Removal of iatrogenic orbital foreign bodies with a 3D model

Facial foreign body (FB) is common after trauma, but iatrogenic orbital FB is a rare and unexpected complication of facial FB removal surgery. We present the case of a 43-year-old man with a glass FB in his nose. During the operation, this FB broke into two pieces, and the larger one pierced into the left orbit, close to the eyeball. A three-dimensional (3D) model was made that accurately recreated the shape and position of the FB in the orbit, according to which the FB was removed. 3D-printing technology is a great tool when dealing with complex facial FB.

Application of CBL teaching based on self-made dynamic cardiovascular three-dimensional model in clinical clerkship of valvular heart disease / 中华医学教育探索杂志

Objective:To explore the effect of self-made dynamic cardiovascular three-dimensional model combined with CBL (case-based learning) teaching method in the clerkship of valvular heart disease for medical students.Methods:Sixty five-year clinical medical undergraduates from Nanjing Medical University (Batch 2016) were randomly divided into experimental group and control group. The experimental group received dynamic cardiovascular 3D model combined with CBL teaching method, while the control group received traditional model combined with CBL teaching method. After the course, the teaching effect was evaluated by examination and questionnaire. SPSS 19.0 was used for independent sample t test and chi-square test. Results:Compared with the control group, the students in experimental group had higher scores of basic theoretical knowledge [(43.10±3.51) vs. (40.87±3.19)] and clinical thinking ability [(42.20±3.15) vs. (40.20±3.81)], with significant differences ( P<0.05). Furthermore, they showed higher evaluation and satisfaction to learning initiative and enthusiasm, mastery of theoretical knowledge, clinical thinking ability, classroom learning interest, classroom activity and clarity of knowledge teaching, with significant differences ( P<0.05). Conclusion:In the teaching of valvular heart disease clerkship, the application of self-made dynamic cardiovascular three-dimensional model combined with CBL teaching method, can cultivate students' clinical diagnostic thinking ability and improve teaching quality.

Determining the accuracy of lumbar 4/5 pedicle screw entry point based on digital three-dimensional technology / 西安交通大学学报(医学版)

【Objective】 To establish a digital model of lumbar 4 and lumbar 5 vertebral bodies through three-dimensional imaging technology so as to explore the precise placement of pedicle screws during the lumbar posterior internal fixation operation. 【Methods】 CT scan image data set of lumbar spine included six specimens. Then lumbar modeling was produced using Mimics software， implanting pedicle screws was simulated with the computer to determine the reliability of pedicle screw for herringbone crest method， Weinstein method， and Magerl method. 【Results】 This study included six specimens （4 males and 2 females）， with an average age of 42.83 years. The distance from the right Magerl entry point to the actual entry point of the lumbar 4 vertebrae was significantly greater than that of the left side. The distance from the left herringbone crest entry point of lumbar 4 vertebrae to the actual entry point was significantly greater than Weinstein method and Magerl method （PMagerl abduction angle > Weinstein abduction angle > herringbone abduction angle. The distances of true-Weinstein and true-herringbone ridges on the left side of lumbar 5 vertebrae were significantly greater than those on the right side （P=0.002 and P=0.004）， and the Weinstein abduction angle on the right side of lumbar 5 vertebrae was greater than that on the left side （P=0.003）. For the left and right sides of lumbar 5 vertebrae， the distance from herringbone crest entry point to the actual entry point was significantly greater than that of Weinstein method and Magerl method （P Magerl abduction angle > Weinstein abduction angle > herringbone abduction angle. 【Conclusion】 Both Weinstein entry point and Magerl entry point for lumbar 4 and lumbar 5 vertebra are close to the real entry point. The Weinstein abduction angle and Magerl abduction angle of lumbar 4 and lumbar 5 vertebrae have minor differences compared with real abduction angle. Therefore， it is recommended that Weinstein method is the preferred choice for lumbar 4 pedicle screw placement， while Weinstein method or Magerl method is the preferred choice for lumbar 5 pedicle screw placement.

Establishment of three-dimensional model of rat retinal angiogenesis <i>in</i> <i>vitro</i> based on endothelial cells and pericytes / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To establish three-dimensional(3D)model of rat retinal angiogenesis <i>in</i> <i>vitro</i> based on retinal microvascular endothelial cells(ECs)and retinal microvascular pericytes(RMPs). <p>METHODS: The identified ECs and RMPs of third generation to seventh generation were used for research after isolated, purified and cultured. The cells were stained with cell tracer. Then, it were mixed and inoculated on Matrigel by the surface culture method for dynamic observation. The expression of VEGF-A was assessed during angiogenesis. <p>RESULTS: At 12h of co-culture, RMPs were recruited by ECs and gathered into cell masses with different sizes. At 24h, ECs/RMPs formed a complex 3D vascular spline network. At 48h, the reticular structure disintegrated obviously, and only a small amount of incomplete and simple reticular structure remained. At 72h, the vascular spline cable network disintegrated completely. In the development of 3D model, the expression of VEGF-A increased, but decreased when it degenerated. <p>CONCLUSION: This study successfully established a 3D model of rat retinal angiogenesis <i>in</i> <i>vitro</i> based on ECs and RMPs.

CT-imaging-based anatomical and three-dimensional modeling of the head and neck arterial vessels of the miniature pig / 中国比较医学杂志

Objective To investigate the anatomical structure of arterial vessels in the head and neck of miniature pigs and the related application of vascular cast specimens,and the technology of three-dimensional model reconstruction by CT imaging. Methods A vascular cast specimen of a miniature pig head and neck was made by a 128-slice spiral CT scanning,and a three-dimensional model of the arterial vessels in the head and neck of the miniature pig was reconstructed. Results The cast specimen clearly showed the distribution and running characteristics of the arteries in the head and neck of a miniature pig. The three-dimensional digital model was realistic and stereoscopic,showing the running and distribution of arteries from multiple angles and layers. Conclusions The distribution and running characteristics of arterial vessels in the head and neck of a miniature pig have been investigated by the combination of cast specimen and three-dimensional digital model,providing a morphological reference for the establishment of pig cerebrovascular models in respects of both solid specimen and virtualized model.

Establishment of electron beam computed tomography and rapid prototyping techniques for a cranial bone defect model in goat / 中华医学美学美容杂志

Objective To establish a cranial bone defect model of goat and to study application in craniomaxillo-facial surgery.Methods Electron beam computed tomography (EBCT) scanner was used to scan goat'heads and faces in series and thin layers.Data of EBCT were input in workstation from digital inlet,and then to three-dimensional reconstruction with method of surface shadow.After final data were transformed to the files,the rapid prototyping machine was able to identify and establish the 3D model.Results The EBCT continuous thin-layer (1 mm) scanning data were passed to wave filter,falling coarse,distinguishing and collecting the outline,3D-reconstruction,curved surface reconstruction with CAD and the substance reconstruction.The final data were input into the laser rapid prototyping machine.Three-dimensional bionic cranium models were fabricated by machine in layer by layer manufacturing principle.Conclusions Establishment of the cranial bone defect model in the goat is very useful to the three-dimensional measurement,individualized reconstruction and basic and clinical research for the cranial bone defect.

Clinical research on the simulation accuracy of zygomatic reduction using an L-shaped osteotomy by Proplan CMF software / 中华整形外科杂志

Objective@#To evaluate the surgical prediction accuracy of Proplan CMF software for zygomatic reduction surgery using L-shaped osteotomy.@*Methods@#Pre-and-postoperative 1-year CBCT data of 26 patients with zygomatic arch hypertrophy were imported in Proplan CMF software during 2014 Jan. to 2016 Jun., the 3D models were reconstructed for simulation of L-shaped osteotomy, characteristic landmarks were selected and 3D point measurement system was established. The measurement result were analyzed by one-way ANOVA. Meanwhile, the overlap color grading charts of preoperative and simulated images were also observed.@*Results@#The facial width, bilateral zygomatic process angle and facial width index were [(128.56±2.72) mm, (106.87±2.53)°, (108.56±3.02)°and 1.41±0.03] in postoperative result, [(129.49±2.26) mm, (108.68±2.40)°, (108.85±3.02)°and 1.42±0.03]in simulated result and [(135.45±2.45) mm, (102.50±2.60)°, (103.41±2.56)°and 1.48±0.05] in preoperative result, with significant difference between preoperative and postoperative result, or between preoperative and simulated result (P<0.05), while no significance between postoperative and simulated result (P>0.05). The soft tissue zygomatic process distance was(153.25±2.58) mm in preoperative result, (150.23±2.76)mm in postoperative result , (149.36±3.27)mm in simulated result, with no significance between any of two groups result (P>0.05). The zygomatic process distance and bilateral zygomatic process tragal distance were (126.35±2.56) mm, (68.75±2.15) mm and(68.86±3.21) mm in postoperative result, showing significant differences compared with preoperative result [(120.16±3.18) mm, (74.58±3.19) mm and(76.14±3.15) mm] and simulated result [(118.86±3.45) mm, (73.85±3.57) mm and(76.87±2.58) mm] respectively(P<0.05), while zygomatic arch distance was not statistically different among the three groups(P>0.05). It indicated that predictive accuracy of facial width, facial width index, zygomatic process angle, soft tissue zygomatic arch distance was high but the soft tissue zygomatic process distance and zygomatic process tragal distance was relatively low. Meanwhile, the color overlay image showed that predictive accuracy was not good in the zygomatic region while the zygomatic arch area was high.@*Conclusions@#The predictive accuracy of Proplan CMF software for zygomatic arch hypertrophy is relatively high except for the zygomatic region. Further improvement of the CMF software is needed.

Evaluation of the invisible bracketless appliance on maxillary molar distalization / 实用口腔医学杂志

Objective:To evaluate the clinical effects of invisible bracketless appliance on the upper molar distalization.Methods:15 patients with class Ⅱ malocclusion(at the average age of 25.3 years) were treated by invisible bracketless appliance,the pre and post three-dimensional digital models were superimposed and measured,the effects of molar distalization were analysed.Results:After treatment,the maxillary first molars were distalized by 2.58 mm on both sides.The left and fight second molars were distalized by 2.57 mm and 2.68 mm respectively.Bilateral central incisors were moved mesially by 0.34 mm.There was no significant difference in the horizontal movement of central incisor.But the left and fight first molars were moved buccally by 0.96 mm and 0.97 mm respectively,the left and fight second molars were moved buccally by 1.01 mm and 1.11 mm separately.Bilateral first molars were intruded by 0.26 mm,the left and right second molars were intruded by 0.37 mm and 0.36 mm,respectively.But the central incisors had no significant vertical movement.There was no significant difference in the buccally or palatally rotation of bilateral first and second molars.Conclusion:Invisible bracketless appliance is efficient for distalization of upper molar,but it may result in mild molar intrusion and anterior anchorage loss.

Modelo virtual tridimensional de la articulación cubital del perro a partir de cortes plastinados ultradelgados / Three-dimensional virtual model of the elbow joint of the dog by means of ultrathin plastinated slices

La articulación cubital del perro es de tipo compuesta, formada por el cóndilo del húmero, la cabeza del radio y la escotadura troclear de la ulna. Esta articulación es propensa a padecer enfermedades del desarrollo, lesiones traumáticas y degenerativas. La corrección de estos padecimientos suele ser quirúrgica, sin embargo, el planteamiento de la cirugía resulta difícil debido a la complejidad estructural de esta articulación. Los modelos anatómicos tridimensionales (3D) obtenidos de los cortes seriados mediante tomografía computarizada han probado ser eficaces en el planteamiento de los abordajes quirúrgicos, sin embargo tiene limitaciones técnicas en la identificación de los tejidos blandos. Los cortes ultradelgados (1 mm) obtenidos mediante plastinación permiten realizar descripciones anatómicas detalladas de regiones anatómicas complejas y también pueden ser usadas para realizar reconstrucciones 3D. El objetivo del presente trabajo, ha sido obtener una reconstrucción 3D de las estructuras anatómicas que conforman el codo del perro a partir de cortes plastinados ultradelgados.

The dog's elbow joint is a very complex structure formed between the humeral condyle, the radial head and the ulnar trochlear notch. This joint is prone to suffer growth disorders, traumatic injuries, and degenerative conditions. All these problems used to be solved by surgical means, nevertheless, the surgical plan, results in a complex decision making process related with the aforementioned joint characteristics, three dimensional (3D) anatomical models from computed tomography have proven to be useful in the surgical approach, nevertheless the image technique is at some point limited, mainly identifying soft tissues. Ultrathin plastinated slices (1 mm) allows to perform very detailed descriptions of complex structures and 3D reconstructions as well. The aim of this work, was to obtain a 3D reconstruction of ultrathin plastinated elbow joint in the dog.

Application of digital three -dimensional model of abdominal and pelvic vessels in selecting intravascular catheterization method / 介入放射学杂志

Objective By using digital three-dimensional (3D) model of abdominal and pelvic vessels to investigate the relationship between the angle/position of the bifurcation of bilateral common iliac arteries and the length of the common iliac artery, thus to guide the endovascular interventional catheterization manipulation. Methods A total of 439 patients, who received abdominal and pelvic CTA at authors’ department during the period from Sep. 2011 to May 2013, were included in this study. By using digital 3D reformation technique, the 3D model of the abdominal and pelvic vessels as well as the lumbosacral vertebrae was established in all patients. With the help of mimics and geomagic software the angles between the left and right common iliac arteries and the lengths of common iliac arteries were determined, and the lumbar vertebra corresponding to the bifurcation of common iliac arteries was recorded. Using statistical software, the relationship between the bifurcation angle of bilateral common iliac arteries and the corresponding lumbar vertebra as well as the length of common iliac arteries was analyzed. Results The digital 3D model of the abdominal and pelvic vessels as well as the lumbosacral vertebrae was successfully reconstructed in all 439 patients. Both the angle between the left and right common iliac arteries and the corresponding lumbosacral level of bifurcation angle were clearly demonstrated on the model. The average angle was 49.1° ± 12.4°. The bifurcation was located at L3 -L4 level in 38 cases, at upper one-third level of L4 in 63 cases, at middle one third level of L4 in 89 cases, at lower one-third level of L4 in 135 cases and at L4 -L5 level in 114 cases. The average length of the left and right common iliac artery was (45.6 ± 15.6) mm and (43.3 ± 15.4) mm respectively. Pearson correlation analysis indicated that a negative correlation existed between the angle and the position level of the left and the right common iliac artery (r = -0.172, P< 0.05), and a negative correlation also existed between the angle and the length of the common iliac artery (left: r = -0.171, P<0.05; right: r = -0.164, P < 0.05). Conclusion The lower the opening position of the left and right common iliac artery is, and the bigger the intersection angle is, the shorter the length of corresponding common iliac artery will be. In this case, catheterization via femoral artery to contralateral iliac artery is a short path, and the catheterization procedure is easy to manipulate with higher success rate. On the contrary, the catheterization will be difficult, and the use of loop-technique will be needed. The digital 3D model of the abdominal and pelvic vessels as well as the lumbosacral vertebrae can help select the optimal catheterization path.

Reconstruction of 3D model of the maxillofacial hard and soft tissues with low-dose CT / 实用口腔医学杂志

Objective:To evaluate of the feasibility of low-dose CT(LDCT)in the reconstruction of three-dimensional(3D)model of maxillofacial hard and soft tissues.Methods:Lightspeed 16-slice spiral CT scanner was used to scan one adult cadaveric head specimens with conventional parameters(280 mA)and low dose parameters(200,150,100,50,35,25,15 and 5 mA)respectively;the 3D model of the hard and soft tissues were reconstructed with Mimics 10.01 software,and 3D comparison were carried on with Geomagic 11.0 software.A comparison of the surface morphology of the hard and soft tissues of the 3D models with different scanning parameters was made.Results:With the reduction of the tube current,the model surface became rough gradually.Compared with the 280 mA scan results,the model surface produced by 35 mA scanning was still fairing,when the dose fell to less than 25 mA,the model surface became rough and the exact shape of the model could not be recognized.The same results of model surface were pro-duced after registration.Conclusion:The low-dose (35 mA)CT can be used to reconstruct 3D model of the maxillofacial hard and soft tissues.

Establishment of a three-dimensional digital model based on multi-source craniofacial profile / 中华医学美学美容杂志

Objective To establish a three-dimensional digitized visible model to meet the clinical and research needs.Methods The head of the volunteer was scanned by a cone beam CT (CBCT).The bone tissue,the facial soft tissue and the teeth were extracted from the cone beam CT raw data according to the different Houns field values.The 3D digital craniofacial model was reconstructed from the three tissues extracted from the CBCT original data.The 3D dental model with high resolution was acquired by scanning the dental cast with the laser scanner.The 3D facial model with texture was acquired by scanning the volunteer's face directly by other laser scanner.With the regis tration algorithm in 3D graphics,the 3D facial model with texture and the 3D dental model with high resolution were transformed to the same coordinate which was of the 3D digital craniofacial model.Results We acquired a complicated 3D craniofacial digital model which combined the teeth model with high resolution,the bone model and the face model with texture.Conclusions The method is able to accurately establish the craniofacial digital model.

Noncompliance screw supported maxillary molar distalization in a parallel manner / 대한치과교정학회지

OBJECTIVE: Intraoral noncompliance upper molar distalization techniques have gained in popularity and have subsequently found to be successful in Class II correction. The aim of the present study was to introduce a screw supported intraoral distalization appliance and investigate its efficiency. METHODS: Twenty-one subjects (11 females, 10 males; average age of 14.9 years) with Angle Class II malocclusion participated in this study. Two screws were inserted behind the incisive foramen and immediately loaded to distalize the upper first molars. An intraoral screw supported distalization appliance was used to distalize the upper molars in order to achieve a Class I molar relationship. Skeletal and dental changes were evaluated using cephalometric and three-dimensional (3D) model analysis. RESULTS: Upper molars were distalized 3.95 mm on average and a Class I molar relationship was achieved without any anchorage loss. The upper molars were tipped only 1.49degrees and the upper right and left molars were rotated only 0.54degrees and 0.74degrees respectively which were statistically non-significant (p > 0.05). CONCLUSIONS: The newly designed screw supported noncompliance distalization appliance was found to be an effective device for achieving bodily molar distalization without any anchorage loss.

Planejamento de cirurgias complexas em cabeça e pescoço - o uso de modelos tridimensionais / Planning of complex surgery in head and neck region - the use of three-dimensional (3D) model

Introdução: O planejamento pré-operatório de cirurgias complexas da região de cabeça e pescoço utiliza usualmente imagens de tomografia computadorizada (TC) ou ressonância nuclear magnética (RNM). Uma reconstrução tridimensional completa das estruturas envolvidas nessas regiões pode propiciar um acesso privilegiado às áreas anatômicas de interesse, explicitando detalhes que não podem ser vistos nos filmes radiográficos comuns. A prototipagem rápida (PR) consiste em um grupo de processos utilizados para produzir objetos em três dimensões pela adição de camadas de material. O processo de sinterização seletiva a laser (SLS ? Selective Laser Sintering) é uma das técnicas disponíveis de PR, que pode ser usada para produzir protótipos biomédicos obtidos a partir de imagens de TC e RNM. Esses protótipos são utilizados com objetivos didáticos, na fabricação de próteses personalizadas, no diagnóstico e planejamento de cirurgias crânio-faciais, incluindo as neoplasias e facilitando também a comunicação entre profissional e paciente. Método: utilizamos o software InVesalius para viabilizar a transformação de imagens médicas de TC e RNM em formato DICOM, para um arquivo no formato STL, empregado em prototipagem rápida. Esse arquivo foi enviado para a máquina de sinterização a laser, que gera um modelo da área óssea de interesse. Esse modelo tridimensional foi estudado pela equipe de cirurgia para planejar o tratamento e, muitas vezes, confeccionar próteses e simular cirurgias. Esses procedimentos foram realizados com forte interação entre profissionais da área médica, de informática e engenharia. Resultados: utilizamos o método em 13 pacientes com câncer de cabeça e pescoço, sendo sete homens e seis mulheres, com idade de 9 a 77 anos (média de 56). O diagnóstico era de neoplasia naso-etmoidal em três pacientes, neoplasia de maxila em dois, neoplasia de órbita em um, neoplasia de mandíbula em sete (sendo neoplasia de face com invasão de mandíbula em dois, neoplasia de boca com invasão de mandíbula em dois, neoplasia primária de mandíbula em três). Em todos os casos, o molde permitiu um planejamento acurado da cirurgia, muitas vezes permitindo fazer uma pré-moldagem de próteses de titânio, programação da reconstrução com microcirurgia, simulação do ato operatório e isso levou a uma otimização e diminuição do tempo esperado da cirurgia. Conclusão: a PR mostrou ser um método eficiente para o planejamento de cirurgias complexas em cabeça e pescoço que incluem ressecção óssea de face ou mandibular. Seu uso parece reduzir o tempo do procedimento cirúrgico e o período de anestesia, o que pode ser muito útil para o tratamento desses casos.

Introduction: the pre-operative planning of complex surgery in head and neck region is usually done by computed tomography (CT) or magnetic resonance images (MRI). A three-dimensional (3D) model of the involved structures in these regions can supply visual and touchable access to the anatomical areas of interest, showing details that could not be seen in conventional radiographic films. The Rapid Prototyping (RP) is a group of processes used to produce 3D models by addition of material. The Selective Laser Sintering (SLS) is one of the techniques utilized in RP that can be used to produce medical models from CT or MRI. These models can be used for pre-operative planning of cranio-facial surgery. Methods: we utilized the software InVesalius to make feasible the transformation of medical images from CT or MRI in DICOM format to a STL format archive of RP machine, a Laser Sintering, that produces a nylon model of the bone area of interest. This 3D model was studied by the surgical team to plan and simulate the surgery, to explain the treatment to the patient and to make prosthesis when necessary. These procedures were carried out with strong interaction of medical, engineering and computer professionals. Results: we applied the method in 13 patients with head and neck cancer, 7 men and 6 women, with age varying from 9 to 77 years (average, 56). Diagnosis were nasoetmoidal tumor in 3 patients, paranasal sinus cancer in 2 patients (2 skull base), orbital cancer in 1, and cancer involving the mandible in 7 patients (2 primary, and 5 with invasion of the mandible). In all cases the model allowed an accurate planning of the surgery, sometimes with pre-operative simulation of the procedure, template of osteosynthetic material, planning of microsurgical reconstruction, and decrease the expected time of the surgery. Conclusions: the RP is an efficient method for preoperative planning in complex surgery of head and neck region that includes osteotomies or resection of facial bone or mandible. Its use seams to reduce the operative time and improve the planning and procedure quality, and the communication with patients and among the surgical team.

Three-dimensional model of development thought and exploration of health management / 中华医学教育探索杂志

The new medical reform policy situation,the professional development of health management should follow the principle of scientific development to achieve three-dimensional models of development.Three-dimensional-style development should focus on the realization of the subject-object interaction,full management,all-round construction,double-entry-style positioning,and compound training of personnel.And through the three-dimensional development strategy we should seek to promote the health management leaps and bounds.

A three-dimensional model of angiogenesis in vitro / 中国现代普通外科进展

Objective:To develop an experimental three-dimensional model by ECV304 cells(human umbilical vein endothelial cell line) for investigating the mechanisms of angiogenesis in vitro.Methods:ECV304 cells were seeded onto three-dimensional collagen gels made of rat-tail collagen.When the endothelial cells were cultured and grown to near confluence,treated with bFGF for 3 to 12 days,and then assessed with inverted phase contrast microscope.Results:The endothelial cells migrated into the gels,formed complex networks by cell cords at different levels through the bottom view,and sprouted capillary-like structures through the side view.Conclusion:ECV304 cells are capable of expressing some early events of angiogenesis in the three-dimensional collagen gels:proliferating,migrating and sprouting and so on.It should be useful for studying angiogenesis in vitro.