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INTRODUCTION: The sensory innervation of the hand is getting a lot of attention because of the quick surge in the usage of local anesthesia and the progress of plastic surgeries. It is significant to know the likely disparities in the sensory innervation of the hand to prevent mistakes while analyzing the symptoms or misdiagnosing the nerve pathology. So this study aims to assess the sensory innervation of the hand. MATERIALS AND METHOD: The study was carried out on 54 upper limbs. All the branches of the median, ulnar and radial nerve were traced. Variations in the distribution and anastomoses were noted. RESULTS: Anastomosis between the median and ulnar nerve was found in 12.95% of cases. In all cadavers, 3 1/2 digits are supplied by the median nerve and 1 1/2 digits by the ulnar nerve bilaterally in the palms. In all cadavers 2 1/2 digits, each is supplied by radial and ulnar nerve bilaterally on the dorsum of hands. CONCLUSION: These anatomic conclusions will aid hand surgeons in identifying differences in sensory losses after either dorsal or palmar injuries.
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Mãos , Extremidade Superior , Humanos , Anastomose Cirúrgica , Cadáver , ÍndiaRESUMO
Purpose: An undergraduate research conducted during the pre-covid times, to highlight the importance of screen time and its association with dry eye in medical students. The aim was to study the prevalence of dry eye among medical students using the ocular surface index (OSDI) questionnaire. Methods: This was a cross-sectional study. This study was conducted among medical students using an OSDI questionnaire in the pre-covid times. Based on the pilot study, the minimum sample size calculated was 245. A total of 310 medical students participated in the study. These medical students answered the OSDI questionnaire. The OSDI score was used to categorize students with dry eye as mild (13-22 points), moderate (23-32 points), and severe (33-100 points). In addition, the associations between the OSDI score and possible risk factors such as gender, contact lens/spectacle wear, laptop/mobile usage, and duration of exposure to air conditioners were also studied. Results: The analysis of the study revealed that out of 310 students, dry eye was seen in 143 (46.1%) and severe dry eyes were seen in 50 (16.1%). A high OSDI score (>13 points) was associated with the usage of a laptop/mobile for more than 6 h in 40 (52.6%) (P < 0.001). Conclusion: The prevalence of dry eye among medical students was 46.1% in the present study. Longer duration of usage of visual display units (laptop/mobile) was the only factor that showed a statistically significant association with dry eye in our study.
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COVID-19 , Síndromes do Olho Seco , Estudantes de Medicina , Humanos , Prevalência , Estudos Transversais , Projetos Piloto , COVID-19/epidemiologia , Inquéritos e Questionários , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/epidemiologiaRESUMO
PURPOSE: Anatomical knowledge of the hypoglossal canal is very important in relation to drilling of occipital condyle, jugular tubercle etc. So, this study was conducted to identify various morphometric and morphological features of the hypoglossal canal and its distance from adjacent structures relative to stable and reliable anatomic landmarks. METHODS: The study was performed on 142 hypoglossal canals of 71 adult human dry skulls. The parameters measured were the transverse, vertical diameter, depth of the hypoglossal canal. The distances from the hypoglossal canal to the foramen magnum, occipital condyle and jugular foramen were also noted. In addition, the different locations of the hypoglossal canal orifices in relation to the occipital condyle were assessed. The different shapes and types of the hypoglossal canal were also noted. RESULTS: There was significant difference (p < 0.05) in measurements taken on the right and left sides in males and females. The intracranial orifice of hypoglossal canal was present in middle 1/3rd in 100% of occipital condyle for both genders. The extracranial orifice of the hypoglossal canal was found to be in the anterior 1/3rd in 99% and 93.7% for male and female, respectively. Simple hypoglossal canal with no traces of partition was found to be more in males and females. The most common shape noted was oval both in males and females (71.8% and 68.7% respectively). CONCLUSION: The results of the dimensions of the hypoglossal canal and its distance from other bony landmarks will be helpful for neurosurgeons to plan which surgical approaches should be undertaken while doing various surgeries in posterior cranial fossa.
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Osso Occipital , Procedimentos Ortopédicos , Adulto , Feminino , Masculino , Humanos , Osso Occipital/cirurgia , Osso Occipital/anatomia & histologia , Forame Magno/cirurgia , Forame Magno/anatomia & histologia , Crânio , Procedimentos Neurocirúrgicos/métodos , Fossa Craniana Posterior/cirurgia , Fossa Craniana Posterior/anatomia & histologia , Base do Crânio/cirurgia , Base do Crânio/anatomia & histologiaRESUMO
Objective: Sulci and gyri of the cerebrum can be easily identified with the aid of radiology but are difficult to locate during surgical operations, owing to anatomical variations and the surgical approach of the sulci through a small aperture. Therefore, this study was performed to locate the main sulci of the brain by using various anatomical landmarks in cadaveric brain specimens and CT scan images. Methods: In 31 cadaveric brain specimens (17 right and 14 left hemispheres) from people of unknown sex, 21 parameters associated with important sulci of the brain were studied. CT scan images for 150 patients in three age groups were examined. The patient IDs were categorized into 50 patients in each of the following age groups: 20-40 yr, 41-60 yr and 61-80 yr. Ten parameters were studied. The data were statistically analyzed in SPSS software. Results: In the cadaveric brain specimens, comparisons of right and left hemispheres indicated that only the posterior part of the calcarine sulcus showed a significant difference (p = 0.0394). In CT scans within each age group, comparison of the right and left sides in males and females showed significant differences for many parameters (e.g., calcarine sulcus to occipital pole: right p = 0.0025; left p = 0.0009). Comparisons between male and female parameters also showed significant differences. Conclusion: This study aids in identifying the important functional areas of the brain situated near the sulci, given that the sulci are connected to the gyral functions and act as a barrier for the gyri. The findings may facilitate neurosurgery operations.
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BACKGROUND: This study aims to assess whether ophthalmic surgical skills can be taught successfully online to a diverse international and interprofessional student group. METHODS: Mixed methods study involving 20 students and 5 instructors. Each student completed a pre-session and post-session questionnaire to assess their perceptions regarding online instruction. Changes in questionnaire responses were analysed using Wilcoxon signed rank (SPSS 25). Semi-structured interviews were conducted to assess instructor perceptions towards virtual surgical skills teaching. Thematic analysis was undertaken using NVivo 12.0 software. RESULTS: There was a 100% completion rate of pre- and post-session questionnaires. Prior to the session, lack of instructor supervision and inability to provide constructive feedback were emergent themes from students. Pre-session concerns regarding online delivery: 40% of students thought their view of skills demonstration would be negatively impacted, 60% their level of supervision and 55% their interaction with instructors. Following the session 10%, 15% and 5% held this view respectively. All students were 'satisfied' or 'very satisfied' regarding the 'Surgeon's View' camera angle as well as the use of breakout rooms. 75% perceived an improvement in their confidence in instrument handling, 80% in cable knot tying and 70% in suture tying. Overall student rating for the virtual surgical skills session was 8.85 (±1.19) out of 10 (10 being most satisfied). CONCLUSIONS: We demonstrate that successful delivery of a virtual ophthalmic surgical skills course is feasible. We were able to widen accessibility and participation through virtual delivery, which has future implications for ophthalmic surgical teaching and its reach.
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Competência Clínica , Procedimentos Cirúrgicos Oftalmológicos , HumanosRESUMO
Background: Aging is a non-modifiable risk factor for neurodegenerative disease. It is well established that the brain undergoes physiological atrophy with age. So, this study was conducted to analyse the correlation between the age of the person and the size of the various subcortical nuclei of the brain and whether these measurements can serve as a useful indicator for physiological atrophy leading to degenerative disease in clinical practice. Methods: A total of 600 MRI scans from healthy individuals were examined and the measurements of subcortical nuclei were taken and subsequently analysed. Results: A statistically significant difference between the genders was observed in the sizes of the axial diameters of caudate nucleus, putamen and globus pallidus. Caudate nucleus transverse diameter showed a moderate negative correlation with age in males. Globus pallidus axial diameter with age showed weak positive correlation for males. Globus pallidus transverse diameter showed weak positive correlation with age for both males and females, but it was stronger for males compared to females. Conclusions: These results will help neurologists and neurosurgeons in analysing various early degenerative diseases and treat them accordingly.
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Envelhecimento , Imageamento por Ressonância Magnética , Doenças Neurodegenerativas , Humanos , Masculino , Feminino , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Adulto , Doenças Neurodegenerativas/diagnóstico por imagem , Doenças Neurodegenerativas/patologia , Idoso , Envelhecimento/patologia , Adulto Jovem , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Idoso de 80 Anos ou mais , Adolescente , Globo Pálido/diagnóstico por imagem , Globo Pálido/patologia , Tamanho do Órgão , Núcleo Caudado/diagnóstico por imagem , Núcleo Caudado/patologia , Fatores EtáriosRESUMO
Objectives: The carotid canal is a foramen located in the petrous part of the temporal bone. Detailed knowledge about the anatomy of the base of the skull is important, as many surgeries are done there for various malignancies and aneurysms. The aim of this study was to collect various morphometric measurements of the carotid canal to aid neurosurgeons with various surgical approaches to easily locate the second fragment of the internal carotid artery. Methods: A retrospective study was done, and 500 CT scans on both sides of the skull were analysed. Various morphometric parameters related to the carotid canal were measured. The shape of the carotid canal was also noted. Statistical analysis was done for all the parameters. Results: The mean anteroposterior diameter and width of the carotid canal was 0.535 and 0.683 cm, respectively. The mean distance of the carotid canal from the external acoustic meatus, zygomatic arch, and mandible was 2.27, 3.28, and 2.34 cm, respectively. The mean distance of the carotid canal from the midline of the base of the skull was 2.97 cm. The mean angle between the zygoma root, external aperture of the carotid canal, and external acoustic meatus was 27.08°. The mean angle between the external acoustic meatus, external aperture of the carotid canal, and supramastoid crest was 26.74°. The carotid canal was round in most cases (50.5%). Conclusion: These measurements will aid neurosurgeons to identify various surgical approaches to easily locate the second part of the internal carotid artery, and they can serve as a reference to guide surgeries at the base of the skull.
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Background: Now a day's many surgeries are done around the head and neck of femur like femoral head resurfacing arthroplasty for managing advanced hip-joint degeneration. Thus, it is vital for an orthopaedic surgeon to exactly understand the vascular supply of the neck of femur. The knowledge of distribution of foramina and their relation to the retinacula of Weitbrecht will help orthopaedic surgeons to choose their management technique for various injuries. So, this study was undertaken to study the number, size and distribution of nutrient foramina in all the surfaces of neck of femur and their relations to the retinacula of Weitbrecht. Materials and method: Study was conducted on 200 adult dry femora. The retinacula of Weitbrecht are first defined later the subcapital, transcervical and basicervical regions of the femoral neck are marked. The number of foramina, size and their distribution in relations to the retinacula of Weitbrecht were observed. Later the results were analyzed statistically. Results: 40.01% of foramina were observed in the subcapital region, 31.74% in basicervical and 28.24% were noted in transcervical region. The nutrient foraminal density was significantly higher in the upper retinacula (57.03%), followed by anterior retinacula (27.3%) and least in the region of inferior retinacula (15.66%). It was observed that most foramina were less than 1 mm diameter followed by 1-2 mm diameter foramina. Conclusion: This knowledge of foraminal distribution in femoral neck will be helpful in surgeries involving the hip joint and femoral head & neck fractures.
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Objective To prevent damage to the facial nerve while doing surgery and to give facial nerve block by anesthetics near the stylomastoid foramen we should know its distance from the important anatomical landmarks. So, this study aims to study the location of stylomastoid with respect to nearby anatomical landmarks. Materials and Methods The study was performed on 58 dry skulls. Measurements of stylomastoid foramen were taken from various anatomical landmarks on both sides of the skull. Data analysis was done by using the Statistical Package for Social Sciences (SPSS) 19 version. Results The mean distance of the center of the stylomastoid foramen (CSMF) to the tip of the mastoid process was 1.60, 1.57 cm on the right and left side, respectively. The mean distance of CSMF to the upper end of the anterior border of the mastoid process was 1.42, 1.39 cm on the right and left side, respectively. The mean angle between CSMF and tip of the mastoid process was 51.6 degrees, 53.5 degrees on right and left side, respectively. The mean distance of CSMF to the center of jugular foramen was 1.27, 1.26 cm on the right and left side, respectively. The position of the stylomastoid foramen in relation to a transverse line passing through the upper end of the anterior border of both mastoid processes was anterior in 82.7%, 94.8% of cases on the right and left side, respectively. Conclusion These measurements will aid neurosurgeons in doing surgeries near the stylomastoid foramen or anesthetics to give facial nerve block near the foramen.
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PRCIS: Laser goniopuncture (LGP) is an effective outpatient procedure which has been shown to maintain reduced intraocular pressure (IOP) 5 years following initial laser treatment in patients who have had viscocanalostomy (VC) (with or without phacoemulsification). PURPOSE: The purpose of this study was to establish the long term (5 y) efficacy of neodymium-doped:yttrium aluminum-garnet LGP to lower IOP following VC or phacoviscocanalostomy (PVC) in patients with glaucoma. PATIENTS AND METHODS: This retrospective study analyzed patients who underwent LGP following VC±phacoemulsification between 2009 and 2012 at the Stanley Eye Unit in Abergele. Reason for further intervention included either increasing IOP outside target range or worsening visual fields. Statistical analyses were performed comparing pregoniopucture values to those taken up to 5 years later. RESULTS: Of the 620 VC and PVC procedures performed between 2009 and 2012, 218 eyes underwent LGP after a mean of 25 months [95% confidence interval (CI): 22.58 to 27.41] following surgery. Patients having a PVC had a longer mean time to goniopuncture compared with those who were phakic and had VC only (P<0.001). Immediately following goniopuncture IOP dropped, and a statistically significant reduction persisted at 5 year follow-up (P<0.001). Goniopuncture reduced IOP significantly from a pretreatment value of 21 to 15 mm Hg over 5 years (95% CI) (χ2F(4)=119.1, P<0.001). In total, 154 eyes (71%) were commenced on IOP-lowering medication at a mean of 14 months (95% CI: 12 to 17). At 5 years, successful IOP control was achieved in 73% (49 of 67) of eyes. There was no difference found between type of surgery and successful pressure control at 5 years (χ2(1)=2.00, P=0.16). CONCLUSION: LGP is an effective procedure which maintains a statistically significant reduction in IOP in the long term.
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Glaucoma , Terapia a Laser , Lasers de Estado Sólido , Glaucoma/cirurgia , Humanos , Pressão Intraocular , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVES: Foetal anthropometry evaluates and monitors foetal development and assesses the nutritional state of the developing foetus. It is a vital indicator of the normalcy of foetal development in-utero. The most relevant parameters in foetal anthropometry are biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). Gestational diabetes mellitus (GDM) and gestational hypertension (GHTN) are the major reasons for variations in foetal development. In this study, we compare foetal anthropometric measurements taken using ultrasounds of normal, gestational diabetes-affected, and hypertensive pregnancies. METHOD: In this study, a total of 615 anomaly scans were done between the gestational ages of 18-22 weeks from 2016 to 2018. The patients' data were collected from the register of the anomaly scanning room. The foetal anthropometric parameters measured BPD, HC, AC, and FL. RESULTS: All the measurements including BPD, HC, and AC were lower in foetuses affected by GHTN, and all the measurements, including FL, were higher in foetuses affected by GDM than in normal pregnancies. A post-hoc analysis using Tukey's test showed that each foetal parameter had a significant correlation with pregnancy-related co-morbidities (p-value < 0.05). CONCLUSION: It is clear from our study that the foetuses of mothers with GDM showed a consistent variation of 10 mm above the normal average in terms of the BPD, HC, AC, and FL measurements. The GHTN-affected foetuses had averages that were lower than normal for BPD, HC, and AC.
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OBJECTIVES: The aim of this study was to compare the standard ultrasound (US) estimated fetal weight (EFW) and MRI volume-derived methods for the midtrimester fetus. METHODS: Twenty-five paired US and MRI scans had the EFW calculated (gestational age [GA] range = 20-26 weeks). The intra- and interobserver variability of each method was assessed (2 operators/modality). A small sub-analysis was performed on 5 fetuses who were delivered preterm (mean GA 29 +3 weeks) and compared to the actual birthweight. RESULTS: Two MRI volumetry EFW formulae under-measured compared to US by -10.9% and -14.5% in the midpregnancy fetus (p < 0.001) but had excellent intra- and interobserver agreement (intraclass correlation coefficient = 0.998 and 0.993). In the preterm fetus, the mean relative difference (MRD) between the MRI volume-derived EFW (MRI-EFW) and actual expected birthweight (at the scan GA) was -13.7% (-159.0 g, 95% CI: -341.7 to 23.7 g) and -17.1% (-204.6 g, 95% CI: -380.4 to -28.8 g), for the 2 MRI formulae. The MRD was smaller for US at 5.3% (69.8 g, 95% CI: -34.3 to 173.9). CONCLUSIONS: MRI-EFW results should be interpreted with caution in midpregnancy. Despite excellent observer agreement with MRI volumetry, refinement of the EFW formula is needed in the second trimester, for the small and for the GA and preterm fetus to compensate for lower fetal densities.
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Peso Fetal , Feto , Feminino , Humanos , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Variações Dependentes do Observador , Gravidez , Segundo Trimestre da GravidezRESUMO
BACKGROUND: It has been documented that cardiac musculature is present in both venae cavae, and they contract together with the atrium, contributing to the pumping mechanism of the heart. So, in the present study, we measured the relative thicknesses of the three histological layers at formation, termination and intermediate levels of the venae cavae along with their histological characteristics. MATERIALS AND METHODS: Ten foetal and 10 adult cadavers were used. The Superior and Inferior Venae Cavae from all three regions were excised and processed for histology. The qualitative and quantitative features of the vessels were observed and recorded. The data thus obtained was then assessed statistically. RESULTS: In superior vena cava, the tunica intima grows actively especially during late gestation. The tunica media shows active growth. The tunica adventitia growth is significant at the middle and termination levels. In inferior vena cava, the tunica intima grows actively at the level of formation. The tunica media shows the active overall growth during early gestation. The tunica adventitia shows active growth during late gestation. In qualitative analysis the plump, spindle-shaped primitive mesenchymal cells were observed. Muscle and collagen fibers show reciprocal abundance with increasing age, with the former being lesser in amount than the latter in earlier stages. Appearance of vasa vasorum was notable from 2nd trimester. The cardiac myocytes were located in the middle and outer tunics of the superior vena cava. CONCLUSION: Cardiac musculature was absent in the inferior vena; however, the vessel shows advanced rate of overall development.
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Feto/irrigação sanguínea , Veia Cava Inferior/crescimento & desenvolvimento , Veia Cava Superior/crescimento & desenvolvimento , Veias Cavas/crescimento & desenvolvimento , Adulto , Cadáver , Coração/anatomia & histologia , Coração/crescimento & desenvolvimento , Humanos , Veia Cava Inferior/anatomia & histologia , Veia Cava Superior/anatomia & histologia , Veias Cavas/anatomia & histologiaRESUMO
BACKGROUND: XEN® gel stent (Allergan, Dublin/Republic of Ireland) is a relatively new microinvasive glaucoma device providing an ab-interno approach to the subconjunctival space for aqueous drainage and reduction of intraocular pressure. It is thought to be less invasive, reduce surgical time and post-operative infection rates compared with traditional glaucoma procedures. Little information however, has been published regarding complications and subsequent management. CASE PRESENTATION: The authors highlight five complicated cases of XEN® stent insertion, how they were managed and key learning points. Cases include: entire stent found at the bottom of the anterior chamber several months after uncomplicated insertion, stent broke into multiple pieces during manipulation within subconjunctiva, XEN45 stent migrated into the anterior chamber 7 months post-operatively and a case of limbal-based conjunctival dissection during open revision which lead to additional scarring around the stent and subsequent raised intraocular pressure. CONCLUSIONS: We present some new and interesting complications of XEN implant as well as potential management options. This can assist clinical decision-making and enable better pre-operative discussions with patients regarding risks of surgery.
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Segmento Anterior do Olho/patologia , Implantes para Drenagem de Glaucoma/efeitos adversos , Glaucoma de Ângulo Aberto/cirurgia , Idoso , Idoso de 80 Anos ou mais , Alquilantes/administração & dosagem , Segmento Anterior do Olho/cirurgia , Humor Aquoso/fisiologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Mitomicina/administração & dosagem , Procedimentos Cirúrgicos Oftalmológicos , Implantação de Prótese , Stents/efeitos adversos , Tonometria OcularRESUMO
BACKGROUND: Intestine plays a major role for the normal growth of the fetus during the prenatal period. The process of the embryonic development is not quantified histologically. Therefore the main aim of the study was to measure the thickness of all part of the wall of the small intestine that are mucosa, submucosa and muscularis externa and to look for the appearance of the Brunner's glands and Peyer's patches in the submucosa of duodenum and ileum. METHODS: The present study was carried out on 30 fetuses of gestational ages ranging from 11-36 weeks. Ten fetuses from each trimester were used in the study. Fetal small intestine were dissected carefully, and were separated as duodenum, jejunum & ileum and fixed in formalin solution. The tissue was processed for histology and then slides were stained with Haematoxylin and Eosin. The microscopic features were noted using light microscope. RESULTS: The thickness of the mucosa, submucosa and the muscularis externa was observed to be increased in first trimester, decreased in the second trimester and again increased in the third trimester, which could be because of the increase cell turnover and the arrangement of the collagen fibers as to support the mucosa and the muscularis externa. CONCLUSION: Thus, the knowledge of the histogenesis and histomorphometry of the human fetal small intestine is crucial for the adult gastroenterologist to appreciate, because of the potential for these early life events to affect the responsiveness of the intestine to physiological or pathological challenges in later life.
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Desenvolvimento Fetal/fisiologia , Feto/citologia , Intestino Delgado/citologia , Morfogênese/fisiologia , Fatores Etários , Feminino , Idade Gestacional , Humanos , Índia , Masculino , GravidezRESUMO
Ultrasound (US) imaging is arguably the most commonly used modality for fetal screening. Recently, 3DUS has been progressively adopted in modern obstetric practice, showing promising diagnosis capabilities, and alleviating many of the inherent limitations of traditional 2DUS, such as subjectivity and operator dependence. However, the involuntary movements of the fetus, and the difficulty for the operator to inspect the entire volume in real-time can hinder the acquisition of the entire region of interest. In this paper, we present two deep convolutional architectures for the reconstruction of the fetal skull in partially occluded 3DUS volumes: a TL deep convolutional network (TL-Net), and a conditional variational autoencoder (CVAE). The performance of the two networks was evaluated for occlusion rates up to 50%, both showing accurate results even when only 60% of the skull is included in the US volume (Dice coeff. $0.84\pm 0.04$ for CVAE and $0.83\pm 0.03$ for TL-Net). The reconstruction networks proposed here have the potential to optimize image acquisition protocols in obstetric sonography, reducing the acquisition time and providing comprehensive anatomical information even from partially occluded images.
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Feto , Crânio , Feminino , Humanos , Imageamento Tridimensional , Gravidez , UltrassonografiaRESUMO
BACKROUND: XEN45 Gel stents are in their infancy, and clinical expertise with microsurgical glaucoma devices are increasing. The soft flexible nature of the XEN stent together with its malleability under the conjunctival tissue should negate any risk of exposure of the XEN45 stent (XEN). However, we report a case in which sight-threatening endophthalmitis was the presenting feature of this complication. CASE REPORT: We present a case of uncomplicated XEN implantation that developed endophthalmitis 4 months after surgery. She gave an 8-day history of diarrhea before presentation. She was noted to have exposure of the XEN stent at the point of entry of the XEN into the subconjunctival space. The stent was removed, pars plana vitrectomy was carried out, and intravitreal antibiotics were administered. Achieving low intraocular pressures, bearing in mind her preservative allergy, became a challenge, as we struggled to manage her advanced glaucoma medically. A CyPass Micro-Stent was subsequently inserted to control the intraocular pressure. CONCLUSIONS: Episodes of XEN stent exposure may not be so isolated. We postulate that poor handwashing transmitted the causative organism to the exposed stent, which then resulted in endopthalmitis. We would like to highlight a few learning points from this case.
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Endoftalmite/etiologia , Infecções Oculares Bacterianas/etiologia , Implantes para Drenagem de Glaucoma/efeitos adversos , Stents/efeitos adversos , Idoso de 80 Anos ou mais , Feminino , Glaucoma/cirurgia , HumanosRESUMO
We propose a new Patch-based Iterative Network (PIN) for fast and accurate landmark localisation in 3D medical volumes. PIN utilises a Convolutional Neural Network (CNN) to learn the spatial relationship between an image patch and anatomical landmark positions. During inference, patches are repeatedly passed to the CNN until the estimated landmark position converges to the true landmark location. PIN is computationally efficient since the inference stage only selectively samples a small number of patches in an iterative fashion rather than a dense sampling at every location in the volume. Our approach adopts a multitask learning framework that combines regression and classification to improve localisation accuracy. We extend PIN to localise multiple landmarks by using principal component analysis, which models the global anatomical relationships between landmarks. We have evaluated PIN using 72 3D ultrasound images from fetal screening examinations. PIN achieves quantitatively an average landmark localisation error of 5.59mm and a runtime of 0.44s to predict 10 landmarks per volume. Qualitatively, anatomical 2D standard scan planes derived from the predicted landmark locations are visually similar to the clinical ground truth.
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BACKGROUND: Knowledge of the size and shape of radial head is essential for construction of radial head prosthesis. Further, the measurements of bicipital tuberosity and its angular relationship to radial head are significant in surgical techniques, like in the reconstruction of biceps tendon. Even the morphometry of the distal radius is significant in numerous clinical orthopedic situations such as reduction of distal radius fractures and in the design of distal radius prosthesis. So, the aim of the study was to determine the morphometric parameters of proximal and distal radius in dry adult Indian radius. METHODS: Fifty intact adult Indian radius (right = 23, left = 27) were chosen, and the various parameters of proximal and distal ends of radius were studied. Student's t-test was done to correlate all these parameters on the right and left sides. RESULTS: The mean length of radius, height of head at medial and lateral ends, head anteroposterior and transverse diameter, head thickness at ventral, dorsal, and lateral ends were 23.5, 0.90, 0.75, 1.91, 1.85, 0.42, 0.32, and 0.30 cm, respectively. The mean depth of articular facet, length of neck, proximal and distal neck diameter, width and length of bicipital tuberosity, and radial circumference at bicipital tuberosity were 0.19, 1.19, 1.36, 1.31, 1.23, 1.97, and 4.54 cm, respectively. The mean length of styloid process, oblique and transverse width of lower end, anteroposterior diameter of lower end, and angle of radial inclination were 0.98cm, 2. 81cm, 2.59cm, 1.86cm, and 25.05°, respectively. CONCLUSION: This study will be useful for orthopedic surgeons in making prosthesis for the proximal and distal ends of radius.