Advanced-sectioned images obtained by microsectioning of the entire male body.

Realistic two-dimensional (2D) and three-dimensional (3D) applications for anatomical studies are being developed from true-colored sectioned images. We generated advanced-sectioned images of the entire male body and verified that anatomical structures of both normal and abnormal shapes could be visualized in them. The cadaver was serially sectioned at constant intervals using a cryomacrotome. The sectioned surfaces were photographed using a digital camera to generate horizontal advanced-sectioned images in which normal and abnormal structures were classified. Advanced-sectioned images of the entire male body were generated. The image resolution was 3.3 × 3.3 fold better than that of the first sectioned images obtained in 2002. In the advanced-sectioned images, normal and abnormal structures ranging from microscopic (≥0.06 mm × 0.06 mm; pixel size) to macroscopic (≤473.1 mm × 202 mm; body size) could be identified. Furthermore, the real shapes and actual sites of lung cancer and lymph node enlargement were ascertained in them. Such images will be useful because of their true color and high resolution in digital 2D and 3D applications for gross anatomy and clinical anatomy. In future, we plan to generate new advanced-sectioned images of abnormal cadavers with different diseases for clinical anatomy studies.

Diabetes and stress hyperglycemia associated with myocardial infarctions at an urban municipal hospital: prevalence and effect on mortality.

Municipal hospitals in large cities provide care for patients from immigrant and mixed ethnic communities that are at high risk for diabetes. Both diabetes and stress hyperglycemia increase the risk of adverse outcome after myocardial infarctions, and the impact of stress hyperglycemia on the outcome of myocardial infarctions in this particular setting has not been previously studied. We therefore undertook a retrospective cohort study to determine the prevalence of diabetes and stress hyperglycemia in patients presenting to a university-affiliated Bronx municipal hospital with myocardial infarction, and the relationship of these conditions to the extent of coronary disease and mortality. We obtained data on 106 consecutive patients from July 1998 to April 1999 with a diagnosis-related group diagnosis of either myocardial infarction or acute coronary syndrome, in which myocardial infarction was confirmed by serum enzymes or characteristic electrocardiographic changes. Patients were followed until March 30, 2001. Measurements of clinical parameters and results of catheterization were obtained for all patients. Death rates were determined by laboratory database, direct patient contact, or data from National Death Index. Eighty percent of the cohort had either a diagnosis of diabetes (n = 45, 42% of cohort) or evidence of stress hyperglycemia (defined as serum glucose greater than 126 mg/dL at the time of admission without prior diagnosis of diabetes, n = 40, 38%). In-hospital mortality for patients with diabetes, stress hyperglycemia, or normal glucose was 20%, 15%, and 14%, respectively. Eighty-three percent of the cohort received beta blockers, and 61% of hospital survivors had catheterization. Left main or triple vessel disease was common in both patients with diabetes (52%) and patients with stress hyperglycemia (32%). Mortality at follow up (maximum follow up 3 years; mean follow up 19.6 months) was much higher in patients with either diabetes (42%) or stress hyperglycemia (52%) than normal subjects (24%). Kaplan-Meier analysis of the difference in mortality between patients with high glucose on admission and normal subjects was borderline significant (P = 0.06). Multivariate regression demonstrated that age (P = 0.020), increase in admission serum creatinine (P = 0.001), and reduction in either ejection fraction (P = 0.016) or admission systolic blood pressure (P = 0.005) were significant predictors of mortality. Glycemic status and sex were not independently associated with death after controlling for these other factors. These results show that the prevalence of both diabetes and stress hyperglycemia on presentation with myocardial infarction is strikingly high in this immigrant, mixed ethnic, urban population. Patients with diabetes and stress hyperglycemia had advanced disease on presentation and much higher mortality at 2 to 3 years than those with normal blood glucose. The mortality difference is the result of older age and more advanced disease rather than hyperglycemia per se.

Virtual dissection table including the Visible Korean images, complemented by free software of the same data / Mesa de disección virtual que incluye las imágenes de Visible Korean, complementadas por programa de libre acceso con igual información

The objective of this study was to introduce the complementary relationship between virtual dissection table (simply, table) and free software, since authors tried to aid interested people in their studying digital human anatomy. Visible Korean (VK) team had presented the serially sectioned images and outlined images of a male cadaver. Thereafter, Anatomage (San Jose, CA) manufactured the table by making 3-dimensional (3D) volume models from the data. Separately, the VK team reconstructed surface models from the same data and inputted the models in portable document format (PDF) file, which can be opened on the personal computer. The software to browse the sectioned and outlined images was also programmed by VK team. In this report, the table and the VK free software were compared to establish their supplementary potentiality. Both the table and free software displayed equivalent 3D models reconstructed from the same sectioned images. In both platforms, the models were labeled for users to recognize the individual structures. Both the table and the free software had respective features to enhance the virtual dissecting experience. The table came with its designated hardware with life-sized display, whereas VK software could be run in any personal computer without burden. The coexistence of the table and free software will enrich the people learning anatomy. With increasing VK data and free software, more and more commercial or complimentary products are expected to be produced.

El objetivo de este estudio fue introducir la relación complementaria entre una mesa virtual de disección (simplemente, la mesa) y un programa de libre acceso. Mediante este proceso los autores trataron de ayudar a aquellas personas interesadas en el estudio de la anatomía humana digital. El equipo Visible Korean (VK) había presentado las imágenes de secciones consecutivas e imágenes de un cadáver de sexo masculino. Partiendo de ese punto, la compañía Anatomage fabricó la mesa produciendo con los datos modelos dimensionales de volumen (3D). En forma paralela, el equipo VK reconstruyó los modelos de superficie con los mismos datos y de entrada de los modelos en formato de documento portátil (PDF), que se pudieran abrir en el ordenador personal. El equipo VK además lo programó para navegar a través de las imágenes seccionadas y descritas. En este informe, la mesa y el programa VK fueron comparados para establecer su potencialidad complementaria. Tanto la mesa como el programa de libre acceso muestran modelos 3D equivalentes reconstruidos a partir de las mismas imágenes seccionadas. En ambas plataformas, se marcaron los modelos para que los usuarios reconozcan las estructuras individuales. Tanto la mesa y el programa libre tenían características respectivas para mejorar la experiencia de disección virtual. La mesa incluía el hardware designado con la pantalla de tamaño natural, mientras que el programa VK podía ser ejecutado en cualquier ordenador personal sin dificultad alguna. La coexistencia de la mesa y el programa libre pueden ser un apoyo importante para quienes estudien anatomía. Con el aumento de los datos de VK y el programa libre, se espera que exista una mayor cantidad de productos comerciales o gratuitos.