Laser-induced changes in the gene expression, growth and development of Gladiolus grandiflorus cv. "White Prosperity".

Corms of Gladiolus grandiflorus cv. "White Prosperity" was irradiated via red laser at wavelength 635 nm. Various morphological, flowering, elemental and chemical characterizations were studied. Irradiation with different power (5, 20, and 50 mW) and various irradiation time (0.0, 0.5, 1, 3, 5 and 10 min) was studied. Several characters), totaletermined include vegetative growth parameter (spouting days, plant height (cm), leaves number, leaves fresh and dry weights (g/plant), diameter of plant middle part (mm) and leaf area (cm2), floral parameters (flowering days, vase life (day), fresh and dry weights of inflorescence (g/plant), number of flowers per inflorescence, inflorescence length(cm), flowers diameter(cm), number of corms per plant, corms fresh weight(g/plant), circumference/ corms), pigments [total chlorophylls in leaves (SPAD), anthocyanin content (mg/100 g F.W.) in petals], NPK (%) in new corms and chemical composition in corms; total carbohydrates (%),total phenol (µg CE/g (%),total flavonoid (µg CE/g) (%), antioxidant (DPPH IC50 (µg /ml (%), and proline content (µ moles/g). The results showed that the medium level (20 mW) of He-Ne laser at 5 min caused favorable changes in the leaf anatomical structures and other studied characters followed by the low level (5 mW) of He-Ne laser at 5min. 112 bands emerged from 22 SSR primers, ranging between 130 and 540 bp, with 32 bands having polymorphism ranging from 17-100%. Out of the 22 SSR primers, 3 primers exhibited a high polymorphism percentage, i.e., SSR6, SSR16 and SSR22 which exhibited 7 positive markers. These findings revealed the efficiency of SSR primers for differentiating gladiolus plants and revealed that some alleles were affected by laser in their corms and the expression resulted in color or abnormalities in leaves and/or flowers. Mutation in some alleles could result in abnormalities like mutation in the allele with 410 bp revealed by SSR16.

Hierarchies of description enable understanding of cognitive phenomena in terms of neuron activity.

One objective of neuroscience is to understand a wide range of specific cognitive processes in terms of neuron activity. The huge amount of observational data about the brain makes achieving this objective challenging. Different models on different levels of detail provide some insight, but the relationship between models on different levels is not clear. Complex computing systems with trillions of components like transistors are fully understood in the sense that system features can be precisely related to transistor activity. Such understanding could not involve a designer simultaneously thinking about the ongoing activity of all the components active in the course of carrying out some system feature. Brain modeling approaches like dynamical systems are inadequate to support understanding of computing systems, because their use relies on approximations like treating all components as more or less identical. Understanding computing systems needs a much more sophisticated use of approximation, involving creation of hierarchies of description in which the higher levels are more approximate, with effective translation between different levels in the hierarchy made possible by using the same general types of information processes on every level. These types are instruction and data read/write. There are no direct resemblances between computers and brains, but natural selection pressures have resulted in brain resources being organized into modular hierarchies and in the existence of two general types of information processes called condition definition/detection and behavioral recommendation. As a result, it is possible to create hierarchies of description linking cognitive phenomena to neuron activity, analogous with but qualitatively different from the hierarchies of description used to understand computing systems. An intuitively satisfying understanding of cognitive processes in terms of more detailed brain activity is then possible.

Segmentation of 71 Anatomical Structures Necessary for the Evaluation of Guideline-Conforming Clinical Target Volumes in Head and Neck Cancers.

The delineation of the clinical target volumes (CTVs) for radiation therapy is time-consuming, requires intensive training and shows high inter-observer variability. Supervised deep-learning methods depend heavily on consistent training data; thus, State-of-the-Art research focuses on making CTV labels more homogeneous and strictly bounding them to current standards. International consensus expert guidelines standardize CTV delineation by conditioning the extension of the clinical target volume on the surrounding anatomical structures. Training strategies that directly follow the construction rules given in the expert guidelines or the possibility of quantifying the conformance of manually drawn contours to the guidelines are still missing. Seventy-one anatomical structures that are relevant to CTV delineation in head- and neck-cancer patients, according to the expert guidelines, were segmented on 104 computed tomography scans, to assess the possibility of automating their segmentation by State-of-the-Art deep learning methods. All 71 anatomical structures were subdivided into three subsets of non-overlapping structures, and a 3D nnU-Net model with five-fold cross-validation was trained for each subset, to automatically segment the structures on planning computed tomography scans. We report the DICE, Hausdorff distance and surface DICE for 71 + 5 anatomical structures, for most of which no previous segmentation accuracies have been reported. For those structures for which prediction values have been reported, our segmentation accuracy matched or exceeded the reported values. The predictions from our models were always better than those predicted by the TotalSegmentator. The sDICE with 2 mm margin was larger than 80% for almost all the structures. Individual structures with decreased segmentation accuracy are analyzed and discussed with respect to their impact on the CTV delineation following the expert guidelines. No deviation is expected to affect the rule-based automation of the CTV delineation.

[Pathologies of the shoulder joint : Anatomy and examination techniques]. / Pathologien des Schultergelenks : Anatomie und Untersuchungstechniken.

CLINICAL ISSUE: The movements and stability of the human shoulder are a complex dynamic interaction between several joints, muscles and ligaments, which on the one hand enable extensive mobility and on the other hand must provide the necessary stability. Furthermore, the complexity of the shoulder is increased by a large number of normal variants. This article aims to explain the relevant anatomical structures and the radiological examination techniques necessary to visualize them. STANDARD RADIOLOGICAL PROCEDURES: Various modalities contribute to the examination of the shoulder. These include X­rays, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound. METHODOLOGICAL INNOVATION: It is important to use the various procedures appropriately. Especially with MRI arthrography, it is necessary to pay attention to suitable sequences and possibly additional examination positions. PRACTICAL RECOMMENDATION: The multimodal examination of the shoulder can contribute to the diagnosis of numerous clinical pictures. Anatomical and methodological foundations are essential for this.

Insertion sites of the muscles attached to the clavicle: a cadaveric study of the clavicle.

BACKGROUND: Clavicle fractures are common injuries, especially in young, active individuals. Operative treatment is recommended for completely displaced clavicle shaft fractures, and plate fixation is stronger than the use of intramedullary nails. Few studies have reported on iatrogenic injuries to the muscle attached to the clavicle during fracture surgery. The aim of this study was to clarify the area of the insertion sites of muscles attached to the clavicle in Japanese cadavers using gross anatomy and three-dimensional (3D) analysis. We also aimed to compare the effects of anterior plate templating and superior plate templating on clavicle shaft fractures using 3D images. METHODS: Thirty-eight clavicles from Japanese cadavers were analyzed. We removed all clavicles to identify the insertion sites and measured the size of the insertion area of each muscle. Three-dimensional templating was performed on both the superior and anterior plates of the clavicle using data obtained from computed tomography. The areas covered by these plates on the muscles attached to the clavicle were compared. Histological examination was performed on four randomly selected specimens. RESULTS: The sternocleidomastoid muscle was attached proximally and superiorly; the trapezius muscle was attached posteriorly and partly superiorly; and the pectoralis major muscle and deltoid muscles were attached anteriorly and partially superiorly. The non-attachment area was located mainly in the posterosuperior part of the clavicle. It was difficult to distinguish the borders of the periosteum and pectoralis major muscles. The anterior plate covered a significantly broader area (mean 6.94 ± 1.36 cm2) of the muscles attached to the clavicle than did the superior plate (mean 4.11 ± 1.52 cm2) (p < 0.0001). On microscopy, these muscles were inserted directly into the periosteum. CONCLUSION: Most of the pectoralis major and deltoid muscles were attached anteriorly. The non-attachment area was located mainly from the superior to posterior part of the clavicle midshaft. Both macroscopically and microscopically, the boundaries between the periosteum and these muscles were difficult to demarcate. The anterior plate covered a significantly broader area of the muscles attached to the clavicle than that by the superior plate.

What are the resection accuracy and guide-fitting errors associated with 3D-printed, patient-specific resection guides for bone tumour resections?

AIMS: This study aimed to analyze the accuracy and errors associated with 3D-printed, patient-specific resection guides (3DP-PSRGs) used for bone tumour resection. METHODS: We retrospectively reviewed 29 bone tumour resections that used 3DP-PSRGs based on 3D CT and 3D MRI. We evaluated the resection amount errors and resection margin errors relative to the preoperative plans. Guide-fitting errors and guide distortion were evaluated intraoperatively and one month postoperatively, respectively. We categorized each of these error types into three grades (grade 1, < 1 mm; grade 2, 1 to 3 mm; and grade 3, > 3 mm) to evaluate the overall accuracy. RESULTS: The maximum resection amount error was 2 mm. Out of 29 resection amount errors, 15 (51.7%) were grade 1 errors and 14 (38.3%) were grade 2 errors. Complex resections were associated with higher-grade resection amount errors (p < 0.001). The actual resection margins correlated significantly with the planned margins; however, there were some discrepancies. The maximum guide-fitting error was 3 mm. There were 22 (75.9%), five (17.2%), and two (6.9%) grade 1, 2, and 3 guide-fitting errors, respectively. There was no significant association between complex resection and fitting error grades. The guide distortion after one month in all patients was rated as grade 1. CONCLUSION: In terms of the accurate resection amount according to the preoperative planning, 3DP-PSRGs can be a viable option for bone tumour resection. However, 3DP-PSRG use may be associated with resection margin length discrepancies relative to the planned margins. Such discrepancies should be considered when determining surgical margins. Therefore, a thorough evaluation of the preoperative imaging and surgical planning is still required, even if 3DP-PSRGs are to be used.Cite this article: Bone Joint J 2023;105-B(2):190-197.

Deep Learning-Based Medical Images Segmentation of Musculoskeletal Anatomical Structures: A Survey of Bottlenecks and Strategies.

By leveraging the recent development of artificial intelligence algorithms, several medical sectors have benefited from using automatic segmentation tools from bioimaging to segment anatomical structures. Segmentation of the musculoskeletal system is key for studying alterations in anatomical tissue and supporting medical interventions. The clinical use of such tools requires an understanding of the proper method for interpreting data and evaluating their performance. The current systematic review aims to present the common bottlenecks for musculoskeletal structures analysis (e.g., small sample size, data inhomogeneity) and the related strategies utilized by different authors. A search was performed using the PUBMED database with the following keywords: deep learning, musculoskeletal system, segmentation. A total of 140 articles published up until February 2022 were obtained and analyzed according to the PRISMA framework in terms of anatomical structures, bioimaging techniques, pre/post-processing operations, training/validation/testing subset creation, network architecture, loss functions, performance indicators and so on. Several common trends emerged from this survey; however, the different methods need to be compared and discussed based on each specific case study (anatomical region, medical imaging acquisition setting, study population, etc.). These findings can be used to guide clinicians (as end users) to better understand the potential benefits and limitations of these tools.

Morphologic, morphometric and contour shape variations of sagittal otoliths of Lepidorhombus spp. in the Aegean Sea.

Otoliths are calcareous anatomical structures in the inner ear of fishes, and they can be used in the discrimination of fish species and stocks due to their species-specific shape. Sagittal otoliths in the Lepidorhombus whiffiagonis and Lepidorhombus boscii, two flatfish species of the same genus distributed in the Aegean Sea, were compared using morphology, morphometry and contour shape analyses. Blind and eyed side otoliths of Lepidorhombus species were evaluated separately due to their morphological features and statistical differences in morphometric measurements (p < 0.05). Four analysis groups were formed: blind side otolith of L. whiffiagonis, eyed side otolith of L. whiffiagonis, blind side otolith of L. boscii and eyed side otolith of L. boscii. Morphometric differences in otolith shape were performed by canonical discriminant analysis, and the first discriminant axis explained 97.4% (Wilks λ = 0.270) of the variance between the groups, and the second axis explained 2.3% (Wilks λ = 0.620). Classification success between Lepidorhombus species based on CDA is 100%, and the overall CDA classification score between groups is 76.5%. The wavelet functions obtained in the contour analysis showed high variability in the anterior, posterior-dorsal, antero-dorsal and ventral regions of the otoliths among these four analysis groups. Consequently, it is thought that this study will contribute to the taxonomic classification of fish with the morphological and morphometric differences in the blind and eyed side otoliths and the analyses made with the high discrimination success obtained in Lepidorhombus species.

Effects of NaCl Stress on the Growth, Physiological Characteristics and Anatomical Structures of Populus talassica × Populus euphratica Seedlings.

In order to elucidate the salt tolerance mechanism of Populus talassica × Populus euphratica, the growth, physiology and anatomical characteristics of P. talassica × P. euphratica were studied under different concentrations of NaCl-stress treatments. In this study, the annual seedlings of Populus talassica × Populus euphratica were used as the test material in a field potted control experiment. The basic salt content of the culture soil was the control (CK), and two NaCl treatments of 200 mmol/L and 400 mmol/L were established. The pot experiment showed that: (1) Compared with CK, the 200 mmol/L NaCl-stress treatment significantly increased the growth parameters of P. talassica × P. euphratica, such as leaf area, plant height, ground diameter, biomass, root length, root surface area, root fork number and root-shoot ratio. However, compared with CK, the 400 mmol/L NaCl-stress treatment significantly reduced most growth parameters. (2) The 200 and 400 mmol/L NaCl-stress treatments significantly decreased various physiological parameters such as relative water content (RWC), chlorophyll content, water potential, stomatal opening and photosynthetic parameters and increased the accumulation of MDA and Pro compared with CK. The 200 mmol/L NaCl-stress treatment significantly increased the activity of antioxidant enzymes, and the 400 mmol/L NaCl-stress treatment significantly decreased the activity of antioxidant enzymes. (3) Compared with CK, 200 and 400 mmol/L NaCl-stress treatments significantly improved the leaf palisade tissue thickness and palisade-to-sea ratio, as well as the stem xylem and stem phloem thickness and pith diameter, and significantly increased the root xylem thickness, root phloem thickness, and root cross-cutting diameter of P. talassica × P. euphratica. The growth, physiological characteristics and anatomical characteristics of P. talassica × P. euphratica under NaCl-stress treatments showed that it had good salt tolerance and adaptability, and the 200 mmol/L NaCl-stress treatment promoted the growth of P. talassica × P. euphratica to a certain extent. This study provided a theoretical basis for the study of the salt-tolerant mechanism of P. talassica × P. euphratica.

Hydraulic constraints determine the distribution of heteromorphic leaves along plant vertical height.

As an interesting and important trait of some drought-tolerant species, heteromorphic leaves are distributed differentially along plant vertical heights. However, the underpinning mechanism for the formation of heteromorphic leaves remains unclear. We hypothesize that heteromorphic leaves are caused by the hydraulic constraints possibly due to the compensation of the changes in functional traits in response to water transport capacity or the reduction of ineffective water loss. In this study, differences in water transport capacity, morphological traits, anatomical structures, and cellular water relations among three typical types of heteromorphic leaves (i.e., lanceolate, ovate, and broad-ovate) of Populus euphratica Oliv. (a dominant species of desert riparian forest in Central and West Asia) and their relationships were analyzed in order to explore the forming mechanism of heteromorphic leaves. The results showed that the lanceolate, ovate, and broad-ovate leaves were growing in the lower, intermediate, and higher positions from the ground, respectively. Morphological traits, anatomical structures, cellular water relations, and water transport capacity significantly varied among the three types of heteromorphic leaves (P< 0.01). Drought stress in broad-ovate leaves was significantly higher than that in ovate and lanceolate leaves (P< 0.01). Water transport capacity has significant correlations with morphological traits, anatomical structures, and cellular water relations (R 2 ≥ 0.30; P< 0.01). Our results indicated that heteromorphic leaves were used as an important adaptive strategy for P. euphratica to alleviate the increase of hydraulic constraints along vertical heights.

Animal models of osteoarthritis : the benefits and costs of reducing variability.

Cite this article: Bone Joint Res 2022;11(8):514-517.

2D Anatomical Structure for COVID-19 Medical Images.

For many clinical goals like surgical planning and radiotherapy treatment planning is necessary to understand the anatomical structures of the organ that is targeted. At the same time the 2D/3D shape of the organ is important to be reconstructed for the benefit of the doctors. For that reason, accurate segmentation techniques must be proposed to overcome the big data medical image storage problem. The main purpose of this work is to apply segmentation techniques for the definition of 3D organs (anatomical structures) when big data information has been stored and must be organized by the doctors for medical diagnosis. The processes would be implemented in the CT images from patients with COVID-19.

Manufacturing Polymer Model of Anatomical Structures with Increased Accuracy Using CAx and AM Systems for Planning Orthopedic Procedures.

Currently, medicine uses typical industrial structure techniques, including reverse engineering, data processing, 3D-CAD modeling, 3D printing, and coordinate measurement techniques. Taking this into account, one can notice the applications of procedures used in the aviation or automotive industries based on the structure of Industry 4.0 in the planning of operations and the production of medical models with high geometric accuracy. The procedure presented in the publication shortens the processing time of tomographic data and increases the reconstruction accuracy within the hip and knee joints. The procedure allows for the partial removal of metallic artifacts from the diagnostic image. Additionally, numerical models of anatomical structures, implants, and bone cement were developed in more detail by averaging the values of local segmentation thresholds. Before the model manufacturing process, additional tests of the PLA material were conducted in terms of its strength and thermal properties. Their goal was to select the appropriate type of PLA material for manufacturing models of anatomical structures. The numerical models were divided into parts before being manufactured using the Fused Filament Fabrication technique. The use of the modifier made it possible to change the density, type of filling, number of counters, and the type of supporting structure. These treatments allowed us to reduce costs and production time and increase the accuracy of the printout. The accuracy of the manufactured model geometry was verified using the MCA-II measuring arm with the MMDx100 laser head and surface roughness using a 3D Talyscan 150 profilometer. Using the procedure, a decrease in geometric deviations and amplitude parameters of the surface roughness were noticed. The models based on the presented approach allowed for detailed and meticulous treatment planning.

Anatomical Structures Responsible for CTEV Relapse after Ponseti Treatment.

Relapse of deformity after a successful Ponseti treatment remains a problem for the management of clubfoot. An untreated varus heel position and restricted dorsal flexion of the ankle are the main features of recurrences. We analyze the anatomical structures responsible for these recurrences. Materials and methods: During 5 years, 52 children with CTEV (Congenital Talipes Equino Varus) were treated with casts according to the Ponseti method, with a mean number of 7 casts. Closed percutaneous tenotomy was performed in 28 infants. Children were followed monthly and treated with the continuous use of a molded cast. We had 9 children with relapsed clubfeet. During the standing and walking phase, they had a fixed deformity with a varus position of the heel and dorsal flexion of the ankle <10 d. They were surgically treated with the posterolateral approach. Results: In all patients, we found a severe thickening of the paratenon of the Achilles in the medial side, with adhesions with the subcutaneous tissue. The achilles after the previous tenotomy was completely regenerated. The achilles was medially displaced. Conclusions: A severe thickening of the paratenon of the achilles and adhesions with the subcutaneous tissue are anatomical structures in fixed relapsed cases of clubfoot. We treated our patients with an appropriate surgical release.

Unenhanced abdominal low-dose CT reconstructed with deep learning-based image reconstruction: image quality and anatomical structure depiction.

PURPOSE: To evaluate the utility of deep learning-based image reconstruction (DLIR) algorithm in unenhanced abdominal low-dose CT (LDCT). MATERIALS AND METHODS: Two patient groups were included in this prospective study: 58 consecutive patients who underwent unenhanced abdominal standard-dose CT reconstructed with hybrid iterative reconstruction (SDCT group) and 48 consecutive patients who underwent unenhanced abdominal LDCT reconstructed with high strength level of DLIR (LDCT group). The background noise and signal-to-noise ratio (SNR) of the liver, pancreas, spleen, kidney, abdominal aorta, inferior vena cava, and portal vein were calculated. Two radiologists qualitatively assessed the overall image noise, overall image quality, and abdominal anatomical structures depiction. Quantitative and qualitative parameters and size-specific dose estimates (SSDE) were compared between SDCT and LDCT groups. RESULTS: The background noise was lower in LDCT group than in SDCT group (P = 0.02). SNRs were higher in LDCT group than in SDCT group (P < 0.001-0.004) except for the liver. Overall image noise was superior in LDCT group than in SDCT group (P < 0.001). Overall image quality was not different between SDCT and LDCT groups (P = 0.25-0.26). Depiction of almost all abdominal anatomical structures was equal to or better in LDCT group than in SDCT group (P < 0.001-0.88). The SSDE was lower in LDCT group (4.0 mGy) than in SDCT group (20.6 mGy) (P < 0.001). CONCLUSIONS: DLIR facilitates substantial radiation dose reduction of > 75% and significantly reduces background noise. DLIR can maintain image quality and anatomical structure depiction in unenhanced abdominal LDCT.

Value of Different Magnetic Resonance Imaging-based Measurements of Anatomical Structures on Preoperative Prostate Imaging in Predicting Urinary Continence After Radical Prostatectomy in Men with Prostate Cancer: A Systematic Review and Meta-analysis.

CONTEXT: Measurements of anatomical structures on preoperative prostate magnetic resonance imaging (MRI) are used in risk models for treatment decisions to predict urinary continence (UC) following radical prostatectomy (RP). However, the association between these parameters and UC is unclear. OBJECTIVE: To systematically summarize the literature on prognostic preoperative prostate MRI measurements of (peri)prostatic structures in relation to time to recovery of postoperative UC in men with prostate cancer. EVIDENCE ACQUISITION: Online libraries were searched up to August 27, 2021. Article selection and critical appraisal were performed by two reviewers. All papers reporting on preoperative MRI measurements with UC correlation in univariable or multivariable analyses were included. EVIDENCE SYNTHESIS: In the 50 studies included (mostly retrospective), 57 MRI parameters were evaluated. The pooled analyses showed that greater membranous urethra length (MUL) was prognostic for regaining UC at 1 mo (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.10-1.21), 3 mo (OR 1.23, 95% CI 1.16-1.31), 6 mo (OR 1.16, 95% CI 1.08-1.25), and 12 mo (OR 1.19, 95% CI 1.10-1.29). Several other anatomical structures showed at least in one study a significant correlation with later return to UC: four prostate-related parameters (greater depth, apical protrusion, larger intravesical protrusion, small dorsal vascular complex), five urethra-related parameters (thicker wall, severe fibrosis, smaller volume, larger preoperative angle between the prostate axis and membranous urethra, shorter minimal residual MUL), and six musculoskeletal-related parameters (lower perfusion ratio, thinner levator ani muscle, larger inner or outer levator distance, shorter pelvic diaphragm length, and larger midpelvic area). CONCLUSIONS: Greater MUL as measured on preoperative MRI was an independent prognostic factor for return to UC within 1 mo after RP and remained prognostic at 12 mo. Other anatomical structures may potentially be predictive, but these would need to be substantiated in prospective trials before being adopted in postoperative UC risk models for treatment decisions in men with prostate cancer. PATIENT SUMMARY: We summarized study data on the relation between measurements of anatomical structures on preoperative magnetic resonance imaging scans and urinary continence after removal of the prostate. Greater length of one part of the urethra (membranous urethra) is associated with faster return to continence. Other anatomical structures have potential for predicting postoperative continence, but need further investigation.

Effects and risks of performing a single incision endoscopic plantar fasciotomy - An anatomical study.

BACKGROUND: Chronic plantar fasciitis with insufficient improvement after conservative treatment can be addressed by surgery. Endoscopic plantar fasciotomy using a single incision technique is an innovative treatment strategy. The aim of this study was to evaluate the effects and potential risks of damaging anatomical structures when performing this technique. METHODS: 40 fresh-frozen foot specimens underwent single incision endoscopic plantar fasciotomy. Operations of group A (n = 20) were done by an experienced surgeon, operations of group B (n = 20) were done by unexperienced residents. RESULTS: In both groups, all major vessels or nerves remained undamaged. Sufficient transection (>90%) was found in 16 of 20 specimens (group A) and 10 of 20 specimens (group B) (p = 0.047). CONCLUSIONS: Our results show that single incision endoscopic plantar fasciotomy can be safely performed even by unexperienced surgeons. In contrast to that, complete transection of the medial fascicle is dependent on the surgeon's experience.

Determining trainees' knowledge of surgical anatomy: A specialist's perspective.

OBJECTIVES: Intraoperative identification of anatomical structures can potentially reduce the risk of surgical complications. This study aims to report specialists' perspectives about the anatomical structures that third-year residents should be able to identify during surgical operations. In addition, the factors which may influence specialists' opinions are discussed. MATERIALS AND METHODS: This qualitative cross-sectional study was conducted on obstetricians and gynaecologists between 1/2/2019 and 30/10/2019. The specialists practising in a hospital with a residency programme were included, and were asked to rate the importance of structures that a third-year resident should be able to identify during operations. We performed a comparison of responses based on specialists' age, gender, practice type, years of experience, and surgical workload. RESULTS: One hundred and sixty-five specialists were recruited with a response rate of 69.3%. The mean age of respondents was 46.1 years, and they had a mean experience of 13.4 years. Furthermore, 86.6% of specialists rated all the anatomical structures as "more important". The importance of surgical structures, as rated by specialists, was not related to gender, years of experience, or surgical workload. The importance of 63% of the anatomical structures was rated higher by junior specialists than senior specialists. CONCLUSION: Knowledge of anatomical structures is vital for gynaecologic residency training. Specialist's perceptions of the importance of various anatomical structures reflect their understanding of the training requirements. Our results highlighted the important anatomical structures that third-year residents are expected to identify during surgical operations. Future research may establish a reference for the core anatomy knowledge essential for each training year.

[Connection of perforating and intramuscular veins of the crus in varicosity]. / Sviaz' perforantnykh i vnutrimyshechnykh ven goleni pri varikoznoi bolezni.

AIM: This study was undertaken to investigate the clinical anatomy of indirect perforating veins and their connection to the intramuscular venous collector of the crus by means of MSCT phlebography. PATIENTS AND METHODS: From 2015 till now, MSCT phlebography was used to examine a total of 400 patients with chronic diseases of lower limb veins. According to the CEAP classification, clinical class C0-C1 was present in 108 (27%) subjects, C2-C3 - in 173 (43.3%) patients, and C4-C6 - in 119 (29.7%) patients. All examinations were performed using a 128-slice multispiral CT scanner Philips Ingenuity, followed by 3D reconstruction with the help of the IntelliSpace Portal Image Editing Software package. RESULTS: In the 400 extremities examined, we identified a total of 11 655 indirect perforating veins of the calf. Studying the anatomical localization of perforating veins demonstrated that 3248 veins belonged to the posterior tibial group, 1830 veins - to the lateral group, 873 veins - to the paraachillary group, 276 veins - to the intergemellary group, 4451 veins - to the medial group, and 997 perforating veins - to the lateral group. 3D imaging made it possible to trace the entire course of the perforating veins originating from the posterior arched, intersaphenous, oblique veins or other communicating branches to the subfascial and intramuscular portions to the connection with the gastrocnemius and soleus veins which as the disease progresses undergo ectasia with the formation therein of pathological segmental hypervolemia. CONCLUSION: Studying the ratio of the revealed indirect perforating veins of the determined groups and the presence of gradually developing ectasia of the intramuscular venous collectors in patients of various clinical classes from C0-C1 to C4-C6 made it possible to draw a conclusion on the involvement of perforating veins and intramuscular veins of the crus into the common pathohaemodynamic circle of the development and progression of chronic venous insufficiency in patients with varicose veins.

[A classification of surgical guides application for dental implantation]. / Klassifikatsiya variantov primeneniya khirurgicheskikh napravlyayushchikh shablonov dlya dental'noi implantatsii.

In dental implantology the treatment planning is the most important item for surgery success as well as for functionality and aesthetics of denture. The current problem is to determine the implant position intraoperatively. On dental market there are many companies offering the different variants of navigation surgery, including surgical guides. The purpose of this study is to create universal classification of surgical guide application for dental implantation based on clinical setting and the individual anatomy of the patient which simplifies the medical activities and predictably performs the treatment protocol.