Characteristics of the Distance and Space Required for Knife Slashing Using a Motion Capture System / 法医学杂志

OBJECTIVES@#To investigate the relationship between the perpetrator's sex, victim's position and slashing location as well as anthropometric parameters on distance and space required for slashing, to provide the theoretical basis for the judgment of whether the crime scene was consistent with the criminal activity space.@*METHODS@#The kinematics data of 12 male and 12 female subjects slashing the neck of standing and supine mannequins as well as the chest of the standing mannequins with a kitchen knife were obtained by using a 3D motion capture system. The relationship between the perpetrator's sex-victim's position, the perpetrator's sex-slashing location, and anthropometric parameters and the distance and space required for the slashing were analyzed by two-factor repeated measures ANOVA and Pearson correlation analysis respectively.@*RESULTS@#Compared with slashing the neck of supine mannequins, the distance (L) and normalized L (l) of slashing the neck of standing mannequins were greater, while vertical distance (LVR) and normalized LVR (lVR) of the knife side were smaller. Compared with slashing the neck of standing mannequins, the L and l slashing the chest of standing mannequins were greater, while LVR and lVR were smaller. Horizontal distance (LHR) and normalized LHR (lHR) of the knife side in males were greater than that in females. Height and arm length were positively correlated with L, LHR, and LVR when striking the standing mannequins.@*CONCLUSIONS@#When slashing the neck of supine or standing victims, the slashing distance is shorter and the slashing height is greater. Furthermore, the distance and space required for slashing are correlate with anthropometric parameters.

A preliminary discussion of the necessity of controlled setting of placebo moxibustion / 针刺研究

Compared with acupuncture research, moxibustion research has made slow progress with great obstacles. With randomized controlled trials as the widely accepted gold standard for the evaluation of clinical effect, moxibustion therapy is facing a great challenge: how to establish a reasonable placebo control group. This article reviewed the current application of placebo moxibustion, analyzed the difficulties in setting up placebo moxibustion, and explored corresponding solutions, in order to attract more attention to moxibustion therapy among traditional Chinese medicine practitioners.

Study on visualized virtual surgery of living-related donor liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the significance of three dimensional visualization and virtual surgery system in living related donor liver transplantation surgery.</p><p><b>METHODS</b>Two patients suffered biliary calculi were scanned by 64 slice helical computer tomography (CT) on livers and the data were imported into medical image proceeding system (MIPS) for sequence. Man-made segmentation and true-up on the image from the data were carried out. Three dimensional (3D) models of the liver and the intrahepatic vessels were reconstructed by VTK software respectively. The models were exported with format STL from it and then were imported into the FreeForm Modeling System for smoothing and modifying. At last, living related donor liver transplantation were simulated with the force-feedback equipment (PHANToM).</p><p><b>RESULTS</b>It had great verisimilar image for the reconstructed 3D liver models with artery, hepatic vein, portal vein and bile duct. By seeing through liver, it had high fidelity and strong 3D effect for the intrahepatic artery, hepatic vein, portal vein and bile duct, and their spatial disposition and course and co-relationship were shown clearly. In the virtual surgery system, the virtual scalpel could be manipulated on 3D liver model with PHANToM. The simulating effect was the same as the clinic operation for living related donor liver transplantation.</p><p><b>CONCLUSIONS</b>The visualized liver model reconstructed is 3D and verisimilar, and it is helpful to design reasonable scheme for liver transplantation. It can improve the surgical effect, decrease the surgical risk, reduce the complication, enhance the communication between doctor and patient through designing surgical plan and demonstrating visualized operation before surgery.</p>

Study on the application of value of digital medical technology in the operation on primary liver cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinical application of digital medical in the operation on primary liver cancer.</p><p><b>METHODS</b>The patients (n=11) with primary hepatic carcinoma treated between February and July 2008, including 9 cases of hepatocellular carcinoma, 2 cases of cholangiocellular carcinoma, were scanned using 64 slices helicon computerized tomography (CT) and the datasets was collected. Segment and three-dimensional (3D) reconstruction of the CT image was carried out by the medical image processing system which was developed. And the 3D moulds were imported to the FreeForm Modeling System for smoothing. Then the hepatectomy in treatment of hepatoma and implanting of catheter were simulated with the force-feedback equipment (PHANToM). Finally, 3D models and results of simulation surgery were used for choosing mode of operation and comparing with the findings during the operation.</p><p><b>RESULTS</b>The reconstructed models were true to life, and their spatial disposition and correlation were shown clearly; Blood supply of primary liver cancer could be seen easily. In the simulation surgery system, the process of virtual partial hepatectomy and implanting of catheter using simulation scalpel and catheter on 3D moulds with PHANToM was consistent with the clinical course of surgery. Life-like could be felt and power feeling can be touched during simulation operation.</p><p><b>CONCLUSIONS</b>Digital medical benefited knowing the relationship between primary liver cancer and the intrahepatic pipe. It gave an advantage to complete primary liver cancer resection with more liver volume remained. It can improve the surgical effect and decrease the surgical risk and reduce the complication through demonstrating visualized operation before surgery.</p>

Study on three dimensional reconstruction and simulation surgery of spleen / 中华外科杂志

<p><b>OBJECTIVE</b>To study the three-dimensional (3D) reconstruction and the visualization simulation surgery of spleen based on the scanning data of 64-slice helical computed tomograph (CT).</p><p><b>METHODS</b>The original data of 64-slice helical CT of spleen was collected, and then the CT image sequences were segmented and automatically extracted using auto-adapted region growth algorithm, and were conducted with the segmented images by adopt self-developed image processing software for 3D reconstruction. Finally, the 3D models were imported into FreeForm Modeling System for modifying and smooth. And the visualization simulation surgery was performed before splenectomy.</p><p><b>RESULTS</b>It was fast and effective to utilize auto-adapted region growth algorithm to conduct spleen image program segmentation; the reconstructed models were seen clearly and could reappear the structure of the spleen and the important surrounding organs. The effect of the splenectomy simulation surgery was similar to the practical surgery.</p><p><b>CONCLUSIONS</b>The research on 3D models of spleen and visualization simulation surgery of splenectomy could lead to clinical benefits. It maybe improve the surgical effect and decrease the surgical risk and reduce the complication demonstrating visualized operation before surgery.</p>

Establishment of a three-dimensional pancreas model for simulating surgical resection of pancreatic tail carcinoma using virtual-reality technique / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the feasibility of visual-reality technique for simulating surgical resection of pancreatic tail carcinoma using a 3-dimensional pancreas model reconstructed on the basis of the CT data.</p><p><b>METHODS</b>The original image data of 64-slice spiral CT was obtained from a patient with pancreatic tail carcinoma. Using adaptive region growing algorithm, the serial CT images were segmented and automatically extracted for 3-dimensional reconstruction of the pancreas and the anatomically related structures with a self-designed program. The model was then processed with Freeform Modeling System for image modification and smoothing. With the assistance of GHST SDK and PHANTOM software systems, preoperative simulation of surgical resection of the carcinoma was performed on the basis of the established pancreatic model.</p><p><b>RESULTS</b>The reconstructed 3-dimensional pancreatic model with the related structures clearly visualized the 3-dimensional structures of the pancreas, the pancreatic tail compromised by the carcinoma, and the adjacent organs, displaying also the distribution, courses and the anatomical relations of the ductal systems including the main pancreatic duct, abdominal aorta, portal vein system, and the biliary tract. During simulated surgery for pancreatic tail carcinoma resection, the GHOST SDK system allowed effective application of the virtual surgical instruments, and the use of PHANTOM software produced a surgical experience with high resemblance of that from an actual operation.</p><p><b>CONCLUSION</b>The serial CT data-based reconstruction of 3-dimensional pancreas model and simulated operation on this model using virtual-reality technique has great potentials for application in individualized surgical planning and surgical risk assessment in cases of pancreatic tail carcinoma, and also facilitates clinical training of the surgeons.</p>

Clinical value of three-dimensional reconstruction of the biliary calculi based on 64-slice spiral CT scanning data / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the clinical value of 3-dimensional (3D) reconstruction of the liver and its ductal structures using 64-slice spiral CT data in hepatobiliary surgery.</p><p><b>METHODS</b>The image data of 64-slice spiral CT scanning was obtained from patients with biliary calculi. Image segmentation was performed both using computer programs and manually, and 3D reconstruction of the liver was carried out using Mimics software. The reconstructed model of the liver and the ductal system was exported in STL format, and then into the FreeForm Modeling System for modification and smoothing, followed by image registration of the liver with the ductal system and the calculi.</p><p><b>RESULTS</b>The reconstructed liver model accurately represented the actual size of the liver and its anatomic landmarks, and by adjusting the transparency of the liver, the hepatic and intrahepatic arteries, veins, the portal vein, some abdominal vessels and the biliary system with the calculi were clearly visualized. The calculi in the intrahepatic and extrahepatic bile ducts were distinct in terms of the location and number, and dilation and stenosis of the intrahepatic and extrahepatic bile ducts were also clearly observed. The model presented with realistic profile of the liver that allowed vivid 3D observation. The model also allowed zooming and rotation for observation in full views.</p><p><b>CONCLUSIONS</b>The reconstructed model of the liver and its ductal system can be useful for preoperative planning and intraoperative complete removal of the calculi from the bile duct, and for the bile duct dilation and stenosis detected in the model, appropriate measures should be taken to reduce the residual calculi and prevent reoccurrence.</p>