Three-dimensional reconstruction and rapid prototyping of femur bone using multiple digital X-rays

The medical industry has made great strides in offering healthcare services, and rapid prototyping (RP) is an example of a tool that has experienced tremendous growth in the medical field. RP technologies are used for building models that provide visual and tactile information. The linking of scanning technology and RP technologies now permit anatomical image data to be viewed in a completely different manner. The feasibility of producing RP models using digital X-rays is explained in this work. Digital X-rays taken at regular angular intervals of the anatomical object are used as input data to reconstruct the anatomical object. Software to detect the edge of the bone projection and export it to two-dimensional coordinates was developed using Visual Basic 6.0. This coordinate data of the image is used for creating the spline of the two-dimensional projections of the bone. Then, using extrusion and Boolean intersection operations, the three-dimensional model of the bone without concavities is reconstructed. In order to incorporate the concavities, a unique method is applied. Using grey-level histograms, the concavities are detected, and using subtraction Boolean operation the concavities are incorporated in the model. The CAD model obtained is converted to stl file format, which is the defacto standard for RP. Using FDM 2000 machine the prototype of the bone is fabricated. The reconstructed model is compared with the CT model of the actual bone. The CT model and X-ray model are compared using the slices taken with a constant inter-slice distance. The fabricated bone model is used as visual-tactile representation, surgical planning and simulation tool for doctors. This would enhance the doctor – patient relationship and reduce the time for surgery.     

Three-dimensional reconstruction and rapid prototyping of femur bone using multiple digital X-rays

The medical industry has made great strides in offering healthcare services, and rapid prototyping (RP) is an example of a tool that has experienced tremendous growth in the medical field. RP technologies are used for building models that provide visual and tactile information. The linking of scanning technology and RP technologies now permit anatomical image data to be viewed in a completely different manner. The feasibility of producing RP models using digital X-rays is explained in this work. Digital X-rays taken at regular angular intervals of the anatomical object are used as input data to reconstruct the anatomical object. Software to detect the edge of the bone projection and export it to two-dimensional coordinates was developed using Visual Basic 6.0. This coordinate data of the image is used for creating the spline of the two-dimensional projections of the bone. Then, using extrusion and Boolean intersection operations, the three-dimensional model of the bone without concavities is reconstructed. In order to incorporate the concavities, a unique method is applied. Using grey-level histograms, the concavities are detected, and using subtraction Boolean operation the concavities are incorporated in the model. The CAD model obtained is converted to stl file format, which is the defacto standard for RP. Using FDM 2000 machine the prototype of the bone is fabricated. The reconstructed model is compared with the CT model of the actual bone. The CT model and X-ray model are compared using the slices taken with a constant inter-slice distance. The fabricated bone model is used as visual-tactile representation, surgical planning and simulation tool for doctors. This would enhance the doctor - patient relationship and reduce the time for surgery.     

快速成型技术在医学中的应用

快速成型是 2 0世纪 80年代末发展起来的新技术 ,它在医学上已得到广泛应用。本文对快速成型进行了简单介绍 ,主要综述了在手术计划、假体制造和生物工程中的应用 ;对某些领域中的不足也进行了讨论 ,主要是相对于工业快速成型技术可达到的精度 ,医学 CT扫描的层距显得过厚。     

Gender differences in electrical pain threshold responses to transcutaneous electrical nerve stimulation (TENS)

Gender differences in pain perception have been frequently discussed, but the documented gender-related pain-alleviating effects of non-pharmacological methods are sparse. In this study we aimed to investigate changes in electrical sensory thresholds and electrical pain thresholds, in response to high frequency transcutaneous electrical nerve stimulation, TENS, for 20 min in healthy women (n=29) and men (n=29). The thresholds were assessed pre-, during-, and post-TENS. The pattern of change in thresholds was evaluated with a rank-based statistical method regarding the level of systematic change, expressed as relative position (RP) and additional individual changes, expressed as relative rank variance (RV), with its 95% confidence intervals. Equal levels of systematic changes towards increased electrical sensory thresholds were seen in women and men post-TENS (RP, 0.35; 95% CI, 0.07, 0.63, and RP, 0.36; 95% CI, 0.17, 0.53, respectively). At the same point of time, systematic changes towards increased electrical pain thresholds were only seen in women (RP, 0.43; 95% CI, 0.27, 0.60), while they were unchanged in men (RP, -0.01; 95% CI, -0.13, 0.10). Significant additional individual variations were found in the women's responses of assessed electrical sensory and pain thresholds but not in the men's. It is concluded that both women and men responded with a significant increase of the electrical sensory threshold to high frequency TENS, but only women responded with increase of the electrical pain thresholds. The individual variation of the responses was greater in the women than in the men.     

数字几何处理技术及在颌骨缺损修复手术中的应用

提出一种精确匹配的定制型医用内植物设计与制造方法。采用医学图像处理和数字几何处理技术从CT图像序列中获得以三角面描述的骨组织面模型。对几何模型进行三角面精简、碎片清除、切割、镜像和合并等几何运算后,用LOM法制作实际大小的快速原型模型。快速原型有利于精确匹配的内植物制作,对手术实施也有导向作用。利用该技术已进行30多例颌骨修复手术,效果良好。     

Technology, governance and patient safety: systems issues in technology and patient safety

Technology and equipment are often identified as contributors to adverse medical events, however technology is seldom the focal point of investigation as a source of medical error or adverse event. It is often seen as both a means of reducing error (e.g., automated drug dispensing machines) or as a major contributing factor to adverse events (e.g., through cognitive overload). Here we review literature about the governance of technology in health settings, which is addressed in relation to patient safety. We outline the challenges of addressing technology governance issues in the health sector, provide an overview of governance processes, and suggest that technology related adverse events have been largely conceptualized as device and user problems rather than system or socio-technical problems, which is reflected in governance processes associated with medical devices. A recognition of the situatedness of medical practices implies that new forms of governance may be required that place greater emphasis on socio-technical and systems issues.     

BCMA and autoantibody-producing RP105 B cells; possible new targets of B cell therapy in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a prototypic systemic autoimmune disease with multiple organ disorders. Although the prognosis of SLE has been recently improved, corticosteroid and immunosuppressive agents are still main treatment used in medical practice. Refractory disease and complications by the conventional drugs still remain. RP105 (CD180) is one of the toll-like receptor associated molecules. The molecule is expressed on mature B cells. Significantly increased population of RP105-negative [RP105(-)] B cells is found in SLE. RP105(-) B cells belong to highly activated and differentiated late B cells and produce autoantibodies including anti-dsDNA antibodies. RP105(-) B cells are further divided into at least 5 subsets that include novel human B cell subsets. In active SLE, subset 1 (activated B cells) and 3 (early-plasmablasts) are significantly increased compared to inactive SLE patients. Especially, subset 3 RP105(-) B cells may play an important role in pathophysiology of SLE. RP105(-) B cells from active SLE patients express preferentially BCMA (B-cell maturation antigen) compared to BAFF-R (B-cell activating factor-receptor) than normal subjects and other autoimmune diseases. In SLE, it is suggested that BAFF/APRIL (a proliferation-inducing ligand) maintain chronic activation and survival of RP105(-) B cells. The increased RP105(-) B cells may reflect the breaking of tolerance checkpoint for autoreactive B cells and finally affect autoimmunity in SLE. For the B cell therapy, especially targeting of autoantibody-producing B cells, including subset 3 of RP105(-) B cells, BCMA and RP105(-) B cell itself may be an ideal target.     

IgA nephropathy in relapsing polychondritis

Relapsing polychondritis (RP) is a multisystem autoimmune disease characterized by the presence of antibodies to type II collagen. This collagen is found predominantly in cartilaginous tissues, vitreous humor, aorta and notochord. Involvement of the kidney is rare, only 7 cases having been recorded, and there is no type II collagen in glomeruli. Six of the previous cases had crescentic glomerulonephritis. We report here two cases of biopsy proven RP in which IgA nephropathy was seen, the first examples recorded. Both patients had hematuria and slight proteinuria, with mild impairment of renal function. The histological and immunofluorescence pattern on both biopsies was in keeping with IgA nephropathy. Both patients received steroids with diminution/disappearance of hematuria and proteinuria. In view of the potentially progressive nature of glomerular disease with RP, the renal status should be investigated in all patients with RP.     

Rapid prototyping of scaffolds derived from thermoreversible hydrogels and tailored for applications in tissue engineering

In the year 2000 a new rapid prototyping (RP) technology was developed at the Freiburg Materials Research Center to meet the demands for desktop fabrication of scaffolds useful in tissue engineering. A key feature of this RP technology is the three-dimensional (3D) dispensing of liquids and pastes in liquid media. In contrast to conventional RP systems, mainly focused on melt processing, the 3D dispensing RP process (3D plotting) can apply a much larger variety of synthetic as well as natural materials, including aqueous solutions and pastes, to fabricate scaffolds for application in tissue engineering. For the first time, hydrogel scaffolds with a designed external shape and a well-defined internal pore structure were prepared by this RP process. Surface coating and pore formation were achieved to facilitate cell adhesion and cell growth. The versatile application potential of new hydrogel scaffolds was demonstrated in cell culture.     

Reticulated platelet and its clinical significance

Reticulated platelets (RP) retain some residual mRNA in their cytoplasm and are thought to be the most recently produced platelets in circulation. They can be visualized on a blood film with new methylene blue staining. RP is a flow cytometric assay utilizing a fluorescent dye, either thiazole orange or auramine O. There is a difference in reference values for RP between thiazole orange and auramine O. From the analytic results of RP in patients with thrombocytopenic disorders, RP measurement is considered useful for estimating thrombopoiesis in bone marrow and for differential diagnosis and elucidating the pathophysiology of thrombocytopenic disorders. In the future, test for RP might have a possibility of routine examination because RP can be rapidly and simply measured using whole blood stained with auramine O using an automated reticulocyte counter modified to determine RP. Furthermore, it is anticipated that standardization and morphological definition for RP are established and accuracy for RP is improved.     

基于VTK的医学图像网格化建模系统开发

开发了一套基于VTK的集医学图像处理、三维重建、有限元网格生成功能为一体的软件系统,实现了从医学图像到有限元网格解剖真实的几何建模.系统通过读取医学切片图像,在图像预处理、分割、表面重建、平滑与简化后生成解剖真实的几何模型和有限元网格.系统可输出CAD、RP/RM、有限元体网格文件,为基于医学图像的生物力学仿真、基于数值模拟的外科手术规划、快速成型与制造服务.     

人工智能在医学的应用研究进展

人工智能技术的快速发展,得益于大数据、数据库、算法、算力的巨大进步,医学研究是人工智能的重要应用方向。人工智能与医学的融合发展,提高了医疗技术水平与医疗服务效率,为医生与医疗设备有效赋能,更好地服务于患者。特别在此次新冠肺炎疫情中取得的巨大成效,足见人工智能在医疗领域中发挥巨大作用,因此吸引了许多研究者不断深入探索。本文对近年来人工智能在医学方面应用的相关文献进行梳理,基于人工智能技术与医学研究的发展背景,重点论述人工智能在药物研发、辅助诊疗、语音识别和语义理解、健康管理、医院管理等领域的应用进展,分析人工智能在医疗领域应用存在的挑战,最后讨论人工智能在医疗领域的发展趋势。 【关键词】人工智能;医学应用;技术挑战;综述     

基于快速成型技术制造生物骨方法的研究

快速成型制造技术以它自由生成固体形状的特点成为骨组织工程中的研究热点之一.本文综述和分析了快速成型技术中的几种主要的制造方法,重点讨论当前国内外热点研究的应用立体光造型(stereo-lithography,SL)、选择性激光烧结(selective laser sintering,SLS)、熔化沉积制造(fusion deposition modeling,FDM)和三维印制(three-dimensional plotting/printing,3DP)等快速成型方法制造生物仿生骨的情况,并且归纳国内外最新的研究方向和成果.     

The evolution of biomedical equipment technology

This feature article presents an overview of how the biomedical equipment technology field developed. It begins with some of the early medical equipment breakthroughs, such as the discovery of X rays. The article then traces the key role of the military in electronic technology design, leading to the concept of specially trained individuals to maintain medical equipment. The Technical Education Research Center is discussed, along with the evolution of BMET schools. Formal BMET education had a strong advocate in Ralph Nader, whose concerns about electrical safety in hospitals supported the need for trained technicians to test medical equipment. BMET certification, BMET careers, and Clinical Engineering are discussed. The article concludes with some speculation on healthcare reform and its possible effect on the biomedical equipment profession.     

医学院校“示波器实验”的改进与实践

目的：示波器不仅可以定量测量信号的幅值、频率、相位差等,还可以直接观察输入信号的波形,因此示波器成为医学实验、诊断、监护和科研等方面广泛使用的、不可缺少的电子测量仪器。现有的示波器实验更适合于理工大学的学生。因此,以物理实验教学要求为出发点,结合医学高等院校特点,我们设计了一个全新的与医学专业密切相关的“示波器实验”。方法：新设计的“示波器实验”与生物信号波相结合。该实验系统的生物信号测量、记录部分由压电传感器、生物信号放大器和数字存储示波器构成．各构成部分的设计要求和工作原理在文中进行了较为详细的介绍。结果：改进后的“示波器实验”大大提高了学生进行医学物理学实验的兴趣。学生不仅体会到了传感器技术和电子技术在医学领域中的应用,也认识到了物理学与现代医学是互相渗透发展的。结论：以实践说明医学院校的物理实验应直接体现物理学和医疗技术学的关系,也从一个侧面论述了医学院校改进“示波器实验”教学的必要性和可行性。     

增材制造骨科植入型医疗器械的发展现状及应用

目的介绍国内外增材制造骨科医疗器械的发展及应用情况,并对基于增材制造技术的定制式骨科植入型医疗器械发展方向进行讨论,以期能为相关研究人员提供参考。方法结合增材制造技术在医疗器械领域的发展现状,简要说明其普遍存在的问题,并对增材制造技术的个性化骨科植入型医疗器械的发展方向进行讨论。结果增材制造是一种通过材料的逐层累加以实现零部件自由成型的加工生产工艺。近年来,增材制造技术因其可实现复杂结构等优势在医疗器械领域,尤其是骨科植入物方面得到了广泛应用,不仅为产品生产提供了一种新的加工工艺,也为医疗产业带来了便利。结论迄今为止,国内外已有多种基于增材制造技术的骨科医疗器械在临床上得到广泛应用,利用增材制造技术完成复杂的医疗器械结构的设计与制造,用于满足特殊需求的治疗案例也越来越多,基于增材制造技术的定制式骨科植入型医疗器械也逐步成为医学研究的热点之一。     

Phenotypic variation of Staphylococcus epidermidis slime production in vitro and in vivo.

Clinical studies performed by us and others have found an association between slime production and strains of coagulase-negative staphylococci that infect indwelling medical devices. By serial low-speed centrifugation of broth cultures we have isolated a stable, weakly adherent strain (RP62A-NA) from a strongly adherent, slime-producing, pathogenic strain of Staphylococcus epidermidis sensu stricto (RP62A, ATCC 35984). We obtained a second strain from RP62A-NA (RP62A-NAR) by serial subculture of glass-adherent cells of RP62A-NA. All three strains had the same pattern of biochemical reactions, antimicrobial susceptibilities, and plasmid analysis. Transmission electron micrograph sections stained with the mucopolysaccharide-specific stain alcian blue demonstrated that the adherent strains RP62A and RP62A-NAR were covered with an extracellular coat of polysaccharide-rich material. In contrast, the nonadherent RP62A-NA strain lacked this external coat. All three strains were used in a mouse model of foreign body infection and a rat model of catheter-induced infective endocarditis. The adherence characteristics of isolates of RP62A and RP62A-NA recovered from experimental animals were relatively stable, although we noted a slight but a significant increase in the adherence of RP62A-NA isolates recovered from the foreign body model. The adherence characteristics of RP62A-NAR isolates recovered from infected animals were variable; in general these isolates were less adherent than the laboratory strain of RP62A-NAR. In both models the 50% infective dose (calculated by the Reed and Muench method) was three times greater for the RP62A-NA strain than for the RP62A strain. The phenotypic expression of slime production is subject to both in vitro and in vivo variation and could play a role in the pathogenesis of foreign body infection.     

Big data analytics in medical engineering and healthcare: methods,advances and challenges

Abstract

Big data analytics are gaining popularity in medical engineering and healthcare use cases. Stakeholders are finding big data analytics reduce medical costs and personalise medical services for each individual patient. Big data analytics can be used in large-scale genetics studies, public health, personalised and precision medicine, new drug development, etc. The introduction of the types, sources, and features of big data in healthcare as well as the applications and benefits of big data and big data analytics in healthcare is key to understanding healthcare big data and will be discussed in this article. Major methods, platforms and tools of big data analytics in medical engineering and healthcare are also presented. Advances and technology progress of big data analytics in healthcare are introduced, which includes artificial intelligence (AI) with big data, infrastructure and cloud computing, advanced computation and data processing, privacy and cybersecurity, health economic outcomes and technology management, and smart healthcare with sensing, wearable devices and Internet of things (IoT). Current challenges of dealing with big data and big data analytics in medical engineering and healthcare as well as future work are also presented.