Automated total kidney volume measurements in pre-clinical magnetic resonance imaging for resourcing imaging data,annotations, and source code

1. Download : Download high-res image (287KB)
2. Download : Download full-size image

     

Morphological variations of the deltoid ligament of the medial ankle

Morphological variations of the deltoid ligament were investigated in this study, with the aim of classifying the different types on the basis of their components. Sixty ankles from 39 cadavers were dissected. The origin and insertion sites of the deltoid ligament were identified, and its length, width, and thickness were measured. The deltoid ligament was divided into two layers, superficial and deep, which respectively comprised four components (tibionavicular, tibiospring, tibiocalcaneal, and superficial posterior tibiotalar ligaments) and two components (anterior tibiotalar and deep posterior tibiotalar ligaments). The tibiospring and tibiocalcaneal ligaments were found in 100% of the specimens, while the prevalence rates of other components lay within the range 63.3–96.7%. The tibionavicular and deep posterior tibiotalar ligaments were the thinnest and thickest, respectively, while the other ligaments had similar thicknesses. The deltoid ligament was classified into types I–IV according to the combinations of these components: all components were present in type I (48.3%), the tibionavicular ligament was absent in type II (36.7%), only the superficial posterior tibiotalar ligament was absent in type III (6.7%), and only the anterior tibiotalar ligament was absent in type IV (8.3%). In conclusion, these results improve knowledge of the morphological and morphometric characteristics of the deltoid ligament and thus provide helpful information for surgical procedures in this region. Clin. Anat. 29:1059–1065, 2016. © 2016 Wiley Periodicals, Inc.     

Looped,Broad, and Deep Buried Suturing Technique for Wound Closure

This study explores the clinical application of the circular wide and deep (looped, broad, and deep buried, LBD) suture technique for scar resection and examines its clinical effectiveness for scar treatment. From June 2017 to March 2019, a total of 68 patients with scars were sutured using LBD technique, and recovery was achieved 24 months postoperatively. In all 68 patients, postoperative scars were slightly evident in two cases of cervical scar, one case of leg scar, and one case of chest scar. In addition, the remaining 62 patients were completely satisfied with the outcome. The LBD suturing technique could provide sustained and stable tension-reducing effects postoperatively and significantly improve scar formation in patients. This method is most applicable to incisions with tension. Therefore, it should be more widely used for clinical scar treatment.     

Evaluating cardiac substructure radiation exposure in breast rotational intensity modulated radiation therapy: Effects of cancer laterality,fractionation and deep inspiration breath-hold

PurposeRotational intensity-modulated radiation therapy currently has a growing role in breast cancer radiation therapy, since this radiation technique reduces cardiac radiation exposure while homogeneously covering target volumes. This study aims to evaluate radiation exposure of cardiac substructures across a broad spectrum of breast cancer cases differing by cancer laterality, fractionation regimen and addition of deep-inspiration breath hold.Materials and methodsCardiac substructures were delineated following guidelines endorsed by the European Society for Radiotherapy and Oncology (ESTRO) for forty-four breast cancer patients having undergone conserving surgery and adjuvant rotational intensity-modulated radiation therapy. Target volumes consisted of the whole breast with a boost, axillary and internal mammary nodes. Patients were treated using free-breathing technique for left-sided or right-sided, normofractionated or hypofractionated helical tomotherapy or volumetric modulated arc therapy, or using deep-inspiration breath hold for left-sided normofractionated volumetric modulated arc therapy. Mean and maximum doses to cardiac substructures were retrieved. Correlations were performed between mean- and maximum radiation doses to cardiac substructures.ResultsLeft-sided and right-sided irradiations were associated with different cardiac substructure exposure patterns despite comparable mean heart dose: 7.21 Gy for left-sided normofractionated regimen, 6.28 Gy for right-sided normofractionated regimen. Deep-inspiration breath hold reduced mean doses to almost all cardiac substructures for left-sided irradiation, but did not decrease maximum doses to coronary arteries. Correlations between mean- and maximum doses to cardiac substructures were usually moderate, but stronger for right-sided irradiation.ConclusionDespite comparable mean heart dose, cardiac substructure radiation exposure patterns with rotational intensity-modulated radiation therapy strongly depend on the breast side, which could trigger clinically different long-term cardiotoxicity events. Deep-inspiration breath hold improves cardiac substructure dosimetry. Mean- and maximum heart dose could probably not be used as surrogate markers for precise cardiac substructure evaluation. In a near future, clinical practice and cardiotoxicity studies could possibly gain by considering cardiac substructure in a more systematic manner, possibly relying on cardiac autosegmentation algorithms.     

颈深部间隙感染的相关危险因素分析

 目的 分析颈深部间隙感染(deep neck space infections,DNSI)的临床特点,探讨DNSI高危因素。方法 回顾性分析2004-01至2017-03广西医科大学第一附属医院耳鼻咽喉头颈外科收治的125例DNSI患者的临床资料,对临床表现、感染间隙、病因、细菌学、高危并发症、治疗方式等进行分析。并对引发患者高危并发症的气道阻塞、肺炎、纵隔炎/脓肿、败血症等相关危险因素进行统计分析。结果 125例中发生高危并发症39例(31.2%);发生高危并发症主要因素为:呼吸困难24例(61.5%),肺炎16例(41.0%),纵隔炎或脓肿11例(28.2%),电解质紊乱5例(12.8%),感染性休克3例(7.6),脓毒血症2例(5.0%)。其余86例无高危并发症。多因素Logistic回归分析显示,伴有糖尿病、累及多间隙感染、全身炎性反应综合征(systemic inflammatory response syndrome,SIRS)是DNSI伴发高危并发症的危险因素。结论 合并糖尿病、累及多间隙、伴有SIRS是导致DNSI高危并发症的危险因素。临床医师应高度重视,并预防和积极处理高危并发症,提高治愈率和降低病死率。     

Deep learning for intelligent diagnosis in thyroid scintigraphy

ObjectiveTo construct deep learning (DL) models to improve the accuracy and efficiency of thyroid disease diagnosis by thyroid scintigraphy.MethodsWe constructed DL models with AlexNet, VGGNet, and ResNet. The models were trained separately with transfer learning. We measured each model’s performance with six indicators: recall, precision, negative predictive value (NPV), specificity, accuracy, and F1-score. We also compared the diagnostic performances of first- and third-year nuclear medicine (NM) residents with assistance from the best-performing DL-based model. The Kappa coefficient and average classification time of each model were compared with those of two NM residents.ResultsThe recall, precision, NPV, specificity, accuracy, and F1-score of the three models ranged from 73.33% to 97.00%. The Kappa coefficient of all three models was >0.710. All models performed better than the first-year NM resident but not as well as the third-year NM resident in terms of diagnostic ability. However, the ResNet model provided “diagnostic assistance” to the NM residents. The models provided results at speeds 400 to 600 times faster than the NM residents.ConclusionDL-based models perform well in diagnostic assessment by thyroid scintigraphy. These models may serve as tools for NM residents in the diagnosis of Graves’ disease and subacute thyroiditis.     

Long-term directional deep brain stimulation: Monopolar review vs. local field potential guided programming

BackgroundDirectional subthalamic stimulation in Parkinson's disease can increase stimulation threshold for adverse effects and widen the therapeutic window. However, selection of programming settings is time consuming, requiring a thorough monopolar clinical review. To overcome this, programming may be guided by intraoperatively recording local field potential beta oscillations (13–35 Hz).Objectives1) Evaluate whether the power of beta oscillations recorded intraoperatively can predict the clinically most effective directional contacts; and 2) assess long-term directional stimulation outcomes between patients programmed based on clinical monopolar review and patients programmed based on beta activity.MethodsWe conducted a non-randomized, prospective study with 24 Parkinson's disease patients divided into two groups. In group A (14 patients, 2016–2018), we investigated whether beta activity in the directional contacts correlated with clinical efficacy. Stimulating parameters were selected according to clinical monopolar review and mean follow-up was 27 months. In group B (10 patients, 2018–2019), stimulating parameters were selected according to beta activity and mean follow-up was 13 months.ResultsNeurophysiological results showed a strong correlation between clinical efficacy and the low-beta sub-band. Contacts with highest beta peaks increased the therapeutic window by 25%. Selecting the two contacts with highest beta peaks provided an 82% probability of selecting the best clinical contact. Clinical results showed similar improvements in group A (motor score, 72% reduction; levodopa-equivalent daily dose, 65% reduction) and B (72% and 63% reduction, respectively), maintained at long-term follow-up.ConclusionsOur results validate the long-term efficacy of directional stimulation guided by intraoperative local field potential beta oscillations.     

Subthalamic nucleus deep brain stimulation improves sleep in Parkinson's disease patients: a retrospective study and a meta-analysis

BackgroundMost Parkinson's patients suffered from sleep problems. There is increasing evidence that Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) has a positive effect on several sleep parameters, improving overall sleep quality in patients with PD. However, the results are controversial.MethodsWe performed a retrospective study and meta-analysis to assess the Parkinson's disease sleep scale (PDSS) in Parkinson's patients.ResultsWe reviewed our data of patients who underwent STN-DBS, and then extracted five other trials to perform a meta-analysis. The pooled results showed an advantage on post-operative PDSS in both our medical center and pooled results (MD = 20.41, 95% CI = [13.03, 27.79], I² = 61%, P < 0.001). There was a significant difference in Unified Parkinson's Disease Rating Scale (UPDRS)-Ⅲ score between pre and post-operation (MD = −12.59, 95% CI = [−14.70, −10.49], I² = 90%, P < 0.001). What's more, Parkinsonian medication was significantly lower in the post-operative groups after DBS (MD = −314.71, 95% CI = [−468.13, −161.28], I² = 53%, P < 0.001).ConclusionIn the retrospective study and meta-analysis of 6 trials, we found that DBS can significantly increase sleep quality. Furthermore, motor function improved and Parkinsonian medication was significantly decreased postoperatively. The sample size was enough and no further investigations would change the conclusion.