Relationship between the occlusal plane and three different levels of ala-tragus line in a sample of sudanese adults / Relación entre el plano oclusal y tres niveles diferentes de la línea ala-trago en una muestra de adultos sudaneses

Aim: Correct orientation of the occlusal plane plays a vital role in achieving the perfect occlusal balance and function of complete dentures. This study aimed to evaluate the most reliable posterior reference point of the ala-tragus line (ATL) concerning occlusal plane (OP) in a sample of the dentate Sudanese population. Materials and Methods: A total of 150 subjects with healthy and well-aligned permanent teeth were randomly selected. Right lateral profile photographs were taken with subjects having a fox plane placed intra-orally, contacting the occlusal plane. Reference points corresponding to inferior, middle, and superior borders of the tragus and inferior border of the ala of the nose were marked on photographs. The angles between the lines were measured using the Auto-CAD software program, and the most parallel relationship was determined. Descriptive statistics in terms of means and standard deviations were presented. Independent t-test and one-way ANOVA tests were used to compare as appropriate. A p-value < 0.05 was considered significant. Results: The mean angle formed by the OP and ATL was 8.5±3.69º for the superior level, 4.68±3.13º for the middle line, and 2.89±2.57º for the inferior line. A significant difference was found between the means of the three angles (p< 0.001), while no significant difference (p> 0.05) was found between both genders regarding the measured angles. Conclusions: The line joining the inferior border of the ala of the nose with the inferior border of the tragus of the ear was the most reliable line in terms of parallelism to determine the occlusal plane orientation.

Antecedentes: La orientación correcta del plano oclusal juega un papel vital para lograr el equilibrio oclusal perfecto y la función de las prótesis completas. Este estudio tuvo como objetivo evaluar el punto de referencia posterior más confiable de la línea ala-trago (ATL) con respecto al plano oclusal (OP) en una muestra de la población dentada de Sudán. Materiales y Métodos: Se seleccionaron aleatoriamente un total de 150 sujetos con dientes permanentes sanos y bien alineados. Se tomaron fotografías de perfil lateral derecho de sujetos a los que se les colocó un plano de zorro intraoralmente, en contacto con el plano oclusal. En las fotografías se marcaron los puntos de referencia correspondientes a los bordes inferior, medio y superior del trago y al borde inferior del ala de la nariz. Los ángulos entre las líneas se midieron utilizando el programa de software Auto-CAD y se determinó la relación más paralela. Se presentaron estadísticas descriptivas en términos de medias y desviaciones estándar. Se utilizaron prueba-t independiente y prueba ANOVA unidireccional para las comparaciones, según correspondiera. Se consideró significativo un valor de p<0,05. Resultados: El ángulo medio formado por OP y ATL fue de 8,5±3,69º para el nivel superior, 4,68±3,13º para la línea media y 2,89±2,57º para la línea inferior. Se encontró una diferencia significativa entre las medias de los tres ángulos (p< 0,001), mientras que no se encontró diferencia significativa (p>0,05) entre ambos sexos con respecto a los ángulos medidos. Conclusión: La línea que une el borde inferior del ala de la nariz con el borde inferior del trago de la oreja fue la línea más confiable en términos de paralelismo para determinar la orientación del plano oclusal.

Visual Contribution to Motor Skill DCD Disorders & Walking Physiology Using Spatial Cognition and Linear Geometries as Landmark Coordination Cues

Problem: Awareness of children, who experience movement, particularly motor coordination difficulties, has increased dramatically over the last ten years. These motor coordination problems of children with Developmental Coordination Disorder (DCD) or/and Attention-Deficit / Hyperactivity Disorder (ADHD) have been frequently associated with poor visual and spatial eye-vision processing.Background: Motor control difficulties for DCD and ADHD children have been discussed in detail. However, just a little is known about the influence of the natural environment on these disorders. Even more, the built environment’s impact as a spatial cognition and coordination functionality has never been considered.Aim: This pilot and innovative study aim to identify the correlation between and evaluate the visual contribution of the so-called “spatial compound linear geometries” and DCD children’s motor/walking control.Methodology: Twenty children aged 5 to 8 years with DCD difficulties (two intervention groups, one with 10 boys and the other one with 10 girls) were assessed by a statistical structural evaluation in three built environments (two urban parks and one pocket park), under two conditions (rich or not in trees, flora, and PnP linear geometries), and different motor coordination control situations (static balance, dynamic balances, dark condition).Results: The worst performances (regarding movement disorders and motor coordination problems) were observed for both groups with DCD children playing in parks poor in or without trees, flora, and spatial compound linear geometries. Instead, a significant performance (strong statistical correlation) was found for the same intervention group (DCD children’s boys or girls) playing in parks rich in trees, flora, and vegetation (natural environment). The best performance (very strong statistical correlation) was detected in parks rich in a natural environment and linear geometries. Conclusions: While the natural environment contribution is bibliographically known, the best performance finding of the visual contribution of the spatial compound linear geometries, as spatial landmarks enriching the visual-spatial motor/walking functionalities for Children with DCD disorder, could provide new cognitive approaches towards an understanding of children’s Developmental Coordination Disorder and walking physiology. DCD children’s performance, scores, and cues were related to both the natural environment and the spatial compound linear geometries as spatial landmark motor coordination cues and spatio-temporal clues. The significant variability in sensory processing among children with DCD, ADHD, and co-occurring symptoms can contribute to understanding how neurological and social factors correlate across diagnoses. Also, derived observations for stepping errors, Gait analysis (variables), and spatio-temporal clues conclude that visual eye-based processing interrelates with motor coordination problems, performance, inattention, environmental conditions (dark), sex identity (boys, girls), and DCD hyperactivity. Applications: Development of interactive visual applications for (i) human spatial cognition and movement improvement; and (ii) children’s motor control and coordination refinement.

Application of body surface markers localization in totally implantable venous access port implantation via internal jugular vein approach / 国际外科学杂志

Objective:To investigate the feasibility of using body surface marker localization method to determine the correct position of catheter tip (lower 1/3 of the superior vena cava or the junction of superior vena cava and right atrium) in totally implantable venous access port (TIVAP) implantation via internal jugular vein approach.Methods:The clinical data of 220 patients who underwent TIVAP implantation in Beijing Tongren Hospital, Capital Medical University from June 2019 to June 2021 were retrospectively analyzed. Among them, 168 patients used the internal jugular vein approach. According to the method implemented for determining the length of central venous catheter (CVC) during the operation, the patients were divided into two groups: 136 patients using the body surface marker localization method were defined as the study group; and the remaining 32 cases treated by the intraoperative X-ray fluoroscopic localization method were defined as the control group. The difference in the excellent or good rate of CVC tip position immediately after implantation and the time of implantation was compared between the two groups. In addition, the correlation between the length of CVC indwelling, height, age, and the distance between the catheter tip and tracheal carina was analyzed for the patients with right and left internal jugular vein catheterization. Kolmogorov-Smirnov test was used for statistical distribution of measurement data. Normal distribution of measurement data was expressed as mean ± standard deviation ( ± s), independent sample t-test was used for comparison between groups. Chi-square test was used for comparison between counting data. With TIVAP catheter indenture length as dependent variable and height as independent variable, Pearson correlation analysis was performed, the relationship equation between ideal catheter indenture length and patient height was analyzed by unitary linear regression. Results:When the CVC tip was located at the second intercostal space, the third sternocostal joint and the third intercostal space, the corresponding probability of being in the correct position was 34.8%, 83.3% and 95.0% respectively. The third sternocostal joint or the third intercostal space had a higher probability of correct CVC tip location than the second intercostal space, and the difference were statistically significant ( P<0.001). Furthermore, there was no significant difference in the possibility of the CVC tip located in the correct position between the third sternocostal joint and the third intercostal space ( P=0.149). Compared with the control group (before adjusting catheter position), the proportion of excellent or good CVC position in the study group was significantly improved (94.1% vs 46.9%), and the difference was statistically significant ( χ2=41.99, P<0.001); while the total operation time was significantly shortened [(33.04±6.69) min vs (42.50±5.54) min], and the difference was statistically significant ( P<0.05). There was a linear correlation between the length of CVC insertion and height. Indwelling catheter length via right internal jugular vein approach (cm) =0.159× height (cm)-1.284 ( r=0.597, r2=0.356, P<0.001); length of catheter indwelling through the left approach (cm) =0.097× height (cm) + 12.139 ( r=0.322, r2=0.104, P=0.020). Conclusions:The third sternocostal joint or the third intercostal space would be the corresponding correct surface landmark of the CVC tip when the body surface marker localization method was adopted during the TIVAP implantation via the internal jugular vein approach. Compared with the intraoperative X-ray fluoroscopy localization, the operation time is significantly shortened with the application of the body surface marker localization method. This technique is simple and easy to master and has high reliability in determining the length of catheter and the position of CVC tip.

Automatic determination of mandibular landmarks based on three-dimensional mandibular average model / 北京大学学报(医学版)

OBJECTIVE@#To explore an efficient and automatic method for determining the anatomical landmarks of three-dimensional(3D) mandibular data, and to preliminarily evaluate the performance of the method.@*METHODS@#The CT data of 40 patients with normal craniofacial morphology were collected (among them, 30 cases were used to establish the 3D mandibular average model, and 10 cases were used as test datasets to validate the performance of this method in determining the mandibular landmarks), and the 3D mandibular data were reconstructed in Mimics software. Among the 40 cases of mandibular data after the 3D reconstruction, 30 cases that were more similar to the mean value of Chinese mandibular features were selected, and the size of the mandibular data of 30 cases was normalized based on the Procrustes analysis algorithm in MATLAB software. Then, in the Geomagic Wrap software, the 3D mandibular average shape model of the above 30 mandibular data was constructed. Through symmetry processing, curvature sampling, index marking and other processing procedures, a 3D mandible structured template with 18 996 semi-landmarks and 19 indexed mandibular anatomical landmarks were constructed. The open source non-rigid registration algorithm program Meshmonk was used to match the 3D mandible template constructed above with the tested patient's 3D mandible data through non-rigid deformation, and 19 anatomical landmark positions of the patient's 3D mandible data were obtained. The accuracy of the research method was evaluated by comparing the distance error of the landmarks manually marked by stomatological experts with the landmarks marked by the method of this research.@*RESULTS@#The method of this study was applied to the data of 10 patients with normal mandibular morphology. The average distance error of 19 landmarks was 1.42 mm, of which the minimum errors were the apex of the coracoid process [right: (1.01±0.44) mm; left: (0.56±0.14) mm] and maximum errors were the anterior edge of the lowest point of anterior ramus [right: (2.52±0.95) mm; left: (2.57±1.10) mm], the average distance error of the midline landmarks was (1.15±0.60) mm, and the average distance error of the bilateral landmarks was (1.51±0.67) mm.@*CONCLUSION@#The automatic determination method of 3D mandibular anatomical landmarks based on 3D mandibular average shape model and non-rigid registration algorithm established in this study can effectively improve the efficiency of automatic labeling of 3D mandibular data features. The automatic determination of anatomical landmarks can basically meet the needs of oral clinical applications, and the labeling effect of deformed mandible data needs to be further tested.

Marcos anatômicos na radiografia para cateter central periférico em neonatos: revisão integrativa / Puntos anatómicos en la radiografía para catéter central periférico en neonatos: revisión integradora / Anatomical landmarks on radiography for peripheral central catheter in newborns: integrative review

Resumo Objetivo Sumarizar as evidências científicas sobre os marcos anatômicos, na radiografia, utilizados para avaliar a ponta distal do cateter central de inserção periférica em recém-nascidos. Métodos Trata-se de uma revisão integrativa da literatura realizada nas bases de dados Web of Science, National Library of Medicine (PubMed/MEDLINE) e Scopus, entre os anos de 2017 e 2021. Resultados Dos 263 documentos encontrados nas bases, 13 preencheram os critérios de elegibilidade e foram selecionados para análise. Destes, 12 eram estudos observacionais e um experimental. Quanto ao país de origem, apenas um estudo foi publicado no Brasil, cinco na China, dois nos Estados Unidos da América e um estudo na Itália, Alemanha, Canadá, Irã e Índia. As evidências encontradas demonstraram a existência de sete marcos anatômicos utilizados na radiografia para visualização da ponta do cateter percutâneo em neonatos, sendo a unidade vertebral o referencial norteador predominante. Conclusão Para cateteres inseridos em membros superiores, os marcos anatômicos que mais se aproximam da junção cavo-atrial são a quinta e sétima vértebra torácica, ou duas unidades vertebrais abaixo da carina. Para os membros inferiores, o posicionamento da ponta do cateter deve estar entre a nona e décima vértebra torácica ou acima da quarta vértebra lombar.

Resumen Objetivo Sintetizar las evidencias científicas sobre los puntos anatómicos, en radiografías, utilizados para evaluar el extremo distal del catéter central de inserción periférica en recién nacidos. Métodos Se trata de una revisión integradora de la literatura realizada en las bases de datos Web of Science, National Library of Medicine (PubMed/MEDLINE) y Scopus, entre los años 2017 y 2021. Resultados De los 263 documentos encontrados en las bases, 13 cumplieron con los criterios de elegibilidad y fueron seleccionados para análisis. Entre ellos, 12 eran estudios de observación y uno era experimental. Con relación al país de origen, únicamente un estudio fue publicado en Brasil, cinco en China, dos en Estados Unidos de América y un estudio en Italia, Alemania, Canadá, Irán e India. Las evidencias encontradas demostraron la existencia de siete puntos anatómicos utilizados en la radiografía para la visualización de la extremidad del catéter percutáneo en neonatos, y la unidad vertebral fue el referente orientador predominante. Conclusión Para catéteres insertados en miembros superiores, los puntos anatómicos que más se aproximaron a la unión cavoatrial son la quinta y la séptima vértebra torácica o dos unidades vertebrales por debajo de la carina. Para los miembros inferiores, la ubicación de la extremidad del catéter debe estar entre la novena y la décima vértebra torácica o sobre la cuarta vértebra lumbar.

Abstract Objective To summarize the scientific evidence on anatomical landmarks on radiography used to evaluate the distal tip of the peripherally inserted central catheter in newborns. Methods This is an integrative literature review performed between 2017 and 2021 in Web of Science, National Library of Medicine (PubMed/MEDLINE) and Scopus databases. Results Thirteen out of 263 documents found in the databases met the eligibility criteria and were selected for analysis. Of these, 12 were observational studies and one was experimental. As for the country of origin, only one study was published in Brazil, five in China, two in the United States of America; and Italy, Germany, Canada, Iran and India with one study each. The evidence found demonstrated the existence of seven anatomical landmarks used in radiography to visualize the tip of the percutaneous catheter in newborns, and the vertebral body as the predominant guiding reference. Conclusion For catheters inserted in the upper limbs, the anatomical landmarks closer to the cavo-atrial junction are the fifth and seventh thoracic vertebrae, or two vertebral bodies below the level of the carina. For the lower limbs, the catheter tip should be positioned between the ninth and tenth thoracic vertebrae or above the fourth lumbar vertebra.

Revista brasileira de educação especial: 30 anos de história / Brazilian journal of special education: 30 years of history

RESUMO Neste artigo, objetivou-se revisitar a história da Revista Brasileira de Educação Especial (RBEE), com um olhar voltado às construções expressas na organização e na estruturação da revista, no decorrer de três décadas de existência. Para isso, percorreram-se as publicações da RBEE de 1992 a 2021, de modo a coletar, organizar e analisar dados sistematizados por meio de unidades de análise. Metodologicamente, o trabalho foi organizado em dois momentos: inicialmente, foram objetos de estudo os sumários, os títulos, os editoriais, as erratas, os informes, as avaliações e os prêmios da revista; em um segundo momento, os títulos das pesquisas publicadas receberam atenção e suas expressões foram sistematizadas para a criação de nuvens de palavras. Desses movimentos, desprendeu-se a criação de três unidades de análise, as quais foram organizadas respeitando marcos históricos evidenciados na RBEE: I) Fase da Criação, a qual contemplou o período de 1992 até 2004, marcado pelo início da institucionalização da RBEE; II) Fase da Expansão, que envolveu o período de 2005 até 2012, no qual se visualizou a manutenção da periodicidade, assim como a indexação da RBEE no sistema Scientific Electronic Library Online (SciELO); III) Fase de Consolidação, a qual compreendeu o período de 2013 até 2021, caracterizado, sobretudo, pela internacionalização da Revista e pelo alcance do Qualis Capes A1 em Educação.

ABSTRACT In this article, the aim was to revisit the history of the Revista Brasileira de Educação Especial [Brazilian Journal of Special Education] (RBEE), with a focus on the constructions expressed in the organization and structuring of the Journal, over its three decades of existence. For this, we went through the publications of the RBEE from 1992 to 2021, in order to collect, organize and analyze systematized data through units of analysis. Methodologically, the work was organized in two moments: initially, the Journal's contents, titles, editorials, errata, reports, evaluations and awards were objects of study; in a second moment, the titles of the published studies received attention and their expressions were systematized to create word clouds. From these movements, we created three units of analysis, which were organized respecting the historical landmarks evidenced in the RBEE: I) Creation Phase, which covered the period from 1992 to 2004, marked by the beginning of the institutionalization of RBEE; II) Expansion Phase, which involved the period from 2005 to 2012, in which we visualized the maintenance of the periodicity, as well as the indexing of the RBEE in the Scientific Electronic Library Online (SciELO) system; III) Consolidation Phase, which comprised the period from 2013 to 2021, mainly characterized by the internationalization of the Journal and the reach of Qualis CAPES A1 in Education.

Importance of distal radius teardrop angle in the treatment of distal radius middle column fracture / 中华骨科杂志

Objective:To investigate the importance of measuring and restoring distal radius tear drop angle in the treatment of distal radius middle column fracture with anterior collapse of lunate fossa joint.Methods:Thirty one cases of distal radius fractures in 29 patients was reported for 2 years from January 2018 to January 2020. Two patients with both distal radius fractures were included in this study. All cases in this group were treated by operation. Among the 29 patients, there were 20 males and 9 females. Their ages were 44.9±15.1 years (ranged from 20 to 78 years). Two patients with both distal radius fractures were included in this study, due to both teardrop angle (TDA) reduced. The time from injury to operation was 4-17 d, with an average of 6.9 d. Except for 2 cases of fracture with simple volar approach, the other cases were treated with combined volar and dorsal approach. All patients were treated with open reduction and internal fixation with plates and bone grafting. The teardrop angle was measured before and after operation, and the effect of surgical recovery of teardrop angle was compared. The wrist function was evaluated by Gartland-Werley scores.Results:The wounds of all patients healed in one stage without postoperative infection. The follow-up time of 29 patients were 15.1±5.2 months, ranged from 7 to 31 months. The healing time for all fractures was 10.3±2.9 weeks (from 8 to 16 weeks). No fracture nonunion or redisplacement. In 31 cases, the tear drop angle was 33.4°±5.83° (20°-45°) before operation, and 58.9°±9.89° (35°-70°) after operation. At the end of follow-up, Gartland-Werley scores was 4.7±4.6, ranged from 0 to 17. Among them, 10 cases were excellent, 16 were good, 5 cases were fair, and the excellent and good rate was 83.9%. The Gartland-Werley scores of the two subgroups with postoperative tear drop angle recovery ≥50° and <50° were compared, and the results were significantly different (the excellent and good rate for two subgroups were 96.2% and 20.0% respectively ( P=0.001). Conclusion:The distal radius fracture with significantly reduced tear drop angle should be actively treated. The measurement and recovery of tear drop angle is an important factor affecting the functional outcome of distal radius fracture with anterior edge collapse of lunate fossa joint, which should be highly concerned by clinical doctors. The recovery of teardrop angle mostly requires dorsal approach.

Anatomic and functional analysis of thoracic kyphosis and lumbar lordosis / Avaliação anatômica e funcional da cifose torácica e lordose lombar / Análisis anatómica y funcionalde la cifosis torácica y la lordosis lumbar

ABSTRACT Objective: Rate and compare radiographic measurements of thoracic kyphosis and lumbar lordosis using anatomical and dynamic parameters. Methods: Measurements were performed on lateral radiographs of 10 adults of both sexes without spinal disease or deformity. Thoracic kyphosis and lumbar lordosis were measured using anatomical parameters (T1-T12, T4-T12, T5-T12 and L1-S1) or dynamic parameters (cervicothoracic or thoracolumbar inflection point). Results: Thoracic kyphosis and lumbar lordosis were different in 30% of subjects. Differences in thoracic kyphosis values were observed according to the anatomical reference used for measurement. Lumbar lordosis wasn`t statistical difference considering the anatomical or dynamic reference, but in 30% of the individuals the inflection point was different from the anatomical reference. Conclusions: Thoracic kyphosis and lumbar lordosis values differ according to anatomical and dynamic references. The reference used must be considered in the measurement and interpretation of values. Level of evidence IV; Case series.

RESUMO: Objetivo: Avaliar e comparar as mensurações radiográficas da cifose torácica e lordose lombar utilizando parâmetros anatômicos e dinâmicos. Métodos: As mensurações foram realizadas nas radiografias em perfil de 10 adultos de ambos os sexos sem doença ou deformidade da coluna vertebral. A cifose torácica e a lordose lombar foram mensuradas utilizando parâmetros anatômicos (T1-T12,T4-T12, T5-T12 e L1-S1) ou dinâmicos (ponto de inflexão cervicotorácico ou toracolombar) Resultados: As referências anatômicas e dinâmicas para a identificação da cifose torácica e lordose lombar foram diferentes em 30% dos indivíduos. Foi observado diferença dos valores da cifose torácica de acordo com a referência anatômica utilizada para a mensuração. A lordose lombar não apresentou diferença estatística considerando a referência anatômica ou dinâmica, mas em 30% dos indivíduos o ponto de inflexão era diferente da referência anatômica. Conclusões: Os valores da cifose torácica e lordose lombar apresentam diferenças de acordo com as referências anatômicas e dinâmicas. A referência utilizada deve ser considerada na mensuração e interpretação dos valores. Nível de evidência IV; Série de casos.

RESUMEN: Objetivo: Calificar y comparar medidas radiográficas de cifosis torácica y lordosis lumbar utilizando parámetros anatómicos y dinámicos. Métodos: Las mediciones se realizaron en radiografías laterales de 10 adultos de ambos sexos sin enfermedad o deformidad de la columna. La cifosis torácica y la lordosis lumbar se midieron mediante parámetros anatómicos (T1-T12, T4-T12, T5-T12 y L1-S1) o dinámicos (punto de inflexión cervicotorácico o toracolumbar). Resultados: La cifosis torácica y la lordosis lumbar fueron diferentes en el 30% de los sujetos. Se observaron diferencias en los valores de cifosis torácica según la referencia anatómica utilizada para la medición. La lordosis lumbar no fue diferencia estadística considerando la referencia anatómica o dinámica, pero en el 30% de los individuos el punto de inflexión fue diferente de la referencia anatómica. Conclusiones: Los valores de cifosis torácica y lordosis lumbar difieren según referencias anatómicas y dinámicas. La referencia utilizada debe ser considerada en la medición e interpretación de los valores. Nivel de evidencia IV; Series de casos.

Métodos de Registro de Dimensión Vertical Oclusal en Pacientes Dentados: Revisión Sistemática

RESUMEN: La Dimensión Vertical Oclusal, es la distancia entre un punto anatómico fijo en el maxilar y otro sobre la parte móvil de la mandíbula cuando los órganos dentarios están en contacto oclusal. La obtención de este registro determina el espacio vertical necesario para la rehabilitación de los pacientes. En la actualidad existen distintos métodos para el registro de la Dimensión Vertical Oclusal, en este estudio se analizaron: Métodos fisiológicos y métodos mecánicos. El objetivo fue realizar una revisión sistemática, sobre los métodos de registro, para determinar la Dimensión Vertical Oclusal en pacientes dentados. Se recopiló información científica desde Mayo 2019 hasta Julio 2020 en diferentes bases de datos electrónicas, encontrando un tota l de 13948 artículos, después de eliminar artículos repetidos, por título, por resumen y por metodología PICO se seleccionaron un total de 24 artículos para su análisis y clasificación. Más de un autor menciona que no existe un método unirversalmente aceptado o exacto para determinar la Dimensión Vertical Oclusal. Se sugiere la combinación de varios métodos de registro de Dimensión Vertical Oclusal, se debe de considerar la manera más adecuada para lograr un registro más acertado.

ABSTRACT: Occlusal Vertical Dimension is the distance between an anatomical point in the maxilla and another on the mobile part of the mandible when the teeth are in occlusal contact. Obtaining this record determines the vertical space necessary for the rehabilitation of patients. Nowadays there are different methods for the record of the Occlusal Vertical Dimension, in this study the following were analyzed: physiological methods and mechanical methods. The objective was to do a systematic review of the registration methods to determine the Occlusal Vertical Dimension in dentate patients. Scientific information was collected from May 2019 to July 2020 in different electronic databases, finding a total of 13,948 articles, after eliminating repeated articles, by title, by abstract and by PICO methodology, a total of 24 articles were selected for analysis and classification. More than one author mentions that there is no universally accepted or exact method for determining Occlusal Vertical Dimension. A combination of several methods of Occlusal Vertical Dimension registration is suggested; it should be considered the most appropriate way to achieve a more accurate registration.

Evidence summary of the method for measuring the length of nasogastric tube insertion / 中国实用护理杂志

Objective:To systematically retrieve, evaluate and summarize the research evidence on the measurement method of adult nasogastric tube indwelling length and provide a basis for clinical nursing practice.Methods:To search for Cochrane Library(CD-SR, DARE), Joanna Briggs(JBI), PubMed (MEDLINE), Web of Science electronic database, China Biomedical Literature Database (CBM), Wanfang Database, China Knowledge Network from the establishment of the database to December 2018. Two researchers independently evaluated the quality of the literature and extracted the data.Results:A total of 9 articles were included in the study. The recommended anatomical landmarks for measuring the length of the inserted gastric tube included XNE, NEX, XJN, Hanson method, GWNUF model, earlobe to xiphoid to navel-nose tip to earlobe NEX 10 cm. The tip of the nasogastric tube and all its lateral hole locations obtained by the Hanson method, the GWNUF model, and the XEN 10 cm method were more likely to be located in the stomach.Conclusion:Although NEX is an external measurement method that is widely used in clinical practice, it has proven to be insufficiently accurate and has considerable risks. Therefore, the method of measuring the length of the nasogastric tube insertion should be carefully selected for teaching or use in practice.

A preliminary validation of the "lung surface intersegmental constant proportion landmarks" in identifying intersegmental planes during segmentectomy / 中国胸心血管外科临床杂志

@#Objective     To verify the feasibility and accuracy of the "lung surface intersegmental constant proportion landmarks", developed by our center, in identifying intersegmental planes during pulmonary segmentectomy. Methods    We prospectively enrolled the patients who planned to receive thoracoscopic segmentectomy in West China Hospital of Sichuan University and The Third People's Hospital of Chengdu from September 2021 to October 2021. We took a relatively objective and feasible method, intravenous injection of indocyanine green, in identifying intersegmental planes as standard control. We intraoperatively judged the consistency between "lung surface intersegmental constant proportion landmarks" and intravenous injection of indocyanine green in identifying intersegmental planes. We discerned main landmarks of intersegmental plane by the constant proportion segment module, which was built based on the "lung surface intersegmental constant proportion landmarks", as well as distinguished the planes with discrepant fluorescence by peripheral intravenous indocyanine green injection. When the distance between the landmarks determined by the "ung surface intersegmental constant proportion landmarks" and the segmental boundaries displayed by indocyanine green  fluorescence staining was ≤1 cm, the landmarks were judged to be consistent with the planes with discrepant fluorescence. As long as one of the landmarks was judged to be consistent, the method was considered to be feasible and accurate. Results 聽 聽 A total of 21 patients who underwent thoracoscopic segmentectomy were enrolled, with 5 male and 16 female patients. The median age was 55 years, ranging from 34 to 76 years. A total of 11 patients received left-side surgery, while 10 patients received right-side surgery. In the operations of 21 pulmonary segmentectomies, at least one intersegmental landmark determined by the "lung surface intersegmental constant proportion landmarks" was consistent with the intersegmental plane determined by indocyanine green fluorescence staining in each patient. Conclusion 聽 聽The intersegmental landmarks determined by the "lung surface intersegmental constant proportion landmarks" are consistent with that determined by indocyanine green fluorescence staining. The method of "lung surface intersegmental constant proportion landmarks" is feasible and accurate in identifying intersegmental planes during pulmonary segmentectomy.

Reliability of tibial anterior crest as the anatomical reference of rotating alignment for tibial component in total knee arthroplasty / 中国骨伤

OBJECTIVE@#This study aimed to research whether anterior tibial crest is a reliable anatomical reference for rotational alignment of tibial component in TKA.@*METHODS@#The study included 122 patients who underwent computed tomography angiography (CTA) examination for unilateral lower extremity trauma with normal contralateral lower extremities, including 89 males and 33 females, with an average age of(51.4±16.4) years old(ranged 18 to 81 years old). Picture archiving and communication system (PACS) was used to mark 11 lines including the surgical epicondylar axis (SEA) connecting the most prominent points of the lateral epicondyle and the deepest point of the sulcus on the medial epicondyle of the femur, axis of medial border of patellar tendon (MEPT)connecting the middle of the posterior cruciate ligament (PCL) and medial border of the patellar tendon at the level of a standard tibial cut from 8 mm distal of the lateral tibial joint surface, transverse axis of tibia (TAT) at the level of a standard tibial cut from 8 mm distal of the lateral tibial joint surface, Akagi line connecting the projected middle of the PCL and medial border of the patellar tendon at the tibial attachment, the axis of the medial 1/3 of patellar tendon(M1/3) connecting the projected middle of PCL and the medial 1/3 of the patellar tendon at the patellar tendon attachment level, Insall line connecting the projected middle of the PCL and the medial 1/3 of tibial tubercle, the axis of medial border of tibial tubercle (MBTT) connecting the projected middle of the PCL and medial border of tibial tubercle, as well as the axis of the proximal anterior tibial crest (PATC), axis 1 of the middle anterior tibial crest (MATC1), axis 2 of the middle anterior tibial crest (MATC2) and the axis of the distal anterior tibial crest (DATC) which were marked by connecting the 4 equidistant points on the sharp anterior tibial crest and the projected middle of the PCL. The angles between TAT and SEA as well as the angles between other axes and the perpendicular to SEA were measured. Pairwise differences among the 10 tibial axes were examined using One-Way ANOVA and paired @*RESULTS@#The angles between the axes of MEPT, Akagi line, M1/3, Insall line, MBTT, PATC, MATC1, MATC2, DATC and the perpendicular to SEA were (-1.6 ±4.5)° , (1.4 ±5.0)° , (10.2±5.1)°, (11.9±5.4)°, (3.6±4.8)°, (12.0±6.9)°, (7.2±8.6)°, (7.1±10.4)°, (6.6±13.5)°, respectively. The angle between TAT and SEA was (4.1±5.3)°. MEPT was external rotation compared to SEA. M1/3, Insall line and PATC were significantly greater than Akagi line, MBTT, TAT (@*CONCLUSION@#The middle tibial anterior crest can be used as a reference for rotational alignment of tibial component in TKA, and its reliability is better than Insall line, but worse than Akagi line, TAT and MBTT.

Landmarks for the Location of the Subthalamic Nucleus Using Magnetic Resonance Imaging

Deep brain stimulation has become an option for advanced Parkinson's disease treatment since the 1990s, but the first reports are from Benabid's team, a French neurosurgeon, in the 1980s. The subthalamic nucleus (STN), more specifically its dorsolateral portion, is the most commonly stimulated brain area. One of the major aspects for a good surgical result is the accurate location of this target. Therefore, the present article aimed to identify landmarks that facilitate and refine the location of the STN using nuclear magnetic resonance imaging (NMRI) of the skull. In order to achieve this goal, a search for articles was performed using the PubMed and Science Direct online databases, and articles regarding the use of NMRI to target STN were included. The precise location of the dorsolateral portion of the STN is fundamental to achieve the best possible effect on motor symptoms and to minimize side effects. One of the most used location methods is the NMRI, associated or not with tomography or ventriculography. The location strategies can be classified as direct and indirect. Landmarks are among the indirect strategies, and the most important ones (red nucleus, Sukeroku sign, dent internal capsule sign, supramammillary commissure, mammillothalamic tract, and interpeduncular cistern) are described in the present article. The various landmarks can be combined to locate with more accuracy the dorsolateral portion of the STN and the ideal position of the electrodes to achieve the best possible clinical result.

Is Tracing of Anatomical Structures Essential for Cephalometric Analysis? A Retrospective Study

In this study, we attempt to identify and trace cephalometric landmarks using two methods within the constraints of hand tracing (manual tracing). In the first method, we identify the specific landmarks pertaining to the particular structure and locate it as a continuation of the landmark tracing. In the second method, we segregate the landmarks but mark only the particular structure with a point in a way which is not too dissimilar to digitalized tracing.METHODS20 lateral Cephalograms were manually traced and analysed by the two different methods employed. Measurement obtained between the two tracings was analysed. Linear and angular measurements were taken for three cephalometric analyses, namely- Steiner’s analysis, McNamara Analysis, and Rakosi-Jarabak’s analysis.RESULTSThe analysis values were checked by the two methods of manual tracing. There seemed to be no significant difference between tracing done by locating the anatomical landmarks associated with the point and with tracing done by locating the reference points. Independent sample t-test was done to determine if any significant difference was present between the two methods of tracing.CONCLUSIONSTracing done by locating only the points after identifying the reference points is in a way, similar to how digital tracing is done. This could help put the doubts related to digitalized tracing to rest and confirm the accuracy of both the tracing methods. However, locating the anatomical landmarks along with the points could help the observer in relating to the point in an easier manner and improve the accuracy of manual tracing by inexperienced postgraduates and beginners.

Correlation between highest point of greater trochanter and the ideal entry point for antegrade femoral nailing by three-dimensional images / 中国骨伤

OBJECTIVE@#To provide reference of the ideal entry point for antegrade femoral nailing according to analysis correlation between highest point of greater trochanter and the middle line of the medullary cavity in adults by three-dimensional images.@*METHODS@#From January 2016 to January 2017, 107 adults who underwent continuous computed tomography (CT) scans were ultimately enrolled, including 64 males and 43 females with an average age of (51.7±16.4) years old;54 patients on the left side and 53 patients on the right side. Three-dimensional images were built by using image-processing software (Volume Viewer) to reconstruct geometry of cortex and medullary canal. All people weregrouped according to different femoral greater trochanter morphology, such as anterior apex (AA), posterior apex (PA), middle apex (MA) and none apex (NA). Forwards inclination was adjusted to apparent neck shaft angle (ANSA) and true neck shaft angle (TNSA) on the coronal and saggittal view, recorded as C-ANSA, C-TNSA, S-ANSA, S-TNSA respectively, vertical distance from the middle line of femur medullary cavity to the highest point of greater trochanter of femur on the 4 positions were measured and performed statistical analysis, multiple linear regression was applied to analysis relationship between clinical data and VD value.@*RESULTS@#(1)Comparison of VD value among 4 groups on the 4 positions, there were no difference in VD value between AA and MA groups on the S-ANSA position;and no differences in VD value among AA, MA and NA groups on the C-ANSA and C-TNSA position. (2)There were differences in VD value among AA, MA and NA groups on the sagittal plane;while had difference in VD value between PA and NA group on the coronal plane. (3)Prediction equation of VD value on S-ANSA and S-TNSA position by multiple linear regression showed R=0.343, F=3.409, =0.012 on the S-ANSA position;R=0.317, F=2.846, =0.028 on the S-TNSA position; neck shaft angle and sex were risk factors of VD value on the sagittal plane, while no difference in VD value on the coronal position.@*CONCLUSION@#(1)When indentify insertion point in adult femoral nail according to the highest point of greater trochanter as anatomic landmark, the morphology of greater trochanter of femur should be distinguished to certain observation position, then evaluate migration before and after on the sagttial plane and lateral offset on the coronal plane. (2)Migration before and after on the sagttial plane is increase with increase of neck shaft angle, and the degree of migration of female before and after is less than that of male.

Comparison of the registration methods for the three-dimensional facial scans applied to the design of full-arch implant supported restoration / 北京大学学报(医学版)

OBJECTIVE@#To compare the registration accuracy of three-dimensional (3D) facial scans for the design of full-arch implant supported restoration by five methods and to explore the suitable registration method.@*METHODS@#According to the criteria, ten patients with maxillary edentulous jaw or end-stage dentition requiring implant supported restorations were enrolled in this study. A special rim with individual feature marks reflected appropriate occlusal relationship and esthetic characteristics was made for each patient. Both 3D facial scan data of natural laughter and with opener traction to expose the teeth or occlusal rim of each patient were acquired by facial scan and input to the digital analysis software Geomagic Qualify 2012. The dataset was superimposed by five different methods: seven facial anatomical landmark points alignment, facial immobile area alignment (forehead and nasal area), facial anatomical landmark points and immobile area combining alignment, facial feature points alignment, facial and intraoral feature points alignment with the same local coordinate system. The three-dimensional deviation of the same selected area was calculated, the smaller the deviation, the higher the registration accuracy. The 3D deviation was compared among the three registration methods of facial anatomical landmark points, facial immobile area alignment and the combination of the above two methods. Friedman test was performed to analyze the difference among the three methods (α=0.05). The effect of the aid of the facial and intraoral feature points were evaluated. Paired t test were performed to analyze the difference (P<0.05).@*RESULTS@#The average three-dimensional deviation of the selected area after alignment with the facial anatomical landmarks was (1.501 2±0.406 1) mm, significantly larger than that of the facial immobile area best-fit alignment [(0.629 1±0.150 6) mm] and the combination of the two methods[(0.629 1±0.150 6) mm] (P < 0.001). The aid of the facial feature points could significantly reduce the deviation (t=1.001 3, P < 0.001). There was no significant statistical difference in the remaining groups.@*CONCLUSION@#The forehead area of the 3D facial scan can be exposed as much as possible. The establishment of facial characteristic landmark points and the use of the invariant area alignment can improve the accuracy of registration. It should be clinically feasible to apply three-dimensional facial scan to the design of full-arch implant supported restoration with the registration of the immobile area on the face especially the forehead area.

Effect of Experience in Landmark Identification on 2D Lateral Cephalograms on Performance of Dental Students Concerning Landmark Identification on 3D Cone Beam Computed Tomography Scans

Abstract Objective: To assess the effect of experience in landmark identification on two-dimensional (2D) lateral cephalograms on performance of dental students concerning landmark identification on three-dimensional (3D) cone-beam computed tomography (CBCT) scans. Material and Methods: This quasi-experimental study evaluated 40 dental students in two groups (n=20). Group 1 included senior dental students who had experience in landmark identification on 2D lateral cephalograms and Group 2 included third-year dental students with no such experience. Both groups received instructions on identification of eight landmarks on 3D CBCT scans. The coordinates of the landmarks were determined in x, y and z axes. One orthodontist determined the mean coordinates of each landmark as a reference by twice measurements with a one-week interval. The mean distance from the identified points to the reference points was reported as the mean consistency (MC), and the standard deviation of the mean was considered as precision of landmark identification. Data were analyzed using independent samples t-test. Results: The mean distances from the points identified as nasion, point B, orbitale, anterior nasal spine (ANS), menton, coronoid process and pogonion in x, y and z axes and point A in x and z axes (p<0.001) to the reference points in Group 1 were greater than those in Group 2 with no such experience. Conclusion: Previous experience in landmark identification on 2D cephalograms does not help in landmark identification on 3D CBCT scans and may even adversely affect the results.

Implications of applicators orientations on bladder, and rectal doses in gynecological mHDR brachytherapy: A retrospective analysis of reproducibility in multi-fractionated regimen

Introduction: Variation of doses due to positional uncertainties of applicators based on orthogonal radiograph has been evaluated by several researchers. The present study has analyzed the various possibilities of special alterations of applicator placements in intracavitary brachytherapy (ICBT) and its impact on the dose to target volume, rectum, and bladder. An innovative approach has been suggested to quantify and utilize the special coordinates for reproducibility of applicator based on the pelvic bone landmark. Materials and Methods: A total of 27 fractions of 9 (n = 9) cancer cervix patients treated with external beam radiotherapy followed by ICBT have been evaluated retrospectively. The first fraction of each patient was planned as per the International Commission on Radiation Units and Measurements report 38 guidelines and was considered reference for consecutive fractions regarding dwell positions, dose to target volume, bladder, and rectum points. For each fraction, positioning of applicators regarding their spatial orientations with respect to pelvic bone landmarks and their correlation with dose to bladder and rectum was recorded and analyzed. Results: It was found that mean angulations between (1) the two applicator points with respect to tip of central tandem (α), (2) the two applicator points with junction point situated on the sacrum bone (β) and (3) the angle between the line joining applicator points and a point defined on pelvic bone (γ) is 62.20° ± 5.74°, 37.13° ± 5.64° and 105.51° ± 6.58°, respectively. Bladder dose increased with increment in α but decreased with increase of β and γ. Dose to rectum remained unaffected for γ. Mean distance from couch top to tip of central tandem and two ovoids is, respectively, 11.17 cm and 8.70 cm. Conclusion: Optimal plans even with orthogonal radiographs may be generated by verifying the application based on the parameters mentioned in the present study and computed tomography-based plans could be utilized more effectively instead of doing automatic or manual optimization. Whereever orthogonal radiograph based or template based ICBT practices is performed this study may create a dataset to have an optimal treatment plan even without three-dimensional images

Morphometric Analysis Of The Sacral Hiatus In Indians: Its Clinical Importance

Introduction: Sacral hiatus (SH) is a significant landmark during caudal epidural block (CEB) which is employedfor analgesia and anaesthesia during a wide range of clinical conditions. This requires a thorough knowledge ofmorphometric characteristics of SH and surrounding landmarks, but variability in morphometric dimensionsexists among different populations.Aim: The aim of this study was to identify different anatomical landmarks to detect the location of SH andprovide a reference database for morphometric dimensions of SH in Indian population.Materials and Methods: The study was done on 108 dry adult human sacra. Linear measurements of the sacrawere taken with the help of digital vernier caliper and angular parameters were determined with a goniometer.Results: The most common shape of the sacral hiatus was inverted ’V’ shaped (59.3%) with the level of the apexat S4 in 66.7% and base at S5 in 86.1% cases. Morphometric dimensions of SH were found to be smaller in presentstudy as compared to reports by other researchers. Left crest-apex angle was observed to be significantly greaterthan the right crest-apex angle. (p 0.001).Conclusion: Multiple bony landmarks and their morphometric dimensions should be considered to locate the SHduring CEB. Values for various morphometric parameters of SH are less in Indians in comparison to otherpopulations, which should be contemplated during caudal epidural injections and trans-sacral thecaloscopy.

Landmark for Identification and Location of Parathyroid Glands during Thyroidsurgeries

Parathyroid glands always remain at risk of damage during the thyroid surgery as they lie in close proximity to the thyroid gland. Parathyroid glands are small endocrine glands that produce parathyroid hormone. The major function of parathyroid hormone is to maintain the level of calcium and phosphate within a narrow range in the body. Aim of the present study was to locate and identify the parathyroid glands during thyroid surgery and to observe their relationship with the surgical landmarks. The present study was a prospective study conducted in the department of otorhinolaryngology and HNS in SMGSH, GMC, Jammu for a time period of 1 year from Nov.2015 to Oct. 2016. 40 patients undergoing thyroid surgery were included in the study. Meticulous technique was employed during dissection and parathyroid glands were identified in the surgical field. Location of the each parathyroid gland was determined in relation to a nearby surgical landmark. The study included 12 right (R) and 8 left (L) hemithyroidectomies, 10 sub- total thyroidectomies and 1 total thyroidectomy. An average of 1.2 parathyroid glands were identified in hemithyroidectomies and 2.4 was the average number of parathyroid glands identified in subtotal and total thyroidectomies. Location of parathyroid glands was observed in relation to cricothyroid (CT) joint, recurrent laryngeal nerve (RLN), inferior thyroid artery (ITA) and tubercle of Zukerkandl for superior parathyroid glands, and in relation to RLN, RLN & ITA junction, tubercle of Zukerdandl & lower pole for inferior parathyroid glands. In this study RLN was the most frequent landmark for identification of superior parathyroid gland while the inferior parathyroid glands were frequently seen related to the lower pole of the thyroid gland.