以上臂皮神经及其伴行血管为蒂岛状皮瓣的应用解剖

目的 :为上臂皮神经及其伴行血管为蒂岛状皮瓣提供解剖学基础。方法 :在 2 8侧经红色乳胶灌注的成人上肢标本上 ,对上臂皮神经及伴行血管的起源、走行、分支及外径进行解剖观测 ,并研究营养血管与皮肤血供的关系。结果 :上臂所有皮神经均有伴行营养血管 ,其伴行血管在其神经束间及神经旁相互吻合构成丰富的血管网 ,并借分支与筋膜皮支所形成的皮下筋膜血管网沟通 ,营养筋膜皮肤。结论 :以上述 4条皮神经及其伴行血管为蒂 ,可分别设计顺行或逆行岛状皮瓣或游离皮瓣 ,修复临近部位、手部的软组织缺损。     

Vascular permeability—the essentials

The vasculature, composed of vessels of different morphology and function, distributes blood to all tissues and maintains physiological tissue homeostasis. In pathologies, the vasculature is often affected by, and engaged in, the disease process. This may result in excessive formation of new, unstable, and hyperpermeable vessels with poor blood flow, which further promotes hypoxia and disease propagation. Chronic vessel permeability may also facilitate metastatic spread of cancer. Thus, there is a strong incentive to learn more about an important aspect of vessel biology in health and disease: the regulation of vessel permeability. The current review aims to summarize current insights into different mechanisms of vascular permeability, its regulatory factors, and the consequences for disease.     

胚胎的血管发育及其调控机制

胚胎血管系统的形成过程可分为血管发生和血管生成这两个不同的阶段，其进程受多种刺激和抑制信号的调控，这些信号必须协调作用，以确保血管发育的每个阶段得以正常进行。本概述了血管的起源以及血管发育的过程，并介绍了影响血管发育进程的一些主要因素。     

Vascular permeability—the essentials

Abstract

The vasculature, composed of vessels of different morphology and function, distributes blood to all tissues and maintains physiological tissue homeostasis. In pathologies, the vasculature is often affected by, and engaged in, the disease process. This may result in excessive formation of new, unstable, and hyperpermeable vessels with poor blood flow, which further promotes hypoxia and disease propagation. Chronic vessel permeability may also facilitate metastatic spread of cancer. Thus, there is a strong incentive to learn more about an important aspect of vessel biology in health and disease: the regulation of vessel permeability. The current review aims to summarize current insights into different mechanisms of vascular permeability, its regulatory factors, and the consequences for disease.     

Recent Advancements in Retinal Vessel Segmentation

Retinal vessel segmentation is a key step towards the accurate visualization, diagnosis, early treatment and surgery planning of ocular diseases. For the last two decades, a tremendous amount of research has been dedicated in developing automated methods for segmentation of blood vessels from retinal fundus images. Despite the fact, segmentation of retinal vessels still remains a challenging task due to the presence of abnormalities, varying size and shape of the vessels, non-uniform illumination and anatomical variability between subjects. In this paper, we carry out a systematic review of the most recent advancements in retinal vessel segmentation methods published in last five years. The objectives of this study are as follows: first, we discuss the most crucial preprocessing steps that are involved in accurate segmentation of vessels. Second, we review most recent state-of-the-art retinal vessel segmentation techniques which are classified into different categories based on their main principle. Third, we quantitatively analyse these methods in terms of its sensitivity, specificity, accuracy, area under the curve and discuss newly introduced performance metrics in current literature. Fourth, we discuss the advantages and limitations of the existing segmentation techniques. Finally, we provide an insight into active problems and possible future directions towards building successful computer-aided diagnostic system.     

应用多源性供血腹部皮瓣再造阴茎

目的探讨采用多源性供血腹部皮瓣作阴茎再造的临床效果。方法根据腹壁多源性供血的解剖学基础,设计以含腹壁下脐旁穿支血管（1～2支以上）及腹壁浅或旋髂浅血管供血的皮下筋膜蒂或带皮肤筋膜窄蒂,保留腹直肌前鞘、仅带少量肌袖。对皮下脂肪厚的腹壁皮瓣,将远端不少于1／2预制成真皮下血管网皮瓣作阴茎再造。结果手术均获成功,皮瓣完全成活,外形逼真,功能较为满意。结论采用腹部深浅两套以上血管支供血的腹部皮瓣,是阴茎再造较理想的选择方法。     

下肢皮神经及其营养血管皮瓣的应用解剖

目的 :为下肢皮神经及其营养血管为蒂的岛状皮瓣提供解剖学依据。方法 :在 38侧经动脉灌注红色乳胶的成人下肢标本上 ,解剖观测了下肢皮神经及其营养血管的来源、走行、分布、吻合及外径 ;2侧成人新鲜下肢标本墨汁灌注 ,观测营养血管的墨染范围。结果 :下肢所有皮神经都有营养血管伴行 ,在神经旁形成纵向血管链 ,除营养神经外 ,发出众多皮支与深筋膜血管网、皮下血管网广泛吻合营养皮肤。结论 :以下肢皮神经及其营养血管为蒂可设计顺行或逆行岛状皮瓣     

Automated Analysis of Retinal Vascular Tortuosity on Color Retinal Images

Recent advances in medical imaging modality have enabled us to identify new features in retinal vasculature. One of the features is retinal vascular tortuosity which has been shown to become a predictive factor for cardiovascular diseases and diabetes. The changes in retinal vascular tortuosity might be a sign of severity or improvement of the disease. In this paper, we propose a new method for measuring retinal vascular tortuosity. We adopt a new technique to analyze tortuosity that consider vessel-segment’s width simultaneously. Our proposed method measures vessel-segment’s tortuosity on its edge. A qualitative assessment shows that the method is appropriate for measuring the tortuosity of the vessels in different widths and directions in the image. Finally, a comparison distinguishing tortuous vs. non tortuous vessels demonstrates that the proposed approach may be suitable for predicting or earlier diagnosis of diabetes or cardiovascular diseases.     

便携式多普勒血管探测仪在皮瓣移植中的应用

目的 :研究皮瓣移植前简单、可靠的血管探测的方法。方法 :在皮瓣移植前 ,以 HADECO ES-1 0 0 0 SPM多普勒血管探测仪对皮瓣血管蒂及皮动脉进行探测 ,与术中皮动脉探查结果进行比较 ,考察术前血管探测的准确性和意义。结果 :皮瓣血管蒂及皮动脉术前探测与术中探查结果完全一致。结论 :便携式血管多普勒仪是皮瓣移植前 ,简单、可靠的血管探测的仪器 ,根据探测结果进行皮瓣设计 ,有效地降低了手术失败的风险     

MSCTA对下肢动脉硬化闭塞症的应用价值

目的通过比较各种MSCTA后处理技术,探讨MSCTA对下肢动脉硬化闭塞症诊断的应用价值。方法对73例下肢动脉硬化闭塞症患者MSCTA检查结果进行MIP、MPR、CPR、VR重组,对比动脉清晰度、管壁钙化、支架显示、病变狭窄段及下肢动脉栓子的检出。对成像方法及临床诊断优选方案进行探讨。结果各种后处理技术均可以清晰显示血管轮廓及血管壁的钙化情况及支架的情况。对于动脉狭窄的显示,MPR、2mmMIP显示最佳。对于动脉栓子的检出,2mmMIP图像具有较大的优势。结论多种后处理方法综合运用,可以显示狭窄病变部位、范围、程度,闭塞远端血管充盈情况,管壁钙化及栓子的情况,术后腔内支架的情况,为临床诊断治疗提供重要信息。     

小腿后部神经血管复合体岛状皮瓣的解剖学基础

目的 为小腿后部神经血管复合体岛状皮瓣提供解剖学依据。方法 用成人下肢标本25侧，解剖观察小隐静脉、腓肠神经、腓肠内侧皮神经和腓肠外侧皮神经及其营养血管的起始、走行、分支、分布，及与其它血管的吻合。结果 腓肠神经由腓肠外侧皮神经和腓肠内侧皮神经合成，腓肠神经的营养血管主要是腘窝中间皮动脉，腓肠外侧皮神经的营养动脉主要是腘窝外侧皮动脉，并与腓动脉的肌间隔穿支、肌皮穿支之间存在诸多吻合，形成血管链，并与神经、小隐静脉构成神经血管复合体。结论 以小腿后部神经血管复合体为蒂可以设计截取顺行或逆行岛状皮瓣。     

Framework of Computer Aided Diagnosis Systems for Cancer Classification Based on Medical Images

Early detection of cancer can increase patients’ survivability and treatment options. Medical images such as Mammogram, Ultrasound, Magnetic Resonance Imaging, and microscopic images are the common method for cancer diagnosis. Recently, computer-aided diagnosis (CAD) systems have been used to help physicians in cancer diagnosis so that the diagnosis accuracy can be improved. CAD can help in decreasing missed cancer lesions due to physician fatigue, reducing the burden of workload and data overloading, and decreasing variability of inter- and intra-readers of images. In this research, a framework of CAD systems for cancer diagnosis based on medical images has been proposed. The proposed work helps physicians in detection of suspicion regions using different medical images modalities and in classifying the detected suspicious regions as normal or abnormal with the highest possible accuracy. The proposed framework of CAD system consists of four stages which are: preprocessing, segmentation of regions of interest, feature extraction and selection, and finally classification. In this research, the framework has been applied on blood smear images to diagnose the cases as normal or abnormal for Acute Lymphoblastic Leukemia (ALL) cases. Ant Colony Optimization (ACO) has been used to select the subsets of features from the features extracted from segmented cell parts which can maximize the classification performance as possible. Different classifiers which are Decision Tree (DT), K-nearest neighbor (K-NN), Naïve Bayes (NB), and Support Vector Machine (SVM) have been applied. The framework has been yielding promising results which reached 96.25% accuracy, 97.3% sensitivity, and 95.35% specificity using decision tree classifier.     

Morphological Multiscale Enhancement,Fuzzy Filter and Watershed for Vascular Tree Extraction in Angiogram

This paper presented an automatic morphological method to extract a vascular tree using an angiogram. Under the assumption that vessels are connected in a local linear pattern in a noisy environment, the algorithm decomposes the vessel extraction problem into several consecutive morphological operators, aiming to characterize and distinguish different patterns on the angiogram: background, approximate vessel region and the boundary. It started with a contrast enhancement and background suppression process implemented by subtracting the background from the original angiogram. The background was estimated using multiscale morphology opening operators by varying the size of structuring element on each pixel. Subsequently, the algorithm simplified the enhanced angiogram with a combined fuzzy morphological opening operation, with linear rotating structuring element, in order to fit the vessel pattern. This filtering process was then followed by simply setting a threshold to produce approximate vessel region. Finally, the vessel boundaries were detected using watershed techniques with the obtained approximate vessel centerline, thinned result of the obtained vessel region, as prior marker for vessel structure. Experimental results using clinical digitized vascular angiogram and some comparative performance of the proposed algorithm were reported.     

Automated Detection of Dark and Bright Lesions in Retinal Images for Early Detection of Diabetic Retinopathy

There is an ever-increasing interest in the development of automatic medical diagnosis systems due to the advancement in computing technology and also to improve the service by medical community. The knowledge about health and disease is required for reliable and accurate medical diagnosis. Diabetic Retinopathy (DR) is one of the most common causes of blindness and it can be prevented if detected and treated early. DR has different signs and the most distinctive are microaneurysm and haemorrhage which are dark lesions and hard exudates and cotton wool spots which are bright lesions. Location and structure of blood vessels and optic disk play important role in accurate detection and classification of dark and bright lesions for early detection of DR. In this article, we propose a computer aided system for the early detection of DR. The article presents algorithms for retinal image preprocessing, blood vessel enhancement and segmentation and optic disk localization and detection which eventually lead to detection of different DR lesions using proposed hybrid fuzzy classifier. The developed methods are tested on four different publicly available databases. The presented methods are compared with recently published methods and the results show that presented methods outperform all others.     

Automated Diagnosis of Glaucoma Using Digital Fundus Images

Glaucoma is a disease of the optic nerve caused by the increase in the intraocular pressure of the eye. Glaucoma mainly affects the optic disc by increasing the cup size. It can lead to the blindness if it is not detected and treated in proper time. The detection of glaucoma through Optical Coherence Tomography (OCT) and Heidelberg Retinal Tomography (HRT) is very expensive. This paper presents a novel method for glaucoma detection using digital fundus images. Digital image processing techniques, such as preprocessing, morphological operations and thresholding, are widely used for the automatic detection of optic disc, blood vessels and computation of the features. We have extracted features such as cup to disc (c/d) ratio, ratio of the distance between optic disc center and optic nerve head to diameter of the optic disc, and the ratio of blood vessels area in inferior-superior side to area of blood vessel in the nasal-temporal side. These features are validated by classifying the normal and glaucoma images using neural network classifier. The results presented in this paper indicate that the features are clinically significant in the detection of glaucoma. Our system is able to classify the glaucoma automatically with a sensitivity and specificity of 100% and 80% respectively.     

远端为蒂逆行小腿皮神经营养血管皮瓣的解剖研究

目的：探寻远端为蒂的逆行小腿皮神经营养血管皮瓣修复小腿远段、足踝部软组织缺损的解剖学基础。方法：选用经动脉灌注红色乳胶的成人下肢标本12例，解剖观察小腿皮神经及营养血管的来源、行径．分支分布及营养血管的外径，特别是营养血管与知名血管的吻合关系：结果：小腿皮神经都有起源于知名血管的营养血管伴行，在神经旁形成3条皮神经营养血管链，除发出分支营养神经外，还发出皮支营养皮肤。结论：以远端为蒂的逆行小腿皮神经营养血管皮瓣可用于修复小腿远段、足踝部软组织缺损。     

大鼠尾部血管的解剖结构与鼠尾的生理功能探讨

目的通过对实验大鼠尾部血管的解剖研究,进一步明确其动静脉走行和分布,以加深对其生理功能的理解,为动物实验技术的规范化和实验动物模型设计提供解剖学基础。方法选用成年SD大鼠,采用红蓝两色颜料对尾部血管进行灌注后解剖、腹主动脉生理压力甲醛灌注固定后尾部组织切片、动脉显微血管造影,三种方法配合互相印证。结果证实了大鼠尾部浅层3套纵向动静脉系统,明确了背侧的动静脉链状结构,填补了深层血管分布的空白。提出了动静脉血管分布不匹配特点及其生理基础,明确了尾部血管的双层笼状沟通结构。结论本研究准确地显露了大鼠尾部丰富的血管结构,揭示了鼠尾深层血管系统的存在,并提出双层框架血管结构的理念,为探讨其生理功能的相关研究,避免重大损伤、后肢缺血代偿反应等打下良好的基础。     

Imaging in pulmonary hypertension, part 2: Large vessel diseases

Pulmonary hypertension is defined by physiological parameters but there are numerous causes that differ in their pathogenesis, management and prognosis. Causes include chronic cardiac or pulmonary diseases and diffuse small vessel disease but also a range of large vessel obstructive diseases. The physiological manifestation of all these diseases is increased pulmonary vascular resistance and pulmonary arterial hypertension, and while clinical features may provide a clue to diagnosis, imaging plays a fundamental role in establishing a precise diagnosis and therefore guiding therapy. Chronic thromboembolic pulmonary hypertension (CTEPH) is the most common large vessel cause of pulmonary hypertension. It is increasingly recognised as a major cause of morbidity and mortality which is underdiagnosed and often diagnosed late. The importance of CTEPH is that for patients in whom the distribution of disease lies predominantly in the proximal vasculature there is potential for symptomatic and physiological cure by surgical pulmonary endarterectomy. More distal disease may be suitable for medical management. Increased awareness on behalf of both clinicians and imagers is therefore paramount. However, there are other rare causes or large vessel obstruction/stenosis such as large vessel vasculitis, pulmonary artery tumour, fibrosing mediastinitis, congenital stenosis or extrinsic compression of the pulmonary arteries/veins. Atypical imaging appearance such as unilateral central pulmonary artery obstruction should lead to consideration of a diagnosis other than CTEPH.     

以前臂皮神经及其伴行血管为蒂岛状皮瓣的应用解剖学研究

目的 :为前臂皮神经伴行血管蒂皮瓣提供形态学基础。方法 :在 34侧红色乳胶灌注的成人上肢标本上 ,解剖观测了前臂皮神经及其伴行血管的起源、走行、分支及外径。结果 :所有皮神经均有营养血管伴行 ,所有穿支血管均有 1～ 2条伴行静脉 ,且在穿出深筋膜部位上有一定的规律性。结论 :可以设计以皮神经伴行血管为蒂的岛状皮瓣。