Semiquantitative correction of posttraumatic enophthalmos with sliced cartilage grafts

A simple surgical technique for correcting posttraumatic enophthalmos is described. The steps are as follows: (1) a plaster mold is obtained of the patient's face, (2) wax is added to the enophthalmic eye of the plaster mold until it becomes symmetrical, (3) the quantity of wax is measured, and (4) the same amount of sliced costal cartilage is implanted beneath the periosteum of the extended orbital wall behind the vertical axis of the globe. Using this technique, we have successfully treated six patients with traumatic orbital floor defects without complication. This approach is useful for decreasing the orbital volume using a semiquantitative procedure to estimate the amount of graft material required. In this respect, costal cartilage demonstrates a marked advantage, with stability and cosmetic appearance verified over 12 months of follow-up.     

Use of 3D geometry modeling of osteochondrosis-like iatrogenic lesions as a template for press-and-fit scaffold seeded with mesenchymal stem cells

Computed tomography (CT) is an effective diagnostic modality for three-dimensional imaging of bone structures, including the geometry of their defects. The aim of the study was to create and optimize 3D geometrical and real plastic models of the distal femoral component of the knee with joint surface defects. Input data included CT images of stifle joints in twenty miniature pigs with iatrogenic osteochondrosis-like lesions in medial femoral condyle of the left knee. The animals were examined eight and sixteen weeks after surgery. Philips MX 8000 MX and View workstation were used for scanning parallel plane cross section slices and Cartesian discrete volume creation. On the average, 100 slices were performed in each stifle joint. Slice matrices size was 512 x 512 with slice thickness of 1 mm. Pixel (voxel) size in the slice plane was 0.5 mm (with average accuracy of +/-0.5 mm and typical volume size 512 x 512 x 100 voxels). Three-dimensional processing of CT data and 3D geometrical modelling, using interactive computer graphic system MediTools formerly developed here, consisted of tissue segmentation (raster based method combination and 5 % of manual correction), vectorization by the marching-cubes method, smoothing and decimation. Stifle- joint CT images of three individuals of different body size (small, medium and large) were selected to make the real plastic models of their distal femurs from plaster composite using rapid prototyping technology of Zcorporation. Accuracy of the modeling was +/- 0.5 mm. The real plastic models of distal femurs can be used as a template for developing custom made press and fit scaffold implants seeded with mesenchymal stem cells that might be subsequently implanted into iatrogenic joint surface defects for articular cartilage-repair enhancement.     

Osteogenesis in cranial defects: reassessment of the concept of critical size and the expression of TGF-beta isoforms

Transforming growth factor-betas (TGF-beta) have been demontstrated to be upregulated during osteoblast function in vitro and during cranial suture fusion in vivo. The authors hypothesized that spontaneous reossification of calvarial defects was also associated with upregulation of TGF-beta. The present study was designed to (1) evaluate the concept of a critical-size defect within the calvaria in an adult guinea pig model and (2) investigate the association between the ossification of calvarial defects and TGF-beta upregulation. Paired circular parietal defects with diameters of 3 and 5 mm and single parietal defects with diameters of 8 or 12 mm were made in 45 six-month-old skeletally mature guinea pigs. Three animals per defect size were killed after survival periods of 3 days, 1 week, 4 weeks, 8 weeks, or 12 weeks. New bone ingrowth was evaluated by assessing for linear closure by a traditional linear method and by a modified cross-sectional area method using an image analysis system in which the thickness of new bone was taken into account. Immunohistochemistry was performed using rabbit polyclonal antibodies to localize TGF-beta1, -beta2, and -beta3. All specimens were photographed, and the intensity of immunostaining was graded based on subjective photographic assessment by three independent reviewers. No defect demonstrated any measurable bone replacement after a survival period of 3 days. All 3- and 5-mm defects were completely reossified after 12 weeks based on the linear analysis of new bone, indicating these defects to be less than critical size. However, new bone formation in the 5-mm defects never exceeded a mean of 40 percent by cross-sectional area of new bone. Percent of new bone formation by cross-sectional area was significantly higher within 3-mm defects than in all larger defects 4 weeks after the craniotomy, reaching a mean of 89 percent new bone by 12 weeks. Persistent gaps were noted on linear analysis of the 8- and 12-mm wounds by 12 weeks, and mean percent new bone by cross-sectional area remained below 30 percent. Immunolocalization demonstrated osteogenic fronts at the advancing bone edge and the endocranial side, in which the osteoblasts stained strongly for all isoforms of TGF-beta. The intensity of osteoblast expression waned considerably after the majority of the defect had reossified. These data indicate that histometric analysis based on cross-sectional area more accurately reflects the osteogenic potential of a cranial defect than does linear inspection of defect closure. Although the interpretation of immunolocalization studies is highly subjective, independent assessment by three reviewers indicates that isoforms of TGF-beta were upregulated during a limited "window" of time corresponding to the period of active calvarial reossification, and expression of TGF-beta corresponded to osteoblast activity within osteogenic fronts.     

A new method to quantify liner deformation within a prosthetic socket for below knee amputees

Many amputees who wear a leg prosthesis develop significant skin wounds on their residual limb. The exact cause of these wounds is unclear as little work has studied the interface between the prosthetic device and user. Our research objective was to develop a quantitative method for assessing displacement patterns of the gel liner during walking for patients with transtibial amputation. Using a reflective marker system and a custom clear socket, evaluations were conducted with a clear transparent test socket mounted over a plaster limb model and a deformable limb model. Distances between markers placed on the limb were measured with a digital caliper and then compared with data from the motion capture system. Additionally, the rigid plaster set-up was moved in the capture volume to simulate walking and evaluate if inter-marker distances changed in comparison to static data. Dynamic displacement trials were then collected to measure changes in inter-marker distance due to vertical elongation of the gel liner. Static and dynamic inter-marker distances within day and across days confirmed the ability to accurately capture displacements using this new approach. These results encourage this novel method to be applied to a sample of amputee patients during walking to assess displacements and the distribution of the liner deformation within the socket. The ability to capture changes in deformation of the gel liner will provide new data that will enable clinicians and researchers to improve design and fit of the prosthesis so the incidence of pressure ulcers can be reduced.     

Reconstruction of large nasal defects with a combination of local flaps based on the aesthetic subunit principle

Herein is described a technique that uses a combination of local flaps to reconstruct large defects involving the nasal dorsum and cheek. The flaps used are a transposition flap elevated from the area adjoining the defect and bilateral cheek advancement flaps. This technique leaves all suture wounds at borders of the aesthetic subunits that have been described previously. Color and texture matches were good and symmetrical. The transposition flap can be modified according to whether the defect includes the nasal tip. After raising the cheek advancement flap, it is also possible to use a dog-ear on the nasolabial region for any alar defects. Nine patients were treated using this procedure. The technique is very reliable (no complications such as congestion and skin necrosis in our series) and is easy to perform. One patient had palpebral ectropion after the operation and underwent secondary repair. In this series, defects measuring 45 x 30 mm in maximum diameter and including the nasal dorsum, nasal tip, ala, and cheek were treated.     

Validity and reliability of an alginate method to measure body surface area

The purpose of this study was to evaluate the validity and reliability of coating methods (plaster bandage, inelastic tape, and the alginate method) and an indirect method using a three dimensional (3D) whole body scanner. The surface area of geometric solids was measured five times using the three coating methods, and analyzed through 2D scanning and a planimeter. Second, to examine the accuracy of the alginate method more closely, the surface areas of boards with different surface properties at various inclines were measured and compared. Lastly, the surface area of a human arm was measured using the three coating methods and a 3D scanning method. The results are as follows: 1) The three coating methods were statistically valid and reliable for measuring the surface area of geometric solids. 2) The planimeter was rejected because the mean error was bigger than in 2D scanning. 3) The method showing the least error was the inelastic tape method, but that method was not recommended because it was too tiresome and laborious. 4) The greater the curvature and smaller the size of a geometric solid, the greater the error. 5) In measuring surface area using the alginate method, the objects that were smoother and had steeper angles showed a greater surface area: however, the mean error was less than 1%. 6) In measuring a human arm, the surface area obtained by 3D scanning was less than any other surface area obtained in the three coating methods, because the 3D scanner could not discern the armpit and fingers. In conclusion, the method using alginate was statistically valid and reliable in the measuring of surface area both of geometric solids and real human skin.     

The free latissimus dorsi flap revisited: a primary option for coverage of wide recurrent lumbosacral defects

In comparison with other regions of the trunk, defects located in the lumbosacral region are infrequent. However, these particular lesions sometimes present difficulties in reconstruction, arising from the quality of the surrounding tissue and the width of the defects. In this area, the skin adheres strongly to subcutaneous tissue and is difficult to mobilize. Attempts to perform local or regional flaps for covering defects of this area often end in necrosis of the flaps, with subsequent risk of infection and unstable wounds. The consequence is larger defects and the need for a wide, tension-free coverage, which can be performed after a wide debridement. The authors report on 10 patients presenting with wide, recurrent (and in some cases, infected) defects of the lumbosacral region, after already having undergone several reconstructive local or regional operations. In all cases, the authors harvested a free latissimus dorsi flap, lengthening the pedicle by means of an arteriovenous suralis loop connected to the thoracodorsal vessels (lumbar defect) or the femoral vessels (sacral defect). The procedure, already described in the past by others, has been revisited by the authors' group and used as the technique of choice in selected cases, that is, in the presence of wide, recurrent, and infected lesions; radiation; and scarring injuries. The authors thus obtained stable coverage with well-vascularized tissue and were able to save the patients any further operations. The authors suggest, therefore, that this procedure can be used in cases of wide and recurrent defects where other conventional procedures have failed. Advantages, disadvantages, and technical features of the method used are discussed in this article.     

Measuring Airway Surface Liquid Depth in Ex Vivo Mouse Airways by X-Ray Imaging for the Assessment of Cystic Fibrosis Airway Therapies

In the airways of those with cystic fibrosis (CF), the leading pathophysiological hypothesis is that an ion channel defect results in a relative decrease in airway surface liquid (ASL) volume, producing thick and sticky mucus that facilitates the establishment and progression of early fatal lung disease. This hypothesis predicts that any successful CF airway treatment for this fundamental channel defect should increase the ASL volume, but up until now there has been no method of measuring this volume that would be compatible with in vivo monitoring. In order to accurately monitor the volume of the ASL, we have developed a new x-ray phase contrast imaging method that utilizes a highly attenuating reference grid. In this study we used this imaging method to examine the effect of a current clinical CF treatment, aerosolized hypertonic saline, on ASL depth in ex vivo normal mouse tracheas, as the first step towards non-invasive in vivo ASL imaging. The ex vivo tracheas were treated with hypertonic saline, isotonic saline or no treatment using a nebuliser integrated within a small animal ventilator circuit. Those tracheas exposed to hypertonic saline showed a transient increase in the ASL depth, which continued for nine minutes post-treatment, before returning to baseline by twelve minutes. These findings are consistent with existing measurements on epithelial cell cultures, and therefore suggest promise for the future development of in vivo testing of treatments. Our grid-based imaging technique measures the ASL depth with micron resolution, and can directly observe the effect of treatments expected to increase ASL depth, prior to any changes in overall lung health. The ability to non-invasively observe micron changes in the airway surface, particularly if achieved in an in vivo setting, may have potential in pre-clinical research designed to bring new treatments for CF and other airway diseases to clinical trials.     

Detection of structural defects in phosphatidylcholine membranes by small-angle neutron scattering. The cluster model of a lipid bilayer

The oriented DPPC multilayers hydrated by D2O have been studied by a small-angle neutron scattering method in the Guinier range, and the gyration radius of the structural inhomogeneities has been estimated at about 29 A. They are interpreted as the annular defects between adjacent clusters uniting the all-trans chain 'segments' adjacent to the polar head group regions. The angle of the 'segment' tilt is determined by the hydrated polar group area (59.2 A2 for DPPC bilayers) and has been estimated to be about 44 degrees under the given experimental conditions. The hydrocarbon interior of a bilayer can be suggested as a 'sandwich' that is formed by two clustered layers (approx. 7 A of the thickness) and the central disordered (liquid) layer. The average cluster size along the bilayer surface is estimated to be approx. 24 A which correlates with the estimations of the short order region dimensions from the halfwidth of the X-ray 'packing' reflex (4.6 A)-1. The average interchain separation of approx. 5 A and the average cross-section area of a chain in a cluster (21.4 A2) were estimated from the reflex position and the chain cross-section geometry. The total volume of defects and the fraction of a bilayer surface occupied by them were estimated too.     

Oil drop size and gas hold-up in an oil–water airlift system with motionless mixers

The degree of emulsification, measured as surface area of oil generated, was studied. The effect of interfacial tension, volume fraction of oil, and power per unit volume on the Sauter mean diameter of the oil drops was determined in an airlift system with motionless mixers. A mathematical expression to predict the Sauter mean diameter was developed using regression techniques. From this equation another equation, which will predict the surface area of oil in terms of the same variables, was derived. The effects of water air surface tension and power per unit volume on the gas hold-up were obtained using similar techniques. The results show that the interfacial tension and the surface tension are important variables when hydrocarbon fermentations are carried out in airlift systems.     

樟子松人工林树冠表面积及体积预估模型的研究

基于樟子松(Pinus sylvestris var. mongolica)人工林6块固定标准地30株枝解析数据,在分析树冠表面积和树冠体积与林分变量和林木变量的基础上,利用幂函数建立了树冠表面积（CSA）和树冠体积(CV)的预估模型,同时还对林木材积生长量与CSA和CV进行了相关分析。研究结果表明：樟子松人工林树冠表面积和树冠体积随着林木胸径、树高和冠长的增大而增大,林木材积生长量与树冠表面积和树冠体积均明显呈线性关系。不同林分条件的樟子松人工林CSA和CV随林分年龄和胸径的增大而增大,CSA随林分密度的增大而减小,而CV与林分密度相关不紧密。林分树冠表面积和树冠体积预估模型的检验结果表明,两个模型的平均相对误差都在±8%之内,预估精度均大于91%,说明所建模型可以很好地预估樟子松人工林不同林分条件下的林木树冠表面积和树冠体积。     

Extensive and complex defects of the scalp, middle third of the face, and palate: the role of microsurgical reconstruction

Twenty-one patients with gigantic defects of the scalp and middle third of the face and palate following excision of neglected or recurrent tumors, burns, and infections have undergone microsurgical reconstruction. Wide resection of the middle third of the face, orbit, and palate requires "complex" three-dimensional volume reconstruction, whereas extensive defects of the scalp and skull (exceeding 80 cm2) require coverage of the larger surface area soft-tissue defect and the exposed brain and dura. The latissimus dorsi free-muscle flap and split-thickness skin graft have become our methods of choice for extensive scalp and skull defects. The latissimus dorsi musculocutaneous free flap is preferable for reconstruction of complex palatal and external skin and orbital defects of the middle third of the face. Microsurgical free-tissue transfer reliably frees the oncologic surgeon from the constraints imposed by conventional reconstructive techniques and may therefore allow improved curative or at least palliative resection of these extensive tumors.     

Influence of Geometry on the Drug Release Profiles of Stereolithographic (SLA) 3D-Printed Tablets

Additive manufacturing (3D printing) permits the fabrication of tablets in shapes unattainable by powder compaction, and so the effects of geometry on drug release behavior is easily assessed. Here, tablets (printlets) comprising of paracetamol dispersed in polyethylene glycol were printed using stereolithographic 3D printing. A number of geometric shapes were produced (cube, disc, pyramid, sphere and torus) with either constant surface area (SA) or constant surface area/volume ratio (SA/V). Dissolution testing showed that printlets with constant SA/V ratio released drug at the same rate, while those with constant SA released drug at different rates. A series of tori with increasing SA/V ratio (from 0.5 to 2.4) were printed, and it was found that dissolution rate increased as the SA/V ratio increased. The data show that printlets can be fabricated in multiple shapes and that dissolution performance can be maintained if the SA/V ratio is constant or that dissolution performance of printlets can be fine-tuned by varying SA/V ratio. The results suggest that 3D printing is therefore a suitable manufacturing method for personalized dosage forms.     

Comparison of leaf morphology among submersed species of Myriophyllum (Haloragaceae) from different habitats and geographical distributions

An image analysis system was used to calculate the surface area and volume of the submerged leaves of seven species of Myriophyllum. We separated the species into two categories based on their distribution and habitat differences and compared their surface area, volume, dry mass, specific leaf area, and surface to volume ratios. The geographic location and habitat of the species explained the greatest percentage of total variance for these variables when compared by analysis of variance. A leaf shape analysis was performed by regressing surface area with volume for each species. Interspecific comparisons of leaf shape were made using analysis of covariance. Fundamental interspecific differences in submerged leaf shape, associated with differences in their geographic distributions and habitats, are explained as adaptations for different nutrient uptake regimes.     

Arthroscopic, histological and MRI analyses of cartilage repair after a minimally invasive method of transplantation of allogeneic synovial mesenchymal stromal cells into cartilage defects in pigs

Background aimsTransplantation of synovial mesenchymal stromal cells (MSCs) may induce repair of cartilage defects. We transplanted synovial MSCs into cartilage defects using a simple method and investigated its usefulness and repair process in a pig modelMethodsThe chondrogenic potential of the porcine MSCs was compared in vitro. Cartilage defects were created in both knees of seven pigs, and divided into MSCs treated and non-treated control knees. Synovial MSCs were injected into the defect, and the knee was kept immobilized for 10 min before wound closure. To visualize the actual delivery and adhesion of the cells, fluorescence-labeled synovial MSCs from transgenic green fluorescent protein (GFP) pig were injected into the defect in a subgroup of two pigs. In these two animals, the wounds were closed before MSCs were injected and observed for 10 min under arthroscopic control. The defects were analyzed sequentially arthroscopically, histologically and by magnetic resonance imaging (MRI) for 3 monthsResultsSynovial MSCs had a higher chondrogenic potential in vitro than the other MSCs examined. Arthroscopic observations showed adhesion of synovial MSCs and membrane formation on the cartilage defects before cartilage repair. Quantification analyses for arthroscopy, histology and MRI revealed a better outcome in the MSC-treated knees than in the non-treated control kneesConclusionsLeaving a synovial MSC suspension in cartilage defects for 10 min made it possible for cells to adhere in the defect in a porcine cartilage defect model. The cartilage defect was first covered with membrane, then the cartilage matrix emerged after transplantation of synovial MSCs.     

Morphometric analysis of the forebrain anomalies in the delayed Splotch mutant embryo

The early development of delayed Splotch mouse embryos was examined histologically using scanning electron microscopy and morphometric techniques. Embryos obtained from matings of mice heterozygous for the delayed Splotch gene exhibited a high incidence of lumbosacral (25%) or cephalic (7%) neural tube defects. The lumbosacral neural tube defects extended from the posterior neuropore region to the tip of the tailbud; cephalic neural tube closure defects were found in the hindbrain and midbrain regions. The frontal region of affected embryos was abnormal in that it was reduced in size, particularly in the developing midface. Histologically, the forebrain region of affected embryos appeared reduced, and the luminal surface of the neuroepithelium was often irregular and infolded. To quantify these alterations and to determine their contribution to the final form of the region, size and areal measurements were recorded and served as input for principal component and cluster analytic techniques. In affected embryos, significant reductions were found in lumen size, in neuroepithelial area but not thickness, and in overall area of forebrain but not hindbrain. Principal component analysis of data from unaffected embryos produced two factors, one containing hindbrain variables and the second forebrain variables; for the affected embryos, three factors were extracted. The first loaded on variables that measured the thickness and area of the neuroepithelium, the second on forebrain variables, and the third on hindbrain variables. Factor scores were then generated from a pooled analysis of normal and affected cases and were analyzed using cluster analysis. Three clusters were identified: one contained eight affected embryos with cephalic neural tube defects; another contained nine affected embryos with lumbosacral neural tube defects and five normal embryos; and the final cluster contained ten unaffected embryos. These results suggest a major role of the delayed Splotch gene on the neuroepithelium itself and support the suggested role of cerebrospinal fluid pressure in normal forebrain histogenesis.     

Comparison of several digital and stereological methods for estimating surface area and volume of cells studied by confocal microscopy.

BACKGROUND: The implementation of different methods for estimating the surface area and volume of cells studied by confocal microscopy was developed. The methods were compared from the point of view of their precision, applicability and efficiency. METHODS: Interactive stereological methods (spatial grid method, fakir method, Cavalieri principle) as well as automatic digital methods (digital Crofton method, voxel counting, triangulation method, iso-intensity contouring method) were considered. The methods were tested on model geometrical solids and on real volume images consisting of a stack of serial sections encompassing entire tobacco BY-2 cells or cell chains. RESULTS: It is shown that many of the studied methods are very precise when applied to cells of simple or moderately complex shapes. The automatic digital methods are fast and precise but their applicability is limited by the necessity to segment automatically the object surface and to find an optimal resolution. This limitation is not present in stereological methods which are applied interactively and thus are more time-consuming. CONCLUSIONS: The presented implementations of the fakir method and the Cavalieri principle enable interactive, unbiased and efficient estimation of the cell surface area and volume. The recommended steps for measuring the surface area and/or volume of objects studied by confocal microscopy are described.     

Hemispherically-Unified Surface Maps of Human Cerebral Cortex: Reliability and Hemispheric Asymmetries

Understanding the anatomical and structural organization of the cerebral cortex is facilitated by surface-based analysis enabled by FreeSurfer, Caret, and related tools. Here, we examine the precision of FreeSurfer parcellation of the cortex and introduce a method to align FreeSurfer-registered left and right hemispheres onto a common template in order to characterize hemispheric asymmetries. The results are visualized using Mollweide projections, an area-preserving map. The regional distribution, inter-hemispheric asymmetries and intersubject variability in cortical curvature, sulcal depth, cortical thickness, and cortical surface area of 138 young, right handed subjects were analyzed on the Mollweide projection map of the common spherical space. The results show that gyral and sulcal structures are aligned with high but variable accuracy in different cortical regions and show consistent hemispheric asymmetries that are maximal in posterior temporal regions.     

人工骨表面覆盖口腔修复膜对颌骨囊性缺损人工骨植入术患者植入腔感染的预防作用

目的:探讨人工骨表面覆盖口腔修复膜对颌骨囊性缺损人工骨植入术患者植入腔感染的预防作用。方法:将我院2012年4月～2016年2月收治的78例颌骨囊性缺损患者按治疗时间分为对照组38例与观察组40例,均行开窗人工骨植入术,其中对照组采取常规抗感染,观察组采取人工骨表面覆盖口腔修复膜。比较两组的囊腔体积、面积缩减率、人工骨植入量、骨厚度及植入腔感染率。结果:两组的囊腔体积、面积缩减率及人工骨植入量比较差异无统计学意义(P0.05)。但观察组的骨厚度明显大于对照组(P0.05),植入腔感染率明显低于对照组(P0.05)。结论:在开窗人工骨植入术的基础上使用口腔修复膜不仅能引导骨组织再生,而且能够显著降低植入腔的感染率。     

Effects of pool size on free-choice selections by atlantic bottlenosed dolphins at one zoo facility

Dolphin pool design often derives from the concept that cetaceans are ocean based and ipso facto should live in open, deep, watery spaces. This emotionally appealing rationale is not data driven. Researchers report that in the wild, some populations of Atlantic bottlenosed dolphins (Tursiops truncatus) reside in shallower areas (approximately 2 m deep) and move to deeper areas only when resources become scarce. This study observed a well-established pod of 7 Atlantic bottlenosed dolphins at the Indianapolis Zoo and tested the hypothesis that they would select areas similar to their natural habitat and avoid areas of significantly larger volumes of water (in captivity, a combination of depth and surface area). This hypothesis was confirmed. When given free choice, the dolphins used moderate areas 67.8% of the time, smaller areas 36% of the time, and larger areas 2.9% of the time. This study evaluated the choices using 4 models based on surface area, volume (in gallons), depth, and location preferences, respectively. Choices of pool and area were significantly different from surface area, volume, depth, and location preference null hypothesis predictions-suggesting that larger pools in captive facilities may not be the preferred environment for dolphins.