Automatic three-dimensional quantitative analysis for evaluation of facial movement.

The aim of this study is to present a new 3D capture system of facial movements called FACIAL CLIMA. It is an automatic optical motion system that involves placing special reflecting dots on the subject's face and video recording with three infrared-light cameras the subject performing several face movements such as smile, mouth puckering, eye closure and forehead elevation. Images from the cameras are automatically processed with a software program that generates customised information such as 3D data on velocities and areas. The study has been performed in 20 healthy volunteers. The accuracy of the measurement process and the intrarater and interrater reliabilities have been evaluated. Comparison of a known distance and angle with those obtained by FACIAL CLIMA shows that this system is accurate to within 0.13 mm and 0.41 degrees . In conclusion, the accuracy of the FACIAL CLIMA system for evaluation of facial movements is demonstrated and also the high intrarater and interrater reliability. It has advantages with respect to other systems that have been developed for evaluation of facial movements, such as short calibration time, short measuring time, easiness to use and it provides not only distances but also velocities and areas. Thus the FACIAL CLIMA system could be considered as an adequate tool to assess the outcome of facial paralysis reanimation surgery. Thus, patients with facial paralysis could be compared between surgical centres such that effectiveness of facial reanimation operations could be evaluated.     

Femoral articular shape and geometry: A three-dimensional computerized analysis of the knee

An average, three-dimensional anatomic shape and geometry of the distal femur were generated from x-ray computed tomography data of five fresh asymptomatic cadaver knees using AutoCAD (AutoDesk, Sausalito, CA), a computer-aided design and drafting software. Each femur model was graphically repositioned to a standardized orientation using a series of alignment templates and scaled to a nominal size of 85 mm in mediolateral and 73 mm in anteroposterior dimensions. An average generic shape of the distal femur was synthesized by combining these pseudosolid models and reslicing the composite structure at different elevations using clipping and smoothing techniques in interactive computer graphics. The resulting distal femoral geometry was imported into a computer-aided manufacturing system, and anatomic prototypes of the distal femur were produced. Quantitative geometric analyses of the generic femur in the coronal and transverse planes revealed definite condylar camber (3°–6°) and toe-in (8°–10°) with an oblique patellofemoral groove (15°) with respect to the mechanical axis of the femur. In the sagittal plane, each condyle could be approximated by three concatenated circular arcs (anterior, distal, and posterior) with slope continuity and a single arc for the patellofemoral groove. The results of this study may have important implications in future femoral prosthesis design and clinical applications.     

In vivo elbow biomechanical analysis during flexion: three-dimensional motion analysis using magnetic resonance imaging

The purpose of this article is to evaluate in vivo 3-dimensional kinematics of the elbow joint during elbow flexion. We studied the ulnohumeral and radiohumeral joint noninvasively in 3 elbows in healthy volunteers using a markerless bone registration algorithm. Magnetic resonance images were acquired in 6 positions of elbow flexion. The inferred contact areas on the ulna against the trochlea tended to occur only on the medial facet of the trochlear notch in all of the elbow positions we tested. The inferred contact areas on the radial head against the capitellum occurred on the central depression of the radial head in all of the tested elbow positions except for 135 degrees flexion, where the anterior rim of the radial head articulates with the capitellum.     

Magnetic resonance imaging of the facial nerve in children with idiopathic facial paralysis.

The role of gadolinium-enhanced MRI (Gd-MRI) in the diagnosis of idiopathic facial paralysis (IFP) in children is not well defined. Fourteen children with IFP were evaluated to assess the use of Gd-MRI for the presence and pattern of enhancement and its usefulness in predicting the recovery of facial function. Six of 14 children had enhancement of the facial nerve on Gd-MRI, whereas 8 had none. Enhancement was noted in the tympanic, mastoid, and most commonly in the distal intracanalicular and labyrinthine segments. The average time from onset of paresis to recovery in patients with enhancement was 19.3 weeks, whereas in those with no enhancement, mean recovery time was 9.5 weeks (P = 0.003, t test). All 14 patients eventually had recovery to House-Brackmann grade I or II. Gd-MRI is not required for all children with IFP but may yield information about the time course of recovery of facial function.     

三维斑点追踪成像评价糖尿病患者心脏损害的Meta分析

目的评价三维斑点追踪成像(3D-STI)定量测评糖尿病(DM)患者左心室应变的临床价值。方法计算机检索PubMed等数据库官方网站中2016年8月1日之前发表的有关3D-STI评价DM患者左心室功能的病例对照研究。确切的纳入与排除标准制定后,独立筛选文献、提取各项数据和评价质量分配给2名两名研究员。通过Stata 12.0软件分析权重均数差(WMD)及95%可信区间(CI)。结果最终纳入12篇病例对照研究,共计620例DM患者和473名正常者。Meta分析:DM组与对照组左心室射血分数的差异无统计学意义[WMD=-0.94,95%CI(-1.92,-0.04),P=0.06];左心室整体应变DM组与对照组相比差异均有统计学意义:径向应变[WMD=-3.63,95%CI(-5.15,-2.11),P0.01]、纵向应变[WMD=3.54,95%CI(2.71,4.36),P0.01]、环向应变[WMD 2.48,95%CI(1.49,3.48),P0.01]、面积应变[WMD=2.92,95%CI(2.33,3.50),P0.01)。结论 3D-STI定量测评糖尿病群体的左心室应变指标具有一定的临床价值。     

数字图像分析在面部整形中的应用

将数字图像分析、模拟技术应用于隆鼻术及烧伤后口唇畸形的整复中，通过测量分析，在术前模拟出术后的面部图像，并输出手术数据，在医生及患者认可后，指导手术进行，否则，继续图像的修改，在手术允许的范围内，直到医、患双方认可。力求美容手术精确化、定量化及图像化并就如何应用数字图像技术于畸形整复进行了探讨     

Dressings cut to shape alleviate facial tissue loads while using an oxygen mask

Non‐invasive ventilation (NIV) masks are commonly used for respiratory support where intubation or a surgical procedure can be avoided. However, prolonged use of NIV masks involves risk to facial tissues, which are subjected to sustained deformations caused by tightening of the mask and microclimate conditions. The risk of developing such medical device‐related pressure ulcers can be reduced by providing additional cushioning at the mask‐face interface. In this work, we determined differences in facial tissue stresses while using an NIV mask with versus without using dressing cuts (Mepilex Lite; Mölnlycke Health Care, Gothenburg, Sweden). First, we developed a force measurement system that was used to experimentally determine local forces applied to skin at the bridge of the nose, cheeks, and chin in a healthy sample group while using a NIV mask. We further demonstrated facial temperature distributions after use of the mask using infrared thermography. Next, using the finite element method, we delivered the measured compressive forces per site of the face in the model and compared maximal effective stresses in facial tissues with versus without the dressing cuts. The dressings have shown substantial biomechanical effectiveness in alleviating facial tissues deformations and stresses by providing localised cushioning to the tissues at risk.     

Complex shoulder trauma: three-dimensional CT imaging

Volumetric three-dimensional imaging is a new technique for CT image processing which generates realistic, three-dimensional models of complex musculoskeletal anatomy from routine transaxial CT data. Volumetric three-dimensional imaging is particularly helpful in evaluating complex shoulder trauma, demonstrating significant advantages over plain film radiography. Multipartite fractures involving the shoulder girdle are displayed in a comprehensive fashion with 3D imaging. With volumetric imaging as implemented on a Pixar Imaging Computer, a 3D model of the injured shoulder can be generated with overlapping structures removed from view, and then rotated about the vertical and horizontal axis for better understanding of abnormal anatomy prior to surgical correction.     

Changes in male salivary testosterone concentration with age

Using a specific and sensitive radioimmunoassay for testosterone, the concentration of the steroid has been determined in samples of saliva taken from men of various ages. The results clearly show that the mean salivary testosterone concentration, which related to the plasma-free, non-protein-bound steroid concentration, falls with advancing age from 236 pmol/l in the 3rd decade to 100 pmol/l in the 8th decade.     

Remodeling in peripheral vein graft revisions: serial study with three-dimensional ultrasound imaging

OBJECTIVE: Remodeling of vein grafts in the lower limb can lead to stenotic lesions that threaten long-term graft patency. Progressive changes in vein graft geometry were measured at sites of repaired stenoses with three-dimensional (3D) ultrasound imaging. METHODS: Ten vein graft revisions with patch angioplasty were followed up for 31 to 47 weeks. Four revisions were at valve sites, and six were at sites of diffuse intimal hyperplasia. Sets of spatially registered two-dimensional (2D) cross-sectional ultrasound images were assembled to create 3D computer models of each vein graft. Cross-sectional area measurements in planes normal to the vessel center axis were calculated from the 3D surface reconstructions. Data sets from serial studies were registered in a common coordinate system, and cross-sectional area measurements were compared at matched sites. RESULTS: Three of the four vein graft revisions at valve sites changed by less than 18%, and one decreased in cross-sectional area by 61%. Five of the six revisions at sites of diffuse intimal hyperplasia demonstrated significant decreases in lumen area ranging from 26% to 61%, and one revision exhibited no significant change in cross-sectional area. Reproducibility of the cross-sectional area measurements derived from the 3D imaging technique was 6.9%. CONCLUSIONS: Sequential area measurements from 3D ultrasound scans demonstrated different remodeling patterns and rates of change among revision sites within the vein grafts. Lumen narrowing documented with 3D scanning was not associated with consistent flow velocity changes on conventional duplex graft surveillance scans.     

Interindividual variability and correlation among morphological parameters of knee joint cartilage plates: analysis with three-dimensional MR imaging

OBJECTIVE: To determine the range and variability of the cartilage volume, thickness, and articular surface areas in the knee joints of healthy male subjects, the association of these parameters within and between the knee joint cartilage plates, and their correlation with anthropometric variables. METHOD: The right knees of 27 individuals (age 23 to 64 years) without cartilage damage were examined. Sagittal magnetic resonance imaging was with a fat-suppressed gradient echo sequence (resolution 2 x 0.31 x 0.31 mm(3)), quantitative parameters being computed for all cartilage plates. RESULTS: The total knee joint cartilage volume ranged from 16.6 to 31.4 ml, the size of the articular surfaces from 102 to 163 cm(2), and the mean cartilage thickness from 1.57 to 2.43 mm. The mean and maximal cartilage thickness were highest in the patella (2.76 and 5.72 mm). There was a significant correlation of the cartilage volume with the mean thickness (R=0.80) and with the joint surface areas (R=0.56), but not between the thickness and surface area (R=0.37). The association among the patella, tibia, and femur was 0.16 to 0.72 for volumes, 0.08 to 0.78 for thickness, and 0.24 to 0.62 for surfaces. The knee joint cartilage volume and the surface areas were significantly associated with the body height (R=0.51 and 0.57), but not the cartilage thickness (R=0.22). CONCLUSION: There is a surprisingly high variability of the quantitative distribution of cartilage within the knee joint, with only moderate correlations between knee joint cartilage plates, and this variability cannot be adequately predicted based on anthropometric variables.     

三维斑点追踪成像左心室应变指标正常参考范围的Meta分析

目的采用Meta分析评估健康成人的三维斑点追踪成像(3D-STI)左心室整体纵向应变(GLS)、整体环向应变(GCS)、整体径向应变(GRS)、整体面积应变(GAS)的正常参考范围。方法在Embase、Pubmed、Cochrane Library等英文资料库中,检索2016年8月1日前公开发表的关于3D-STI评价左心功能的病例对照研究。按照纳入和排除标准,对文献进行筛查和提取数据。以加权均数差(WMD)及95%可信区间(CI)作为合并统计量,采用的统计分析软件为STATA 12.0。结果最终纳入27项研究,1 552名健康成年被试。GLS的WMD和95%CI为17.80、(16.27,19.33),GCS的WMD和95%CI为24.73、(22.50,26.95),GRS的WMD和95%CI为47.86、(39.52,56.19),GAS的WMD和95%CI为36.17、(34.08,38.26)。结论通过Meta分析确定成人左心室应变指标的正常参考范围,对采用3D-STI评价疾病状态下心脏结构和功能的变化具有一定的指导意义。