The Common Coordinate Framework (CCF) Organ VR Gallery

The CCF Organ VR Gallery lets the user explore 21 human organs, journeying from the Whole Body, to the Organ, to the Cell stage and back, presented in real-world size and 3D. The user discovers hidden regions by exploding and collapsing organs into their individual anatomical structures. We show cell type populations for a kidney using a data-driven dot density visualization. The organ models were developed to map trillions of cells for the Human BioMolecular Atlas Program (HuBMAP).

Proposal for a Unitary Anatomo-Clinical and Radiological Classification of Third Mobile Window Abnormalities

Introduction: An increased number of otic capsule dehiscence (OCD) variants relying on the third window pathomechanism have been reported lately. Therefore, a characterization of the anatomical structures involved and an accurate radiological description of the third window (TW) interface location have become essential for improving the diagnosis and appropriate therapeutic modalities. The purpose of this article is to propose a classification based on clinical, anatomical, and radiological data of third mobile window abnormalities (TMWA) and to discuss the alleged pathomechanism in lesser-known clinical variants.Materials and Methods: The imaging records of 259 patients who underwent, over the last 6 years, a high-resolution CT (HRCT) of the petrosal bone for conductive hearing loss were analyzed retrospectively. Patients with degenerative, traumatic, or chronic infectious petrosal bone pathology were excluded. As cases with a clinical presentation similar to those of a TW syndrome have recently been described in the literature but without these being confirmed radiologically, we thought it necessary to be integrated in a separated branch of this classification as “CT - TMWA.” The same goes for certain intralabyrinthine pathologies also recently reported in the literature, which mimic to some extent the symptoms of a TW pathology. Therefore, we suggest to call them intralabyrinthine TW-like abnormalities.Results: Temporal bone HRCT and, in some cases, 3T MRI of 97 patients presenting symptomatic or pauci-symptomatic, single or multiple, unilateral or bilateral OCD were used to develop this classification. According to the topography and anatomical structures involved at the site of the interface of the TW, a third-type classification of OCD is proposed.Conclusions: A classification reuniting all types of TMWA as the one proposed in this article would allow for a better systematization and understanding of this complex pathology and possibly paves the way for innovative therapeutic approaches. To encompass all clinical and radiological variants of TMWA reported in the literature so far, TMWAs have been conventionally divided into two major subgroups: Extralabyrinthine (or “true” OCD with three subtypes) and Intralabyrinthine (in which an additional mobile window-like mechanism is highly suspected) or TMWA-like subtype. Along these subgroups, clinical forms of OCD with multiple localization (multiple OCD) and those that, despite the fact that they have obvious characteristics of OCD have a negative CT scan (or CT – TMWA), were also included.

A randomized trial to determine the minimum effective lidocaine volume for median nerve block using hydrodissection

Ultrasound-guided hydrodissection with 5% dextrose in water (DW5) creates a peri-nervous compartment, separating the nerve from the neighboring anatomical structures. The aim of this randomized study was to determine the minimum volume of lidocaine 2% with epinephrine 1:200,000 required when using this technique to achieve an effective median nerve block at the elbow in 95% of patients (MEAV95). Fifty-two patients scheduled for elective hand surgery received an ultrasound-guided circumferential perineural injection of 4 ml DW5 and an injection of local anesthetic (LA) following a biased coin up-and-down sequential allocation method. A successful block was defined as a light touch completely suppressed on the two distal phalanges of the index finger within a 30-min evaluation period. The MEAV95 of lidocaine 2% with epinephrine was 4 ml [IQR 3.5–4.0]. Successful median nerve block was obtained in 38 cases (82.6%) with median onset time of 20.0 [10.0–21.2] minutes (95% CI 15–20). The analgesia duration was 248 [208–286] minutes (95% CI 222–276). Using an ultrasound-guided hydrodissection technique with DW5, the MEAV95 to block the median nerve at the elbow with 2% lidocaine with epinephrine was 4 ml [IQR 3.5–4.0]. This volume is close to that usually recommended in clinical practice.Trial registration clinicaltrials.gov. NCT02438657, Date of registration: May 8, 2015.

Ten Years of Pediatric Lung Ultrasound: A Narrative Review

Lung diseases are the most common conditions in newborns, infants, and children and are also the primary cause of death in children younger than 5 years old. Traditionally, the lung was not thought to be a target for an ultrasound due to its inability to penetrate the gas-filled anatomical structures. With the deepening of knowledge on ultrasound in recent years, it is now known that the affected lung produces ultrasound artifacts resulting from the abnormal tissue/gas/tissue interface when ultrasound sound waves penetrate lung tissue. Over the years, the application of lung ultrasound (LUS) has changed and its main indications in the pediatric population have expanded. This review analyzed the studies on lung ultrasound in pediatrics, published from 2010 to 2020, with the aim of highlighting the usefulness of LUS in pediatrics. It also described the normal and abnormal appearances of the pediatric lung on ultrasound as well as the benefits, limitations, and possible future challenges of this modality.

Temperature distribution in beech wood during vacuum drying

Temperature distribution in beech wood during vacuum drying. The temperature distribution and changes in humidity in beech wood in the form of friezes during drying in a vacuum were analysed. The intensity of the occurring phenomena of desorption and the volumetric flow of moisture through the anatomical structures of the wood, depending on the absolute pressure and the temperature of the process, was determined. It was found that the fastest temperature increase took place in the subsurface layers directly adjacent to the heating plates. The introduction of conditioning between the drying phases made it possible to even out the humidity and temperature distribution in the entire element. On the basis of the analysis of changes taking place between the volumes of the three components of wood, it was found that the volume of moisture in the form of vapor removed in the initial phase of drying is over 20 times greater than the volume of voids in wood structures, and in the following phases it decreases to 0.27. The average volume of vapour removed from 1 m3 of wood at the temperature of 55℃ is 13.9 m3/h, decreasing in the following phases to 9.1 m3/h at the drying temperature of 60℃ and then 3.1 m3/h at the temperature of 65℃. The drying rates for these phases reach the value of 0.15%/h, 0.17%/h and 0.075%/h, respectively. Direct measurements of wood moisture, made during the experimental course of the drying process at an absolute pressure of 150 hPa, follow the equivalent moisture, determined on the basis of the Hailwood-Horrobin model, taking into account the appropriate calculation factors.

Detecting Small Anatomical Structures in 3D Knee MRI Segmentation by Fully Convolutional Networks

Accurately identifying the pixels of small organs or lesions from magnetic resonance imaging (MRI) has a critical impact on clinical diagnosis. U-net is the most well-known and commonly used neural network for image segmentation. However, the small anatomical structures in medical images cannot be well recognised by U-net. This paper explores the performance of the U-net architectures in knee MRI segmentation to find a relative structure that can obtain high accuracies for both small and large anatomical structures. To maximise the utilities of U-net architecture, we apply three types of components, residual blocks, squeeze-and-excitation (SE) blocks, and dense blocks, to construct four variants of U-net, namely U-net variants. Among these variants, our experiments show that SE blocks can improve the segmentation accuracies of small labels. We adopt DeepLabv3plus architecture for 3D medical image segmentation by equipping SE blocks based on this discovery. The experimental results show that U-net with SE block achieves higher accuracy in parts of small anatomical structures. In contrast, DeepLabv3plus with SE block performs better on the average dice coefficient of small and large labels.

Ensuring the effectiveness and safety of peripheral blockades

Adequate analgesia determines the success of the performed surgical intervention. In modern surgery, most of postoperative complications are directly related to ineffective therapy of pain syndrome in the perioperative period. The main principle of modern analgesia is its multicomponence, when analgesia, neurovegetative blockade and relaxation are achieved and potentiated by different drugs and methods. The blockade of nociceptive impulses with a local anesthetic at the transmission stage provides effective, targeted analgesia, hyporefl exia and muscle relaxation, prevents the sensitization of neuroaxial structures, hyperalgesia and the development of postoperative chronic pain syndrome. At the same time, providing analgesia with drugs of central action leads to the ineffectiveness of therapy in 80 % of cases, which has serious consequences.The aim. According to the literature review, to evaluate the effectiveness and safety of peripheral blockades on the example of performing a blockade of the pterygopalatine ganglion.Conclusion. The pterygopalatine blockade has broad indications for use in ophthalmology, which is explained by the complex structure of the pterygopalatine ganglion and the possibility of simultaneous infl uence on sympathetic, parasympathetic and nociceptive innervation. All the presented methods of pterygopalatine blockade performance have their advantages and disadvantages. Ultrasound navigation eliminates technical difficulties and the possibility of damage of the pterygopalatine fossa anatomical structures, ensuring the effectiveness and safety of the pterygopalatine blockade.

The Effects of Suprabullar Pneumatization on the Orientation of Its Surrounding Anatomical Structures Relevant to the Frontal Drainage Pathway

Objective: The aim of this study was to evaluate the effects of suprabullar pneumatization on the orientation of the frontal sinus outflow structures and its association with the volume of anterior ethmoid sinus. Methods: A retrospective chart review of computed tomography of paranasal sinuses (CTPNS) images was conducted. A total of 370 sides of the CTPNS of 185 patients were analyzed. Results: The course of anterior ethmoidal artery (AEA) along the skull base (p = 0.04) and position of AEA at the second lamella (p = 0.04) was significantly associated with the type of suprabullar pneumatization. The AEA is expected to be lower at the skull base and at a longer distance from the second lamella with the increase in grading of the suprabullar pneumatization. The distance of AEA to the second lamella (p < 0.001) and third lamella (p = 0.04) was significantly different depending on the type of suprabullar pneumatization, which indicates AEA is expected to be at a longer distance from the second lamella and third lamella in higher grade suprabullar pneumatization. The type of suprabullar pneumatization has a significant but weak association with the anterior ethmoid sinus volume (p = 0.04). Conclusions: There is a significant effect of the type of suprabullar pneumatization on the orientation of the surrounding anatomical structures at the frontal recess. The type of suprabullar pneumatization is influenced by the anterior ethmoid sinus volume, which suggests it has a possible role in the frontal drainage pathway.

Prevalence of favourable anatomy for palatal emergence of an immediate implant in the maxillary central incisor post-extraction site.

The purpose of this study was to determine the prevalence of favourable anatomy for palatal emergence of an immediate flapless implant in the maxillary central incisor post-extraction site. Implants were virtually placed into maxillary central incisor sites using 3D implant planning software. Following a strict implant placement criteria to keep a safety distance to the buccal plate and other anatomical structures, sockets where assessed to determine their suitability for a palatally emerging implant. From 321 patients included in this study, 62.3% presented a suitable socket anatomy for an immediate implant to be placed with the angulation for a screw retained crown. In 29% of the cases, the implants had to be labially tilted to keep a minimum distance to the buccal plate. 8.7% were unsuitable for immediate implants due to anatomic limitations. The position and angulation for an implant in the maxillary central incisor socket should be carefully assessed preoperatively with 3D images, as many sites will not be candidates for a palatal emergence and thus, a screw retained restoration.