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Ultrasound in Medicine & Biology May 2017The vena contracta and effective regurgitant orifice area (EROA) are currently used for the clinical assessment of mitral regurgitation (MR) from 2-D color Doppler...
The vena contracta and effective regurgitant orifice area (EROA) are currently used for the clinical assessment of mitral regurgitation (MR) from 2-D color Doppler imaging. In addition to being highly user dependent and having low repeatability, these methods do not represent accurately the anatomic regurgitant orifice (ARO), which affects the adequate assessment of MR patients. We propose a novel method for semi-automatic detection and quantitative assessment of the 3-D ARO shape from 3-D transesophageal echocardiographic images. The algorithm was tested on a set of 25 patients with MR, and compared with EROA for validation. Results indicate the robustness of the proposed approach, with low variability in relation to different settings of user-defined segmentation parameters. Although EROA and ARO exhibited a good correlation (r = 0.8), relatively large biases were measured, indicating that EROA probably underestimates the real shape and size of the regurgitant orifice. Along with the higher reproducibility of the proposed approach, this highlights the limitations of current clinical approaches and underlines the importance of accurate assessment of the ARO shape for diagnosis and treatment in MR patients.
Topics: Algorithms; Echocardiography, Three-Dimensional; Echocardiography, Transesophageal; Female; Humans; Image Interpretation, Computer-Assisted; Male; Middle Aged; Mitral Valve Insufficiency; Reproducibility of Results; Severity of Illness Index
PubMed: 28216111
DOI: 10.1016/j.ultrasmedbio.2016.12.017 -
Journal of Endodontics Dec 2004The purpose of this study was to investigate the anatomical features of C-shaped root canal system in mandibular second molars using micro-computed tomography (microCT)....
The purpose of this study was to investigate the anatomical features of C-shaped root canal system in mandibular second molars using micro-computed tomography (microCT). Fifty-eight extracted mandibular second molars with fused roots were collected from a native Chinese population. The teeth were scanned into layers of 0.5-mm thickness by microCT and measurements were made at eleven levels. The ratio of the depth of the deepest part of the groove to the buccal-lingual thickness of the cross-section of the root was calculated for each tooth. The canal shapes of the scanned cross-sections were assessed and classified according to a modified Melton's method. Results were subject to the Kruskal-Wallis test. Of the 58 molars, 54 had a C-shaped canal system with a mean groove-to-thickness ratio of 47.96%; the four teeth without a C-shaped canal had a mean ratio of 14.82%. Most orifices (98.1%) were found within 3 mm below the cementoenamel junction. Of teeth with a C-shape canal system, a majority demonstrated an orifice with an uninterrupted "C" configuration. Seventeen canals divided in the apical portion, most of which did so within 2 mm from the apex. The cross-sectional shape varied drastically along the length of the canal. Teeth with a high groove-to-thickness ratio had at least one section with C1, C2, or C3 configuration. The canal shape in middle and apical thirds of C-shaped canal systems could not be predicted on the basis of the shape at the orifice level. Section 2 of this paper addressed the correlation between the radiographic appearance and these microCT images.
Topics: Anatomy, Cross-Sectional; Asian People; China; Dental Pulp Cavity; Humans; Mandible; Molar; Odontometry; Statistics, Nonparametric; Tomography, X-Ray Computed; Tooth Root
PubMed: 15564874
DOI: 10.1097/01.don.0000136207.12204.e4 -
The Prostate 1981Earlier morphologic studies of the prostate, though often extensive, have never systematically delineated its completed structure. Recent comprehensive analysis of 500...
Earlier morphologic studies of the prostate, though often extensive, have never systematically delineated its completed structure. Recent comprehensive analysis of 500 prostates has more precisely defined its anatomic composition, identifying previously undetected features and unsuspected complexities. Using a three-dimensional model, these structures and relationships are demonstrated. Four basic anatomic regions are described. The relationship of each to the urethra provides a central anatomic reference point. 1. The peripheral zone constitutes over 70% of the glandular prostate. It forms a disc of tissue whose ducts radiate laterally from the urethra lateral and distal to the verumontanum. Almost all carcinomas arise here. 2. The central zone constitutes 25% of the glandular prostate. Its ducts arise close to the ejaculatory duct orifices and follow these ducts proximally, branching laterally near the prostate base. Its lateral border fuses with the proximal peripheral zone border, completing in continuity with the peripheral zone, a full disc of secretory tissue oriented in a coronal plane. Marked histologic differences between central and peripheral zones suggest important biologic differences. 3. Preprostatic region. The urethral segment proximal to the verumontanum is kinked anteriorly at a 35-degree angle to the distal segment. No major ducts arise in the proximal segment, but the lateral rows of peripheral zone orifices continue. Duct development is aborted here, producing only a small transition zone and several tinier periurethral ducts. The development of these small ducts is possibly determined and limited by their intimate relationship to a periurethral smooth muscle sphincter that exists only proximal to the verumontanum. These small ducts in a restricted area are the exclusive site of nodular hyperplasia (BPH) origin. 4. The anterior fibromuscular stroma forms the entire anterior surface of the prostate as a thick, nonglandular apron, shielding from view the anterior surface of the three glandular regions. Its inseparable fusion to the glandular prostate has probably delayed recognition of the anatomic features described here.
Topics: Animals; Female; Humans; Macaca mulatta; Male; Models, Structural; Pregnancy; Prostate; Species Specificity; Urethra; Urinary Bladder
PubMed: 7279811
DOI: 10.1002/pros.2990020105 -
BioMed Research International 2015The establishment of radiofrequency catheter ablation techniques as the mainstay in the treatment of tachycardia has renewed new interest in cardiac anatomy. The... (Review)
Review
The establishment of radiofrequency catheter ablation techniques as the mainstay in the treatment of tachycardia has renewed new interest in cardiac anatomy. The interventional arrhythmologist has drawn attention not only to the gross anatomic details of the heart but also to architectural and histological characteristics of various cardiac regions that are relevant to the development or recurrence of tachyarrhythmias and procedural related complications of catheter ablation. In this review, therefore, we discuss some anatomic landmarks commonly used in catheter ablations including the terminal crest, sinus node region, Koch's triangle, cavotricuspid isthmus, Eustachian ridge and valve, pulmonary venous orifices, venoatrial junctions, and ventricular outflow tracts. We also discuss the anatomical features of important structures in the vicinity of the atria and pulmonary veins, such as the esophagus and phrenic nerves. This paper provides basic anatomic information to improve understanding of the mapping and ablative procedures for cardiac interventional electrophysiologists.
Topics: Cardiac Electrophysiology; Heart; Humans; Models, Cardiovascular
PubMed: 26665006
DOI: 10.1155/2015/547364 -
Laryngo- Rhino- Otologie Jun 2019Functional endoscopic sinus surgery (FESS) is the minimal-invasive standard procedure for surgical treatment of patients with chronic rhinosinusitis. FESS follows the...
Functional endoscopic sinus surgery (FESS) is the minimal-invasive standard procedure for surgical treatment of patients with chronic rhinosinusitis. FESS follows the principle to remove all pathologies within the paranasal sinuses while sparing normal mucosa and all functionally relevant anatomical structures. To understand the functional integrity and the principles of FESS, it is important to have fundamental knowledge of the anatomy of the paranasal sinuses, especially of the orifices to the different sinuses. Normally based on a computed tomography of the paranasal sinuses in two section planes, the FESS surgeon has to reproduce the individual anatomy and to plan the individual extent of the FESS. The severity of the disease and the extent of surgery can be classified. In this review the knowledge to be known by an otorhinolaryngologist is reflected and the main steps of FESS are explained. The equipment will be described. Typical complications of FESS and complication management will be elucidated.
Topics: Endoscopy
PubMed: 31167294
DOI: 10.1055/a-0830-3960 -
Clinical Oral Investigations Jun 2021This study evaluated the danger zone (DZ) in mesial roots of mandibular molars and the correlation between anatomical references of the DZ and some anatomical landmarks...
OBJECTIVES
This study evaluated the danger zone (DZ) in mesial roots of mandibular molars and the correlation between anatomical references of the DZ and some anatomical landmarks including tooth/root length, depth of mesial and distal grooves, and inter-canal orifices distance.
MATERIAL AND METHODS
Twenty-eight mesial roots of mandibular molars with 2 independent canals were scanned and divided into 2 groups according to root length. The anatomical landmarks were correlated (Pearson or Spearman coefficients) with root level, thickness, and position of the DZ and also compared (independent samples t or Mann-Whitney tests) between the 2 groups at α = 5%.
RESULTS
No statistical difference was observed between groups regarding DZ parameters and depth of mesial and distal grooves (P > 0.05). Orifice distance in group 2 (4.49 ± 0.75 mm) was significantly greater than group 1 (3.76 ± 0.89 mm) (P < 0.05). Significant correlations (P < 0.05) were found between (i) DZ level and root/tooth length (r = 0.54 and 0.49, respectively), (ii) DZ thickness and distal groove depth (r = - 0.45), and orifice distance (r = 0.38), and (iii) DZ position and depth of mesial (r = 0.39) and distal (r = 0.40) grooves. Other variables such as root length and distal groove depth (r = 0.28), and orifice distance and mesial groove depth (r = 0.36) were also correlated (P < 0.05).
CONCLUSIONS
The length of tooth/root, the distance of canal orifices, and the depth of mesial/distal grooves of mesial roots of mandibular molars might be predictive factors for the root level, position, and thickness of the DZ.
CLINICAL RELEVANCE
The length, distance of mesial canal orifices, and the depth of mesial and distal grooves of the mesial roots of mandibular molars might be moderate predictive factors for the root level, position, and thickness of the DZ.
Topics: Dental Pulp Cavity; Mandible; Molar; Tooth Root
PubMed: 33236240
DOI: 10.1007/s00784-020-03686-7 -
Cureus May 2023Superior lumbar hernias are extremely rare, and surgical repair is essential for their treatment. However, the direct observation of the hernial orifice is frequently...
Superior lumbar hernias are extremely rare, and surgical repair is essential for their treatment. However, the direct observation of the hernial orifice is frequently difficult because the hernia disappears in prone or lateral positions, which is an issue when using the open approach. Therefore, using anatomical landmarks to detect the hernial orifice on preoperative CT scans may be useful for correct identification and visualization. Here, we report two cases of superior lumbar hernias successfully treated using the abovementioned method.
PubMed: 37332402
DOI: 10.7759/cureus.39154 -
Sports Medicine and Arthroscopy Review Mar 2016Transoral microscopic odontoidectomy followed by posterior fixation has been accepted as a standard procedure to treat nonreducible basilar invagination during the half... (Review)
Review
Transoral microscopic odontoidectomy followed by posterior fixation has been accepted as a standard procedure to treat nonreducible basilar invagination during the half past century. In recent years, the development of endoscopic techniques has raised challenges regarding the traditional treatment algorithm. The endoscopic transnasal odontoidectomy is a feasible and effective method in the treatment of irreducible ventral cervicomedullary junction compression, which has several advantages over the transoral approach. The endoscopic odontoidectomy includes transnasal, transoral, and transcervical approaches. The 3 different approaches for endoscopic odontoidectomy present complementary advantages and limitations. The necessity of posterior fixation after odontoidectomy should be considered in every single case on the basis of the peculiar anatomic and clinical conditions.
Topics: Atlanto-Occipital Joint; Decompression, Surgical; Humans; Joint Instability; Natural Orifice Endoscopic Surgery; Odontoid Process
PubMed: 26752771
DOI: 10.1097/JSA.0000000000000081 -
Arthroscopy Techniques Jun 2021In anterior cruciate ligament (ACL) reconstruction, fixation of the graft with hardware is a routine procedure. However, in some cases when the hardware is not intended...
In anterior cruciate ligament (ACL) reconstruction, fixation of the graft with hardware is a routine procedure. However, in some cases when the hardware is not intended to be used or is unavailable, ACL reconstruction with hardware-free fixation must be the treatment of choice. We introduce a single-bundle anatomical hardware-free ACL reconstruction technique in which a set of Y-shaped femoral tunnels is created for the fixation of the proximal end of the graft over the bone bridge between the 2 outer orifices, and a transtibial ridge tunnel is created to set a suture loop with a knot for the fixation of the distal end of the graft at the suture loop. We believe the introduction of this technique will provide a reasonable option for single-bundle anatomical ACL reconstruction.
PubMed: 34258211
DOI: 10.1016/j.eats.2021.03.002 -
World Neurosurgery Jul 2019In the study and practice of neurosurgery at the "Federico II" University of Naples, a central role has always been reserved for anatomy. Based on worldwide cooperation,...
In the study and practice of neurosurgery at the "Federico II" University of Naples, a central role has always been reserved for anatomy. Based on worldwide cooperation, the meaning of anatomical research has evolved from methodological investigation to an educational and communication tool. The contribution of our school to the anatomical data on the sellar region has been chronologically reviewed in the present report. The path that brought us to focus on the endoscopic endonasal anatomy has been presented, together with the evolution of anatomical investigation. The confidence achieved with decades of cadaveric laboratory studies has changed the profile of our anatomical investigations. The quantification and comparison became essential in these studies owing to their effect on surgical application and advanced imaging techniques entered the field of anatomical dissection. Anatomy at our school is an evolving science. Our efforts in anatomical scientific publications and organization of participatory courses have made us a center of reference for endoscopic endonasal surgery and have allowed us to share our knowledge with other specialists in this field.
Topics: Cadaver; Humans; Natural Orifice Endoscopic Surgery; Neuroendoscopy; Orbit; Sella Turcica; Skull Base
PubMed: 31266133
DOI: 10.1016/j.wneu.2019.03.050