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1.
Int J Oral Maxillofac Implants ; 0(0): 1-29, 2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38717354

RESUMEN

PURPOSE: One-size implant-abutment (OSIA) connection systems have been developed for simplicity of clinical use and for a range of implant diameters. The aim of this in vitro study was to investigate the rotational load fatigue performance of different implant diameters and abutment platforms of an OSIA connection system. METHODOLOGY: Narrow, regular and wide diameter implants were tested with Regular Base (RB/WB) abutments of an OSIA system (Straumann. BLX). Wide diameter implants were also tested with Wide Base (WB) abutments. This resulted in 4 test groups (n=5): N-RB/WB (Narrow, 3.5mm, RB/WB abutment), R-RB/WB (Regular, 4.0mm, RB/WB abutment), W-RB/WB (Wide, 5.0mm, RB/WB abutment) and W-WB (Wide, 5.0mm, WB abutment). A rotational load fatigue machine applied a sinusoidally varying stress at an angle of 45o, producing an effective bending moment of 35Ncm at a frequency of 10 Hz in air at 20 oC. The number of cycles to failure was recorded. Results were evaluated using ANOVA. Failed specimens were examined with SEM to evaluate the failure mode. Pristine specimens were sectioned to examine the implant-abutment connection. RESULTS: All specimens in the 3 test groups with RB/WB abutments failed within the range of 558,750 cycles to 4,497,619 cycles, while the W-WB test group reached the upper limit of 5 million cycles without failure. Significant difference was found between abutment platforms (P < .001). There were no significant differences found for implant diameters (P =.857). However, with increasing implant diameter, implant fracture was less common and the location of failure was more coronal and consistently at the level of the implant platform for the abutment, and at the screw neck. CONCLUSIONS: For wide diameter implants, WB abutments exhibited a superior fatigue performance than RB/WB abutments, and would be preferred in situations of high mechanical risk. Increasing implant diameter, when used with RB/WB abutments, did not improve fatigue performance due to the one-size prosthetic connection, but failures were less catastrophic, and coronally located, which may be advantageous in managing failures.

2.
Int J Biol Macromol ; 261(Pt 2): 129935, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38309389

RESUMEN

Rice starch is a promising biopolymer for buccal formulations but typical oven drying may promote starch retrogradation that affects mechanical properties. Hence, lyophilisation was proposed here to improve starch product's stability. This study aims to investigate the effects of plasticisers (sorbitol and Tween® 80, T80) on the characteristics and drug release profiles of lyophilised rice starch wafers incorporated with propranolol hydrochloride. The wafers were prepared by lyophilising starch mixture (5%w/v) with plasticiser (0.2 and 0.3 g/g) and drug (10, 20, 30%w/w). Control wafers exhibited loose layers with rough wrinkled surface. Sorbitol resulted in a dense structure with higher puncture strength (PS) but lower water absorption capacity (WAC) while T80 loosened the flakes that reduced PS and increased WAC. Drug inclusion decreased PS and increased WAC of unplasticised wafers. T80-plasticised wafers with drug had a lower PS and higher WAC than sorbitol-plasticised wafers. Particularly, T80-plasticised wafers achieved outstandingly high PS and the lowest WAC at 30%w/w drug. Drug dissolution of wafers relied mainly on the drug crystallinity and WAC at 10 and 30%w/w drug. Plasticisers reduced and increased drug dissolution at 10 and 20%w/w drug, respectively. This study highlights the potential of lyophilisation in preparing rice starch wafers for buccal delivery.


Asunto(s)
Oryza , Polímeros , Tensoactivos , Almidón/química , Preparaciones Farmacéuticas , Sorbitol
3.
Int J Oral Maxillofac Implants ; 39(1): 119-126, 2024 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-38416005

RESUMEN

PURPOSE: This in vitro study investigated the effect of implant geometry and diameter on the rotational load fatigue performance of an implant system with an internal conical connection with microthreads. MATERIALS AND METHODS: Regular (4.2 mm) and wide-diameter (4.8 mm) Astra Tech EV implants with straight (S) and conical (C) geometries were tested with their corresponding titanium abutments, comprising four test groups: 4.2-mm S (Group 1), 4.2-mm C (Group 2), 4.8-mm S (Group 3), and 4.8-mm C (Group 4). Five samples were included in each group. Customized brass implant holders and abutment holders were machined. A rotational load fatigue machine was used to apply a sinusoidally varying load to the implant-abutment interface at an angle of 45 degrees to produce an effective bending moment of 35 Ncm at a frequency of 14 Hz (air temperature: 20°C). The number of cycles to failure was recorded, with the upper limit set at 5 × 106 cycles. Results were analyzed using ANOVA. Failed samples were examined with a scanning electron microscope to evaluate the mode of failure. RESULTS: Of the 20 total samples, 2 failed, with Groups 1 and 2 each reporting one failure. Abutment and abutment screw fracture were observed in the failed sample in Group 1, while implant and abutment screw fracture occurred in the failed sample in Group 2. All wide-diameter implants ran beyond the cut-off without failure, but abutment screw loosening was noted in one sample in Group 3. No significant difference was found between implant groups of different geometries and diameters. Damage to the abutments and the implant internal surface were noted in all failed samples. CONCLUSIONS: While no significant differences were found between the test groups, failures were observed only in the regular-diameter group. The abutment and abutment screw fractured deep within the implant, and the implant fractured below the simulated bone level. These modes of failure may pose a significant clinical challenge during retrieval of these components.


Asunto(s)
Implantes Dentales , Falla de Equipo , Ensayo de Materiales , Proyectos de Investigación , Temperatura , Titanio
4.
World J Pediatr ; 2023 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-37853276

RESUMEN

BACKGROUND: Pediatric antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is a life-threatening systemic vasculitis featured by liability to renal involvement. However, there are few studies on the risk factors and predictive models for renal outcomes of AAV in children. METHODS: Data from 179 AAV children in multiple centers between January 2012 and March 2020 were collected retrospectively. The risk factors and predictive model of end-stage renal disease (ESRD) in AAV were explored. RESULTS: Renal involvement was the most typical manifestation (95.5%), and the crescent was the predominant pathological lesion (84.9%). The estimated glomerular filtration rate (eGFR) was evaluated in 114 patients, of whom 59.6% developed ESRD, and the median time to ESRD was 3.20 months. The eGFR [P = 0.006, odds ratio (OR) = 0.955, 95% confidence interval (CI) = 0.924-0.987] and the percentages of global glomerulosclerosis (pGGS; P = 0.018, OR = 1.060, 95% CI = 1.010-1.112) were independent risk factors for ESRD of renal biopsy. Based on the pGGS and eGFR at renal biopsy, we developed three risk grades of ESRD and one predictive model. The Kaplan‒Meier curve indicated that renal outcomes were significantly different in different risk grades (P < 0.001). Compared with serum creatinine at baseline, the predictive model had higher accuracy (0.86 versus 0.58, P < 0.001) and a lower coefficient of variation (0.07 versus 0.92) in external validation. CONCLUSIONS: Renal involvement is the most common manifestation of pediatric AAV in China, of which more than half deteriorates into ESRD. The predictive model based on eGFR at renal biopsy and the pGGS may be stable and accurate in speculating the risk of ESRD in AAV children. Supplementary file 2 (MP4 18937 KB).

5.
Alzheimers Res Ther ; 15(1): 17, 2023 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-36670424

RESUMEN

BACKGROUND: Neuroinflammatory factors, especially chemokines, have been widely reported to be involved in the pathogenesis of Alzheimer's disease (AD). It is unclear how chemokines are altered in AD, and whether dysregulation of chemokines is the cause, or the consequence, of the disease. METHODS: We initially screened the transcriptomic profiles of chemokines from publicly available datasets of brain tissues of AD patients and mouse models. Expression alteration of chemokines in the blood from AD patients was also measured to explore whether any chemokine might be used as a potential biomarker for AD. We further analyzed the association between the coding variants of chemokine genes and genetic susceptibility of AD by targeted sequencing of a Han Chinese case-control cohort. Mendelian randomization (MR) was performed to infer the causal association of chemokine dysregulation with AD development. RESULTS: Three chemokine genes (CCL5, CXCL1, and CXCL16) were consistently upregulated in brain tissues from AD patients and the mouse models and were positively correlated with Aß and tau pathology in AD mice. Peripheral blood mRNA expression of CXCL16 was upregulated in mild cognitive impairment (MCI) and AD patients, indicating the potential of CXCL16 as a biomarker for AD development. None of the coding variants within any chemokine gene conferred a genetic risk to AD. MR analysis confirmed a causal role of CCL5 dysregulation in AD mediated by trans-regulatory variants. CONCLUSIONS: In summary, we have provided transcriptomic and genomic evidence supporting an active role of dysregulated CXCL16 and CCL5 during AD development.


Asunto(s)
Enfermedad de Alzheimer , Animales , Ratones , Enfermedad de Alzheimer/patología , Biomarcadores , Quimiocina CXCL16/genética , Quimiocina CXCL16/metabolismo , Quimiocinas/genética , Genómica , Transcriptoma
6.
J Sep Sci ; 46(6): e2200803, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36661243

RESUMEN

Saponins extracted from Panax notoginseng leaves by methanol or water could be orally administrated for insomnia with very low bioavailability, which might be bio-converted by gut microbiota to generate potential bioactive products. Moreover, gut microbiota profiles from insomniac patients are very different from healthy subjects. We aimed to compare the metabolic characteristics and profiles of the two saponins extract by incubation with gut microbiota from insomniac patients. The ginsenosides, notoginsenosides, and metabolites were identified and relatively quantified by high-performance liquid chromatography-tandem mass spectrometry. Gut microbiota was profiled by 16S ribosomal RNA gene sequencing. The results showed that saponins were very different between methanol or water extract groups, which were metabolized by gut microbiota to generate similar yields. The main metabolites included ginsenoside Rd, ginsenoside F2 , ginsenoside C-Mc or ginsenoside C-Y, ginsenoside C-Mx, ginsenoside compound K, and protopanaxadiol in both groups, while gypenoside XVII, notoginsenoside Fe, ginsenoside Rd2 , and notoginsenoside Fd were the intermediates in the methanol group. Moreover, the microbial, Faecalibacterium prausnitzi, could bio-convert the saponins to obtain the corresponding metabolites. Our study implied that saponins extracted from P. notoginseng leaves by methanol or water could be used for insomniac patients due to gut microbiota biotransformation.


Asunto(s)
Microbioma Gastrointestinal , Ginsenósidos , Panax notoginseng , Panax , Saponinas , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Ginsenósidos/análisis , Panax notoginseng/química , Metanol , Saponinas/análisis , Hojas de la Planta/química , Biotransformación , Agua/análisis , Panax/química
7.
Neurobiol Aging ; 123: 170-181, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36437134

RESUMEN

Alzheimer's disease (AD) is the most common neurodegenerative disease with high heritability. Growth factors (GFs) might contribute to the development of AD due to their broad effects on neuronal system. We herein aimed to investigate the role of rare and common variants of GFs in genetic susceptibility of AD. We screened 23 GFs in 6324 individuals using targeted sequencing. A rare-variant-based burden test and common-variant-based single-site association analyses were performed to identify AD-associated GF genes and variants. The burden test showed an enrichment of rare missense variants (p = 6.08 × 10-4) in GF gene-set in AD patients. Among the GFs, EGF showed the strongest signal of enrichment, especially for loss-of-function variants (p = 0.0019). A common variant rs4698800 of EGF showed significant associations with AD risk (p = 3.24 × 10-5, OR = 1.26). The risk allele of rs4698800 was associated with an increased EGF expression, whereas EGF was indeed upregulated in AD brain. These findings suggested EGF as a novel risk gene for AD.


Asunto(s)
Enfermedad de Alzheimer , Enfermedades Neurodegenerativas , Humanos , Enfermedad de Alzheimer/genética , Factor de Crecimiento Epidérmico/genética , Pueblos del Este de Asia , Predisposición Genética a la Enfermedad/genética
9.
Mol Neurobiol ; 58(5): 1894-1903, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33404980

RESUMEN

Accumulating evidence demonstrated that GABAergic dysfunction contributes to the pathogenesis of Alzheimer's disease (AD). The GABA aminotransferase (ABAT) gene encodes a mitochondrial GABA transaminase and plays key roles in the biogenesis and metabolism of gamma-aminobutyric acid (GABA), which is a major inhibitory neurotransmitter. In this study, we performed an integrative study at the genetic and expression levels to investigate the potential genetic association between the ABAT gene and AD. Through re-analyzing data from the currently largest meta-analysis of AD genome-wide association study (GWAS), we identified genetic variants in the 3'-UTR of ABAT as the top AD-associated SNPs (P < 1 × 10-4) in this gene. Functional annotation of these AD-associated SNPs indicated that these SNPs are located in the regulatory regions of transcription factors or/and microRNAs. Expression quantitative trait loci (eQTL) analysis and luciferase reporter assay showed that the AD risk alleles of these SNPs were associated with a reduced expression level of ABAT. Further analysis of mRNA expression data and single-cell transcriptome data of AD patients showed that ABAT reduction in the neuron is an early event during AD development. Overall, our results indicated that ABAT genetic variants may be associated with AD through affecting its mRNA expression. An abnormal level of ABAT will lead to a disturbance of the GABAergic signal pathway in AD brains.


Asunto(s)
4-Aminobutirato Transaminasa/genética , Enfermedad de Alzheimer/genética , 4-Aminobutirato Transaminasa/metabolismo , Enfermedad de Alzheimer/metabolismo , Encéfalo/metabolismo , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Humanos , Polimorfismo de Nucleótido Simple , Sitios de Carácter Cuantitativo
10.
Clin Anat ; 33(2): 275-285, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31639237

RESUMEN

Controversies regarding structure and function of the pelvic floor persist because of its poor accessibility and complex anatomical architecture. Most data are based on dissection. This "surgical" approach requires profound prior knowledge, because applying the scalpel precludes a "second look." The "sectional" approach does not entail these limitations, but requires segmentation of structures and three-dimensional reconstruction. This approach has produced several "Visible Human Projects." We dealt with limited spatial resolution and difficult-to-segment structures by proceeding from clear-cut to more fuzzy boundaries and comparing segmentation between investigators. We observed that the bicipital levator ani muscle consisted of pubovisceral and puborectal portions; that the pubovisceral muscle formed, together with rectococcygeal and rectoperineal muscles, a rectal diaphragm; that the external anal sphincter consisted of its subcutaneous portion and the puborectal muscle only; that the striated urethral sphincter had three parts, of which the middle (urethral compressor) was best developed in females and the circular lower ("membranous") best in males; that the rectourethral muscle, an anterior extension of the rectal longitudinal smooth muscle, developed a fibrous node in its center (perineal body); that the perineal body was much better developed in females than males, so that the rectourethral subdivision into posterior rectoperineal and anterior deep perineal muscles was more obvious in females; that the superficial transverse perineal muscle attached to the fibrous septa of the ischioanal fat; and that the uterosacral ligaments and mesorectal fascia colocalized. To facilitate comprehension of the modified topography we provide interactive 3D-PDFs that are freely available for teaching purposes. Clin. Anat. 33:275-285, 2020. © 2019 Wiley Periodicals, Inc.


Asunto(s)
Anatomía/educación , Imagenología Tridimensional , Modelos Anatómicos , Diafragma Pélvico/anatomía & histología , Femenino , Humanos , Masculino
11.
J Anat ; 233(4): 447-459, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30051458

RESUMEN

The fibro-muscular architecture of the urogenital triangle remains contentious. Reasons are small size of the constituting structures and poor visibility with most imaging methods. We reinvestigated the area in serial sections of three males (21-38 years old) of the American and Chinese Visible Human Projects and two 26-week-old male fetuses, and compared the findings with earlier observations in females. The mass of the levator ani muscle was approximately twofold smaller and its funnel shape steeper in males than females. In the levator hiatus, a strand of the smooth longitudinal muscle layer of the rectum, the 'rectourethral (RU) muscle', extended anteriorly from the anorectal bend to the penile bulb. Fibrous tissue that formed in the inferior reach of the fetal RU muscle identified the location of the developing perineal body (PB) and divided the muscle into posterior 'rectoperineal' and anterior 'deep perineal' portions. In males, the PB remained small and bipartite, so that the RU muscle presented as an undivided midline structure. The well-developed female PB, instead, intertwined with the deep perineal muscle and both structures passed the vagina bilaterally to form the perineal membrane in the posterior portion of the urogenital triangle. The urethral rhabdosphincter extended in the anterior portion of the urogenital triangle between the penile bulb inferiorly and the bladder neck superiorly, and consisted of a well-developed circular 'membranous' portion with bilateral posteroinferior 'wings' and a thinner 'prostatic' portion on the prostate anterior side. In men, muscles occupy the urogenital triangle, but additional tightening of the locally fibrous adipose tissue by the superficial transverse perineal muscle appears necessary to generate functional support in women. An interactive 3D pdf file with these anatomical details (available online) should allow more accurate interpretation of ultrasound, computed tomography and magnetic resonance images.


Asunto(s)
Diafragma Pélvico/anatomía & histología , Caracteres Sexuales , Adulto , Femenino , Humanos , Masculino , Adulto Joven
12.
Clin Biomech (Bristol, Avon) ; 50: 130-138, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29100186

RESUMEN

BACKGROUND: Operative level is a potential biomechanical risk factor for construct failure during anterior fixation for distractive flexion injury. No biomechanical study of this concept has been reported, although it is important in clinical management. METHODS: To explore the mechanism of this concept, a previously validated three-dimensional C2-T1 finite element model was modified to simulate surgical procedure via the anterior approach for treating single-level distractive flexion injury, from C2-C3 to C7-T1. Four loading conditions were used including no-compression, follower load, axial load, and combined load. Construct stability at the operative level was assessed. FINDINGS: Under these loading conditions with the head's weight simulated, segmental stability decreases when the operative level shifts cephalocaudally, especially at C6-C7 and C7-T1, the stress of screw-bone interface increases cephalocaudally, and in the same operative level, the caudal screws always carries more load than the cephalad ones. All these predicted results are consistent with failure patterns observed in clinical reports. In the contrast, under other loading conditions without the weight of head, no obvious segmental divergence was predicted. INTERPRETATION: This study supports that the biomechanical mechanism of this phenomenon includes eccentric load from head weight during sagittal movements and difference of moment arms. Our study suggests that anterior fixation is not recommended for treating distractive flexion injury at the caudal segments of the subaxial cervical spine, especially at C6-C7 and C7-T1, because of the intrinsic instability in these segments. Combined posterior rigid fixation with anterior fixation should be considered for these segments.


Asunto(s)
Tornillos Óseos , Vértebras Cervicales/lesiones , Falla de Equipo , Fijación Interna de Fracturas/métodos , Fusión Vertebral/instrumentación , Fenómenos Biomecánicos , Biofisica , Femenino , Análisis de Elementos Finitos , Humanos , Movimiento/fisiología , Rigidez Muscular , Rango del Movimiento Articular/fisiología , Procedimientos de Cirugía Plástica , Adulto Joven
13.
J Anat ; 230(5): 651-663, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28299781

RESUMEN

The pelvic floor guards the passage of the pelvic organs to the exterior. The near-epidemic prevalence of incontinence in women continues to generate interest in the functional anatomy of the pelvic floor. However, due to its complex architecture and poor accessibility, the classical 'dissectional' approach has been unable to come up with a satisfactory description, so that many aspects of its anatomy continue to raise debate. For this reason, we opted for a 'sectional' approach, using the Chinese Visible Human project (four females, 21-35 years) and the Visible Human Project (USA; one female, 59 years) datasets to investigate age-related changes in the architecture of the anterior and middle compartments of the pelvic floor. The puborectal component of the levator ani muscle defined the levator hiatus boundary. The urethral sphincter complex consisted of a circular proximal portion (urethral sphincter proper), a sling that passed on the vaginal wall laterally to attach to the puborectal muscle (urethral compressor), and a circular portion that surrounded the distal urethra and vagina (urethrovaginal sphincter). The exclusive attachment of the urethral sphincter to soft tissues implies dependence on pelvic-floor integrity for optimal function. The vagina was circular at the introitus and gradually flattened between bladder and rectum. Well-developed fibrous tissue connected the inferior vaginal wall with urethra, rectum and pelvic floor. With eight-muscle insertions, the perineal body was a strong, irregular fibrous node that guarded the levator hiatus. Only loose areolar tissue comprising a remarkably well developed venous plexus connecting the middle and superior parts of the vagina with the lateral pelvic wall. The posterolateral boundary of the putative cardinal and sacrouterine ligaments coincided with the adventitia surrounding the mesorectum. The major difference between the young-adult and postmenopausal pelvic floor was the expansion of fat in between the components of the pelvic floor. We hypothesize that accumulation of pelvic fat compromises pelvic-floor cohesion, because the pre-pubertal pelvis contains very little fibrous and adipose tissue, and fat is an excellent lubricant.


Asunto(s)
Envejecimiento/fisiología , Diafragma Pélvico/anatomía & histología , Diafragma Pélvico/fisiología , Posmenopausia/fisiología , Adulto , Femenino , Humanos , Ligamentos/anatomía & histología , Ligamentos/fisiología , Persona de Mediana Edad , Uretra/anatomía & histología , Uretra/fisiología , Vagina/anatomía & histología , Vagina/fisiología , Adulto Joven
14.
J Biomech ; 49(13): 2854-2862, 2016 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-27457429

RESUMEN

The uncovertebral joint (UJ) is an important load-bearing structure in the subaxial cervical spine (SCS) and the medial wall of the intervertebral foramen (IVF). To investigate the UJ׳s role in load distribution and transmission under physiological loading, we developed and validated a detailed finite element model (C2-T1). Based on the initial model, two additional models were modified to simulate surgical resection and degeneration of UJs, to evaluate their influence on SCS kinematics and load distribution. The three models were subjected to 2Nm pure moment (flexion, extension, lateral bending, and axial rotation). Foraminal narrowing and potential nerve compression were evaluated. In the initial model, contact forces provided by the UJ were apparent in lateral bending and axial rotation. In axial rotation, the UJs and contralateral facet joints participated in joint activity, implying a possible restraint/counterbalance mechanism of these two joints. Peak vertebral stress was observed in the pedicle of vertebrae and was higher in the uncovertebral region than in the facet region. Resection of uncinate processes led to an apparent range of motion increase in lateral bending and axial rotation, while sagittal kinematics is influenced slightly. The load on other structures was slightly increased, but in axial rotation, resection of UJs changed the load distribution pattern. Degeneration of UJs significantly increased SCS stiffness and shielded other load-bearing structures. Peak IVF narrowing, but no nerve compression, was observed in axial rotation of the resection model. Thus, resection did not induce apparent secondary foraminal stenosis when other structures were still functional.


Asunto(s)
Vértebras Cervicales/fisiología , Vértebras Cervicales/fisiopatología , Análisis de Elementos Finitos , Degeneración del Disco Intervertebral/fisiopatología , Articulaciones/fisiología , Articulaciones/cirugía , Fenómenos Biomecánicos , Femenino , Humanos , Articulaciones/fisiopatología , Presión , Rango del Movimiento Articular , Rotación , Soporte de Peso , Adulto Joven
16.
PLoS One ; 10(8): e0132226, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26305117

RESUMEN

BACKGROUND: Pelvic-floor anatomy is usually studied by artifact-prone dissection or imaging, which requires prior anatomical knowledge. We used the serial-section approach to settle contentious issues and an interactive 3D-pdf to make the results widely accessible. METHOD: 3D reconstructions of undeformed thin serial anatomical sections of 4 females and 2 males (21-35y) of the Chinese Visible Human database. FINDINGS: Based on tendinous septa and muscle-fiber orientation as segmentation guides, the anal-sphincter complex (ASC) comprised the subcutaneous external anal sphincter (EAS) and the U-shaped puborectal muscle, a part of the levator ani muscle (LAM). The anococcygeal ligament fixed the EAS to the coccygeal bone. The puborectal-muscle loops, which define the levator hiatus, passed around the anorectal junction and inserted anteriorly on the perineal body and pubic bone. The LAM had a common anterior attachment to the pubic bone, but separated posteriorly into puborectal and "pubovisceral" muscles. This pubovisceral muscle was bilayered: its internal layer attached to the conjoint longitudinal muscle of the rectum and the rectococcygeal fascia, while its outer, patchy layer reinforced the inner layer. ASC contraction makes the ano-rectal bend more acute and lifts the pelvic floor. Extensions of the rectal longitudinal smooth muscle to the coccygeal bone (rectococcygeal muscle), perineal body (rectoperineal muscle), and endopelvic fascia (conjoint longitudinal and pubovisceral muscles) formed a "diaphragm" at the inferior boundary of the mesorectum that suspended the anorectal junction. Its contraction should straighten the anorectal bend. CONCLUSION: The serial-section approach settled contentious topographic issues of the pelvic floor. We propose that the ASC is involved in continence and the rectal diaphragm in defecation.


Asunto(s)
Canal Anal/patología , Canal Anal/cirugía , Imagenología Tridimensional , Procedimientos de Cirugía Plástica/métodos , Femenino , Humanos , Masculino , Músculos/cirugía , Perineo/cirugía , Recto/patología , Adulto Joven
17.
Chin Med J (Engl) ; 126(23): 4417-22, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24286399

RESUMEN

BACKGROUND: During scanning of the right hypochondrium and right intercostal regions with an ultrasonic transducer, several ultrasonic images of oblique sections are obtained. It is still a challenge for ultrasonography to divide these non-conventional sections into an accurate hepatic segmentation pattern. The aim of this research was to investigate the value of the virtual hepatic segment model (VHSM) in assisting the ultrasonic localization of space-occupying hepatic lesions. METHODS: VHSM was constructed via 3D reconstruction according to the first Chinese visible human dataset. Preoperative ultrasonography, contrast-enhanced CT scan and VHSM techniques were performed in 100 patients with space-occupying focal lesions in the liver parenchyma for segmental localization. The results of these three techniques were compared with the operative findings. RESULTS: VHSM was successfully detected on 2D sectional images by 3D reconstruction through surface rendering and volume rendering. The model could simulate ultrasonic directions to conduct a virtual dissection on any section plane, and fine liver segmentation could be displayed in any virtual plane. In 100 patients, there were 112 liver space-occupying focal lesions distributed in 148 liver segmentations. Regarding the positioning accuracies for lesions of different sizes and the lesion segmental distribution accuracies estimated using the three methods mentioned above, ultrasonography exhibited a significantly lower accuracy than VHSM for the segmental localization of lesions (P < 0.05), and contrast-enhanced CT was not significantly different from ultrasonography plus VHSM (P > 0.05). CONCLUSION: VHSM increased the accuracy of ultrasonic localization of space-occupying hepatic lesions, particularly in hepatic hypovascular regions.


Asunto(s)
Simulación por Computador , Hígado/diagnóstico por imagen , Hígado/patología , Humanos , Radiografía , Ultrasonografía
18.
Exp Ther Med ; 6(2): 606-610, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24137235

RESUMEN

The aim of this study was to distinguish the individual bundles of the anterior cruciate ligament (ACL) using the Chinese Visible Human (CVH) dataset and images obtained by low-field routine magnetic resonance imaging (MRI) in the oblique and coronal planes. Sectional anatomical data of the knee were selected from the CVH dataset and reconstructed in 3D. MRI of normal knees was performed with a low-field-strength magnet in the coronal plane. The shape of the ACL was clearly displayed. Using the oblique coronal plane, the anteromedial (AM) and posterolateral (PL) bundles of the ACL were distinguished in the reconstructed anatomical data and the MR images. The double-bundle structure of the ACL was evaluated in the CVH 3D reconstructions and MR images. Using the oblique coronal plane, it was possible to review the ACL structure in the knee. The study demonstrated the feasibility of distinguishing the two bundles in the ACL with CVH 3D reconstruction and low-field strength MRI. The accuracy in the grading of ACL injury in presurgical planning may be improved.

19.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 28(4): 274-7, 2012 Jul.
Artículo en Chino | MEDLINE | ID: mdl-23173424

RESUMEN

OBJECTIVE: To evaluate the feasibility of 3-Dimensional (3-D) model reconstruction of penis and surrounding structures based on magnetic resonance images, which may provide the model building method for modeling surgery of individual penoplasty. METHODS: Magnetic resonance (MR) images of penis with different imaging parameters were evaluated. With the surface rendering construction, the 3D virtual model was established by Amira software. RESULTS: The anatomical details imaging is better in T2-weighted fast spin-echo images with 3.0 mm slice thickness. The established model based on the MR images can show the soft-tissue, suspensory ligament of the penis. The suspensory ligament stretches between the pubic symphysis and the corpora cavernosa. The penile roots attach to inferior ramus of pubis. CONCLUSIONS: MR imaging provides enough anatomical information for modeling. It can be used for the development of model surgery system of individual penoplasty.


Asunto(s)
Modelos Anatómicos , Pene/anatomía & histología , Adulto , Humanos , Imagenología Tridimensional , Imagen por Resonancia Magnética , Masculino
20.
Comput Med Imaging Graph ; 36(4): 336-42, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22391063

RESUMEN

OBJECTIVE: Segmentation is a necessary step when creating realistic three-dimensional (3D) models. In order to build 3D models of whole body structures and have a wider lateral application, the thin sectional anatomical images of the Chinese Visible Human (CVH) dataset should be segmented. The more detailed structures are segmented to provide greater potential for wider application of the segmented images. MATERIALS AND METHODS: All the images based on the CVH male and female dataset were segmented semi-automatically using PHOTOSHOP software. This research lasted about 7 years. RESULT: In this study, 869 structures of CVH male and 860 structures of CVH female were semi-automatically segmented, and the formats for the segmented color-filled image data were PSD and PNG. In these segmented structures, nearly all skeletal muscles included muscle belly and tendon, and hollow organs included their organ walls and their lumen. Most nerve trunks, small arteries, lymph nodes, and lymph ducts were also segmented. Many surface-rendering and volume-rendering organ models were created using these segmented images. CONCLUSION: The CVH male and female images represent the normal Asian population. After segmentation, the images can be reconstructed directly in 3D and greatly facilitate the biological modeling of physical and physiological information, a great help in improving medical and biological science in China.


Asunto(s)
Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional/métodos , Proyectos Humanos Visibles , Anatomía Transversal , Cadáver , China , Femenino , Humanos , Masculino , Programas Informáticos
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