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1.
Am J Orthod Dentofacial Orthop ; 159(1): e49-e58, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33357762

RESUMO

INTRODUCTION: The midsagittal plane (MSP) is the foundation for 3-dimensional (3D) cephalometric analyses. This article aimed to provide a protocol to construct a reliable and accurate MSP for 3D cephalometric craniofacial analysis. METHODS: Cone-beam computed tomography data of 16 adult patients without obvious bilateral asymmetry were collected. The model of the anterior cranial base and sphenoid bone was constructed, and the candidate MSP was determined on the basis of the symmetry of this model. Intraclass correlation coefficients were used to assess intra- and interexaminer reliability of the candidate MSP. To investigate the accuracy of this candidate MSP, we constructed a true plane of symmetry of craniomaxillofacial structure and a control plane on the basis of 3 cranial midline points. We then compared these with the candidate MSP. RESULTS: This candidate MSP resembled the true plane of symmetry with all the mean absolute errors <1 mm, and all the absolute errors for the candidate MSP were significantly smaller than the control plane (P ≤0.002). The relative intra- and interexaminer reliability for this candidate MSP was almost perfect (intraclass correlation coefficients >0.9). CONCLUSIONS: The candidate MSP constructed using this method was thought to be reliable and accurate for 3D cephalometric analysis in patients without obvious cranial asymmetry.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Imageamento Tridimensional , Adulto , Pontos de Referência Anatômicos/diagnóstico por imagem , Cefalometria , Humanos , Reprodutibilidade dos Testes , Base do Crânio/diagnóstico por imagem
2.
Plast Reconstr Surg ; 146(6): 1268-1273, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33234956

RESUMO

Upper eyelid ptosis correction is a complex procedure. The ethnic differences in the Asian upper eyelid anatomy are compounded by the technical challenges of primary and revision ptosis correction. The authors present a technique of upper eyelid ptosis correction that estimates the exact location of suture fixation that uses the musculoaponeurotic junction of the levator as the reference point. The preoperative considerations in determining the fixation point relative to the musculoaponeurotic junction include the following: A, the extent of ptosis correction needed; B, the degree of compensatory brow elevation with eye opening; and C, eye dominance. The benefits of this approach are the shortened operative time because of more precise preoperative planning and greater predictability and reproducibility of the results. The authors have found that this technique produced consistent and superior results for ptosis correction in Asian patients.


Assuntos
Blefaroplastia/métodos , Blefaroptose/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Sistema Musculoaponeurótico Superficial/anatomia & histologia , Pontos de Referência Anatômicos , Grupo com Ancestrais do Continente Asiático , Pálpebras/anatomia & histologia , Pálpebras/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Músculos Oculomotores/anatomia & histologia , Músculos Oculomotores/cirurgia , Planejamento de Assistência ao Paciente , Complicações Pós-Operatórias/etiologia , Cuidados Pré-Operatórios/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sistema Musculoaponeurótico Superficial/cirurgia , Resultado do Tratamento , Adulto Jovem
3.
BMC Oral Health ; 20(1): 270, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028287

RESUMO

BACKGROUND: Despite the integral role of cephalometric analysis in orthodontics, there have been limitations regarding the reliability, accuracy, etc. of cephalometric landmarks tracing. Attempts on developing automatic plotting systems have continuously been made but they are insufficient for clinical applications due to low reliability of specific landmarks. In this study, we aimed to develop a novel framework for locating cephalometric landmarks with confidence regions using Bayesian Convolutional Neural Networks (BCNN). METHODS: We have trained our model with the dataset from the ISBI 2015 grand challenge in dental X-ray image analysis. The overall algorithm consisted of a region of interest (ROI) extraction of landmarks and landmarks estimation considering uncertainty. Prediction data produced from the Bayesian model has been dealt with post-processing methods with respect to pixel probabilities and uncertainties. RESULTS: Our framework showed a mean landmark error (LE) of 1.53 ± 1.74 mm and achieved a successful detection rate (SDR) of 82.11, 92.28 and 95.95%, respectively, in the 2, 3, and 4 mm range. Especially, the most erroneous point in preceding studies, Gonion, reduced nearly halves of its error compared to the others. Additionally, our results demonstrated significantly higher performance in identifying anatomical abnormalities. By providing confidence regions (95%) that consider uncertainty, our framework can provide clinical convenience and contribute to making better decisions. CONCLUSION: Our framework provides cephalometric landmarks and their confidence regions, which could be used as a computer-aided diagnosis tool and education.


Assuntos
Processamento de Imagem Assistida por Computador , Redes Neurais de Computação , Pontos de Referência Anatômicos/diagnóstico por imagem , Teorema de Bayes , Cefalometria , Reprodutibilidade dos Testes
4.
PLoS One ; 15(10): e0240328, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031413

RESUMO

Modern day investigation in fields of archaeology and palaeontology can be greatly characterised by an exponential growth of integrated new technologies, nevertheless, while these advances are of great significance to multiple lines of research, their evaluation and update over time is equally as important. Here we present an application of inter and intra-observer analysis in taphonomy based geometric morphometrics, employing robust non-parametric statistical analyses for the study of experimental carnivore tooth pit morphologies. To fully understand the influence of measurement errors in the collection of this data, our statistical assessment was performed on fully superimposed, partially superimposed and raw landmark coordinates collected from 3D surface scanning. Experimental samples used to assess these errors includes wolf and dog tooth pits used in modern day ecological livestock predation analysis. Results obtained from this study highlight the importance of landmark type in the assessment of error, emphasising the value of semi-landmark models over the use of ambiguous Type III landmarks. In addition to this, data also reveals the importance of observer experience for the collection of data alongside an interesting increase in error when working with fully superimposed landmarks due to the "Pinocchio Effect". Through this study we are able to redefine the geometric morphometric models used for tooth pit morphological analyses. This final hybrid Type II fixed landmark and semi-landmark model presents a significant reduction in human induced error, generating a more metrically reliable and replicable method that can be used for data pooling in future inter-institutional research. These results can be considered a fundamental step forward for carnivore inspired studies, having an impact on archaeological, palaeontological, modern-day ecological research as well as applications in other forensic sciences.


Assuntos
Antropometria/métodos , Dente/anatomia & histologia , Pontos de Referência Anatômicos/anatomia & histologia , Animais , Arqueologia , Cães , Imageamento Tridimensional , Análise de Componente Principal
5.
Laryngoscope ; 130 Suppl 6: S1-S17, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32865822

RESUMO

OBJECTIVES: In 2009, the Food and Drug Administration approved the use of the surgical robotic system for removal of benign and malignant conditions of the upper aerodigestive tract. This novel application of robotic-assisted surgery, termed transoral robotic surgery (TORS), places robotic instruments and camera system through the mouth to reach recessed areas of the pharynx and larynx. Over the successive decade, there was a rapid adoption of TORS with a surgical growth rate that continues to increase. Despite the rapid clinical acceptance, the field of TORS has not yet seen substantive changes or advances in the technical shortcomings, the lack of which has restricted objective TORS-specific surgical skills assessment as well as subsequent skills improvement efforts. One of the primary technical challenges of TORS is operating in a confined space, where the robotic system is maneuvered within the restrictive boundaries of the mouth and throat. Due to these confined boundaries of the pharynx, instruments can frequently collide with anatomic structures such as teeth and bone, producing anatomic collisions. Therefore, we hypothesized that anatomic collisions negatively impact TORS surgical performance. Secondarily, we hypothesized that avoidance of unwanted anatomic collisions could improve TORS surgical proficiency. METHODS: Design and fidelity testing for a custom TORS training platform with an integrated anatomic collision-sensing system providing real-time tactile feedback is described. Following successful platform assembly and testing, validation study using the platform was carried through prospective surgical training with trial randomization. Twenty otolaryngology-head and neck surgery residents, each trainee performing three discrete mock surgical trials (n = 60), performed the initial system validation. Ten of the 20 residents were randomized to perform the surgical trials utilizing the real-time feedback system. The remaining 10 residents were randomized to perform the surgical trials without the feedback system, although the system still could record collision data. Surgical proficiency was measured by Global Evaluative Assessment of Robotic Skills (GEARS) score, time to completion, and tumor resection scores (categorical scale ranging 0-3, describing the adequacy of resection). RESULTS: Major anatomic collisions (greater than 5N of force) negatively affected GEARS robotic skills. A mixed model analysis demonstrated that for every additional occurrence of a major collision, GEARS robotic skills assessment score would decrease by 0.29 points (P = .04). Real-time collision awareness created significantly fewer major (> 5 N) anatomic collisions with the tactile feedback system active (n = 30, mean collisions = 2.9 ± 4.2) as compared with trials without tactile feedback (n = 30, mean collisions = 12.53 ± 23.23) (P < .001). The second assessment measure of time to completion was unaffected by the presence of collisions or by the use of tactile feedback system. The third proficiency assessment was measured with tumor resection grading. Tumor resection scores was significantly (P = .02) improved with collision awareness system activated than trials without collision awareness. CONCLUSION: In order to test our primary hypothesis, a novel TORS training platform was successfully developed that provides collision force measurements including frequency, severity, and duration of anatomic collisions. Additionally, the platform was modulated to provide real-time tactile feedback of the occurrence of out-of-field collisions. Utilizing this custom platform, our hypothesis that anatomic collisions during TORS diminishes surgical performance was supported. Additionally, our secondary hypothesis that subsequent reduction of anatomic collisions improves TORS proficiency was supported by the surgical trial. Dedicated investigation to characterize the effect size and clinical impact is required in order to translate this finding into training curriculums and into clinical utilization. LEVEL OF EVIDENCE: II (Randomized trial) Laryngoscope, 130:S1-S17, 2020.


Assuntos
Pontos de Referência Anatômicos/cirurgia , Complicações Intraoperatórias/prevenção & controle , Boca/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Cirurgia Assistida por Computador/métodos , Pontos de Referência Anatômicos/lesões , Competência Clínica , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Complicações Intraoperatórias/etiologia , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Cirurgia Endoscópica por Orifício Natural/educação , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/educação
7.
Medicine (Baltimore) ; 99(31): e21475, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756171

RESUMO

RATIONALE: Typically, the tendon of the pectoralis major inserts into the crest of the greater tubercle of the humerus. However, anomalous insertion sites of the pectoralis major tendons have been noted. PATIENT CONCERNS: The cadaver of a 95-year-old Japanese man was selected from the bodies used for gross anatomy practice at the Tokai University School of Medicine in 2018. DIAGNOSIS: In this cadaver, the left side of the pectoralis major tendon appeared to insert at the crest of the greater tubercle and lesser tubercle of the humerus, forming a tunnel measuring 2.5 cm in total length. INTERVENTION: We removed the fat and skin around the shoulder joint and upper extremity for observational purposes and carefully examined the structures during gross anatomy. OUTCOMES: The medial side of the insertion of the pectoralis major tendon was not into the humerus but had combined with the tendon of the latissimus dorsi, which then loosely inserted into the humerus. As the roof and both walls comprised the tendon of the pectoralis major and the floor was formed by the tendon of the latissimus dorsi and humerus, the structure formed a tunnel. LESSONS: This study is important for orthopedic and rehabilitation physicians in treating diseases of the long head of the biceps brachii tendon. As part of management, the condition of the tendon of the pectoralis major should be confirmed using magnetic resonance imaging or echocardiography.


Assuntos
Músculos Peitorais/anatomia & histologia , Músculos Superficiais do Dorso/anatomia & histologia , Tendões/anormalidades , Idoso de 80 Anos ou mais , Pontos de Referência Anatômicos , Cadáver , Dissecação , Humanos , Masculino
8.
BMC Cardiovasc Disord ; 20(1): 377, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32811431

RESUMO

BACKGROUND: Recently, left bundle branch area pacing (LBBAP) has been shown to be feasible. However, the right ventricular (RV) implantation site for LBBAP remains elusive. We believe that the RV implantation site should be located at the posteromedial basal septum, and in this paper, we propose a new method to help guide lead implantation. The aim of this study is to demonstrate the feasibility of the proposed method. METHODS: The RV implantation site was positioned by a combination of a nine-grid system on fluoroscopy and the use of intracardiac echocardiogram (ICE) and then verified by ICE. RESULTS: Fifteen patients were enrolled for LBBAP using our method. The acute success rate was 86.7% (13/15), which demonstrated that our method is useful for assisting with lead implantation. According to ICE, the distance between the implantation site and apex (the front) and the distance between the implantation site and tricuspid annulus (the back) were 44.9 ± 10.7 and 33.2 ± 10.4 mm, respectively, and the ratio of the front and the back was 1.57 ± 0.80. The distance between the implantation site and the front junction point of the left-right ventricle (the upper) and the distance between the implantation site and the back junction point (the lower) were 33.4 ± 10.6 and 24.5 ± 10.2 mm, respectively. The ratio of the upper to the lower was 1.76 ± 1.36. These results suggest that the implantation site was at the posteromedial basal septum. The width of the QRS duration increased from 110.4 ± 33.1 ms at baseline to 114.1 ± 16.1 ms post LBBAP (P > 0.05). The operation time was 133 ± 32.9 min. The time of X-ray fluoroscopy was 21.2 ± 5.9 min. The mean time for lead positioning during LBBAP was 33.8 ± 16.6 min. During a follow-up of 3 months, the LBB capture threshold remained stable in 12 patients, except for one patient who had an increase in the LBB capture threshold to 3.0 v/0.4 ms. CONCLUSIONS: Our preliminary results indicate that the posteromedial basal septum could be seen as the implantation site for LBBAP. As a technique for LBBAP, ICE is a useful method for assisting with lead implantation. It is feasible and safe to use a nine-grid system combined with ICE for LBBAP.


Assuntos
Potenciais de Ação , Fascículo Atrioventricular/diagnóstico por imagem , Bloqueio de Ramo/terapia , Estimulação Cardíaca Artificial , Ecocardiografia , Frequência Cardíaca , Ventrículos do Coração/diagnóstico por imagem , Marca-Passo Artificial , Adulto , Idoso , Idoso de 80 Anos ou mais , Pontos de Referência Anatômicos , Fascículo Atrioventricular/fisiopatologia , Bloqueio de Ramo/diagnóstico por imagem , Bloqueio de Ramo/fisiopatologia , Estudos de Viabilidade , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Resultado do Tratamento
9.
BMC Cardiovasc Disord ; 20(1): 383, 2020 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-32838758

RESUMO

BACKGROUND: Variability in the anatomy and orientation of the triangle of Koch (TK) complicates ablation procedures involving the atrioventricular (AV) node. We used CT angiography (CTA) to assess the anatomical TK orientation, the CS ostium direction, and the relationship between the two, and we validated an individualized CS-guided projection during ablation procedures. METHODS: In 104 patients without structural heart disease undergoing computed tomography (CT) angiography, TK orientations were determined in relation to the coronary sinus ostium (CSo) as well as two standard right anterior oblique (RAO) projection angles (30o and 45o) commonly used in ablation procedures. RESULTS: A CS-guided RAO projection (RAOCS) was shown to best track the orientation of the TK compared to RAO30° and 45°, with TK orientation strongly correlating with the CSo direction (r = 0.86, P < 0.001). In addition, the mean relative difference between the angle of the CSo and TK orientation was 5.54 ± 0.48°, consistent with a reduction in the degree of image shortening compared to traditional RAOs. Moreover, in vivo validation following ablation revealed that using a CS-guided projection limited the degree of on-screen image shortening compared to both the RAO30° and 45° in 25 patients with catheter ablation procedures. CONCLUSION: In hearts with a normal structure, the CSo direction offers a reliable predictor of the TK orientation which can be used to guide the projection of the TK during ablation procedures.


Assuntos
Fibrilação Atrial/diagnóstico por imagem , Nó Atrioventricular/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Seio Coronário/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Taquicardia por Reentrada no Nó Atrioventricular/diagnóstico por imagem , Adulto , Idoso , Pontos de Referência Anatômicos , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/cirurgia , Nó Atrioventricular/fisiopatologia , Nó Atrioventricular/cirurgia , Ablação por Cateter , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Taquicardia por Reentrada no Nó Atrioventricular/fisiopatologia , Taquicardia por Reentrada no Nó Atrioventricular/cirurgia , Resultado do Tratamento
11.
Sci Rep ; 10(1): 13059, 2020 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-32747744

RESUMO

We design a framework based on Mask Region-based Convolutional Neural Network to automatically detect and separately extract anatomical components of mosquitoes-thorax, wings, abdomen and legs from images. Our training dataset consisted of 1500 smartphone images of nine mosquito species trapped in Florida. In the proposed technique, the first step is to detect anatomical components within a mosquito image. Then, we localize and classify the extracted anatomical components, while simultaneously adding a branch in the neural network architecture to segment pixels containing only the anatomical components. Evaluation results are favorable. To evaluate generality, we test our architecture trained only with mosquito images on bumblebee images. We again reveal favorable results, particularly in extracting wings. Our techniques in this paper have practical applications in public health, taxonomy and citizen-science efforts.


Assuntos
Culicidae/anatomia & histologia , Processamento de Imagem Assistida por Computador , Redes Neurais de Computação , Pontos de Referência Anatômicos , Animais , Abelhas/anatomia & histologia , Reprodutibilidade dos Testes
12.
Leg Med (Tokyo) ; 47: 101773, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32810795

RESUMO

Sex estimation is the keystone for positive identification when an unidentified human body is recovered in forensic contexts. However, in complex death scenes such as mass disasters, the remains are often fleshed, mutilated, burned, and/or commingled. In situations such as these where it is not possible to analyze pelvis and/or cranium data, traditional metric and qualitative morphological methods on postcranial bones can yield unsatisfactory results. In such cases, geometric morphometric techniques offer an alternative to the analysis of both shape and size components of morphological variation that can be of great utility for sex estimation in forensic investigations. The study population consisted of 72 well-preserved adult humeri (40 males and 32 females; mean age of 62 years) that were photographed in standardized positions with landmarks located in four two-dimensional views of the humerus (anterior surface of the proximal epiphysis, and anterior, posterior and inferior surface of distal epiphysis). Principal components analysis, canonical variates analysis and discriminant analysis were applied. The data indicated that males and females were classified with low levels of accuracy (54.95-77.92% for males; 56.87-71.78% for females) based on shape variables. However, when the shape variable was combined with the centroid size, the levels of accuracy increased (81.86-94.92% for males; 84.08-94.88% for females). To obtain larger differences between males and females, it is necessary the combination of centroid size with shape variables; the shape of the humerus is insufficient to discriminate sex with accuracy.


Assuntos
Restos Mortais , Antropologia Forense/métodos , Úmero/anatomia & histologia , Determinação do Sexo pelo Esqueleto/métodos , Pontos de Referência Anatômicos/anatomia & histologia , Análise Discriminante , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultados Negativos , Análise de Componente Principal , Sensibilidade e Especificidade
14.
Medicine (Baltimore) ; 99(28): e21252, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664180

RESUMO

Laparoscopic surgery performed through a single incision is relatively new. Here, we investigated the importance of radiological anatomical evaluation of the umbilicus prior to such surgery.Umbilical images of 500 patients who underwent computed tomography (CT) in 2019 were evaluated retrospectively, using both transverse and sagittal sections.Spearman rank correlation analysis indicated a significant positive relationship between age and the sagittal and transverse umbilical measurements (all patients: P < .01; men: P = .001; women: P < .01). Mean transverse and sagittal measurements were 5.63 ±â€Š1.9 and 6.2 ±â€Š2.0 mm in women and 5.49 ±â€Š1.9 and 6.2 ±â€Š1.8 mm in men.Umbilical anatomy can be evaluated radiologically as a component of preoperative evaluation.


Assuntos
Pontos de Referência Anatômicos/diagnóstico por imagem , Laparoscopia/métodos , Cuidados Pré-Operatórios/métodos , Tomografia Computadorizada por Raios X , Umbigo/diagnóstico por imagem , Adolescente , Adulto , Pontos de Referência Anatômicos/anatomia & histologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Umbigo/anatomia & histologia , Adulto Jovem
15.
Int J Surg ; 80: 168-174, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32650119

RESUMO

BACKGROUND: The diversity in definitions for the rectosigmoid junction is becoming a major obstacle in standardizing optimal treatment of rectal cancers. The study aimed to determine the average distance of the sigmoid take-off from the anal verge and its association with individual factors. MATERIALS AND METHODS: Patients diagnosed with rectal and sigmoid colon cancer in our centre from January 2010 to December 2018 were retrospectively enrolled in the cancer group. The results of 200 controls without colorectal disease were also reviewed (normal group). The distance of different landmarks and margins of cancer from the anal verge were retrieved from computed tomography (CT), magnetic resonance imaging (MRI), and endoscopy findings. RESULTS: The cancer group comprised 635 patients (381 men, median age: 64 years). The average distances of the sigmoid take-off from the anal verge measured in CT and MRI were comparable (P = 0.483). On MRI, the average distance of the sigmoid take-off from the anal verge in the cancer group was comparable with that of the normal group (P = 0.070). Multivariate regression revealed that the distance of the sigmoid take-off from the anal verge was associated with the distances of the sacral promontory (P < 0.001) and peritoneal reflection (P < 0.001) from the anal verge. CONCLUSION: The cancer distributions of patients varied widely with the application of different definitions. The point of sigmoid take-off is an intuitive landmark influenced by individual factors. The measurement of the sigmoid take-off by different researchers in both CT and MRI revealed good consistency. Further studies regarding the clinical significance of this definition are still needed.


Assuntos
Canal Anal/patologia , Pontos de Referência Anatômicos/patologia , Colo Sigmoide/patologia , Neoplasias Retais/patologia , Reto/patologia , Neoplasias do Colo Sigmoide/patologia , Canal Anal/diagnóstico por imagem , Canal Anal/cirurgia , Pontos de Referência Anatômicos/diagnóstico por imagem , Colo Sigmoide/diagnóstico por imagem , Colo Sigmoide/cirurgia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/cirurgia , Reto/diagnóstico por imagem , Reto/cirurgia , Análise de Regressão , Estudos Retrospectivos , Neoplasias do Colo Sigmoide/diagnóstico por imagem , Neoplasias do Colo Sigmoide/cirurgia , Tomografia Computadorizada por Raios X
16.
J Hand Surg Asian Pac Vol ; 25(3): 388-392, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32723051

RESUMO

The conventional hand tendon zones and subzones do not reflect the actual lengths covered by the involved locus of the tendon during full digital and wrist motion, which warrant reappraisal of the tendon zone concept. Because of the tendon excursions many lacerations should be regarded as multiple zone injuries. Furthermore, the length-spans of glide of the distal tendon stump and of the tendon junction (i.e. the glide zones of tendon injury and repair, respectively) are mostly not of the same length because, due to pulley release and bulkiness of the tenorrhaphy, the glide zone of tendon repair is shorter than that of tendon injury. Therefore, it would be practical to notate the glide zones of the lacerated tendon by indicating the anatomic position of the distal tendon stump and tendon junction in full extension and flexion. This data can be provided separately or along with the conventional tendon zones, e.g. II (A4-C2) or II-III (A2-PA), where A, C, and PA stand for the annular, cruciform, and palmar aponeurosis pulleys, respectively. The conventional tendon zone classification could be improved with a tendon glide zone concept. Documentation of the actual excursions of the distal tendon stump and of the tenorrhaphy interface would prevent misinterpretation of the actual level of tendon injury and repair.


Assuntos
Traumatismos dos Dedos/classificação , Traumatismos dos Tendões/classificação , Tendões/anatomia & histologia , Pontos de Referência Anatômicos , Documentação , Humanos
17.
Int J Cardiovasc Imaging ; 36(11): 2165-2172, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32642877

RESUMO

The main objective of this study was to investigate the diagnostic performance of FINE in generating and displaying 3 specific abnormal fetal echocardiography views such as left ventricular outflow tract (LVOT) view, right ventricular outflow tract (RVOT) view, and 3-vessels and trachea (3VT) view in fetuses with double-outlet right ventricle (DORV). In this prospective study, thirty fetuses diagnosed with DORV by fetal echocardiography in the second and third trimesters were enrolled. One or more STIC volume data-sets were collected from the 4-chamber view as initial view for each fetus, one optimal volume per fetus was selected for on-line analysis using FINE, and the diagnosis plane image was optimized using the Virtual Intelligent Sonographer Assistance (VIS-assistance).The visualization rates of 3 specific abnormal fetal echocardiography views of DORV and key diagnostic elements were calculated. One or more STIC volumes (n = 30 total) were obtained in 25 patients. A single STIC volume per patient was analyzed using the FINE method. FINE was able to successfully generate and display 3 specific abnormal fetal echocardiography views. The display rates of the 3 specific abnormal fetal echocardiography views (3VT, LVOT, RVOT) were 84.0%, 76.0% and 84.0%, respectively. By applying intelligent navigation technology to STIC volume data-sets, the FINE method can successfully generate three specific abnormal cardiac fetal echocardiography diagnostic views in fetuses with DORV, the FINE method can be used for screening and remote consultation of fetal DORV.


Assuntos
Inteligência Artificial , Diagnóstico por Computador , Dupla Via de Saída do Ventrículo Direito/diagnóstico por imagem , Ecocardiografia Quadridimensional , Coração Fetal/diagnóstico por imagem , Ultrassonografia Pré-Natal , Adulto , Pontos de Referência Anatômicos , Dupla Via de Saída do Ventrículo Direito/fisiopatologia , Feminino , Coração Fetal/anormalidades , Coração Fetal/fisiopatologia , Idade Gestacional , Humanos , Interpretação de Imagem Assistida por Computador , Valor Preditivo dos Testes , Gravidez , Reprodutibilidade dos Testes , Análise Espaço-Temporal , Adulto Jovem
19.
Cancer Radiother ; 24(5): 444-452, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32620457

RESUMO

The aim of the present paper is to systematically review all available literature on preradiotherapy high uptake areas (hotspots) as a potential target for dose escalation in different tumour sites, and to understand the potential role and limitations of fluorodeoxyglucose (FDG)-positron-emission tomography (PET)/computed tomography (CT) in this context. An electronic database (Medline) search was conducted to identify articles reporting on a correlation between high tracer uptake on pretreatment PET and preferential sites of local recurrence after radiotherapy. Search was limited to English language. No date range limitation was applied. Among 45 studies initially identified, nine series matching with inclusion criteria have finally been retained from the literature after reviewing (5 retrospective and 4 prospective). Primary tumour locations were head-neck (n=2), lung (n=4), oesophageal (n=2) and rectal (n=1) areas. Overlaps between FDG hotspot on preradiotherapy PET/CT and site of local recurrence on post-treatment scan showed good to excellent agreement. Only studies on head-neck cancer reported moderate agreement probably explained by the lack of reproducibility of the patients positioning between pre- and post-treatment FDG-PET/CT; and by the rigid registration process of images limited by post-therapeutic changes that highly affect anatomical landmarks. FDG hotspot-guided radiotherapy may allow dose escalation in respecting a robust methodology (treatment position, co-registration method, four-dimensional PET).


Assuntos
Fluordesoxiglucose F18 , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Pontos de Referência Anatômicos/diagnóstico por imagem , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/radioterapia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/radioterapia , Neoplasias/radioterapia , Posicionamento do Paciente , Estudos Prospectivos , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/radioterapia , Estudos Retrospectivos
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