orientation calculation. Additionally, a method of 4D (3D + time) medical data visualization is proposed. Also some exemplary results are presented.

The Influence of Body Position on Cerebrospinal Fluid Pressure Gradient and Movement in Cats with Normal and Impaired Craniospinal Communication

PubMed Central

Radoš, Milan; Erceg, Gorislav; Petošić, Antonio; Jurjević, Ivana

2014-01-01

Intracranial hypertension is a severe therapeutic problem, as there is insufficient knowledge about the physiology of cerebrospinal fluid (CSF) pressure. In this paper a new CSF pressure regulation hypothesis is proposed. According to this hypothesis, the CSF pressure depends on the laws of fluid mechanics and on the anatomical characteristics inside the cranial and spinal space, and not, as is today generally believed, on CSF secretion, circulation and absorption. The volume and pressure changes in the newly developed CSF model, which by its anatomical dimensions and basic biophysical features imitates the craniospinal system in cats, are compared to those obtained on cats with and without the blockade of craniospinal communication in different body positions. During verticalization, a long-lasting occurrence of negative CSF pressure inside the cranium in animals with normal cranio-spinal communication was observed. CSF pressure gradients change depending on the body position, but those gradients do not enable unidirectional CSF circulation from the hypothetical site of secretion to the site of absorption in any of them. Thus, our results indicate the existence of new physiological/pathophysiological correlations between intracranial fluids, which opens up the possibility of new therapeutic approaches to intracranial hypertension. PMID:24748150

Micro-endoscopic ear anatomy of guinea pig applied to experimental surgery.

PubMed

Barros, Bruno Borges de Carvalho; Andrade, José Santos Cruz de; Garcia, Leandro Borborema; Pifaia, Gustavo Ribeiro; Cruz, Oswaldo Laércio Mendonça; Onishi, Ektor Tsuneo; Penido, Norma de Oliveira

2014-01-01

To describe topographic and endoscopic anatomy of guinea pig ear for development of surgical approaches in experimental studies. Experimental study. Eight adult guinea pigs (Cavia porcellus) were used in this study. Four animals were described through endoscopic view and four animals were used to describe topographic anatomy. The main structures of middle ear were well identified through endoscopy view: oval and round window, ossicles and vascular structures. Temporal bone position, landmarks and its relations to skull are perceived with topographic description. Topographic anatomic description allowed exposition of temporal bone relations for external surgical approaches. Alternatively, grooves and middle ear structures were identified and may be used to transcanal accesses.

Neurovascular risks of sacral screws with bicortical purchase: an anatomical study.

PubMed

Ergur, Ipek; Akcali, Omer; Kiray, Amac; Kosay, Can; Tayefi, Hamid

2007-09-01

The aim of this cadaver study is to define the anatomic structures on anterior sacrum, which are under the risk of injury during bicortical screw application to the S1 and S2 pedicles. Thirty formaldehyde-preserved human male cadavers were studied. Posterior midline incision was performed, and soft tissues and muscles were dissected from the posterior part of the lumbosacral region. A 6 mm pedicle screw was inserted between the superior facet of S1 and the S1 foramen. The entry point of the S2 pedicle screw was located between S1 and S2 foramina. S1 and S2 screws were placed on both right and the left sides of all cadavers. Then, all cadavers were turned into supine position. All abdominal and pelvic organs were moved away and carefully observed for any injury. The tips of the sacral screws were marked and the relations with the anatomic structures were defined. The position of the sacral screws relative to the middle and lateral sacral arteries and veins, and the sacral sympathetic trunk were measured. There was no injury to the visceral organs. In four cases, S1 screw tip was in direct contact with middle sacral artery. In two cases, S1 screw tip was in direct contact with middle sacral vein. It was observed that the S1 screw tips were in close proximity to sacral sympathetic trunk on both right and the left sides. The tip of the S2 screw was in contact with middle sacral artery on the left side only in one case. It is found that the tip of the S2 screw was closely located with the middle sacral vein in two cases. The tip of the S2 pedicle screw was in contact with the sacral sympathetic trunk in eight cases on the right side and seven cases on the left side. Lateral sacral vein was also observed to be disturbed by the S1 and S2 screws. As a conclusion, anterior cortical penetration during sacral screw insertion carries a risk of neurovascular injury. The risk of sacral sympathetic trunk and minor vascular structures together with the major neurovascular structures and viscera should be kept in mind.

Intraoperative Comparison of Anatomical versus Round Implants in Breast Augmentation: A Randomized Controlled Trial.

PubMed

Hidalgo, David A; Weinstein, Andrew L

2017-03-01

The purpose of this randomized controlled trial was to determine whether anatomical implants are aesthetically superior to round implants in breast augmentation. Seventy-five patients undergoing primary breast augmentation had a round silicone implant of optimal volume, projection, and diameter placed in one breast and an anatomical silicone device of similar volume and optimal shape placed in the other. After intraoperative photographs were taken, the anatomical device was replaced by a round implant to complete the procedure. A survey designed to measure breast aesthetics was administered to 10 plastic surgeon and 10 lay reviewers for blind evaluation of the 75 cases. No observable difference in breast aesthetics between anatomical and round implants was reported by plastic surgeons in 43.6 percent or by lay individuals in 29.2 percent of cases. When a difference was perceived, neither plastic surgeons nor lay individuals preferred the anatomical side more often than the round side. Plastic surgeons judged the anatomical side superior in 51.1 percent of cases and the round side superior in 48.9 percent of cases (p = 0.496). Lay individuals judged the anatomical side superior in 46.7 percent of cases and the round side superior in 53.3 percent (p = 0.140). Plastic surgeons identified implant shape correctly in only 26.5 percent of cases. This study provides high-level evidence supporting no aesthetic superiority of anatomical over round implants. Given that anatomical implants have important and unique disadvantages, a lack of proven aesthetic superiority argues against their continued use in breast augmentation. Therapeutic, I.

Evaluation of the diagnostic yield of dental radiography and cone-beam computed tomography for the identification of anatomic landmarks in small to medium-sized brachycephalic dogs.

PubMed

Döring, Sophie; Arzi, Boaz; Barich, Catherine R; Hatcher, David C; Kass, Philip H; Verstraete, Frank J M

2018-01-01

OBJECTIVE To evaluate the diagnostic yield of dental radiography (Rad method) and 3 cone-beam CT (CBCT) methods for the identification of predefined anatomic landmarks in brachycephalic dogs. ANIMALS 19 client-owned brachycephalic dogs admitted for evaluation and treatment of dental disease. PROCEDURES 26 predefined anatomic landmarks were evaluated separately by use of the RAD method and 3 CBCT software modules (serial CBCT slices and custom cross sections, tridimensional rendering, and reconstructed panoramic views). A semiquantitative scoring system was used, and mean scores were calculated for each anatomic landmark and imaging method. The Friedman test was used to evaluate values for significant differences in diagnostic yield. For values that were significant, the Wilcoxon signed rank test was used with the Bonferroni-Holm multiple comparison adjustment to determine significant differences among each of the 6 possible pairs of diagnostic methods. RESULTS Differences of diagnostic yield among the Rad and 3 CBCT methods were significant for 19 of 26 anatomic landmarks. For these landmarks, Rad scores were significantly higher than scores for reconstructed panoramic views for 4 of 19 anatomic landmarks, but Rad scores were significantly lower than scores for reconstructed panoramic views for 8 anatomic landmarks, tridimensional rendering for 18 anatomic landmarks, and serial CBCT slices and custom cross sections for all 19 anatomic landmarks. CONCLUSIONS AND CLINICAL RELEVANCE CBCT methods were better suited than dental radiography for the identification of anatomic landmarks in brachycephalic dogs. Results of this study can serve as a basis for CBCT evaluation of dental disorders in brachycephalic dogs.

Anatomical Mercury: Changing Understandings of Quicksilver, Blood, and the Lymphatic System, 1650-1800.

PubMed

Hendriksen, Marieke M A

2015-10-01

The use of mercury as an injection mass in anatomical experiments and preparations was common throughout Europe in the long eighteenth century, and refined mercury-injected preparations as well as plates of anatomical mercury remain today. The use and meaning of mercury in related disciplines such as medicine and chemistry in the same period have been studied, but our knowledge of anatomical mercury is sparse and tends to focus on technicalities. This article argues that mercury had a distinct meaning in anatomy, which was initially influenced by alchemical and classical understandings of mercury. Moreover, it demonstrates that the choice of mercury as an anatomical injection mass was deliberate and informed by an intricate cultural understanding of its materiality, and that its use in anatomical preparations and its perception as an anatomical material evolved with the understanding of the circulatory and lymphatic systems. By using the material culture of anatomical mercury as a starting point, I seek to provide a new, object-driven interpretation of complex and strongly interrelated historiographical categories such as mechanism, vitalism, chemistry, anatomy, and physiology, which are difficult to understand through a historiography that focuses exclusively on ideas. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Changes in regional activity of the psoas major and quadratus lumborum with voluntary trunk and hip tasks and different spinal curvatures in sitting.

PubMed

Park, Rachel J; Tsao, Henry; Claus, Andrew; Cresswell, Andrew G; Hodges, Paul W

2013-02-01

Cross-sectional controlled laboratory study. To investigate the function of discrete regions of psoas major (PM) and quadratus lumborum (QL) with changes in spinal curvature and hip position. Anatomically discrete regions of PM and QL may have differential function on the lumbar spine, based on anatomical and biomechanical differences in their moment arms between fascicles within each muscle. Fine-wire electrodes were inserted with ultrasound guidance into PM fascicles arising from the transverse process (PM-t) and vertebral body (PM-v) and anterior (QL-a) and posterior (QL-p) layers of QL. Recordings were made on 9 healthy participants, who performed 7 tasks with maximal voluntary efforts and adopted 3 sitting postures that involved different spinal curvatures and hip angles. Activity of PM-t was greater during trunk extension than flexion, whereas activity of PM-v was greater during hip flexion than trunk efforts. Activity of QL-p was greater during trunk extension and lateral flexion, whereas QL-a showed greater activity during lateral flexion. During sitting tasks, PM-t was more active when sitting with a short lordosis than a flat (less extended) lumbar spine posture, whereas PM-v was similarly active in both sitting postures. Activity of PM-t was more affected by changes in position of the lumbar spine than the hip, whereas PM-v was more actively involved in the movement of the hip rather than that of the lumbar spine. Moreover, from its anatomy, PM-t has a combined potential to extend/lordose the lumbar spine and flex the hip, at least in a flexed-hip position.

Virtual Cerebral Ventricular System: An MR-Based Three-Dimensional Computer Model

ERIC Educational Resources Information Center

Adams, Christina M.; Wilson, Timothy D.

2011-01-01

The inherent spatial complexity of the human cerebral ventricular system, coupled with its deep position within the brain, poses a problem for conceptualizing its anatomy. Cadaveric dissection, while considered the gold standard of anatomical learning, may be inadequate for learning the anatomy of the cerebral ventricular system; even with…

Assessment of vinyl polysiloxane as an innovative injection material for the anatomical study of vasculature.

PubMed

Dargaud, Jacques; Chalvet, Laurane; Del Corso, Marco; Cerboni, Elsa; Feugier, Patrick; Mertens, Patrick; Simon, Emile

2016-04-01

There are numerous injection materials for the study of vasculature in anatomical specimens, each having its own advantages and disadvantages. Latex and resins are the most widely used injection materials but need several days to set. The development of new materials taking shorter time to polymerize might be very useful to improve anatomic specimen study conditions. The aim of the present study was to evaluate vinyl polysiloxane (VPS), a silicon material widely used for dental impressions with the advantage to set very rapidly, as an injection material. We assessed the preparation, use, diffusion and setting time of the product in different anatomical regions (central nervous system, external carotid/jugular, lower limb) to observe its behavior in variably sized vessels. Our results suggest that VPS might be of interest for the study of vessels in anatomical specimens. The main strengths of the product are represented by (1) simplicity of use, as it is a ready-to-use material, (2) very rapid polymerization, (3) availability in a range of viscosities making easier the exploration of small vessels, (4) its better elasticity compared to resins, (5) and finally its availability in a range of colors making it a material of choice for vascular system dissections including those with very small caliber vessels.

Interactive-rate Motion Planning for Concentric Tube Robots.

PubMed

Torres, Luis G; Baykal, Cenk; Alterovitz, Ron

2014-05-01

Concentric tube robots may enable new, safer minimally invasive surgical procedures by moving along curved paths to reach difficult-to-reach sites in a patient's anatomy. Operating these devices is challenging due to their complex, unintuitive kinematics and the need to avoid sensitive structures in the anatomy. In this paper, we present a motion planning method that computes collision-free motion plans for concentric tube robots at interactive rates. Our method's high speed enables a user to continuously and freely move the robot's tip while the motion planner ensures that the robot's shaft does not collide with any anatomical obstacles. Our approach uses a highly accurate mechanical model of tube interactions, which is important since small movements of the tip position may require large changes in the shape of the device's shaft. Our motion planner achieves its high speed and accuracy by combining offline precomputation of a collision-free roadmap with online position control. We demonstrate our interactive planner in a simulated neurosurgical scenario where a user guides the robot's tip through the environment while the robot automatically avoids collisions with the anatomical obstacles.

Cerebral amyloid angiopathy initially occurs in the meningeal vessels.

PubMed

Takeda, Shigeki; Yamazaki, Kazunori; Miyakawa, Teruo; Onda, Kiyoshi

2017-12-01

To clarify the frequency of CAA in the brain parenchyma and subarachnoid space (SAS), we counted sections of blood vessels showing positive staining for Aβ in the SAS, cerebral cortex (CC) and cerebral white matter (WM) using paraffin-embedded sections of the frontal, temporal and occipital lobes. The specimens had been taken for routine neuropathological examination from the brains of 105 Japanese patients (aged 40-95 years) selected from among 200 consecutive patients autopsied between 1989 and 2015 at our hospital. We examined the anatomical ratios of blood-vessel sections in the SAS relative to the CC in three selected CAA cases, and those of Aβ-positive blood-vessel sections in CAA cases. CAA was found in 53 of the 105 cases (50.5%), and the youngest patient affected was a 51-year-old man. The incidence of CAA increased with age. The anatomical ratio of blood vessel sections in the SAS relative to the CC was 1/3.70-1/4.37 (mean: 1/3.94). The ordinary CAA group, in which CAA was seen in both the SAS and CC, included 41 cases (77.4%). In 37 of these cases, the SAS/CC ratio of Aβ-positive blood vessels was 1/0.05-1/0.66 (mean: 1/0.26), and in the other four cases the ratio was 1/1-1/1.5. In the ordinary CAA group, the SAS/CC ratio of Aβ-positive blood vessels was smaller than the anatomical ratio. The meningeal CAA group, in which CAA was found only in the SAS, included 12 cases (22.6%). These patients ranged in age from their fifties to their nineties. There was no case in which CAA was limited only to the CC. We concluded that CAA initially develops in the meningeal blood vessels, and not in the cortical blood vessels. CAA in the WM was seen in 10 cases, not only in nine cases that were severe, but also in a mild case. © 2017 Japanese Society of Neuropathology.

Optimization of abdominal fat quantification on CT imaging through use of standardized anatomic space: A novel approach

PubMed Central

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

2014-01-01

Purpose: The quantification of body fat plays an important role in the study of numerous diseases. It is common current practice to use the fat area at a single abdominal computed tomography (CT) slice as a marker of the body fat content in studying various disease processes. This paper sets out to answer three questions related to this issue which have not been addressed in the literature. At what single anatomic slice location do the areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) estimated from the slice correlate maximally with the corresponding fat volume measures? How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? Are there combinations of multiple slices (not necessarily contiguous) whose area sum correlates better with volume than does single slice area with volume? Methods: The authors propose a novel strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. The authors then study the volume-to-area correlations and determine where they become maximal. To address the third issue, the authors carry out similar correlation studies by utilizing two and three slices for calculating area sum. Results: Based on 50 abdominal CT data sets, the proposed mapping achieves significantly improved consistency of anatomic localization compared to current practice. Maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized currently for single slice area estimation as a marker. Conclusions: The maximum area-to-volume correlation achieved is quite high, suggesting that it may be reasonable to estimate body fat by measuring the area of fat from a single anatomic slice at the site of maximum correlation and use this as a marker. The site of maximum correlation is not at L4-L5 as commonly assumed, but is more superiorly located at T12-L1 for SAT and at L3-L4 for VAT. Furthermore, the optimal anatomic locations for SAT and VAT estimation are not the same, contrary to common assumption. The proposed standardized space mapping achieves high consistency of anatomic localization by accurately managing nonlinearities in the relationships among landmarks. Multiple slices achieve greater improvement in correlation for VAT than for SAT. The optimal locations in the case of multiple slices are not contiguous. PMID:24877839

Optimization of abdominal fat quantification on CT imaging through use of standardized anatomic space: A novel approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tong, Yubing; Udupa, Jayaram K., E-mail: jay@mail.med.upenn.edu; Torigian, Drew A.

Purpose: The quantification of body fat plays an important role in the study of numerous diseases. It is common current practice to use the fat area at a single abdominal computed tomography (CT) slice as a marker of the body fat content in studying various disease processes. This paper sets out to answer three questions related to this issue which have not been addressed in the literature. At what single anatomic slice location do the areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) estimated from the slice correlate maximally with the corresponding fat volume measures? How doesmore » one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? Are there combinations of multiple slices (not necessarily contiguous) whose area sum correlates better with volume than does single slice area with volume? Methods: The authors propose a novel strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. The authors then study the volume-to-area correlations and determine where they become maximal. To address the third issue, the authors carry out similar correlation studies by utilizing two and three slices for calculating area sum. Results: Based on 50 abdominal CT data sets, the proposed mapping achieves significantly improved consistency of anatomic localization compared to current practice. Maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized currently for single slice area estimation as a marker. Conclusions: The maximum area-to-volume correlation achieved is quite high, suggesting that it may be reasonable to estimate body fat by measuring the area of fat from a single anatomic slice at the site of maximum correlation and use this as a marker. The site of maximum correlation is not at L4-L5 as commonly assumed, but is more superiorly located at T12-L1 for SAT and at L3-L4 for VAT. Furthermore, the optimal anatomic locations for SAT and VAT estimation are not the same, contrary to common assumption. The proposed standardized space mapping achieves high consistency of anatomic localization by accurately managing nonlinearities in the relationships among landmarks. Multiple slices achieve greater improvement in correlation for VAT than for SAT. The optimal locations in the case of multiple slices are not contiguous.« less

Maximizing Modern Distribution of Complex Anatomical Spatial Information: 3D Reconstruction and Rapid Prototype Production of Anatomical Corrosion Casts of Human Specimens

ERIC Educational Resources Information Center

Li, Jianyi; Nie, Lanying; Li, Zeyu; Lin, Lijun; Tang, Lei; Ouyang, Jun

2012-01-01

Anatomical corrosion casts of human specimens are useful teaching aids. However, their use is limited due to ethical dilemmas associated with their production, their lack of perfect reproducibility, and their consumption of original specimens in the process of casting. In this study, new approaches with modern distribution of complex anatomical…

Increased anteversion of press-fit femoral stems compared with anatomic femur.

PubMed

Emerson, Roger H

2012-02-01

With contemporary canal-filling press-fit stems, there is no adjustability of stem position in the canal and therefore the canal anatomy determines stem version. Stem version will affect head/neck impingement, polyethylene wear from edge loading, and hip stability, but despite this, the postoperative version of a canal-filling press-fit stem is unclear. Is there a difference between the version of the nonoperated femur and the final version of a canal-filling press-fit femoral component? Could a difference create an alignment problem for the hip replacement? Sixty-four hips were studied with fluoroscopy and 46 nonarthritic and 41 arthritic hips were studied with MRI. A standardized fluoroscopic technique for determining preoperative and postoperative femoral version was developed with the patient supine on a fracture table undergoing supine total hip arthroplasty. To validate the methods, the results were compared with two selected series of axial MRI views of the hip comparing the version of the head with the version of the canal at the base of the neck. For the operated hips, the mean anatomic hip version was less than the stem version: 18.9° versus 27.0°. The difference on average was 8.1° of increased anteversion (SD, 7.4°). Both MRI series showed the femoral neck was more anteverted on average than the femoral head, thereby explaining the operative findings. With a canal-filling press-fit femoral component there is wide variation of postoperative component anteversion with most stems placed in increased anteversion compared with the anatomic head. The surgical technique may need to adjust for this if causing intraoperative impingement or instability.

[INCIDENCE AND SURGICAL IMPORTANCE OF PYRAMIDAL LOBE AND TUBERCLE OF THE THYROID GLAND: A PROSPECTIVE STUDY].

PubMed

Kovacić, Marijan; Kovadcić, Ivan

2015-01-01

The pyramidal lobe and tubercles are common anatomic variations of the thyroid gland, and their frequency is highly represented. While pyramidal lobe requires additional seriousness in identifying and its removal, especially in patients with hyperthyroidism and thyroid cancer, the presence of tubercles is desirable. Tubercle is covered by recurrent laryngeal nerve and directs the surgeon in his search and besides this, serves to facilitate detection of the upper parathyroid glands. In this prospective study we analysed 342 patients who underwent total thyroidectomy in the period from January 2009 to March 2015. We looked at the incidence and anatomic characteristics of pyramidal lobe and tubercles of the thyroid gland. The pyramidal lobe was present in 52.3% of the patients with more frequent central and left placement. Bilateral tubercles were present in 14.9%, while position right-sided phenomenon was represented in 39.5% and 18.5% in lower left (64.3% patients). Their prevalence by gender showed no significant difference (p = 0.59; p = 0.2). Associated presence of pyramidal lobe and tubercles on one or both sides is highly represented in our group of patients (34%), also with no differences by gender (p = 0.29). Length of the pyramidal lobe ranged from 1.3 to 4.7 cm (average 2.3 cm), and the size of tubercles in 36% of patients was over 1 cm. Recurrent laryngeal nerve was only in 1.8% placed laterally of tubercles, and the upper parathyroid gland in 95.4% was located above tubercle. Considering that only 16.5% of our patients did not have any of these anatomical variations, their presence during surgery is the rule, not the exception.

Leaf density explains variation in leaf mass per area in rice between cultivars and nitrogen treatments.

PubMed

Xiong, Dongliang; Wang, Dan; Liu, Xi; Peng, Shaobing; Huang, Jianliang; Li, Yong

2016-05-01

Leaf mass per area (LMA) is an important leaf trait; however, correlations between LMA and leaf anatomical features and photosynthesis have not been fully investigated, especially in cereal crops. The objectives of this study were (a) to investigate the correlations between LMA and leaf anatomical traits; and (b) to clarify the response of LMA to nitrogen supply and its effect on photosynthetic nitrogen use efficiency (PNUE). In the present study, 11 rice varieties were pot grown under sufficient nitrogen (SN) conditions, and four selected rice cultivars were grown under low nitrogen (LN) conditions. Leaf anatomical traits, gas exchange and leaf N content were measured. There was large variation in LMA across selected rice varieties. Regression analysis showed that the variation in LMA was more closely related to leaf density (LD) than to leaf thickness (LT). LMA was positively related to the percentage of mesophyll tissue area (%mesophyll), negatively related to the percentage of epidermis tissue area (%epidermis) and unrelated to the percentage of vascular tissue area (%vascular). The response of LMA to N supplementation was dependent on the variety and was also mainly determined by the response of LD to N. Compared with SN, photosynthesis was significantly decreased under LN, while PNUE was increased. The increase in PNUE was more critical in rice cultivars with a higher LMA under SN supply. Leaf density is the major cause of the variation in LMA across rice varieties and N treatments, and an increase in LMA under high N conditions would aggravate the decrease in PNUE. © The Author 2016. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The comparative osteology of the petrotympanic complex (ear region) of extant baleen whales (Cetacea: Mysticeti).

PubMed

Ekdale, Eric G; Berta, Annalisa; Deméré, Thomas A

2011-01-01

Anatomical comparisons of the ear region of baleen whales (Mysticeti) are provided through detailed osteological descriptions and high-resolution photographs of the petrotympanic complex (tympanic bulla and petrosal bone) of all extant species of mysticete cetaceans. Salient morphological features are illustrated and identified, including overall shape of the bulla, size of the conical process of the bulla, morphology of the promontorium, and the size and shape of the anterior process of the petrosal. We place our comparative osteological observations into a phylogenetic context in order to initiate an exploration into petrotympanic evolution within Mysticeti. The morphology of the petrotympanic complex is diagnostic for individual species of baleen whale (e.g., sigmoid and conical processes positioned at midline of bulla in Balaenoptera musculus; confluence of fenestra cochleae and perilymphatic foramen in Eschrichtius robustus), and several mysticete clades are united by derived characteristics. Balaenids and neobalaenids share derived features of the bulla, such as a rhomboid shape and a reduced anterior lobe (swelling) in ventral aspect, and eschrichtiids share derived morphologies of the petrosal with balaenopterids, including loss of a medial promontory groove and dorsomedial elongation of the promontorium. Monophyly of Balaenoidea (Balaenidae and Neobalaenidae) and Balaenopteroidea (Balaenopteridae and Eschrichtiidae) was recovered in phylogenetic analyses utilizing data exclusively from the petrotympanic complex. This study fills a major gap in our knowledge of the complex structures of the mysticete petrotympanic complex, which is an important anatomical region for the interpretation of the evolutionary history of mammals. In addition, we introduce a novel body of phylogenetically informative characters from the ear region of mysticetes. Our detailed anatomical descriptions, illustrations, and comparisons provide valuable data for current and future studies on the phylogenetic relationships, evolution, and auditory physiology of mysticetes and other cetaceans throughout Earth's history.

Do early sensory cortices integrate cross-modal information?

PubMed

Kayser, Christoph; Logothetis, Nikos K

2007-09-01

Our different senses provide complementary evidence about the environment and their interaction often aids behavioral performance or alters the quality of the sensory percept. A traditional view defers the merging of sensory information to higher association cortices, and posits that a large part of the brain can be reduced into a collection of unisensory systems that can be studied in isolation. Recent studies, however, challenge this view and suggest that cross-modal interactions can already occur in areas hitherto regarded as unisensory. We review results from functional imaging and electrophysiology exemplifying cross-modal interactions that occur early during the evoked response, and at the earliest stages of sensory cortical processing. Although anatomical studies revealed several potential origins of these cross-modal influences, there is yet no clear relation between particular functional observations and specific anatomical connections. In addition, our view on sensory integration at the neuronal level is coined by many studies on subcortical model systems of sensory integration; yet, the patterns of cross-modal interaction in cortex deviate from these model systems in several ways. Consequently, future studies on cortical sensory integration need to leave the descriptive level and need to incorporate cross-modal influences into models of the organization of sensory processing. Only then will we be able to determine whether early cross-modal interactions truly merit the label sensory integration, and how they increase a sensory system's ability to scrutinize its environment and finally aid behavior.

Investigation of topographical anatomy of Broca's area: an anatomic cadaveric study.

PubMed

Eser Ocak, Pınar; Kocaelı, Hasan

2017-04-01

The sulci constituting the structure of the pars triangularis and opercularis, considered as 'Broca's area', present wide anatomical and morphological variations between different hemispheres. The boundaries are described differently from one another in various studies. The aim of this study was to explore the topographical anatomy, confirm the morphological asymmetry and highlight anatomical variations in Broca's area. This study was performed with 100 hemispheres to investigate the presence, continuity, patterns and connections of the sulcal structures that constitute the morphological asymmetry of Broca's area. Considerable individual anatomical and morphological variations between the inferior frontal gyrus and related sulcal structures were detected. Rare bilateralism findings supported the morphological asymmetry. The inferior frontal sulcus was identified as a single segment in 54 % of the right and two separate segments in 52 % of the left hemispheres, which was the most common pattern. The diagonal sulcus was present in 48 % of the right and 54 % of the left hemispheres. It was most frequently connected to the ascending ramus on both sides. A 'V' shape was observed in 42.5 % of the right hemispheres and a 'Y' shape in 38.3 % of the left hemispheres, which was the most common shape of the pars triangularis. Moreover, the full results are specified in detail. Knowledge of the anatomical variations in this region is indispensable for understanding the functional structure and performing safe surgery. However, most previously published studies have aimed to determine the anatomical asymmetry of the motor speech area without illuminating the topographical anatomy encountered during surgery.

Patient-specific surgical planning and hemodynamic computational fluid dynamics optimization through free-form haptic anatomy editing tool (SURGEM).

PubMed

Pekkan, Kerem; Whited, Brian; Kanter, Kirk; Sharma, Shiva; de Zelicourt, Diane; Sundareswaran, Kartik; Frakes, David; Rossignac, Jarek; Yoganathan, Ajit P

2008-11-01

The first version of an anatomy editing/surgical planning tool (SURGEM) targeting anatomical complexity and patient-specific computational fluid dynamics (CFD) analysis is presented. Novel three-dimensional (3D) shape editing concepts and human-shape interaction technologies have been integrated to facilitate interactive surgical morphology alterations, grid generation and CFD analysis. In order to implement "manual hemodynamic optimization" at the surgery planning phase for patients with congenital heart defects, these tools are applied to design and evaluate possible modifications of patient-specific anatomies. In this context, anatomies involve complex geometric topologies and tortuous 3D blood flow pathways with multiple inlets and outlets. These tools make it possible to freely deform the lumen surface and to bend and position baffles through real-time, direct manipulation of the 3D models with both hands, thus eliminating the tedious and time-consuming phase of entering the desired geometry using traditional computer-aided design (CAD) systems. The 3D models of the modified anatomies are seamlessly exported and meshed for patient-specific CFD analysis. Free-formed anatomical modifications are quantified using an in-house skeletization based cross-sectional geometry analysis tool. Hemodynamic performance of the systematically modified anatomies is compared with the original anatomy using CFD. CFD results showed the relative importance of the various surgically created features such as pouch size, vena cave to pulmonary artery (PA) flare and PA stenosis. An interactive surgical-patch size estimator is also introduced. The combined design/analysis cycle time is used for comparing and optimizing surgical plans and improvements are tabulated. The reduced cost of patient-specific shape design and analysis process, made it possible to envision large clinical studies to assess the validity of predictive patient-specific CFD simulations. In this paper, model anatomical design studies are performed on a total of eight different complex patient specific anatomies. Using SURGEM, more than 30 new anatomical designs (or candidate configurations) are created, and the corresponding user times presented. CFD performances for eight of these candidate configurations are also presented.

Dosimetric evaluation of anatomical changes during treatment to identify criteria for adaptive radiotherapy in oesophageal cancer patients.

PubMed

Nyeng, Tine Bisballe; Nordsmark, Marianne; Hoffmann, Lone

2015-01-01

Some oesophageal cancer patients undergoing chemotherapy and concomitant radiotherapy (chemoRT) show large interfractional anatomical changes during treatment. These changes may modify the dose delivered to the target and organs at risk (OARs). The aim of the presenwt study was to investigate the dosimetric consequences of anatomical changes during treatment to obtain criteria for an adaptive RT decision support system. Twenty-nine patients were treated with chemoRT for oesophageal and gastro-oesophageal junction cancer and set up according to daily cone beam computed tomography (CBCTs) scans. All patients had an additional replanning CT scan at median fraction number 10 (9-14), which was deformably registered to the original planning CT. Gross tumour volumes (GTVs), clinical target volumes (CTVs) and OARs were transferred to the additional CT and corrected by an exwperienced physician. Treatment plans were recalculated and dose to targets and OARs was evaluated. Treatment was adapted if the volume receiving 95% of the prescribed dose (V95%) coverage of CTV decreased > 1% or planning target volume (PTV) decreased by > 3%. In total, nine adaptive events were observed: All nine were triggered by PTV V95% decrease > 3% [median 11% (5-41%)] and six of these were additionally triggered by CTV V95% decrease > 1% [median 5% (2-35%)]. The largest discrepancies were caused by interfractional baseline or amplitude shifts in diaphragm position (n = 5). Mediastinal (n = 6), oesophageal (n = 6) and bowel filling changes (n = 2) caused the remainder of the changes. For patients with dosimetric changes exceeding the adaptation limits, the discrepancies were confirmed by inspecting the daily CBCTs. In 31% of all patients, heart V30Gy increased more than 2% (maximum 5%). Only minor changes in lung dose or liver dose were seen. Target coverage throughout the course of chemoRT treatment is compromised in some patients due to interfractional anatomical changes. Dose to the heart may increase as well.

Ultrafast 3D balanced steady-state free precession MRI of the lung: Assessment of anatomic details in comparison to low-dose CT.

PubMed

Heye, Tobias; Sommer, Gregor; Miedinger, David; Bremerich, Jens; Bieri, Oliver

2015-09-01

To evaluate the anatomical details offered by a new single breath-hold ultrafast 3D balanced steady-state free precession (uf-bSSFP) sequence in comparison to low-dose chest computed tomography (CT). This was an Institutional Review Board (IRB)-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant prospective study. A total of 20 consecutive patients enrolled in a lung cancer screening trial underwent same-day low-dose chest CT and 1.5T MRI. The presence of pulmonary nodules and anatomical details on 1.9 mm isotropic uf-bSSFP images was compared to 2 mm lung window reconstructions by two readers. The number of branching points on six predefined pulmonary arteries and the distance between the most peripheral visible vessel segment to the pleural surface on thin slices and 50 mm maximum intensity projections (MIP) were assessed. Image quality and sharpness of the pulmonary vasculature were rated on a 5-point scale. The uf-bSSFP detection rate of pulmonary nodules (32 nodules visible on CT and MRI, median diameter 3.9 mm) was 45.5% with 21 false-positive findings (pooled data of both readers). Uf-bSSFP detected 71.2% of branching points visible on CT data. The mean distance between peripheral vasculature and pleural surface was 13.0 ± 4.2 mm (MRI) versus 8.5 ± 3.3 mm (CT) on thin slices and 8.6 ± 3.9 mm (MRI) versus 4.6 ± 2.5 mm (CT) on MIPs. Median image quality and sharpness were rated 4 each. Although CT is superior to MRI, uf-bSSFP imaging provides good anatomical details with sufficient image quality and sharpness obtainable in a single breath-hold covering the entire chest. © 2014 Wiley Periodicals, Inc.

[Extended endoscopic endonasal posterior (transclival) approach to tumors of the clival region and ventral posterior cranial fossa. Part 1. Topographic and anatomical features of the clivus and adjacent structures].

PubMed

Shkarubo, A N; Koval', K V; Dobrovol'skiy, G F; Shkarubo, M A; Karnaukhov, V V; Kadashev, B A; Andreev, D N; Chernov, I V; Gadzhieva, O A; Aleshkina, O Yu; Anisimova, E A; Kalinin, P L; Kutin, M A; Fomichev, D V; Sharipov, O I; Ismailov, D B; Selivanov, E S

to describe the main topographic and anatomical features of the clival region and its adjacent structures for improvement and optimization of the extended endoscopic endonasal posterior (transclival) approach for resection of tumors of the clival region and ventral posterior cranial fossa. We performed a craniometric study of 125 human skulls and a topographic anatomical study of heads of 25 cadavers, the arterial and venous bed of which was stained with colored silicone (the staining technique was developed by the authors) to visualize bed features and individual variability. Currently, we have clinical material from more than 120 surgical patients with various skull base tumors of the clival region and ventral posterior cranial fossa (chordomas, pituitary adenomas, meningiomas, cholesteatomas, etc.) who were operated on using the endoscopic transclival approach. We present the main anatomical landmarks and parameters of some anatomical structures that are required for performing the endoscopic endonasal posterior approach. The anatomical landmarks, such as the intradural openings of the abducens and glossopharyngeal nerves, may be used to arbitrarily divide the clival region into the superior, middle, and inferior thirds. The anatomical landmarks important for the surgeon, which are detected during a topographic anatomical study of the skull base, facilitate identification of the boundaries between the different clival portions and the C1 segments of the internal carotid arteries. The superior, middle, and inferior transclival approaches provide an access to the ventral surface of the upper, middle, and lower neurovascular complexes in the posterior cranial fossa. The endoscopic transclival approach may be used to access midline tumors of the posterior cranial fossa. The approach is an alternative to transcranial approaches in surgical treatment of clival region lesions. This approach provides results comparable (and sometimes better) to those of the transcranial and transfacial approaches.

Analysis of the influence of handset phone position on RF exposure of brain tissue.

PubMed

Ghanmi, Amal; Varsier, Nadège; Hadjem, Abdelhamid; Conil, Emmanuelle; Picon, Odile; Wiart, Joe

2014-12-01

Exposure to mobile phone radio frequency (RF) electromagnetic fields depends on many different parameters. For epidemiological studies investigating the risk of brain cancer linked to RF exposure from mobile phones, it is of great interest to characterize brain tissue exposure and to know which parameters this exposure is sensitive to. One such parameter is the position of the phone during communication. In this article, we analyze the influence of the phone position on the brain exposure by comparing the specific absorption rate (SAR) induced in the head by two different mobile phone models operating in Global System for Mobile Communications (GSM) frequency bands. To achieve this objective, 80 different phone positions were chosen using an experiment based on the Latin hypercube sampling (LHS) to select a representative set of positions. The averaged SAR over 10 g (SAR10 g) in the head, the averaged SAR over 1 g (SAR1 g ) in the brain, and the averaged SAR in different anatomical brain structures were estimated at 900 and 1800 MHz for the 80 positions. The results illustrate that SAR distributions inside the brain area are sensitive to the position of the mobile phone relative to the head. The results also show that for 5-10% of the studied positions the SAR10 g in the head and the SAR1 g in the brain can be 20% higher than the SAR estimated for the standard cheek position and that the Specific Anthropomorphic Mannequin (SAM) model is conservative for 95% of all the studied positions. © 2014 Wiley Periodicals, Inc.

Analysis of laboratory testing results collected in an enhanced chlamydia surveillance system in Australia, 2008-2010.

PubMed

Dimech, Wayne; Lim, Megan S C; Van Gemert, Caroline; Guy, Rebecca; Boyle, Douglas; Donovan, Basil; Hellard, Margaret

2014-06-12

Chlamydial infection is the most common notifiable disease in Australia, Europe and the US. Australian notifications of chlamydia rose four-fold from 20,274 cases in 2002 to 80,846 cases in 2011; the majority of cases were among young people aged less than 29 years. Along with test positivity rates, an understanding of the number of tests performed and the demographics of individuals being tested are key epidemiological indicators. The ACCESS Laboratory Network was established in 2008 to address this issue. The ACCESS Laboratory Network collected chlamydia testing data from 15 laboratories around Australia over a three-year period using data extraction software. All chlamydia testing data from participating laboratories were extracted from the laboratory information system; patient identifiers converted to a unique, non-reversible code and de-identified data sent to a single database. Analysis of data by anatomical site included all specimens, but in age and sex specific analysis, only one testing episode was counted. From 2008 to 2010 a total of 628,295 chlamydia tests were referred to the 15 laboratories. Of the 592,626 individual episodes presenting for testing, 70% were from female and 30% from male patients. In female patients, chlamydia positivity rate was 6.4% overall; the highest rate in 14 year olds (14.3%). In male patients, the chlamydia positivity rate was 9.4% overall; the highest in 19 year olds (16.5%). The most common sample type was urine (57%). In 3.2% of testing episodes, multiple anatomical sites were sampled. Urethral swabs gave the highest positivity rate for all anatomical sites in both female (7.7%) and male patients (14%), followed by urine (7.6% and 9.4%, respectively) and eye (6.3% and 7.9%, respectively). The ACCESS Laboratory Network data are unique in both number and scope and are representative of chlamydia testing in both general practice and high-risk clinics. The findings from these data highlight much lower levels of testing in young people aged 20 years or less; in particular female patients aged less than 16 years, despite being the group with the highest positivity rate. Strategies are needed to increase the uptake of testing in this high-risk group.

Analysis of laboratory testing results collected in an enhanced chlamydia surveillance system in Australia, 2008–2010

PubMed Central

2014-01-01

Background Chlamydial infection is the most common notifiable disease in Australia, Europe and the US. Australian notifications of chlamydia rose four-fold from 20,274 cases in 2002 to 80,846 cases in 2011; the majority of cases were among young people aged less than 29 years. Along with test positivity rates, an understanding of the number of tests performed and the demographics of individuals being tested are key epidemiological indicators. The ACCESS Laboratory Network was established in 2008 to address this issue. Methods The ACCESS Laboratory Network collected chlamydia testing data from 15 laboratories around Australia over a three-year period using data extraction software. All chlamydia testing data from participating laboratories were extracted from the laboratory information system; patient identifiers converted to a unique, non-reversible code and de-identified data sent to a single database. Analysis of data by anatomical site included all specimens, but in age and sex specific analysis, only one testing episode was counted. Results From 2008 to 2010 a total of 628,295 chlamydia tests were referred to the 15 laboratories. Of the 592,626 individual episodes presenting for testing, 70% were from female and 30% from male patients. In female patients, chlamydia positivity rate was 6.4% overall; the highest rate in 14 year olds (14.3%). In male patients, the chlamydia positivity rate was 9.4% overall; the highest in 19 year olds (16.5%). The most common sample type was urine (57%). In 3.2% of testing episodes, multiple anatomical sites were sampled. Urethral swabs gave the highest positivity rate for all anatomical sites in both female (7.7%) and male patients (14%), followed by urine (7.6% and 9.4%, respectively) and eye (6.3% and 7.9%, respectively). Conclusions The ACCESS Laboratory Network data are unique in both number and scope and are representative of chlamydia testing in both general practice and high-risk clinics. The findings from these data highlight much lower levels of testing in young people aged 20 years or less; in particular female patients aged less than 16 years, despite being the group with the highest positivity rate. Strategies are needed to increase the uptake of testing in this high-risk group. PMID:24920016

Beyond the pineal gland assumption: a neuroanatomical appraisal of dualism in Descartes' philosophy.

PubMed

Berhouma, Moncef

2013-09-01

The problem of the substantial union of the soul and the body and therefore the mechanisms of interaction between them represents the core of the Cartesian dualistic philosophy. This philosophy is based upon a neuroanatomical obvious misconception, consisting mainly on a wrong intraventricular position of the pineal gland and its capacity of movement to act as a valve regulating the flow of animal spirits. Should we consider the Cartesian neurophysiology as a purely anatomical descriptive work and therefore totally incorrect, or rather as a theoretical conception supporting his dualistic philosophy? From the various pre-Cartesian theories on the pineal organ, we try to explain how Descartes used his original conception of neuroanatomy to serve his dualistic philosophy. Moreover, we present an appraisal of the Cartesian neuroanatomical corpus from an anatomical but also metaphysical and theological perspectives. A new interpretation of Descartes' writings and an analysis of the secondary related literature shed the light on the voluntary anatomical approximations aiming to build an ad hoc neurophysiology that allows Descartes' soul-body theory. By its central position within the brain mass and its particular shape, the pineal gland raised diverse metaphysical theories regarding its function, but the most original theory remains certainly its role as the seat of soul in René Descartes' philosophy and more precisely the organ where soul and body interact. The author emphasizes on the critics raised by Descartes' theories on the soul-body interaction through the role of the pineal gland. Copyright © 2013 Elsevier B.V. All rights reserved.

Learning-based stochastic object models for use in optimizing imaging systems

NASA Astrophysics Data System (ADS)

Dolly, Steven R.; Anastasio, Mark A.; Yu, Lifeng; Li, Hua

2017-03-01

It is widely known that the optimization of imaging systems based on objective, or task-based, measures of image quality via computer-simulation requires use of a stochastic object model (SOM). However, the development of computationally tractable SOMs that can accurately model the statistical variations in anatomy within a specified ensemble of patients remains a challenging task. Because they are established by use of image data corresponding a single patient, previously reported numerical anatomical models lack of the ability to accurately model inter- patient variations in anatomy. In certain applications, however, databases of high-quality volumetric images are available that can facilitate this task. In this work, a novel and tractable methodology for learning a SOM from a set of volumetric training images is developed. The proposed method is based upon geometric attribute distribution (GAD) models, which characterize the inter-structural centroid variations and the intra-structural shape variations of each individual anatomical structure. The GAD models are scalable and deformable, and constrained by their respective principal attribute variations learned from training data. By use of the GAD models, random organ shapes and positions can be generated and integrated to form an anatomical phantom. The randomness in organ shape and position will reflect the variability of anatomy present in the training data. To demonstrate the methodology, a SOM corresponding to the pelvis of an adult male was computed and a corresponding ensemble of phantoms was created. Additionally, computer-simulated X-ray projection images corresponding to the phantoms were computed, from which tomographic images were reconstructed.

A novel anatomical short glass fiber reinforced post in an endodontically treated premolar mechanical resistance evaluation using acoustic emission under fatigue testing.

PubMed

Wang, Hsuan-Wen; Chang, Yen-Hsiang; Lin, Chun-Li

2017-01-01

This study evaluates the fracture resistance in an endodontically treated tooth using circular fiber-reinforced composite (FRC) and innovated anatomical short glass fiber reinforced (SGFR) posts under fatigue testing, monitored using the acoustic emission (AE) technique. An anatomical SGFR fiber post with an oval shape and slot/notch design was manufactured using an injection-molding machine. Crown/core maxillary second premolar restorations were executed using the anatomical SGFR and commercial cylindrical fiber posts under fatigue test to understand the mechanical resistances. The load versus AE signals in the fracture and fatigue tests were recorded to evaluate the restored tooth failure resistance. The static fracture resistance results showed that teeth restored using the anatomical SGFR post presented higher resistance than teeth restored using the commercial FRC post. The fatigue test endurance limitation (1.2×10 6 cycles) was 207.1N for the anatomical SGFR fiber post, higher than the 185.3N found with the commercial FRC post. The average accumulated number of AE signals and corresponding micro cracks for the anatomical SGFR fiber post (153.0 hits and 2.44 cracks) were significantly lower than those for the commercial FRC post (194.7 hits and 4.78 cracks) under 40% of the static maximum resistance fatigue test load (pass 1.2×10 6 cycles). This study concluded that the anatomical SGFR fiber post with surface slot/notch design made using precise injection molding presented superior static fracture resistance and fatigue endurance limitation than those for the commercial FRC post in an endodontically treated premolar. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Expression and correlation of Fra-1 and HMGA1 in laryngeal squamous cell carcinoma].

PubMed

Zhang, Y L; Song, X F; Duan, Y J; Zhao, R L

2017-12-07

Objective: To investigate the expressions of Fra -1 and HMGA 1 in laryngeal squamous cell carcinoma and their correlation . Methods: Immunohistochemistry and reverse transcription-polymer chain reaction (RT-PCR) were used to detect the expressions of HMGA 1 and Fra -1 in laryngeal squamous carcinoma tissues in 47 cases and para - carcinoma tissues in 21 cases ( the First Hospital of Shijiazhuang ). The relationship between the gene expressions in carcinoma tissues and clinopathological parameters such as pathological grade, clinical stage, lymph metastasis, age and anatomic site and the relevance of the two gene expressions were analyzed . SPSS 13.0 software was used to analyze the data . Results: The positive expression rates of Fra-1 and HMGA1 proteins in laryngeal squamous cancer tissue were 48.9% and 53.2%, which were respectively higher than the rates of 19.0% for Fra-1 (χ(2)=5.416, P <0.05) and of 23.8% for HMGA1 (χ(2)=5.083, P <0.05) in adjacent tissues. The expression of Fra -1 gene was correlation with pathological grade, clinical stage and lymph metastasis (t values were -1.079, -1.066 and -1.067, all P<0.05), but not with age and anatomic site (t values were -1.068 and -1.054, both P>0.05). The expression of HMGA 1 gene was correlation with pathological grade, clinical stage, lymph metastasis and age (t values were -1.112, -1.065, -1.009 and -1.066, all P<0.05), but not with anatomic site (t=-1.036, P>0.05). The expressions of Fra -1 and HMGA 1 gene were positively correlation (r=0.672, P<0.05). Conclusions: In laryngeal squamous cancer, Fra -1 and HMGA 1 are excessive expression, with a positive correlation between the expressions of both genes .

Renal mass anatomic characteristics and perioperative outcomes of laparoscopic partial nephrectomy: a critical analysis.

PubMed

Tsivian, Matvey; Ulusoy, Said; Abern, Michael; Wandel, Ayelet; Sidi, A Ami; Tsivian, Alexander

2012-10-01

Anatomic parameters determining renal mass complexity have been used in a number of proposed scoring systems despite lack of a critical analysis of their independent contributions. We sought to assess the independent contribution of anatomic parameters on perioperative outcomes of laparoscopic partial nephrectomy (LPN). Preoperative imaging studies were reviewed for 147 consecutive patients undergoing LPN for a single renal mass. Renal mass anatomy was recorded: Size, growth pattern (endo-/meso-/exophytic), centrality (central/hilar/peripheral), anterior/posterior, lateral/medial, polar location. Multivariable models were used to determine associations of anatomic parameters with warm ischemia time (WIT), operative time (OT), estimated blood loss (EBL), intra- and postoperative complications, as well as renal function. All models were adjusted for the learning curve and relevant confounders. Median (range) tumor size was 3.3 cm (1.5-11 cm); 52% were central and 14% hilar. While 44% were exophytic, 23% and 33% were mesophytic and endophytic, respectively. Anatomic parameters did not uniformly predict perioperative outcomes. WIT was associated with tumor size (P=0.068), centrality (central, P=0.016; hilar, P=0.073), and endophytic growth pattern (P=0.017). OT was only associated with tumor size (P<0.001). No anatomic parameter predicted EBL. Tumor centrality increased the odds of overall and intraoperative complications, without reaching statistical significance. Postoperative renal function was not associated with any of the anatomic parameters considered after adjustment for baseline function and WIT. Learning curve, considered as a confounder, was independently associated with reduced WIT and OT as well as reduced odds of intraoperative complications. This study provides a detailed analysis of the independent impact of renal mass anatomic parameters on perioperative outcomes. Our findings suggest diverse independent contributions of the anatomic parameters to the different measures of outcomes (WIT, OT, EBL, complications, and renal function) emphasizing the importance of the learning curve.

Component alignment in revision total knee arthroplasty using diaphyseal engaging modular offset press-fit stems.

PubMed

Nakasone, Cass K; Abdeen, Ayesha; Khachatourians, Armond G; Sugimori, Tanzo; Vince, Kelly G

2008-12-01

We performed a retrospective study of the radiographic position of femoral and tibial components in a series of revision total knee arthroplasties using diaphyseal-engaging, press fit, modular stems. Fifty-two consecutive revision cases were performed. Femoral and tibial component alignment was measured preoperatively and postoperatively. The canal-filling ratio was measured and correlated with anatomic alignment. There was a trend toward improved alignment with increasing canal fill, suggesting that uncemented diaphyseal engaging press-fit modular stems facilitate accurate alignment for both femoral and tibial components in revision surgery.

Students’ perceptions of anatomy across the undergraduate problem-based learning medical curriculum: a phenomenographical study

PubMed Central

2013-01-01

Background To get insight in how theoretical knowledge is transformed into clinical skills, important information may arise from mapping the development of anatomical knowledge during the undergraduate medical curriculum. If we want to gain a better understanding of teaching and learning in anatomy, it may be pertinent to move beyond the question of how and consider also the what, why and when of anatomy education. Methods A purposive sample of 78 medical students from the 2nd, 3rd, 4th and 6th year of a PBL curriculum participated in 4 focus groups. Each group came together twice, and all meetings were recorded and transcribed verbatim. Data were analysed with template analysis using a phenomenographical approach. Results Five major topics emerged and are described covering the students’ perceptions on their anatomy education and anatomical knowledge: 1) motivation to study anatomy, 2) the relevance of anatomical knowledge, 3) assessment of anatomical knowledge, 4) students’ (in)security about their anatomical knowledge and 5) the use of anatomical knowledge in clinical practice. Conclusions Results indicated that a PBL approach in itself was not enough to ensure adequate learning of anatomy, and support the hypothesis that educational principles like time-on-task and repetition, have a stronger impact on students’ perceived and actual anatomical knowledge than the educational approach underpinning a curriculum. For example, students state that repetitive studying of the subject increases retention of knowledge to a greater extent than stricter assessment, and teaching in context enhances motivation and transfer. Innovations in teaching and assessment, like spiral curriculum, teaching in context, teaching for transfer and assessment for learning (rewarding understanding and higher order cognitive skills), are required to improve anatomy education. PMID:24252155

Characterization of Breast Implant Surfaces, Shapes, and Biomechanics: A Comparison of High Cohesive Anatomically Shaped Textured Silicone, Breast Implants from Three Different Manufacturers.

PubMed

Atlan, Michael; Bigerelle, Maxence; Larreta-garde, Véronique; Hindié, Mathilde; Hedén, Per

2016-02-01

Several companies offer anatomically shaped breast implants but differences among manufacturers are often misunderstood. The shell texture is a crucial parameter for anatomically shaped implants to prevent rotation and to decrease the risk of capsular contracture, even though concerns have recently been raised concerning the complications associated with textured breast implants. The aim of this study was to characterize differences in terms of texture, cell adhesion, shape, and stiffness between some commonly used anatomically shaped implants from three different manufacturers. Five commercially available anatomically shaped breast implants from 3 different manufacturers (Allergan, Mentor, and Sebbin) were used. Scanning electron microscopy, X-ray microtomography, and scanning mechanical microscopy were used to characterize the shell texture. Human fibroblast adhesion onto the shells was evaluated. 3D models of the implants were obtained using CT-scan acquisitions to analyze their shape. Implant stiffness was evaluated using a tractiometer. Major differences were observed in the topography of the textures of the shells, but this was not conveyed by a statistically significant fibroblast adhesion difference. However, fibroblasts adhered better on anatomically shaped textured implants than on smooth implants (p < 0.01). Our work pointed out differences in the Biocell® texture in comparison with older studies. The 3D analysis showed significant shape differences between the anatomically shaped implants of the 3 companies, despite similar dimensions. Implant stiffness was comparable among the 3 brands. Each texture had its specific topography, and this work is the first description of Sebbin anatomic breast implant texturation. Moreover, major discrepancies were found in the analysis of the Biocell® texture when comparing our results with previous reports. These differences may have clinical implications and are discussed. This study also highlighted major shape differences among breast implants from different manufacturers, which is quite counterintuitive. The clinical impact of these differences however needs further investigation. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Incomplete Hippocampal Inversion: A Comprehensive MRI Study of Over 2000 Subjects.

PubMed

Cury, Claire; Toro, Roberto; Cohen, Fanny; Fischer, Clara; Mhaya, Amel; Samper-González, Jorge; Hasboun, Dominique; Mangin, Jean-François; Banaschewski, Tobias; Bokde, Arun L W; Bromberg, Uli; Buechel, Christian; Cattrell, Anna; Conrod, Patricia; Flor, Herta; Gallinat, Juergen; Garavan, Hugh; Gowland, Penny; Heinz, Andreas; Ittermann, Bernd; Lemaitre, Hervé; Martinot, Jean-Luc; Nees, Frauke; Paillère Martinot, Marie-Laure; Orfanos, Dimitri P; Paus, Tomas; Poustka, Luise; Smolka, Michael N; Walter, Henrik; Whelan, Robert; Frouin, Vincent; Schumann, Gunter; Glaunès, Joan A; Colliot, Olivier

2015-01-01

The incomplete-hippocampal-inversion (IHI), also known as malrotation, is an atypical anatomical pattern of the hippocampus, which has been reported in healthy subjects in different studies. However, extensive characterization of IHI in a large sample has not yet been performed. Furthermore, it is unclear whether IHI are restricted to the medial-temporal lobe or are associated with more extensive anatomical changes. Here, we studied the characteristics of IHI in a community-based sample of 2008 subjects of the IMAGEN database and their association with extra-hippocampal anatomical variations. The presence of IHI was assessed on T1-weighted anatomical magnetic resonance imaging (MRI) using visual criteria. We assessed the association of IHI with other anatomical changes throughout the brain using automatic morphometry of cortical sulci. We found that IHI were much more frequent in the left hippocampus (left: 17%, right: 6%, χ(2)-test, p < 10(-28)). Compared to subjects without IHI, subjects with IHI displayed morphological changes in several sulci located mainly in the limbic lobe. Our results demonstrate that IHI are a common left-sided phenomenon in normal subjects and that they are associated with morphological changes outside the medial temporal lobe.

Incomplete Hippocampal Inversion: A Comprehensive MRI Study of Over 2000 Subjects

PubMed Central

Cury, Claire; Toro, Roberto; Cohen, Fanny; Fischer, Clara; Mhaya, Amel; Samper-González, Jorge; Hasboun, Dominique; Mangin, Jean-François; Banaschewski, Tobias; Bokde, Arun L. W.; Bromberg, Uli; Buechel, Christian; Cattrell, Anna; Conrod, Patricia; Flor, Herta; Gallinat, Juergen; Garavan, Hugh; Gowland, Penny; Heinz, Andreas; Ittermann, Bernd; Lemaitre, Hervé; Martinot, Jean-Luc; Nees, Frauke; Paillère Martinot, Marie-Laure; Orfanos, Dimitri P.; Paus, Tomas; Poustka, Luise; Smolka, Michael N.; Walter, Henrik; Whelan, Robert; Frouin, Vincent; Schumann, Gunter; Glaunès, Joan A.; Colliot, Olivier

2015-01-01

The incomplete-hippocampal-inversion (IHI), also known as malrotation, is an atypical anatomical pattern of the hippocampus, which has been reported in healthy subjects in different studies. However, extensive characterization of IHI in a large sample has not yet been performed. Furthermore, it is unclear whether IHI are restricted to the medial-temporal lobe or are associated with more extensive anatomical changes. Here, we studied the characteristics of IHI in a community-based sample of 2008 subjects of the IMAGEN database and their association with extra-hippocampal anatomical variations. The presence of IHI was assessed on T1-weighted anatomical magnetic resonance imaging (MRI) using visual criteria. We assessed the association of IHI with other anatomical changes throughout the brain using automatic morphometry of cortical sulci. We found that IHI were much more frequent in the left hippocampus (left: 17%, right: 6%, χ2−test, p < 10−28). Compared to subjects without IHI, subjects with IHI displayed morphological changes in several sulci located mainly in the limbic lobe. Our results demonstrate that IHI are a common left-sided phenomenon in normal subjects and that they are associated with morphological changes outside the medial temporal lobe. PMID:26733822

The evaluation of multi-structure, multi-atlas pelvic anatomy features in a prostate MR lymphography CAD system

NASA Astrophysics Data System (ADS)

Meijs, M.; Debats, O.; Huisman, H.

2015-03-01

In prostate cancer, the detection of metastatic lymph nodes indicates progression from localized disease to metastasized cancer. The detection of positive lymph nodes is, however, a complex and time consuming task for experienced radiologists. Assistance of a two-stage Computer-Aided Detection (CAD) system in MR Lymphography (MRL) is not yet feasible due to the large number of false positives in the first stage of the system. By introducing a multi-structure, multi-atlas segmentation, using an affine transformation followed by a B-spline transformation for registration, the organ location is given by a mean density probability map. The atlas segmentation is semi-automatically drawn with ITK-SNAP, using Active Contour Segmentation. Each anatomic structure is identified by a label number. Registration is performed using Elastix, using Mutual Information and an Adaptive Stochastic Gradient optimization. The dataset consists of the MRL scans of ten patients, with lymph nodes manually annotated in consensus by two expert readers. The feature map of the CAD system consists of the Multi-Atlas and various other features (e.g. Normalized Intensity and multi-scale Blobness). The voxel-based Gentleboost classifier is evaluated using ROC analysis with cross validation. We show in a set of 10 studies that adding multi-structure, multi-atlas anatomical structure likelihood features improves the quality of the lymph node voxel likelihood map. Multiple structure anatomy maps may thus make MRL CAD more feasible.

The thoracic surface anatomy of adult black South Africans: A reappraisal from CT scans.

PubMed

Keough, N; Mirjalili, S A; Suleman, F E; Lockhat, Z I; van Schoor, A

2016-11-01

Surface landmarks or planes taught in anatomy curricula derive from standard anatomical textbooks. Although many surface landmarks are valid, clear age, sex, and population differences exist. We reappraise the thoracic surface anatomy of black South Africans. We analyzed 76 (female = 42; male = 34) thoracoabdominal CT-scans. Patients were placed in a supine position with arms abducted. We analyzed the surface anatomy of the sternal angle, tracheal, and pulmonary trunk bifurcation, azygos vein termination, central veins, heart apex, diaphragm, xiphisternal joint, and subcostal plane using standardized definitions. Surface anatomy landmarks were mostly within the normal variation limits described in previous studies. Variation was observed where the esophagus (T9) and inferior vena cava (IVC) (T8/T9/T10) passed through the diaphragm. The bifurcations of the trachea and pulmonary trunk were inferior to the sternal angle. The subcostal plane level was positioned at L1/L2. The origin of inferior mesenteric artery was mostly inferior to the subcostal plane. Sex differences were noted for the plane of the xiphisternal joint (P = 0.0082), with males (36%) intersecting at T10 and females (36%) intersecting at T9. We provide further evidence for population variations in surface anatomy. The clinical relevance of surface anatomical landmarks depends on descriptions of normal variation. Accurate descriptions of population, sex, age, and body type differences are essential. Clin. Anat. 29:1018-1024, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Transabdominal ultrasonography as a screening test for second-trimester placenta previa.

PubMed

Quant, Hayley S; Friedman, Alexander M; Wang, Eileen; Parry, Samuel; Schwartz, Nadav

2014-03-01

To determine the test characteristics of transabdominal ultrasonography as a screening test for second-trimester placenta previa. This secondary analysis of a prospective cohort study evaluated the distance from the placental edge to the internal os (placenta-cervix distance) through both transabdominal and transvaginal ultrasonography during the anatomic survey. Patients were recruited in the Maternal-Fetal Medicine Ultrasound Unit at the Hospital of the University of Pennsylvania, an urban tertiary care center. Transabdominal placenta-cervix distance cutoffs with high sensitivity for detection of previa and low-lying placenta were identified, and test characteristics were calculated. Follow-up ultrasound data, pregnancy, and delivery outcomes for those with second-trimester previa or low-lying placenta were obtained. One thousand two hundred fourteen women were included in the analysis. A transabdominal placenta-cervix distance cutoff of 4.2 cm was 93.3% sensitive and 76.7% specific for detection of previa with a 99.8% negative predictive value at a screen-positive rate of 25.0%. A cutoff of 2.8 cm was 86.7% sensitive and 90.5% specific with a 99.6% negative predictive value at a screen-positive rate of 11.4%. Only 9.8% (four of 41) of previas and low-lying placentas persisted through delivery. Transabdominal ultrasonography is an effective screening test for second-trimester placenta previa. At centers not performing universal transvaginal ultrasonography at the time of the anatomic survey, evidence-based transabdominal placenta-cervix distance cutoffs can optimize the identification of patients who require further surveillance for previa.

Prone positioning for head and neck reconstructive surgery.

PubMed

Mobley, Steven Ross; Miller, Brian Thomas; Astor, Frank C; Fine, Bradley; Halliday, N James

2007-11-01

Certain head and neck surgical cases require the patient to be positioned prone. Such positioning carries with it an attendant subset of risks and complications not otherwise encountered in more traditional supine positioning. Gaining awareness of these risks and complications, and developing proactive positioning strategies, will enable the surgical team to position the patient optimally for the procedure and provide for every consideration of patient safety. This article consists of a specific literature review of those issues directly related to the anatomical and physiological concerns arising from prone positioning. Particular attention is paid to the cardiopulmonary, renal, ophthalmologic, and neurological vulnerabilities unique to this position. Proper planning by the surgical team and utilization of the correct equipment are a necessity. A tailored approach to the needs of the individual patient and an intimate awareness of the potential pitfalls will contribute to better outcomes when using the prone position.

Toward morphological thoracic EIT: major signal sources correspond to respective organ locations in CT.

PubMed

Ferrario, Damien; Grychtol, Bartłomiej; Adler, Andy; Solà, Josep; Böhm, Stephan H; Bodenstein, Marc

2012-11-01

Lung and cardiovascular monitoring applications of electrical impedance tomography (EIT) require localization of relevant functional structures or organs of interest within the reconstructed images. We describe an algorithm for automatic detection of heart and lung regions in a time series of EIT images. Using EIT reconstruction based on anatomical models, candidate regions are identified in the frequency domain and image-based classification techniques applied. The algorithm was validated on a set of simultaneously recorded EIT and CT data in pigs. In all cases, identified regions in EIT images corresponded to those manually segmented in the matched CT image. Results demonstrate the ability of EIT technology to reconstruct relevant impedance changes at their anatomical locations, provided that information about the thoracic boundary shape (and electrode positions) are used for reconstruction.

Anatomic Outside-In Reconstruction of the Anterior Cruciate Ligament Using Femoral Fixation with Metallic Interference Screw and Surgical Staples (Agrafe) in the Tibia: An Effective Low-Cost Technique.

PubMed

Diego, Ariel de Lima; Stemberg Martins, de Vasconcelos; Dias, Leite José Alberto; Moreira, Pinto Dilamar; Beltrão, Teixeira Rogério; Coelho, de Léo Álvaro; de Lima, Silveira Leonardo; Krause, Gonçalves Romeu; Carvalho Krause, Gonçalves Marcelo; Carolina Leite, de Vasconcelos Ana; Dias Costa, Filho Carlos Frederico; Lana Lacerda, de Lima

2017-01-01

An anterior cruciate ligament (ACL) rupture is a frequent injury, with short and long-term consequences if left untreated. With a view to benefitting as many patients as possible and preventing future complications, we created a low-cost ligament reconstruction technique. The present article describes an anatomic ACL reconstruction technique. The technique involves single-band reconstruction, using flexors tendon graft, outside-in tunnel perforation, femoral fixation with metal interference screw and surgical staples (Agrafe) in the longitudinal position. We present a simple, easy-to-reproduce technique that, when executed on patients with good bone quality, primarily in the tibia, is effective and inexpensive, favoring its large scale application.

Anatomic Outside-In Reconstruction of the Anterior Cruciate Ligament Using Femoral Fixation with Metallic Interference Screw and Surgical Staples (Agrafe) in the Tibia: An Effective Low-Cost Technique

PubMed Central

Diego, Ariel de Lima; Stemberg Martins, de Vasconcelos,; Dias, Leite, José Alberto; Moreira, Pinto, Dilamar; Beltrão, Teixeira, Rogério; Coelho, de Léo, Álvaro; de Lima, Silveira, Leonardo; Krause, Gonçalves, Romeu; Carvalho Krause, Gonçalves, Marcelo; Carolina Leite, de Vasconcelos, Ana; Dias Costa, Filho, Carlos Frederico; Lana Lacerda, de Lima,

2017-01-01

Background: An anterior cruciate ligament (ACL) rupture is a frequent injury, with short and long-term consequences if left untreated. With a view to benefitting as many patients as possible and preventing future complications, we created a low-cost ligament reconstruction technique. Method: The present article describes an anatomic ACL reconstruction technique. Results: The technique involves single-band reconstruction, using flexors tendon graft, outside-in tunnel perforation, femoral fixation with metal interference screw and surgical staples (Agrafe) in the longitudinal position. Conclusion: We present a simple, easy-to-reproduce technique that, when executed on patients with good bone quality, primarily in the tibia, is effective and inexpensive, favoring its large scale application. PMID:29290851

A functional-anatomical approach to the spine-pelvis mechanism: interaction between the biceps femoris muscle and the sacrotuberous ligament.

PubMed

van Wingerden, J P; Vleeming, A; Snijders, C J; Stoeckart, R

1993-10-01

Summary. Sacroiliac joint dysfunction is often overlooked as a possible cause of low back pain. This is due to the use of reductionistic anatomical models. From a kinematic point of view, topographic anatomical models are generally inadequate since they categorize pelvis, lower vertebral column and legs as distinct entities. This functional-anatomical study focuses on the question whether anatomical connections between the biceps femoris muscle and the sacrotuberous ligament are kinematically useful. Forces applied to the tendon of the biceps femoris muscle, simulating biceps femoris muscle force, were shown to influence sacrotuberous ligament tension. Since sacrotuberous ligament tension influences sacroiliac joint kinematics, hamstring training could influence the sacroiliac joint and thus low back kinematics. The clinical implications with respect to 'short' hamstrings, pelvic instability and walking are discussed.

Three-dimensional prediction of the human eyeball and canthi for craniofacial reconstruction using cone-beam computed tomography.

PubMed

Kim, Sang-Rok; Lee, Kyung-Min; Cho, Jin-Hyoung; Hwang, Hyeon-Shik

2016-04-01

An anatomical relationship between the hard and soft tissues of the face is mandatory for facial reconstruction. The purpose of this study was to investigate the positions of the eyeball and canthi three-dimensionally from the relationships between the facial hard and soft tissues using cone-beam computed tomography (CBCT). CBCT scan data of 100 living subjects were used to obtain the measurements of facial hard and soft tissues. Stepwise multiple regression analyses were carried out using the hard tissue measurements in the orbit, nasal bone, nasal cavity and maxillary canine to predict the most probable positions of the eyeball and canthi within the orbit. Orbital width, orbital height, and orbital depth were strong predictors of the eyeball and canthi position. Intercanine width was also a predictor of the mediolateral position of the eyeball. Statistically significant regression models for the positions of the eyeball and canthi could be derived from the measurements of orbit and maxillary canine. These results suggest that CBCT data can be useful in predicting the positions of the eyeball and canthi three-dimensionally. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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.

A comparative study of modified transcanalicular diode laser dacryocystorhinostomy versus conventional transcanalicular diode laser dacryocystorhinostomy.

PubMed

Feijó, Eduardo Damous; Caixeta, Juliana Alves; de Souza Nery, Ana Carla; Limongi, Roberto Murillo; Matayoshi, Suzana

2017-08-01

External dacryocystorhinostomy (DCR) is the gold standard surgical technique for the treatment of primary acquired nasolacrimal duct obstruction (PANDO). However, new techniques such as endoscopic DCR and transcanalicular dacryocystorhinostomy (T-DCR) are being studied in an attempt to reduce surgical time, avoid external scarring and preserve the lacrimal pump while achieving the same efficacy. The purpose of this study was to compare the efficacy between conventional T-DCR and modified transcanalicular dacryocystorhinostomy (MT-DCR) in patients with PANDO. MT-DCR is performed to remove nasal mucosa prior to laser osteotomy. This is a comparative, prospective, interventionist and randomized study. Patients with PANDO were selected to undergo MT-DCR or T-DCR by blocked randomization. PANDO was diagnosed based on clinical presentation, dye disappearance test and dacryocystography. All of the procedures were performed by the same surgery team members. Anatomical success outcome was defined as positive lacrimal syringing and functional success outcome was defined as the absence or improvement of epiphora. A total of 44 surgical procedures were performed (22 MT-DCR and 22 T-DCR). In the case of MT-DCR, the anatomical and functional success rates after 12 months were 90 and 86%, respectively. After T-DCR, these rates were 77 and 72%, respectively (p = 0.162). MT-DCR and T-DCR are both safe and fast procedures with low morbidity and well-tolerated.

Femoral anatomical frame: assessment of various definitions.

PubMed

Della Croce, U; Camomilla, V; Leardini, A; Cappozzo, A

2003-06-01

The reliability of the estimate of joint kinematic variables and the relevant functional interpretation are affected by the uncertainty with which bony anatomical landmarks and underlying bony segment anatomical frames are determined. When a stereo-photogrammetric system is used for in vivo studies, minimising and compensating for this uncertainty is crucial. This paper deals with the propagation of the errors associated with the location of both internal and palpable femoral anatomical landmarks to the estimation of the orientation of the femoral anatomical frame and to the knee joint angles during movement. Given eight anatomical landmarks, and the precision with which they can be identified experimentally, 12 different rules were defined for the construction of the anatomical frame and submitted to comparative assessment. Results showed that using more than three landmarks allows for more repeatable anatomical frame orientation and knee joint kinematics estimation. Novel rules are proposed that use optimization algorithms. On the average, the femoral frame orientation dispersion had a standard deviation of 2, 2.5 and 1.5 degrees for the frontal, transverse, and sagittal plane, respectively. However, a proper choice of the relevant construction rule allowed for a reduction of these inaccuracies in selected planes to 1 degrees rms. The dispersion of the knee adduction-abduction and internal-external rotation angles could also be limited to 1 degrees rms irrespective of the flexion angle value.

Anatomic characterization of the humeral nutrient artery: Application to fracture and surgery of the humerus.

PubMed

Ichimura, Koichiro; Kinose, Shota; Kawasaki, Yuto; Okamura, Taro; Kato, Kota; Sakai, Tatsuo

2017-10-01

Anatomic characterization of the humeral nutrient artery varies among the several textbooks on human anatomy. To clarify the anatomic characteristics of the humeral nutrient artery, we reexamined its origin and course by cadaveric dissection. In typical cases, one prominent nutrient foramen was situated on the anteromedial surface of the humeral shaft, and the nutrient canal distally penetrated the cortical bone layer. The humeral nutrient artery originated from the brachial artery below the level of the nutrient foramen as a short ascending branch. On reaching near the nutrient foramen, the humeral nutrient artery formed a hairpin loop on the periosteum to enter into the nutrient foramen. In some cases, an accessory nutrient foramen was also found near the groove for the radial nerve on the posterior surface of the humerus. This accessory nutrient foramen received an accessory humeral nutrient artery that originated from the radial collateral artery. The present findings corresponded well with the descriptions in the anatomy textbooks published in English-speaking countries. However, textbooks published in German-speaking countries describe only one type of humeral nutrient artery, the branch of the profunda brachii artery. Terminologia Anatomica, the international standard in human anatomic terminology, most likely adopted the description in the German anatomy textbooks, and thus, it is necessary to correct the position of the humeral nutrient artery in the hierarchy of Terminologia Anatomica for accurate morphological description. Clin. Anat. 30:978-987, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Cell tracing reveals a dorsoventral lineage restriction plane in the mouse limb bud mesenchyme.

PubMed

Arques, Carlos G; Doohan, Roisin; Sharpe, James; Torres, Miguel

2007-10-01

Regionalization of embryonic fields into independent units of growth and patterning is a widespread strategy during metazoan development. Compartments represent a particular instance of this regionalization, in which unit coherence is maintained by cell lineage restriction between adjacent regions. Lineage compartments have been described during insect and vertebrate development. Two common characteristics of the compartments described so far are their occurrence in epithelial structures and the presence of signaling regions at compartment borders. Whereas Drosophila compartmental organization represents a background subdivision of embryonic fields that is not necessarily related to anatomical structures, vertebrate compartment borders described thus far coincide with, or anticipate, anatomical or cell-type discontinuities. Here, we describe a general method for clonal analysis in the mouse and use it to determine the topology of clone distribution along the three limb axes. We identify a lineage restriction boundary at the limb mesenchyme dorsoventral border that is unrelated to any anatomical discontinuity, and whose lineage restriction border is not obviously associated with any signaling center. This restriction is the first example in vertebrates of a mechanism of primordium subdivision unrelated to anatomical boundaries. Furthermore, this is the first lineage compartment described within a mesenchymal structure in any organism, suggesting that lineage restrictions are fundamental not only for epithelial structures, but also for mesenchymal field patterning. No lineage compartmentalization was found along the proximodistal or anteroposterior axes, indicating that patterning along these axes does not involve restriction of cell dispersion at specific axial positions.

Changes in the cerebellar and cerebro-cerebellar circuit in type 2 diabetes.

PubMed

Fang, Peng; An, Jie; Tan, Xin; Zeng, Ling-Li; Shen, Hui; Qiu, Shijun; Hu, Dewen

2017-04-01

Currently, 422 million adults suffer from diabetes worldwide, leading to tremendous disabilities and a great burden to families and society. Functional and structural MRIs have demonstrated that patients with type 2 diabetes mellitus (T2DM) exhibit abnormalities in brain regions in the cerebral cortex. However, the changes of cerebellar anatomical connections in diabetic patients remains unclear. In the current study, diffusion tensor imaging deterministic tractography and statistical analysis were employed to investigate abnormal cerebellar anatomical connections in diabetic patients. This is the first study to investigate the altered cerebellar anatomical connectivity in T2DM patients. Decreased anatomical connections were found in the cerebellar and cerebro-cerebellar circuits of T2DM patients, providing valuable new insights into the potential neuro-pathophysiology of diabetes-related motor and cognitive deficits. Copyright © 2017. Published by Elsevier Inc.

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)

Prostatome: A combined anatomical and disease based MRI atlas of the prostate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rusu, Mirabela; Madabhushi, Anant, E-mail: anant.madabhushi@case.edu; Bloch, B. Nicolas

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,more » 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 yielded a central gland Dice similarity coefficient (DSC) of 90%, and prostate DSC of 88%, while the misalignment of the urethra and verumontanum was found to be 3.45 mm, and 4.73 mm, respectively, which were measured to be significantly smaller compared to the alternative strategies. As might have been anticipated from our limited cohort of biopsy confirmed cancers, the disease atlas showed that most of the tumor extent was limited to the peripheral zone. Moreover, central gland tumors were typically larger in size, possibly because they are only discernible at a much later stage. Conclusions: The authors presented the AnCoR framework to explicitly model anatomic constraints for the construction of a fused anatomic imaging-disease atlas. The framework was applied to constructing a preliminary version of an anatomic-disease atlas of the prostate, the prostatome. The prostatome could facilitate the quantitative characterization of gland morphology and imaging features of prostate cancer. These techniques, may be applied on a large sample size data set to create a fully developed prostatome that could serve as a spatial prior for targeted biopsies by urologists. Additionally, the AnCoR framework could allow for incorporation of complementary imaging and molecular data, thereby enabling their careful correlation for population based radio-omics studies.« less

Social networking sites use and the morphology of a social-semantic brain network.

PubMed

Turel, Ofir; He, Qinghua; Brevers, Damien; Bechara, Antoine

2017-09-30

Social lives have shifted, at least in part, for large portions of the population to social networking sites. How such lifestyle changes may be associated with brain structures is still largely unknown. In this manuscript, we describe two preliminary studies aimed at exploring this issue. The first study (n = 276) showed that Facebook users reported on increased social-semantic and mentalizing demands, and that such increases were positively associated with people's level of Facebook use. The second study (n = 33) theorized on and examined likely anatomical correlates of such changes in demands on the brain. Findings indicated that the grey matter volumes of the posterior parts of the bilateral middle and superior temporal, and left fusiform gyri were positively associated with the level of Facebook use. These results provided preliminary evidence that grey matter volumes of brain structures involved in social-semantic and mentalizing tasks may be linked to the extent of social networking sites use.

Assessment of morphological and anatomical characteristics of mental foramen using cone beam computed tomography.

PubMed

Goyushov, Samir; Tözüm, Melek Didem; Tözüm, Tolga Fikret

2018-05-25

To determine the shape, position, vertical height, surrounding bone characteristics, and opening angle of mental foramen (MF) using dental cone beam computed tomography (CBCT). A retrospective study was performed on 663 patients. CBCT records analyzed for the shape, position, and surrounding bone measurements of the MF using Simplant 3D software (Hasselt, Belgium). Opening angle of MF was also assessed. Kruskal-Wallis and Mann-Whitney U tests were employed to test significant differences between parameters, genders and ages. All mental foramina were visualized. Regarding location, 49.2% of the MFs were located between first and second premolars, 7.7 distal and 39.7% coincident to the apex of the mandibular second premolar. The mean MF opening angle was 45.4° on the right side, and 45.9° on the left. There were no statistically differences between gender groups with regard to the opening angle degrees. This study may provide useful information about variations in the position, shape and size, angle of mental foramen, which may help the practitioners to perform safer mental nerve blocks and surgical procedures.