Modified Laryngeal Forceps for Arytenoid Cartilage Dislocation Caused by Endotracheal Intubation: A Retrospective Case-Control Pilot Study.

Background: Arytenoid cartilage dislocation is considered as a rare laryngeal injury and closed reduction is commonly used as the first choice for the arytenoid dislocation. However, the tools of closed reduction vary, and there is no dedicated tool for closed reduction, and the treatment outcome varies from person to person. This study compared the treatment outcome of the modified laryngeal forceps and traditional laryngeal forceps. Material and Methods: This study conformed to the strengthening the reporting of observational studies in epidemiology guidelines regarding retrospective studies. From May 2021 to February 2023, the records of 28 patients with arytenoid cartilage dislocation caused by endotracheal intubation were reviewed. They were divided into the traditional group (n = 14) and the modified group (n = 14) by gender. Indirect or direct laryngoscopy, video stroboscopy, high-resolution computed tomography, and cricoarytenoid joint 3-dimensional reconstruction were used to evaluate arytenoid position and motion. Clinical characteristics, voice function, procedural skill, and treatment outcome for each case were recorded. Results: Each patient was diagnosed with arytenoid dislocation caused by endotracheal intubation. There was no significant difference in the treatment outcome between the traditional group and the modified group (P > .05). However, the median time interval between closed reduction and the return of normal voice in the traditional group was 31.08 ± 10.56 days, which was significantly longer than the median time of 17.92 ± 3.83 days in the modified group (P < .05). Conclusion: Closed reduction with the modified laryngeal forceps under local anesthesia is an effective and safe procedure. Compared with traditional laryngeal forceps, the modified laryngeal forceps can shorten the treatment duration.

Ultrastructure and 3D reconstruction of a diplonemid protist (Diplonemea) and its novel membranous organelle.

IMPORTANCE: The knowledge of cell biology of a eukaryotic group is essential for correct interpretation of ecological and molecular data. Although diplonemid protists are one of the most species-rich lineages of marine eukaryotes, only very fragmentary information is available about the cellular architecture of this taxonomically diverse group. Here, a large serial block-face scanning electron microscopy data set complemented with light and fluorescence microscopy allowed the first detailed three-dimensional reconstruction of a diplonemid species. We describe numerous previously unknown peculiarities of the cellular architecture and cell division characteristic for diplonemid flagellates, and illustrate the obtained results with multiple three-dimensional models, comprehensible for non-specialists in protist ultrastructure.

Reliability and validity of a mobile application for femoral anteversion measurement in adult patients.

BACKGROUND: Femoral torsion is primarily measured by computed tomography (CT), which has cost and radiation exposure concerns. Recently, femoral anteversion measurement by a simple radiograph-based mobile application was developed for patients with cerebral palsy. This study aimed to validate the use of a mobile application that can reconstruct a three-dimensional model of the femur from conventional radiographs for adults. METHODS: Medical records of 76 patients undergoing conventional femur anteroposterior/lateral radiography and femur CT were reviewed. To measure femoral anteversion on the reconstructed 3-dimensional images from both the mobile application and CT, we drew a line which connects the posterior margins of each femoral condyle and another line which passes through the center of the femoral head and the midpoint of the femoral neck. After the reliability test, a single examiner measured femoral anteversion on the mobile application and CT. Pearson's correlation analysis was used to assess the correlation between anteversion on the mobile application and CT. RESULTS: Femoral anteversion measured on both CT and the mobile application showed excellent reliability (intraclass correlation coefficients: 0.808-0.910). The correlation coefficient between femoral anteversion measured using CT and the mobile application was 0.933 (p < 0.001). The correlation of femoral anteversion between CT and the mobile application was relatively higher in the absence of metallic implants (correlation coefficient: 0.963, p < 0.001) than in the presence of metallic implants (correlation coefficient: 0.878, p < 0.001). CONCLUSIONS: Using two simple radiographs, the mobile application showed excellent validity and reliability for femoral anteversion measurement in adults as compared to CT. With the high accessibility and cost-effectiveness of this mobile application, femoral torsion measurement might be easily performed with simple radiography in clinical settings in the near future.

Evaluation of angles of the tracheobronchial tree with the 3-dimensional reconstruction method: a morphometric and radiologic study / Evaluación de los ángulos del árbol traqueobronquial con el método de reconstrucción tridimensional: un estudio morfométrico y radiológico

SUMMARY: The objective of the current research is to assess the branching angles of the tracheobronchial tree and the correlation between these angles and the lung volume using the 3-dimensional reconstruction method. Thorax CT (computed tomography) images of 150 individuals, who were over 18 years of age and did not have any pathology on CT, were obtained retrospectively. A 3-dimensional reconstruction of the trachea, bronchi, and lungs was carried out. External and internal angles between the trachea and main bronchi, between the main bronchi and lobar bronchi, and between the lobar bronchi were measured. The volume measurement of the right and left lungs was performed. The individuals included in the study were grouped by sex and age (20-40 years, 41-61 years, and 62-87 years). The left subcarinal angle (LSA), total subcarinal angle (TSA), and left interbronchial angle (LIA) were found to be greater in the 62-87 age group. Both the external angle (LULB-LMBE) and the internal angle (LULB- LMBI) between the left upper lobar bronchus and the left main bronchus were observed to be greater in males. In males, a statistically significant negative moderate correlation was identified between the right lung volume and the right subcarinal angle (RSA). In females, a statistically significant positive moderate correlation was revealed between the external (RULB-IBE) and internal angles (RULB-IBI) between the right upper lobar bronchus and the intermediate bronchus, and the right lung volume. In the literature review we performed, we did not find any studies investigating the correlation between the branching angles of the tracheobronchial tree and the lung volume using the 3-dimensional reconstruction method. Therefore, we are of the opinion that our study will contribute to the literature.

El objetivo de la investigación fue evaluar los ángulos de ramificación del árbol traqueobronquial y la correlación entre estos ángulos y el volumen pulmonar utilizando el método de reconstrucción tridimensional. Se obtuvieron retrospectivamente imágenes de tomografía computarizada de tórax de 150 individuos mayores de 18 años sin patología. Se realizó una reconstrucción tridimensional de la tráquea, los bronquios y los pulmones. Se midieron los ángulos externo e interno entre la tráquea y los bronquios principales, entre los bronquios principales y los bronquios lobares, y entre los bronquios lobares. Se realizó la medición del volumen de los pulmones derecho e izquierdo. Los individuos incluidos en el estudio fueron agrupados por sexo y edad (20-40 años, 41-61 años y 62-87 años). Se encontró que el ángulo subcarinal izquierdo, el ángulo subcarinal total y el ángulo interbronquial izquierdo eran mayores en el grupo de edad de 62 a 87 años. Tanto el ángulo externo (LULB-LMBE) como el ángulo interno (LULB-LMBI) entre el bronquio lobular superior izquierdo y el bronquio principal izquierdo era mayor en los hombres. En los hombres, se identificó una correlación moderada negativa estadísticamente significativa entre el volumen pulmonar derecho y el ángulo subcarinal derecho. En mujeres, se reveló una correlación positiva moderada estadísticamente significativa entre los ángulos externos (RULB-IBE) e internos (RULB-IBI) entre el bronquio lobar superior derecho y el bronquio intermedio, y el volumen pulmonar derecho. En la revisión bibliográfica que realizamos, no encontramos ningún estudio que analizara la correlación entre los ángulos de ramificación del árbol traqueobronquial y el volumen pulmonar utilizando el método de reconstrucción tridimensional. Por lo tanto, consideramos que nuestro estudio contribuirá a la literatura especializada del tema.

Morphometric examination of the trachea and bronchi in follow-up computed tomography scans of COVID-19 patients / Examen morfométrico de la tráquea y los bronquios en tomografías computarizadas de seguimiento de pacientes con COVID-19

SUMMARY: The purpose of this study is to evaluate changes in the trachea and bronchi using 3-dimensional reconstruction images obtained from the initial and follow-up computed tomography (CT) scans of COVID-19 patients. A hundred COVID-19 patients over the age of 18 were included in our study. CT images were transferred to Mimics software, and a 3-dimensional reconstruction of the trachea and bronchi was performed. The initial and follow-up CT images of COVID-19 patients were graded as none (grade 0), mild (grade 1), moderate (grade 2), and severe (grade 3) according to the total lung severity score. The patients were divided into progression and regression groups according to the grade increase/decrease between the initial and follow-up CTs. Moreover, the patients were divided into groups as 0-2 weeks, 2-4 weeks, 4-12 weeks, and over 12 weeks according to the duration between the initial and follow-up CTs. The mean cross-sectional area, circumference, and diameter measurements of the right upper lobar bronchus, intermediate bronchus, middle lobar bronchus, and left lower lobar bronchus decreased in the follow-up CTs of the progression group. This decrease was not found to be statistically significant. In the follow-up CTs of the regression group, the left upper lobar bronchus and left lower lobar bronchus measurements increased but not statistically significant. Upon comparing the onset of the disease and the follow-up period, statistically significant changes did not occur in the trachea, main bronchus, and lobar bronchus of COVID-19 patients.

El propósito de este estudio fue evaluar los cambios en la tráquea y los bronquios utilizando imágenes de reconstrucción tridimensionales obtenidas de las tomografías computarizadas (TC) iniciales y de seguimiento de pacientes con COVID-19. En nuestro estudio se incluyeron 100 pacientes con COVID-19 mayores de 18 años. Las imágenes de TC se transfirieron al software Mimics y se realizó una reconstrucción tridimensional de la tráquea y los bronquios. Las imágenes de TC iniciales y de seguimiento de los pacientes con COVID-19 se calificaron como ninguna (grado 0), leve (grado 1), moderada (grado 2) y grave (grado 3) según la puntuación total de gravedad pulmonar. Los pacientes se dividieron en grupos de progresión y regresión según el aumento/disminución del grado entre las TC iniciales y de seguimiento. Además, los pacientes se dividieron en grupos de 0 a 2 semanas, de 2 a 4 semanas, de 4 a 12 semanas y de más de 12 semanas según la duración entre la TC inicial y la de seguimiento. Las mediciones medias del área transversal, la circunferencia y el diámetro del bronquio lobar superior derecho, el bronquio intermedio, el bronquio lobar medio y el bronquio lobar inferior izquierdo disminuyeron en las TC de seguimiento del grupo de progresión. No se encontró que esta disminución fuera estadísticamente significativa. En las TC de seguimiento del grupo de regresión, las mediciones del bronquio lobar superior izquierdo y del bronquio lobar inferior izquierdo aumentaron pero no fueron estadísticamente significativas. Al comparar el inicio de la enfermedad y el período de seguimiento, no ocurrieron cambios estadísticamente significativos en la tráquea, el bronquio principal y el bronquio lobar de los pacientes con COVID-19.

Prevalence and anatomical characteristics of subsuperior segment in lung lower lobe.

OBJECTIVE: The subsuperior segment is an atypical pulmonary segment of the lung lower lobe. With the increased application of segmentectomy, it has received increased attention from thoracic surgeons. Studies of the subsuperior segment are scarce and mostly on the basis of small-sample autopsy studies, whose described characteristics are inconsistent with intraoperative observations. Our objective was to accurately define the subsuperior segment and elucidate its prevalence and anatomical characteristics in detail. METHODS: A total of 2194 chest computed tomography images were obtained using separate random sampling on the basis of the amount of data available to each of the 6 thoracic surgery institutions in different provinces covering various regions of China. All of the images were reconstructed in 3 dimensions. Subsuperior segments were screened according to their new definition and statistically analyzed for their prevalence and anatomical characteristics. RESULTS: The prevalence of subsuperior segments was 32.04%, with 413 on the right (18.79%); the value was higher than that on the left (347; 15.81%). The average volume of the subsuperior segment was 52.81 ± 21.96 cm3. Only 1 bronchus was detected in the unilateral subsuperior segment, with an average diameter of 2.53 ± 0.61 mm. Only 1 pulmonary artery was observed in most of the subsuperior segments (89.34%), but 81 cases (10.66%) had 2 in our study. One intersegmental vein of the subsuperior segment was the most common situation on both sides. CONCLUSIONS: Using a multicenter large-sample study, we calculated a 32.04% prevalence and systematically detailed the anatomical characteristics of the subsuperior segment in the lung lower lobe, corrected previous reports, and supplemented pulmonary anatomical studies.

Anatomic evaluation of Pancoast tumors using three-dimensional models for surgical strategy development.

OBJECTIVE: Pancoast tumor resection planning requires precise interpretation of 2-dimensional images. We hypothesized that patient-specific 3-dimensional reconstructions, providing intuitive views of anatomy, would enable superior anatomic assessment. METHODS: Cross-sectional images from 9 patients with representative Pancoast tumors, selected from an institutional database, were randomly assigned to presentation as 2-dimensional images, 3-dimensional virtual reconstruction, or 3-dimensional physical reconstruction. Thoracic surgeons (n = 15) completed questionnaires on the tumor extent and a zone-based algorithmic surgical approach for each patient. Responses were compared with surgical pathology, documented surgical approach, and the optimal "zone-specific" approach. A 5-point Likert scale assessed participants' opinions regarding data presentation and potential benefits of patient-specific 3-dimensional models. RESULTS: Identification of tumor invasion of segmented neurovascular structures was more accurate with 3-dimensional physical reconstruction (2-dimensional 65.56%, 3-dimensional virtual reconstruction 58.52%, 3-dimensional physical reconstruction 87.50%, P < .001); there was no difference for unsegmented structures. Classification of assessed zonal invasion was better with 3-dimensional physical reconstruction (2-dimensional 67.41%, 3-dimensional virtual reconstruction 77.04%, 3-dimensional physical reconstruction 86.67%; P = .001). However, selected surgical approaches were often discordant from documented (2-dimensional 23.81%, 3-dimensional virtual reconstruction 42.86%, 3-dimensional physical reconstruction 45.24%, P = .084) and "zone-specific" approaches (2-dimensional 33.33%, 3-dimensional virtual reconstruction 42.86%, 3-dimensional physical reconstruction 45.24%, P = .501). All surgeons agreed that 3-dimensional virtual reconstruction and 3-dimensional physical reconstruction benefit surgical planning. Most surgeons (14/15) agreed that 3-dimensional virtual reconstruction and 3-dimensional physical reconstruction would facilitate patient and interdisciplinary communication. Finally, most surgeons (14/15) agreed that 3-dimensional virtual reconstruction and 3-dimensional physical reconstruction's benefits outweighed potential delays in care for model construction. CONCLUSIONS: Although a consistent effect on surgical strategy was not identified, patient-specific 3-dimensional Pancoast tumor models provided accurate and user-friendly overviews of critical thoracic structures with perceived benefits for surgeons' clinical practices.

A cross-sectional study: analysis of anatomical variation in the right upper lung intersegmental vein V2a based on a 3D reconstruction technique.

Background: This study aimed to summarize and analyze the anatomical structures of the right upper lung intersegmental vein V2a based on 3-dimensional (3D) reconstruction technology. Methods: We collected the enhanced computed tomography (CT) scans of 157 patients with pulmonary diseases, and reconstructed the right upper lung tissue structure through interactive qualitative and quantitative analysis (IQQA). According to the reconstruction results, the V2a of the right upper pulmonary intersegmental vein was returned to different veins for classification, and the subtypes were further subdivided according to the different vascular routes and the location of the pulmonary segmental bronchus. Results: Among 157 patients, there were 4 types of V2a according to the anatomical position of the veins. In type B (15 cases, 9.6%), V2a returned to the apical vein V1. In type C (2 cases, 1.3%), V2a did not exist, while in type D (1 case, 0.6%), V2a directly flowed into the right atrium. Type A is further divided into three subtypes (A1, A2, A3) according to the type of veins returned and the anatomical location of their confluence. In subtype A1 (110/139 cases, 79.1%), V2a returned to the posterior segment central vein. In subtype A2 (8/139 cases, 5.8%), V2a flowed from the B2 mediastinal surface down to the interlobular part of the posterior segmental vein. In subtype A3 (21/139 cases, 15.1%), V2a flowed between B1a and B2a and back to the central vein at the junction of the B2 and B3 bronchus. Type B is further divided into 3 subtypes (B1, B2, B3) according to the location of the apical posterior segmental bronchus. In B1 subtype (1/15 cases, 6.7%), V2a continued from the mediastinal surface of B1 back down to V1. In B2 subtype (7/15 cases, 46.7%), V2a continued from the medial side of the B1 lung back down to V1. In subtype B3 (7/15 cases, 46.7%), V2a flowed back into the central part of the posterior segmental vein. Conclusions: This study, supported by 3D reconstruction technology, preliminarily summarized the V2a typology and further refined the anatomical differences of each subtype.

Characterization of Microscopic Multicellular Foci in Grossly Normal Renal Parenchyma of Von Hippel-Lindau Kidney.

Background and Objectives: This study aims to describe the earliest renal lesions in patients with von Hippel-Lindau (VHL) disease, especially the multicellular microscopic pathologic events, to get information into the genesis of renal neoplasms in this condition. Materials and Methods: Multicellular events were identified, and 3dimensional reconstruction was performed in grossly normal kidney parenchyma from VHL disease patients by using H&E-stained slides previously prepared. Results: The lesions were measured and the volume of clusters was calculated. Immunohistochemistry was performed for downstream HIF-target protein carbonic anhydrase 9 (CAIX) as well as CD34 for assessment of angiogenesis. We divided lesions into four types according to lesion height/size. The number of lesions was markedly decreased from lesion 1 (smallest) to lesion 2, then from lesions 2 to 3, and again from lesion 3 to 4. Distribution was highly consistent in the four cases, and the same decrement pattern was seen in all blocks studied. The volumes of clusters were measured and divided into three categories according to their volume. The most frequent pathologic event in VHL kidneys was category 1 (smallest volume), then category 2, and then category 3. Conclusion: We demonstrate that tracking histologic and morphologic changes in 3 dimensions of multicellular microscopic pathologic events enabled us to confirm a protracted sequence of events from smaller to larger cellular amplification events in VHL kidney.

Traditional T1-S1 Measurement of the Spinal Length on X-ray Images Does Not Correlate With the True Length of the Spine.

BACKGROUND: The T1-S1 distance to evaluate spinal length is traditionally measured as a straight line on an anteroposterior radiograph. However, this method may not reflect the true 3-dimensional (3D) spinal length. The objective of the study was to evaluate the difference between the traditional T1-S1 measurement and a 3D reconstruction from standard x-ray imaging. METHODS: Radiological assessment and 3D reconstruction of spinal length in pediatric patients with various spine deformities. The 3D reconstruction derived from standard biplanar spine x-ray images using a specialized but free available software and calibration device. Direct comparison of length, intraobserver variance for repeated measurements, as well as interobserver correlation for both measurement methods and between different levels of training were evaluated. Furthermore, the influence on spinal length by the degree of spinal deformity as well as other factors was analyzed. RESULTS: A total of 39 x-ray images from 35 patients at a mean age of 15.4 years (8.9-26.8 years) were evaluated. There was excellent agreement for intra- and interobserver correlation for both measurement techniques. Spinal length assessed using 3D reconstruction was significantly longer compared with the traditional T1-S1 distance, on average 2.7 cm (0.5-6.1 cm). There was also a significant positive correlation between the maximum extent of the deformity and the difference in spinal length. CONCLUSIONS: Traditional T1-S1 distance significantly underestimates the true length of the spine. A 3D measurement reflects the real length of the spine more adequately. CLINICAL RELEVANCE: Such information is relevant to the treating spine surgeon when planning or assessing therapeutic measures, especially in advanced deformities.

Multimodality Imaging for Evaluation of Bicaval Valved Stent Implantation in Severe Tricuspid Regurgitation.

Preprocedural planning and postprocedural evaluation after transcatheter treatment of severe tricuspid regurgitation remain challenging and require further research and standardization. We illustrate the use of multimodality imaging techniques in 3 patients undergoing implantation of a novel custom-made bicaval valved stent for symptomatic treatment of severe tricuspid regurgitation. (Level of Difficulty: Advanced.).

How far will minimally invasive thoracic surgery go? Uniportal video-assisted thoracoscopic lingulectomy with 1 cm incision complicated by a mediastinal lingual artery: A case report.

Here, we present the case of a 36-year-old female patient who was found to have a ground-glass nodule (GGN) in the left lingual segment on chest computed tomography (CT) and who successfully underwent lingulectomy via 1 cm incision uniportal video-assisted thoracoscopic surgery (VATS). This is a technically safe and feasible procedure in selected patients and produces better cosmetic results than traditional thoracoscopic surgery.

The contact area of the radiocapitellar joint under pronation and supination with axial load using a 3-dimensional computed tomography: an in vivo study.

OBJECTIVE: To evaluate the contact area of the radiocapitellar joint with forearm pronation and supination under axial loading. MATERIALS AND METHODS: Six healthy volunteers (2 males and 4 females, mean age: 44.6 years) were included in the study. A computed tomography scan of the extended elbow joints was obtained at 4 positions of forearm: full pronation with or without load and full supination with or without load. Mimics, 3-matic Medical, Geomagic, and Photoshop were used to reconstruct 3-dimensional models. The contact area of the radiocapitellar joint was measured. Shifting of the center of the contact area of the radiocapitellar joint was measured. RESULTS: The axial load added 8.6% and 10.5% contact area to pronation and supination without load, respectively. From pronation without load, the center of contact area significantly shifted 2.4 ± 1.1 mm anteromedially to supination without load and shifted by 1.0 ± 0.5 mm to the center of the radial head compared with the pronation with load. The center of the contact area significantly shifted 2.4 ± 1.5 mm anteromedially from the pronation to the supination under loading. The contact area of the tuberosity anterior in the radial head significantly increased by 14% (without load) and 8% (with load) from pronation to supination. CONCLUSION: Axial loading increases the contact area of the radiocapitellar joint. The center of the contact area of the radiocapitellar joint changed according to loading and shifted to the anterior tuberosity of the radial head from forearm pronation to supination.

Thoracic aortic computed tomography angiography in swine: establishment of a baseline for endovascular evaluation of the ascending aorta.

OBJECTIVES: Our goal was to establish a baseline of computed tomography (CT) angiographic data for the porcine ascending thoracic aorta for endovascular evaluation of animal experiments and device development. METHODS: Thoracic aortic CT angiography was conducted on 49 pigs with an average body weight of 60-65 kg. The CT angiographic scans were done on an imaging reconstruction workstation to obtain the specific aortic geometric data, including the diameters of the planes, the heights among the planes and the clock positions of target arteries. RESULTS: Fourteen important planes were defined in the study for endograft customizing reference. The diameters of the planes were measured, and the heights among the planes were recorded. For endograft fenestrations, the right coronary artery ostium clock position was 100.11 ± 7.29°, and the brachiocephalic trunk ostium clock position was 74.72 ± 6.45°. The best projection angle of the tangent position of the left coronary artery was the right anterior oblique 17 ± 7° position. A pig with a rare congenital giant dilated aorta was found among the candidate experimental animals. CONCLUSIONS: For experimental porcine models, CT angiography has proved to be a suitable imaging technique. The established baseline angiography of the swine can provide reference values for future animal experiments and device development.

Precise Resection of Macrodactyly Under Assistance of Three-Dimensional Reconstruction Technology: A Case Report.

Macrodactyly of the foot is an extremely rare congenital malformation characterized by an increase in the size of all the elements or structures of a digit or digits. Most sources indicate that macrodactyly affects the hand more often than the foot. This rare medical condition usually requires surgical intervention with a precise preoperative plan and postoperative rehabilitation. We present a case of macrodactyly of the right foot in which surgical reduction of the foot under assistance of 3-dimensional image technology was performed with satisfying cosmetic and functional outcomes.

Differences in the Tensor Veli Palatini Muscle and Hearing Status in Children With and Without 22q11.2 Deletion Syndrome.

PURPOSE: To investigate the dimensions of the tensor veli palatini (TVP) muscle using high image resolution 3-dimensional magnetic resonance imaging (MRI) of the soft palate among children with normal velopharyngeal and craniofacial anatomy and to compare values to individuals with a diagnosis of 22q11.2 deletion syndrome (22q11DS). We also sought to determine whether there is a relationship between hypoplasia of the TVP and severity of middle ear dysfunction and hearing loss. METHODS: Three-dimensional MRI were used to collect and analyze data obtained across 53 children between 4 and 12 years of age, including 40 children with normal velopharyngeal and craniofacial anatomy and 13 children with a diagnosis of 22q11.2 DS. Tensor veli palatini muscle length, thickness, and volume as well as bihamular distance were compared among participant groups. RESULTS: A Welch's t-test revealed that the TVP in participants with 22q11DS is significantly shorter (P = .005, 17.3 vs 19.0 mm), thinner (P < .001, 1.1 vs 1.8 mm), and less voluminous (P < .001, 457.5 vs 667.3 mm3) than participants without 22q11DS. Participants with 22q11DS also had a greater (P = .006, 27.7 vs 24.7 mm) bihamular distance than participants without 22q11DS. There was an inverse relationship between TVP abnormalities noted above and the severity of audiologic and otologic histories. CONCLUSION: The TVP muscle is substantially reduced in volume, length, and thickness in children with 22q11DS. These findings serve as preliminary support for the association of patient hearing and otologic severity and TVP dysmorphology.

Patient-Specific 3-Dimensional Model for High-Intensity Focused Ultrasound Treatment Through the Rib Cage: A Preliminary Study.

OBJECTIVES: The purpose of this study was to develop a patient-specific 3-dimensional model for high-intensity focused ultrasound (HIFU) treatment through the rib cage using patient data. METHODS: Experimental testing to derive parameters used in defining the amount of energy and alteration needed in treatment protocols for upper abdominal disorders under the rib cage was performed. Reconstructed rib cage models based on patient data, tissue-mimicking material phantoms, and magnetic resonance imaging-guided HIFU using a multielement phased array transducer were used in the experiments. Changes in the focal temperature, acoustic power, and acoustic pressure distribution were investigated with and without the presence of the rib cage model. An ExAblate system (InSightec Ltd, Tirat Carmel, Israel) was used to sonicate phantoms by varying the target phantom or rib cage model location. RESULTS: The effect of the rib cage on the acoustic pressure distribution and acoustic power was closely related to the anatomic structures of the ribs. Thermometry revealed that heating at the focus could be controlled by changing either the power or duration of HIFU application to improve the focal temperature change. The focal temperature change was found to be related to the distance between the rib cage model and focus and the shadow area on the transducer elements covered by the rib cage model in the beam path. CONCLUSIONS: Experimental results suggest that the rib cage model is a valuable and useful tool that can provide realistic human anatomic structures and properties for evaluating the effects of the rib cage on ultrasound propagation.

Fully automated tri-variational rebuilding of ideal solid-state models within mixed boundary conditions.

In this work, a rasterized mesh construction of our 3D solid-state model is generated to achieve an improved rasterization of a rigid-body surface using a series of polygonal model transfers. In the field of remodeling, auxiliary starters have been obtained from either ready-made or fabricated input point datasets. Building 3D solid meshes from clusters of inbound points to model objects is made possible by our method. Demonstrative illustrations of how the initial series of points can be transferred to mesh models by passing through the boundary conditions are presented using a customized method. A handmade weaving technique combines each different cluster of points, yielding a relevant transformation result. Additionally, newer remodeling methods involve more than the adaptation of boundary values to generate solid surfaces via finite restructuring of geometrical building blocks; our remodeling methods have been optimized in terms of both realism and computational costs. Our reconstructions are highly optimized to achieve high-quality and realistic results within a reasonable time. In higher-order creative restorations, our boundary conditions are regularized by quadratic equalizer functions. Areal-based regularizations are combined within mixed boundary values over 3D multigrids of finite differential combinations. Newly created solid models are reshaped by exclusive reconstructions to form our final models. Equally distributed multidimensional grids are seamlessly rebuilt via an ideal model-driven process with our tri-variational remodeling method that is constrained by a mixture of boundary conditions. Here, our remodeling method continuously triangulates the discrete topological structures as solid models. The final model shapes are triangulated as a consequence of postpolygonization by our unique reconstructors. An exact solution can be obtained via a convex hulling process on the preliminary finite fields by means of high-resolution configurations. Our 3D remodeling method using solid-state tessellation has opened the field to wider ranges of complete-gridding plans to achieve matchless enriched reformation capability, which makes our new solidification remeshing of models better than the majority of currently available methods.

Powering the hagfish "bite": The functional morphology of the retractor complex of two hagfish feeding apparatuses.

Hagfish use forceful retractions of a dental plate to shear and ingest food. Retractile force is generated by the retractor muscle complex of the posterior hagfish feeding apparatus (HFA). While gross morphological descriptions exist, the organization of muscle and connective tissue fibers that form the soft tissue retractor complex do not. In this study, we used paraffin histology to prepare serial sections of Pacific (Eptatretus stoutii, Lockington, 1879) and Atlantic (Myxine glutinosa, Linnaeus, 1758) hagfishes in order to describe constituent soft tissue anatomy and fiber orientations. We generated 3D reconstructions in which digitized sections were segmented and fitted to volumetric scans of retractor complexes taken prior to microtomy. These models confirmed that the retractor complex is composed of a perpendicularis muscle that fits within the eye of a needle-shaped clavatus muscle, which anteriorly bears the dental plate tendon, and in turn fits within a sleeve-like tubulatus muscle. Analysis of fiber orientations within these muscles resulted in novel functional hypotheses: (a) The tubulatus muscle represents a novel tubular bipennate muscle with a considerable physiological cross-sectional area. Its activation may indirectly create tension in the dental plate tendon: as the tubulatus muscle forcefully extends, it displaces the terminal bulb and the clavatus muscle posteriorly. (b) Within the HFA terminal bulb, the muscle fibers of the clavatus and perpendicularis muscles are mutually perpendicular and may cocontract to form a swelling stopper knot-like muscular complex that resists being pulled through the tubulatus muscle. (c) While overall feeding apparatus muscle morphology is conserved, the physiological cross-sectional area of the tubulatus muscle in E. stoutii, is relatively larger than that of M. glutinosa, suggesting a more forceful retraction. The tubular bipennate construction of the tubulatus may represent a novel soft robotic actuator design.