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Sample records for acquired fibular segmental

  1. Accuracy of mandibular reconstruction by three-dimensional guided vascularised fibular free flap after segmental mandibulectomy.

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    Weitz, J; Bauer, F J M; Hapfelmeier, A; Rohleder, N H; Wolff, K-D; Kesting, M R

    2016-06-01

    Mandibular reconstruction with a fibular free flap has become standard in specialised centres for head and neck reconstruction, particularly for defects with more than one osteotomy that are challenging even for experienced surgeons. Virtual surgical planning is a potential tool to facilitate harvesting of the fibula and the osteostomy. The purpose of this study was to compare the two methods of mandibular reconstruction - conventionally planned (conventional group) and "virtually" planned (virtual group) - with regard to accuracy, bony consolidation, complications, and operating time. Fifty patients who required mandibular reconstruction after segmental mandibulectomy were evaluated retrospectively, 24 virtually planned and 26 conventionally planned. The overall survival of flaps was 92% (46/50). The bony consolidation rate in the virtual group was significantly better than that in the conventional group (p=0.002). The difference between the angle of the mandible before and after was highly significant with a median of 11.5° (range 2°-75°) in the conventional group and 4.5° (range 0-18°) in the virtual group (p=0.0001). Operations were mean (SD) of 34 (21.2) minutes shorter in virtually-planned cases (p=0.12). The overall morbidity did not differ significantly between the groups. The use of virtual surgical planning in mandibular reconstruction by fibular free flap is beneficial for optimising accuracy, consolidation of bony segments, and operating time, while increasing the predictability of results for the surgeon. However, additional costs have to be carefully weighed against the benefits.

  2. Reconstruction of multiple metacarpal bone defect using segmentated free fibular bone flap: Case report

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    Rahmi Evinc

    2014-04-01

    Full Text Available In this report we present a case of blast injury to hand, including multiple metacarpal bone defect. Bone defects were reconstructed using fibular flap. Structural integrity of metacarpal bones was preserved with good functional results. [Hand Microsurg 2014; 3(1.000: 29-32

  3. Reconstruction of multiple metacarpal bone defect using segmentated free fibular bone flap: Case report

    OpenAIRE

    Rahmi Evinc; Can Kopal; Dogan Bek; Muzaffer Durmus

    2014-01-01

    In this report we present a case of blast injury to hand, including multiple metacarpal bone defect. Bone defects were reconstructed using fibular flap. Structural integrity of metacarpal bones was preserved with good functional results. [Hand Microsurg 2014; 3(1.000): 29-32

  4. An anatomic study of vascularized fibular grafts

    Institute of Scientific and Technical Information of China (English)

    ZHU Yue-liang; XU Yong-qing; YANG Jun; Li Jun; LAN Xiu-fu

    2008-01-01

    Objective: To study the applied anatomy of the vascular and muscular innervations related to vascularized fibular grafts.Methods: Thirty-four cadaveric lower extremities were dissected for this study.The observations included fibular length,fibular nutrient artery,arcuate arteries,and innervation of fibular muscles.The fibulas were averagely divided into four segments and the locations of relevant vessels and nerves were ascertained.Results: All specimens had 1 fibular nutrient artery and 4-9 arcuate arteries except 1 specimen which had only 1 arcuate artery.The fibular nutrient artery and the first threearcuate arteries were constantly located between the distal half of the 1/4 segment and 2/4 segment of the fibula.The muscular branch of the superficial peroneal nerve passed through the surface of the periosteum in the 2/4 segment of the fibula.Conclusions: The most proximal osteotomy point locates at the midpoint of the 1/4 segment by which it ensure the maximal potential for preserving the nutrient vessels.The muscular branch of the superficial peroneal nerve is fragile to injury at the 2/4 segment of the fibula.

  5. Protective mechanisms of the common fibular nerve in and around the fibular tunnel: a new concept.

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    El Gharbawy, Ramadan M; Skandalakis, Lee J; Skandalakis, John E

    2009-09-01

    The most frequent site at which the common fibular nerve is affected by compression, trauma, traction, masses, and surgery is within and around the fibular tunnel. The aim of this study was to determine whether there were protective mechanisms at this site that guard against compression of the nerve. Twenty-six lower limbs of 13 preserved adult cadavers (11 males and two females) were used. Proximal to the entrance of the tunnel, three anatomical configurations seemed to afford the required protection for the nerve: reinforcement of the deep fascia; tethering of the common fibular nerve to both the tendon of the biceps femoris and the reinforced fascia; and the particular arrangement of the deep fascia, fibular head, and soleus and gastrocnemius muscles. At the entrance of the tunnel, contraction of the first segment of fibularis longus muscle could afford the required protection. In the tunnel, contraction of the second and third segments of fibularis longus muscle could guard against compression of the nerve. The tough fascia on the surface of fibularis longus muscle and the fascial band within it, which have long been accused of compression of the nerve, may actually be elements of the protective mechanisms. We conclude that there are innate, anatomical protective mechanisms which should be taken into consideration when decompressing the common fibular nerve. To preserve these mechanisms whenever possible, the technique should be planned and varied according to the underlying etiology.

  6. Early syllabic segmentation of fluent speech by infants acquiring French.

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    Goyet, Louise; Nishibayashi, Léo-Lyuki; Nazzi, Thierry

    2013-01-01

    Word form segmentation abilities emerge during the first year of life, and it has been proposed that infants initially rely on two types of cues to extract words from fluent speech: Transitional Probabilities (TPs) and rhythmic units. The main goal of the present study was to use the behavioral method of the Headturn Preference Procedure (HPP) to investigate again rhythmic segmentation of syllabic units by French-learning infants at the onset of segmentation abilities (around 8 months) given repeated failure to find syllabic segmentation at such a young age. The second goal was to explore the interaction between the use of TPs and syllabic units for segmentation by French-learning infants. The rationale was that decreasing TP cues around target syllables embedded in bisyllabic words would block bisyllabic word segmentation and facilitate the observation of syllabic segmentation. In Experiments 1 and 2, infants were tested in a condition of moderate TP decrease; no evidence of either syllabic or bisyllabic word segmentation was found. In Experiment 3, infants were tested in a condition of more marked TP decrease, and a novelty syllabic segmentation effect was observed. Therefore, the present study first establishes early syllabic segmentation in French-learning infants, bringing support from a syllable-based language to the proposal that rhythmic units are used at the onset of segmentation abilities. Second, it confirms that French-learning infants are sensitive to TP cues. Third, it demonstrates that they are sensitive to the relative weight of TP and rhythmic cues, explaining why effects of syllabic segmentation are not observed in context of high TPs. These findings are discussed in relation to theories of word segmentation bootstrapping, and the larger debate about statistically- versus prosodically-based accounts of early language acquisition.

  7. Early syllabic segmentation of fluent speech by infants acquiring French.

    Directory of Open Access Journals (Sweden)

    Louise Goyet

    Full Text Available Word form segmentation abilities emerge during the first year of life, and it has been proposed that infants initially rely on two types of cues to extract words from fluent speech: Transitional Probabilities (TPs and rhythmic units. The main goal of the present study was to use the behavioral method of the Headturn Preference Procedure (HPP to investigate again rhythmic segmentation of syllabic units by French-learning infants at the onset of segmentation abilities (around 8 months given repeated failure to find syllabic segmentation at such a young age. The second goal was to explore the interaction between the use of TPs and syllabic units for segmentation by French-learning infants. The rationale was that decreasing TP cues around target syllables embedded in bisyllabic words would block bisyllabic word segmentation and facilitate the observation of syllabic segmentation. In Experiments 1 and 2, infants were tested in a condition of moderate TP decrease; no evidence of either syllabic or bisyllabic word segmentation was found. In Experiment 3, infants were tested in a condition of more marked TP decrease, and a novelty syllabic segmentation effect was observed. Therefore, the present study first establishes early syllabic segmentation in French-learning infants, bringing support from a syllable-based language to the proposal that rhythmic units are used at the onset of segmentation abilities. Second, it confirms that French-learning infants are sensitive to TP cues. Third, it demonstrates that they are sensitive to the relative weight of TP and rhythmic cues, explaining why effects of syllabic segmentation are not observed in context of high TPs. These findings are discussed in relation to theories of word segmentation bootstrapping, and the larger debate about statistically- versus prosodically-based accounts of early language acquisition.

  8. Robust Optic Nerve Segmentation on Clinically Acquired CT.

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    Panda, Swetasudha; Asman, Andrew J; Delisi, Michael P; Mawn, Louise A; Galloway, Robert L; Landman, Bennett A

    2014-03-21

    The optic nerve is a sensitive central nervous system structure, which plays a critical role in many devastating pathological conditions. Several methods have been proposed in recent years to segment the optic nerve automatically, but progress toward full automation has been limited. Multi-atlas methods have been successful for brain segmentation, but their application to smaller anatomies remains relatively unexplored. Herein we evaluate a framework for robust and fully automated segmentation of the optic nerves, eye globes and muscles. We employ a robust registration procedure for accurate registrations, variable voxel resolution and image field-of-view. We demonstrate the efficacy of an optimal combination of SyN registration and a recently proposed label fusion algorithm (Non-local Spatial STAPLE) that accounts for small-scale errors in registration correspondence. On a dataset containing 30 highly varying computed tomography (CT) images of the human brain, the optimal registration and label fusion pipeline resulted in a median Dice similarity coefficient of 0.77, symmetric mean surface distance error of 0.55 mm, symmetric Hausdorff distance error of 3.33 mm for the optic nerves. Simultaneously, we demonstrate the robustness of the optimal algorithm by segmenting the optic nerve structure in 316 CT scans obtained from 182 subjects from a thyroid eye disease (TED) patient population.

  9. Fibular hemimelia: a case report

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    Kim, Byung Joon; Hong, Suk Joo; Kim, Kyung Min; Seol, Hae Young; Cha, In Ho; Song, Hae Ryong [Korea University Gu-ro Hospital, Seoul (Korea, Republic of)

    2006-11-15

    Fibular hemimelia is the most common congenital absence or hypoplasia of long bone. In addition to fibular absence or hypoplasia, this entity also includes various combined abnormalities of the lower limbs. We present here three cases of fibular hemimelia who underwent diagnosis and treatment in our hospital. We especially focus on the imaging findings of the plain radiographs, and we compare them with the findings found at another presentation.

  10. Efficient Abdominal Segmentation on Clinically Acquired CT with SIMPLE Context Learning.

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    Xu, Zhoubing; Burke, Ryan P; Lee, Christopher P; Baucom, Rebeccah B; Poulose, Benjamin K; Abramson, Richard G; Landman, Bennett A

    2015-03-20

    Abdominal segmentation on clinically acquired computed tomography (CT) has been a challenging problem given the inter-subject variance of human abdomens and complex 3-D relationships among organs. Multi-atlas segmentation (MAS) provides a potentially robust solution by leveraging label atlases via image registration and statistical fusion. We posit that the efficiency of atlas selection requires further exploration in the context of substantial registration errors. The selective and iterative method for performance level estimation (SIMPLE) method is a MAS technique integrating atlas selection and label fusion that has proven effective for prostate radiotherapy planning. Herein, we revisit atlas selection and fusion techniques for segmenting 12 abdominal structures using clinically acquired CT. Using a re-derived SIMPLE algorithm, we show that performance on multi-organ classification can be improved by accounting for exogenous information through Bayesian priors (so called context learning). These innovations are integrated with the joint label fusion (JLF) approach to reduce the impact of correlated errors among selected atlases for each organ, and a graph cut technique is used to regularize the combined segmentation. In a study of 100 subjects, the proposed method outperformed other comparable MAS approaches, including majority vote, SIMPLE, JLF, and the Wolz locally weighted vote technique. The proposed technique provides consistent improvement over state-of-the-art approaches (median improvement of 7.0% and 16.2% in DSC over JLF and Wolz, respectively) and moves toward efficient segmentation of large-scale clinically acquired CT data for biomarker screening, surgical navigation, and data mining.

  11. Efficient multi-atlas abdominal segmentation on clinically acquired CT with SIMPLE context learning.

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    Xu, Zhoubing; Burke, Ryan P; Lee, Christopher P; Baucom, Rebeccah B; Poulose, Benjamin K; Abramson, Richard G; Landman, Bennett A

    2015-08-01

    Abdominal segmentation on clinically acquired computed tomography (CT) has been a challenging problem given the inter-subject variance of human abdomens and complex 3-D relationships among organs. Multi-atlas segmentation (MAS) provides a potentially robust solution by leveraging label atlases via image registration and statistical fusion. We posit that the efficiency of atlas selection requires further exploration in the context of substantial registration errors. The selective and iterative method for performance level estimation (SIMPLE) method is a MAS technique integrating atlas selection and label fusion that has proven effective for prostate radiotherapy planning. Herein, we revisit atlas selection and fusion techniques for segmenting 12 abdominal structures using clinically acquired CT. Using a re-derived SIMPLE algorithm, we show that performance on multi-organ classification can be improved by accounting for exogenous information through Bayesian priors (so called context learning). These innovations are integrated with the joint label fusion (JLF) approach to reduce the impact of correlated errors among selected atlases for each organ, and a graph cut technique is used to regularize the combined segmentation. In a study of 100 subjects, the proposed method outperformed other comparable MAS approaches, including majority vote, SIMPLE, JLF, and the Wolz locally weighted vote technique. The proposed technique provides consistent improvement over state-of-the-art approaches (median improvement of 7.0% and 16.2% in DSC over JLF and Wolz, respectively) and moves toward efficient segmentation of large-scale clinically acquired CT data for biomarker screening, surgical navigation, and data mining.

  12. Efficient abdominal segmentation on clinically acquired CT with SIMPLE context learning

    Science.gov (United States)

    Xu, Zhoubing; Burke, Ryan P.; Lee, Christopher P.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-03-01

    Abdominal segmentation on clinically acquired computed tomography (CT) has been a challenging problem given the inter-subject variance of human abdomens and complex 3-D relationships among organs. Multi-atlas segmentation (MAS) provides a potentially robust solution by leveraging label atlases via image registration and statistical fusion. We posit that the efficiency of atlas selection requires further exploration in the context of substantial registration errors. The selective and iterative method for performance level estimation (SIMPLE) method is a MAS technique integrating atlas selection and label fusion that has proven effective for prostate radiotherapy planning. Herein, we revisit atlas selection and fusion techniques for segmenting 12 abdominal structures using clinically acquired CT. Using a re-derived SIMPLE algorithm, we show that performance on multi-organ classification can be improved by accounting for exogenous information through Bayesian priors (so called context learning). These innovations are integrated with the joint label fusion (JLF) approach to reduce the impact of correlated errors among selected atlases for each organ, and a graph cut technique is used to regularize the combined segmentation. In a study of 100 subjects, the proposed method outperformed other comparable MAS approaches, including majority vote, SIMPLE, JLF, and the Wolz locally weighted vote technique. The proposed technique provides consistent improvement over state-of-the-art approaches (median improvement of 7.0% and 16.2% in DSC over JLF and Wolz, respectively) and moves toward efficient segmentation of large-scale clinically acquired CT data for biomarker screening, surgical navigation, and data mining.

  13. Angiosome of the fibular artery as anatomic basis for free composite fibular flap

    OpenAIRE

    Manojlović Radovan; Milisavljević Milan; Tabaković Dejan; Ćetković Mila; Bumbaširević Marko

    2007-01-01

    Introduction. The free osteoseptocutaneus fibular flap is, anatomically, an angiosome of the fibular artery. Knowledge of detailed topography anatomy of the fibular artery and its branches is necessary for successful creation and elevation of the flap. Objective. The aim of the study was to determine topography of the tissue of the leg supplied only by the fibular artery, to describe topography relations of the branches of the fibular artery, their number, anastomoses, vascular plexus and the...

  14. Computer simulation surgery for mandibular reconstruction using a fibular osteotomy guide.

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    Jeong, Woo Shik; Choi, Jong Woo; Choi, Seung Ho

    2014-09-01

    In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

  15. Unified framework for automated iris segmentation using distantly acquired face images.

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    Tan, Chun-Wei; Kumar, Ajay

    2012-09-01

    Remote human identification using iris biometrics has high civilian and surveillance applications and its success requires the development of robust segmentation algorithm to automatically extract the iris region. This paper presents a new iris segmentation framework which can robustly segment the iris images acquired using near infrared or visible illumination. The proposed approach exploits multiple higher order local pixel dependencies to robustly classify the eye region pixels into iris or noniris regions. Face and eye detection modules have been incorporated in the unified framework to automatically provide the localized eye region from facial image for iris segmentation. We develop robust postprocessing operations algorithm to effectively mitigate the noisy pixels caused by the misclassification. Experimental results presented in this paper suggest significant improvement in the average segmentation errors over the previously proposed approaches, i.e., 47.5%, 34.1%, and 32.6% on UBIRIS.v2, FRGC, and CASIA.v4 at-a-distance databases, respectively. The usefulness of the proposed approach is also ascertained from recognition experiments on three different publicly available databases.

  16. An eye movement based reading intervention in lexical and segmental readers with acquired dyslexia.

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    Ablinger, Irene; von Heyden, Kerstin; Vorstius, Christian; Halm, Katja; Huber, Walter; Radach, Ralph

    2014-01-01

    Due to their brain damage, aphasic patients with acquired dyslexia often rely to a greater extent on lexical or segmental reading procedures. Thus, therapy intervention is mostly targeted on the more impaired reading strategy. In the present work we introduce a novel therapy approach based on real-time measurement of patients' eye movements as they attempt to read words. More specifically, an eye movement contingent technique of stepwise letter de-masking was used to support sequential reading, whereas fixation-dependent initial masking of non-central letters stimulated a lexical (parallel) reading strategy. Four lexical and four segmental readers with acquired central dyslexia received our intensive reading intervention. All participants showed remarkable improvements as evident in reduced total reading time, a reduced number of fixations per word and improved reading accuracy. Both types of intervention led to item-specific training effects in all subjects. A generalisation to untrained items was only found in segmental readers after the lexical training. Eye movement analyses were also used to compare word processing before and after therapy, indicating that all patients, with one exclusion, maintained their preferred reading strategy. However, in several cases the balance between sequential and lexical processing became less extreme, indicating a more effective individual interplay of both word processing routes.

  17. Comparison of miniplates and biodegradable plates in reconstruction of the mandible with a fibular free flap.

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    Kim, N K; Nam, W; Kim, H J

    2015-03-01

    Miniplates and reconstruction plates are usually used to fix a fibular free flap, the gold standard in reconstruction of large segmental mandibular defects. Though biodegradable plates are used in orthognathic operations and repair of fractures nowadays, we know of no studies of the use of biodegradable plates in the reconstruction of segmental mandibular defects including a fibular free flap. We retrospectively reviewed 47 patients who had reconstruction of segmental mandibular defects with fibular free flaps during the past 10 years, and recorded clinical data and morbidity. We compared patients who had reconstruction of such defects with fibular free flaps and miniplates (n=26) with those in whom biodegradable plates had been used (n=21). There was no significant difference between miniplates and biodegradable plates with regard to overall complications (p=0.45) and failure of flaps (p=0.59). After confounding factors had been adjusted for with Cox's proportional hazards regression, there was no significant difference in the proportion of patients who developed a complication between the two groups (p=0.4). The type of plate does not seem to affect overall morbidity in reconstruction of the mandible with a fibular free flap.

  18. Fibular free flap reconstruction of the "true" lateral mandibular defect.

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    Anthony, J P; Foster, R D; Kaplan, M J; Singer, M I; Pogrel, M A

    1997-02-01

    The purpose of this study was to determine the role of the fibular free flap in reconstructing lateral segmental defects of the mandible. Over the past 5 1/2 years, 17 consecutive patients underwent reconstruction of their lateral mandible with the fibular free flap. Patients included 12 men and 5 women, the mean age was 54 years (range, 29-76 years), and the mean length of the mandibular defect was 6.3 cm (range, 2.5-9 cm). The majority of patients with tumors (54%) were treated for recurrence and 92% received radiation to the operative field. The mean operative time to perform the microsurgery and bone plating was 4 hours. Postoperative morbidity occurred in 3 patients (18%) (plate fracture, malocclusion, orocutaneous fistula). Five patients (29%) required leg donor site skin grafting. Donor site morbidity included a minor cellulitis, a transient neuropraxia, and one case of leg swelling. None required additional surgery for donor complications. Thus far, 71% of the patients have received dental rehabilitation and 35% had osseointegrated implants placed in their bone flap. Eighty-two percent of the patients achieved both good or excellent aesthetic and functional results. Sixteen patients (94%) tolerate at least a soft diet and 65% are on a regular diet. Five patients developed tumor recurrence an average of 9 months postoperatively with a mean survival of 21 months. This study demonstrates that the fibular free flap is highly reliable for reconstructing the lateral mandible in a single stage, with low overall morbidity, and provides for excellent dental and speech rehabilitation. For most patients, the fibular free flap should be considered for lateral mandibular reconstruction even in those patients with a limited life expectancy.

  19. Application of short-segment nerve conduction studies in the entrapment of the peroneal nerve across the fibular head%短节段神经传导检测法在腓总神经腓骨小头部位嵌压性损伤中的应用价值

    Institute of Scientific and Technical Information of China (English)

    左星; 张蓓; 林涛; 高瑛; 徐堂辉; 王丹; 李亚军

    2016-01-01

    Objective To evaluate the usefulness of the short-segment nerve conduction studies (SSCSs,inching test) of the peroneal nerve across the fibular head in order to diagnose and localize the site of entrapment of the nerve.Methods Fifty-four patients with suspected peroneal nerve palsy and 30 controls were studied.The symptoms all occurred in unilateral leg,involving 25 left legs and 29 right legs.Both long segment motor nerve conduction studies (LSMCs) and SSCSs were performed in all patients and controls.SSCSs were obtained at 2 cm intervals,starting 6 cm proximal (P6,P4 and P2) and 4 cm distal (D2 and D4) ending to the fibular head prominence (P).Results When nerve conduction of the entire 10 cm segment across the fibular head was tested by the conventional method,only 40 showed reduction in amplitude or slowing of motor conduction velocity or both.However,with SSCSs,54 peroneal nerves were all discovered abnormal.The results of comparison of conventional methods suggested that there were significant differences in conduction velocity between the fibular head-Ankle segment and the knee-fibular head segment in the case group,the latter ((33.63 ± 9.29) m/s) being slower than the former ((47.92 ± 4.04) m/s;t =9.776,P =0.000),while there was no obvious abnormality in the control group.The results of the control group detected by SSCSs showed that there was no significant difference between the left and right sides of the mean amplitude of the stimulation points and the mean time of segmental nerve conduction.Therefore,we set the exception criteria as the segmental nerve conduction time is longer than the corresponding control group (i + 2 s),and the CMAP amplitude of proximal stimulation point decreased by more than 20% than the adjacent distal segment.In accordance with this standard,we found that the lesions were located in P6 to P4 in 2/54 (3.7%) legs,P4 to P2 in 4/54 (7.4%) legs,P2 to P in 43/54 (79.6%) legs,P to D2 in 12/54 (22.2%) legs,D2 to D4 in 3

  20. Rapid gains in segmenting fluent speech when words match the rhythmic unit: evidence from infants acquiring syllable-timed languages

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    Laura eBosch

    2013-03-01

    Full Text Available The ability to extract word-forms from sentential contexts represents an initial step in infants’ process towards lexical acquisition. By age 6 months the ability is just emerging and evidence of it is restricted to certain testing conditions. Most research has been developed with infants acquiring stress-timed languages (English, but also German and Dutch whose rhythmic unit is not the syllable. Data from infants acquiring syllable-timed languages are still scarce and limited to French (European and Canadian, partially revealing some discrepancies with English regarding the age at which word segmentation ability emerges. Research reported here aims at broadening this cross-linguistic perspective by presenting first data on the early ability to segment monosyllabic word-forms by infants acquiring Spanish and Catalan. Three different language groups (two monolingual and one bilingual and two different age groups (8- and 6-month-old infants were tested using natural language and a modified version of the HPP with familiarization to passages and testing on words. Results revealed positive evidence of word segmentation in all groups at both ages, but critically, the pattern of preference differed by age. A novelty preference was obtained in the older groups, while the expected familiarity preference was only found at the younger age tested, suggesting more advanced segmentation ability with an increase in age. These results offer first evidence of an early ability for monosyllabic word segmentation in infants acquiring syllable-timed languages such as Spanish or Catalan, not previously described in the literature. Data show no impact of bilingual exposure in the emergence of this ability and results suggest rapid gains in early segmentation for words that match the rhythm unit of the native language.

  1. Rapid gains in segmenting fluent speech when words match the rhythmic unit: evidence from infants acquiring syllable-timed languages.

    Science.gov (United States)

    Bosch, Laura; Figueras, Melània; Teixidó, Maria; Ramon-Casas, Marta

    2013-01-01

    The ability to extract word-forms from sentential contexts represents an initial step in infants' process toward lexical acquisition. By age 6 months the ability is just emerging and evidence of it is restricted to certain testing conditions. Most research has been developed with infants acquiring stress-timed languages (English, but also German and Dutch) whose rhythmic unit is not the syllable. Data from infants acquiring syllable-timed languages are still scarce and limited to French (European and Canadian), partially revealing some discrepancies with English regarding the age at which word segmentation ability emerges. Research reported here aims at broadening this cross-linguistic perspective by presenting first data on the early ability to segment monosyllabic word-forms by infants acquiring Spanish and Catalan. Three different language groups (two monolingual and one bilingual) and two different age groups (8- and 6-month-old infants) were tested using natural language and a modified version of the HPP with familiarization to passages and testing on words. Results revealed positive evidence of word segmentation in all groups at both ages, but critically, the pattern of preference differed by age. A novelty preference was obtained in the older groups, while the expected familiarity preference was only found at the younger age tested, suggesting more advanced segmentation ability with an increase in age. These results offer first evidence of an early ability for monosyllabic word segmentation in infants acquiring syllable-timed languages such as Spanish or Catalan, not previously described in the literature. Data show no impact of bilingual exposure in the emergence of this ability and results suggest rapid gains in early segmentation for words that match the rhythm unit of the native language.

  2. Rapid gains in segmenting fluent speech when words match the rhythmic unit: evidence from infants acquiring syllable-timed languages

    Science.gov (United States)

    Bosch, Laura; Figueras, Melània; Teixidó, Maria; Ramon-Casas, Marta

    2013-01-01

    The ability to extract word-forms from sentential contexts represents an initial step in infants' process toward lexical acquisition. By age 6 months the ability is just emerging and evidence of it is restricted to certain testing conditions. Most research has been developed with infants acquiring stress-timed languages (English, but also German and Dutch) whose rhythmic unit is not the syllable. Data from infants acquiring syllable-timed languages are still scarce and limited to French (European and Canadian), partially revealing some discrepancies with English regarding the age at which word segmentation ability emerges. Research reported here aims at broadening this cross-linguistic perspective by presenting first data on the early ability to segment monosyllabic word-forms by infants acquiring Spanish and Catalan. Three different language groups (two monolingual and one bilingual) and two different age groups (8- and 6-month-old infants) were tested using natural language and a modified version of the HPP with familiarization to passages and testing on words. Results revealed positive evidence of word segmentation in all groups at both ages, but critically, the pattern of preference differed by age. A novelty preference was obtained in the older groups, while the expected familiarity preference was only found at the younger age tested, suggesting more advanced segmentation ability with an increase in age. These results offer first evidence of an early ability for monosyllabic word segmentation in infants acquiring syllable-timed languages such as Spanish or Catalan, not previously described in the literature. Data show no impact of bilingual exposure in the emergence of this ability and results suggest rapid gains in early segmentation for words that match the rhythm unit of the native language. PMID:23467921

  3. Reconstruction of a postraumatic radial club hand with a free fibular osteoseptocutaneous flap and Sauve-Kapandji procedure-A case report.

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    Horta, Ricardo; Nascimento, Ricardo; Silva, Alvaro; Pinto, Rui; Negrão, Pedro; São-Simão, Ricardo; Carvalho, Jorge; Santos Silva, Marta; Amarante, Jose

    2016-10-01

    Radial club hand may be congenital or acquired; radial deviation of the hand is usually found, associated with palmar flexion-pronation and treatment of severe forms of radial club hand is often difficult. Here we present a case of reconstruction of a severe postraumatic radial club hand with a free fibular osteoseptocutaneous flap and Sauve-Kapandji procedure in a 28-year-old man. The patient had a radial deviation of the wrist and right upper limb shortening as a result of an infected pseudarthrosis of the radius. This deformity was reconstructed with a free fibular osteoseptocutaneous flap associated to arthrodesis of the distal radioulnar joint and an ulnar resection osteotomy proximal to the arthrodesis in order to restore rotation of the forearm (Sauvé-Kapandji procedure). The flap fully survived and no complications were seen in the early postoperative period at both recipient and donor sites. Radius alignment was restored. At 5-month follow-up, the skeleton was healed. There was minimal osteopenia at the distal radial segment. Wrist extension was 48 degrees, flexion 24 degrees, and pronation-supination was 58-0-48 degrees, with full finger flexion. The patient could hold a 4 kg dumbbell with the elbow flexed without discomfort. His DASH score-Disabilities of the Arm, Shoulder, and Hand Questionnaire was 15.83. Combined free fibular osteoseptocutaneous flap and Sauve-Kapandji procedure may be considered in severe forms of postraumatic radial club hand, however, further data are necessary. © 2016 Wiley Periodicals, Inc. Microsurgery 36:593-597, 2016. © 2016 Wiley Periodicals, Inc.

  4. Heterotopic ossification in the submental triangle remote from the vascular pedicle after reconstruction with a fibular free flap: a previously unreported complication.

    Science.gov (United States)

    Panaretou, E; Blythe, J N St J; Conti, M; Brennan, P A

    2016-05-01

    Fibular free flaps are routinely used to reconstruct segmental mandibular defects after resection. While ossification of the vascular pedicle is uncommon but well reported, to our knowledge, heterotopic ossification remote from the pedicle has not previously been described. We report a case in which this occurred. It serves as a reminder that bony, hard lumps in the neck can present years after reconstruction with a fibular flap.

  5. 瘤段截骨加热70℃蒸馏水中15 min:灭活回植治疗腓骨近端骨肿瘤%Replantation of inactivated tumor segment boiled in 70℃ distilled water for 15 minutes in the treatment of proximal fibular tumors

    Institute of Scientific and Technical Information of China (English)

    包毅敏; 张国梁; 杜佩晋; 王跃文

    2014-01-01

    BACKGROUND:Apart from a complete resection of tumor tissues, the therapeutic goal for bone tumors is to maximize the repair and restoration of tissue defects and damaged functions. Autologous inactivated bone graft is of practical value for transplantation and reconstruction. OBJECTIVE:To investigate the effect of improved Malawer method combined with replantation of inactivated tumor segment in the treatment of proximal fibular tumors. METHODS: Since 2007, five patients with proximal fibular tumors (six sides) were admitted in the Affiliated Hospital of Inner Mongolia Medical University. These five patients were subjected to distal femoral amputation, intralesional curettage and bone grafting, upper fibular osteotomy + tumor segment heating (boiling in 70℃ distiled water for 15 minutes) + inactivated bone replantation. Therapeutic effects were folowed. RESULTS AND CONCLUSION: One case of amputation had no recurrence and systemic metastasis during 4 years of folow-up; one case of intralesional curettage and bone grafting relapsed 1 year after operation; three cases of upper fibular osteotomy + tumor segment heating + inactivated bone replantation folowed for 5 months recovered walking function and exhibited good healing of the outer structure of the knee, showing non-healing of inactivated tumor segment, non-remarkable calus formation, no local tumor recurrence, no loosening of internal fixation, and inactivated bone without fracture and absorption. These results confirmed that the tumor curettage and amputation both have obvious limitations; based on Malawer method, the replantation of inactive tumor segment can better ensure the structure integrity of the lower leg and in suit reconstruct the lateral biceps femoris tendon and the lateral colateral ligament, but geneticaly the revascularization and healing of inactivated bones wil be difficult and slow with temperature increases, and therefore the period of postoperative brace protection should be relatively

  6. Segmentation of the macular choroid in OCT images acquired at 830nm and 1060nm

    Science.gov (United States)

    Lee, Sieun; Beg, Mirza F.; Sarunic, Marinko V.

    2013-06-01

    Retinal imaging with optical coherence tomography (OCT) has rapidly advanced in ophthalmic applications with the broad availability of Fourier domain (FD) technology in commercial systems. The high sensitivity afforded by FD-OCT has enabled imaging of the choroid, a layer of blood vessels serving the outer retina. Improved visualization of the choroid and the choroid-sclera boundary has been investigated using techniques such as enhanced depth imaging (EDI), and also with OCT systems operating in the 1060-nm wavelength range. We report on a comparison of imaging the macular choroid with commercial and prototype OCT systems, and present automated 3D segmentation of the choroid-scleral layer using a graph cut algorithm. The thickness of the choroid is an important measurement to investigate for possible correlation with severity, or possibly early diagnosis, of diseases such as age-related macular degeneration.

  7. Tibial and fibular angles in homozygous sickle cell disease

    Energy Technology Data Exchange (ETDEWEB)

    Akamaguna, A.I.; Odita, J.C.; Ugbodaga, C.I.; Okafor, L.A.

    1986-05-01

    Measurements of the tibial and fibular angles made on ankle radiographs of 34 patients with sickle cell disease were compared with those of 36 normal Nigerians. Widening of the fibular angle, which is an indication of tibiotalar slant, was demonstrated in about 79% of sickle cell disease patients. By using fibular angle measurements as an objective method of assessing subtle tibiotalar slant, it is concluded that the incidence of this deformity is much higher among sickle cell disease patients than previously reported. The mean values of tibial and fibular angles in normal Nigerians are higher than has been reported amongst Caucasians.

  8. Osteotomising the fibular free flap: an anatomical perspective.

    Science.gov (United States)

    Fry, A M; Laugharne, Dave; Jones, Keith

    2016-07-01

    Multiple osteotomies with the help of 3-dimensional planning have improved the accuracy of reconstructions, and the reliability and versatility of the fibular free flap is well recognised. To investigate the periosteal blood supply of the fibula and to define safe limits for the size of bony segments, we performed a cadaveric study on 10 fresh frozen lower limbs using a combined barium latex mixture. We modelled cuts at intervals of 1.0, 1.5, and 2.0cm, and assessed the number of periosteal vessels. After virtual dissections using DICOM data obtained from high-resolution computed tomograms (CT), on average we found 12.8 periosteal branches, with a mean (SD) distance between them of 1.36 (0.18)cm. In 34.9% of the 1cm segments there were no visible periosteal vessels. Vascularity seemed to be more reliable in longer segments, with 83.4% of those 1.5cm long, and 94% of those of over 2cm containing at least one branch.

  9. Endoscopic treatment of calcaneo-fibular impingement.

    Science.gov (United States)

    Bauer, T; Deranlot, J; Hardy, Ph

    2011-01-01

    The calcaneo-fibular impingement syndrome is frequent after calcaneal fracture and is linked to the decreased space between the tip of the fibula and the lateral wall of the calcaneus. The reasons for the painful symptoms are mixed with both bony and soft tissue involvement. The abnormal bony contact between the lateral calcaneal cortex and the tip of the fibula depends mainly on the size and localization of the lateral exostosis of the calcaneal wall. The soft tissue impingement is due to the fibrosis and scar tissues in the lateral gutter and to the compression of the peroneal tendons in the retromalleolar groove and under the tip of the malleolus. A 2-portal endoscopic technique is described for the treatment of calcaneo-fibular impingement with bone resection, soft tissue debridement and peroneal tendons release. One of the advantages of this endoscopic technique is the possibility of an assessment and treatment of associated lesions in the same procedure. A subtalar joint fusion can be done before if needed under arthroscopic control. As this endoscopic technique is very efficient to relieve symptoms of calcaneo-fibular impingement and is focused on the most relevant symptoms, it can thus be indicated for most of cases of calcaneal malunions, whatever the type of malunion and depending of the painful symptoms.

  10. Word Segmentation in Monolingual Infants Acquiring Canadian English and Canadian French: Native Language, Cross-Dialect, and Cross-Language Comparisons

    Science.gov (United States)

    Polka, Linda; Sundara, Megha

    2012-01-01

    In five experiments, we tested segmentation of word forms from natural speech materials by 8-month-old monolingual infants who are acquiring Canadian French or Canadian English. These two languages belong to different rhythm classes; Canadian French is syllable-timed and Canada English is stress-timed. Findings of Experiments 1, 2, and 3 show that…

  11. Repeated freeze-thaw cycles do not alter the biomechanical properties of fibular allograft bone.

    Science.gov (United States)

    Shaw, Joshua M; Hunter, Shawn A; Gayton, J Christopher; Boivin, Gregory P; Prayson, Michael J

    2012-03-01

    Allograft tissues can undergo several freeze-thaw cycles between donor tissue recovery and final use by surgeons. However, there are currently no standards indicating the number of reasonable freeze-thaw cycles for allograft bone and it is unclear how much a graft may be degraded with multiple cycles. We therefore asked whether (1) the mechanical properties of fibular allograft bone would remain unchanged with increasing numbers of freeze-thaw cycles and (2) histologic alterations from increased numbers of freeze-thaw cycles would correspond to any mechanical changes. Fibular allograft segments were subjected to two, four, and eight freeze-thaw cycles and compared biomechanically and histologically with a control group (one freeze-thaw cycle). Two freeze-dried treatments, one after being subjected to one freeze-thaw cycle and the other after being subjected to three freeze-thaw cycles, also were compared with the control group. For all segments, the average ultimate stress was 174 MPa, average modulus was 289 MPa, average energy was 2.00 J, and the average stiffness was 1320 N/mm. The material properties of the freeze-thaw treatment groups were similar to those of the control group: ultimate stress and modulus were a maximum of 16% and 70% different, respectively. Both freeze-dried treatments showed increased stiffness (maximum 53% ± 71%) and energy to failure (maximum 117% ± 137%) but did not exhibit morphologic differences. There were no alterations in the histologic appearance of the bone sections in any group. Fibular allograft segments can be refrozen safely up to eight times without affecting the biomechanical or morphologic properties. Freeze-dried treatments require further study to determine whether the detected differences are caused by the processing. Cryopreserved cortical allografts are thawed by surgeons in preparation for procedures and then occasionally discarded when not used. Refreezing allograft tissues can result in a cost savings because of a

  12. Three-Dimensional Analysis of Fibular Motion After Fixation of Syndesmotic Injuries With a Screw or Suture-Button Construct.

    Science.gov (United States)

    LaMothe, Jeremy M; Baxter, Josh R; Murphy, Conor; Gilbert, Susannah; DeSandis, Bridget; Drakos, Mark C

    2016-12-01

    Suture-button constructs are an alternative to screw fixation for syndesmotic injuries, and proponents advocate that suture-button constructs may allow physiological motion of the syndesmosis. Recent biomechanical data suggest that fibular instability with syndesmotic injuries is greatest in the sagittal plane, but the design of a suture-button construct, being a rope and 2 retention washers, is most effective along the axis of the rope (in the coronal plane). Some studies report that suture-button constructs are able to constrain fibular motion in the coronal plane, but the ability of a tightrope to constrain sagittal fibular motion is unknown. The purpose of this study was to assess fibular motion in response to an external rotation stress test in a syndesmotic injury model after fixation with a screw or suture-button constructs. Eleven fresh-frozen cadaver whole legs with intact tibia-fibula articulations were secured to a custom fixture. Fibular motion (coronal, sagittal, and rotational planes) in response to a 6.5-Nm external rotation moment applied to the foot was recorded with fluoroscopy and a high-resolution motion capture system. Measures were taken for the following syndesmotic conditions: intact, complete lateral injury, complete lateral and deltoid injury, repair with a tetracortical 4.0-mm screw, and repair with a suture button construct (Tightrope; Arthrex, Naples, FL) aimed from the lateral fibula to the anterior medial malleolus. The suture-button construct allowed significantly more sagittal plane motion than the syndesmotic screw. Measurements acquired with mortise imaging did not detect differences between the intact, lateral injury, and 2 repair conditions. External rotation of the fibula was significantly increased in both injury conditions and was not restored to intact levels with the screw or the suture-button construct. A single suture-button placed from the lateral fibula to the anterior medial malleolus was unable to replicate the motion

  13. Repositioning template for mandibular reconstruction with fibular free flaps: an alternative technique to pre-plating and virtual surgical planning.

    Science.gov (United States)

    Berrone, M; Crosetti, E; Succo, G

    2014-08-01

    Oral malignancies involving the mandibular bone require a complex reconstructive plan. Mandibular reconstruction with a fibular free flap is currently considered the best choice for functional and aesthetic rehabilitation after oncological surgery. This flap can be modelled with multiple osteotomies and can provide bone, muscle and skin for composite reconstruction. One of the most delicate aspects of mandibular reconstruction is the technique of bone modelling; the risk of prolonging the period of ischaemia and not restoring the correct maxillomandibular and occlusal relationships can ultimately lead to a higher rate of complications as well as poor aesthetic and functional results. Recently, there has been rising interest in virtual surgical planning and computer-assisted mandibular reconstruction in pre-operative planning; however, this is not always possible because of the costs involved and the set-up time for the entire procedure. In this paper, we present a simple and inexpensive technique for fibular free flap modelling and repositioning after segmental resection of the mandible; the technique entails the pre-operative preparation of a resin repositioning template on a stereolithographic model. This technique has been successfully applied in four cases: two cases underwent resection involving only the mandibular body, one case involving the mandibular body and symphysis and one case in which a ramus to ramus resection was performed. In this preliminary report, we show that the resin repositioning template is an easy, safe and useful tool for mandibular reconstruction with a fibular free flap.

  14. Ulnar forearm osteocutaneous flap harvesting using Kapandji procedure for pre-existing complicated fibular flap on mandible reconstruction--cadaveric and clinical study.

    Science.gov (United States)

    Lin, Chih-Hung; Liao, Chun-Ta; Lin, Cheng-Hung; Tan, Bien-Keem; Lee, Chun-Ta

    2015-05-01

    It is not uncommon that after using a fibular flap for lower gum cancer reconstruction, nonunion, chronic osteomyelitis, or fibular bone exposure occurs, which requires a composite bone and soft tissue reconstruction. Radial forearm osteocutaneous flap possesses the risk of stress fracture. Ulnar forearm osteocutaneous flap can be another option for small bone defect reconstruction. Six patients who had undergone fibular flap for mandible reconstructions and sustained either bone exposure (3 patients), chronic osteomyelitis (1 patient), malocclusion (1 patient), or osteoradionecrosis (1 patient) underwent ulnar forearm osteocutaneous flap with 3-cm ulnar bone for touch-up procedure. The distal radioulnar joints were fused with a screw. Six ulnar forearm osteocutaneous flap dissections were also performed on 4 fresh frozen cadavers to clarify the anatomic distribution of the distal ulnar artery. All 6 ulnar forearm osteocutaneous flaps survived with one re-exploration for venous occlusion. All presented bone union. Comparable to the clinical dissection, the cadaveric distal ulnar artery demonstrates a periosteal branch that runs between the proper ulnar nerve and dorsal sensory nerve. This periosteal branch comes out of an ulnar artery approximately 3 cm proximal to the wrist joint. Ulnar forearm osteocutaneous flap can provide a secondary flap of wide skin paddle and small segment bone for specific mandibular defect after a fibular flap transfer.

  15. FIBULAR MOTOR NERVE CONDUCTION STUDIES AND ANKLE SENSORIMOTOR CAPACITIES*

    Science.gov (United States)

    Richardson, James K.; Allet, Lara; Kim, Hogene; Ashton-Miller, James A.

    2012-01-01

    Introduction Nerve conduction studies provide information regarding the status of the peripheral nerve, but relationships with sensorimotor capacities that influence mobility have not been defined. Methods A secondary analysis was conducted of data from 41 older subjects (20 women, age 69.1 ± 8.3 years), 25 with diabetic neuropathy of varying severity, and 16 without diabetes or neuropathy. Measurements included routine fibular motor nerve conduction studies and laboratory-based determination of ankle inversion/eversion proprioceptive thresholds and ankle inversion/eversion motor function. Results Independent of age, fibular amplitude correlated robustly with ankle inversion/eversion proprioceptive thresholds (R2 = .591, p < .001), moderately with ankle inversion and eversion rates of torque generation (R2 = .216; p = .004 and R2 = .200; p = .006, respectively), and more strongly when fibular motor amplitude was normalized for body mass index (R2 = .350; p < .001 and R2 = .275; p = .001). Discussion Fibular motor amplitude was strongly associated with ankle sensorimotor capacities that influence lateral balance and recovery from perturbations during gait. The results suggest that nerve conduction study measures have potential for an expanded clinical role in evaluating mobility function in the population studied. PMID:23225524

  16. Evaluation of mandibular reconstruction with free vascularized fibular flap

    Institute of Scientific and Technical Information of China (English)

    Krishna Gopal Bhuju; Shuzhong Xing; Hualian Liu

    2008-01-01

    Objective: To evaluates mandible reconstruction by free vascularized fibular flap with special emphasis on the immediate complications. Methods:The clinical data of 63 patients were reviewed, 35 male and 28 female(age range l6 to 73 years). Aesthetic and functional outcomes were evaluated by follow-up and/or telephone conversation. Results:Among the 63 fibular flaps, 29 were osteocutaneous flaps with one or two skin islands. All the flaps were surviving well and the success rate was 100%. Long term donor site disability was not recorded for any patient. Thirty-one patients responded for aesthetic and functional evaluation, 20 cases(64.5%) reported their facial appearance as excellent or good, 11 (35.48%) felt fair; 14 cases (45%) could eat unrestricted diet, 17(55%) could eat soft diet; 21 cases were(67.67%) speech normal, 10(22.33%) speech intelligible. Conclusion:Free fibular flap reflects good functional and esthetic results with a high degree of consistency, and acceptable level of complications, and we strongly believe the vascularized fibular flap is the first choice for mandibular reconstruction.

  17. Statistical learning of an auditory sequence and reorganization of acquired knowledge: A time course of word segmentation and ordering.

    Science.gov (United States)

    Daikoku, Tatsuya; Yatomi, Yutaka; Yumoto, Masato

    2017-01-27

    Previous neural studies have supported the hypothesis that statistical learning mechanisms are used broadly across different domains such as language and music. However, these studies have only investigated a single aspect of statistical learning at a time, such as recognizing word boundaries or learning word order patterns. In this study, we neutrally investigated how the two levels of statistical learning for recognizing word boundaries and word ordering could be reflected in neuromagnetic responses and how acquired statistical knowledge is reorganised when the syntactic rules are revised. Neuromagnetic responses to the Japanese-vowel sequence (a, e, i, o, and u), presented every .45s, were recorded from 14 right-handed Japanese participants. The vowel order was constrained by a Markov stochastic model such that five nonsense words (aue, eao, iea, oiu, and uoi) were chained with an either-or rule: the probability of the forthcoming word was statistically defined (80% for one word; 20% for the other word) by the most recent two words. All of the word transition probabilities (80% and 20%) were switched in the middle of the sequence. In the first and second quarters of the sequence, the neuromagnetic responses to the words that appeared with higher transitional probability were significantly reduced compared with those that appeared with a lower transitional probability. After switching the word transition probabilities, the response reduction was replicated in the last quarter of the sequence. The responses to the final vowels in the words were significantly reduced compared with those to the initial vowels in the last quarter of the sequence. The results suggest that both within-word and between-word statistical learning are reflected in neural responses. The present study supports the hypothesis that listeners learn larger structures such as phrases first, and they subsequently extract smaller structures, such as words, from the learned phrases. The present

  18. Grebe syndrome with bilateral fibular hemimelia and thumb duplication

    Energy Technology Data Exchange (ETDEWEB)

    Rao, Narasimha; Joseph, Benjamin [Department of Orthopaedics, Kasturba Medical College, Karnataka State (India)

    2002-03-01

    Grebe syndrome is a rare recessively inherited form of short-limbed dwarfism. Among the skeletal anomalies reported in the past, complete fibular hemimelia and thumb duplication have not been documented. We report a case of Grebe syndrome with these associated anomalies and review the various skeletal anomalies reported in the literature related to this syndrome. Awareness of the skeletal anomalies that can occur in this syndrome should enable an accurate diagnosis. (orig.)

  19. Novel management of distal tibial and fibular fractures with Acumed fibular nail and minimally invasive plating osteosynthesis technique

    Science.gov (United States)

    Wang, Tie-Jun; Ju, Wei-Na; Qi, Bao-Chang

    2017-01-01

    Abstract Rationale: Anatomical characteristics, such as subcutaneous position and minimal muscle cover, contribute to the complexity of fractures of the distal third of the tibia and fibula. Severe damage to soft tissue and instability ensure high risk of delayed bone union and wound complications such as nonunion, infection, and necrosis. Patient concerns: This case report discusses management in a 54-year-old woman who sustained fractures of the distal third of the left tibia and fibula, with damage to overlying soft tissue (swelling and blisters). Plating is accepted as the first choice for this type of fracture as it ensures accurate reduction and rigid fixation, but it increases the risk of complications. Diagnosis: Closed fracture of the distal third of the left tibia and fibula (AO: 43-A3). Interventions: After the swelling was alleviated, the patient underwent closed reduction and fixation with an Acumed fibular nail and minimally invasive plating osteosynthesis (MIPO), ensuring a smaller incision and minimal soft-tissue dissection. Outcomes: At the 1-year follow-up, the patient had recovered well and had regained satisfactory function in the treated limb. The Kofoed score of the left ankle was 95. Lessons: Based on the experience from this case, the operation can be undertaken safely when the swelling has been alleviated. The minimal invasive technique represents the best approach. Considering the merits and good outcome in this case, we recommend the Acumed fibular nail and MIPO technique for treatment of distal tibial and fibular fractures. PMID:28328865

  20. Classification of Cruciate Ligament Dysplasia and the Severity of Congenital Fibular Deficiency.

    Science.gov (United States)

    Walker, Janet L; Milbrandt, Todd A; Iwinski, Henry J; Talwalkar, Vishwas R

    2016-12-22

    Dysplasia of the cruciate ligaments has been found in many patients with congenital fibular deficiency. A recent classification system has shown that radiographic tibial spine changes can predict the hypoplasia and aplasia of the cruciate ligaments. We used this radiographic classification to determine the frequency of these abnormalities and how they correlate with the severity of fibular deficiency and lateral femoral condylar hypoplasia. Using a hospital database search for fibular deficiency, 99 patients ≥6 years with unilateral fibular deficiency were identified. Existing radiographs of both knees were available for 75 patients and reviewed for the tibial spine changes and Achterman and Kalamchi classification of the fibular deficiency. Measurements of femoral condyle heights in 74 of 75 patients were recorded before any surgery to the distal femoral physis to assess lateral femoral condylar hypoplasia. Twenty-two patients had hypoplasia of the lateral tibial spine+normal medial spine, 29 had absence of the lateral tibial spine+hypoplastic medial spine, and 11 had absence of both tibial spines. Five tibial spines were normal and 8 were unclassifiable. The severity of the tibial spine dysplasia, particularly absence of the lateral tibial spine, correlated with the severity of the fibular deficiency. (Pdysplasia in fibular deficiency is directly correlated with the severity of fibular absence, lateral femoral condylar hypoplasia, and the absence of foot rays. This suggests that the embryological factors involved have a complex interplay for all of these clinical findings. Level III.

  1. Bilateral Maxillary Reconstruction Using Fibular Flap in Bisphosphonate-related Osteonecrosis

    Science.gov (United States)

    Fujiwara, Toshihiro; Kawai, Kenichiro; Nishimoto, Soh; Kakibuchi, Masao

    2016-01-01

    Summary: Recent reports have shown successful transfer of vascularized fibular flap in bisphosphonate-induced mandibular osteonecrosis. We present a case of a 50-year-old patient who presented with bisphosphonate-related osteonecrosis of bilateral maxilla, which is reconstructed using a fibular flap.

  2. Gorham's disease in humerus treated with autogenous vascularized fibular graft

    Science.gov (United States)

    Kim, Jeung Woo; Kang, Hong Je; Kim, Dong Chul; Shin, Chang Hyun

    2017-01-01

    Gorham's disease is a rare disorder of the bone characterized by progressive massive osteolysis. The pathophysiology is unknown, and diagnosis is often difficult. Most cases are often recognized retrospectively. There is no standardized treatment and management for Gorham's disease. We report a case of an 18-year-old male presenting with a pathologic fracture in the humerus shaft diagnosed with Gorham's disease. Patient was treated with autogenous vascularized fibular graft with wide excision and a 10 years followup after first surgery. PMID:28400670

  3. Gorham's disease in humerus treated with autogenous vascularized fibular graft

    Directory of Open Access Journals (Sweden)

    Jeung Woo Kim

    2017-01-01

    Full Text Available Gorham's disease is a rare disorder of the bone characterized by progressive massive osteolysis. The pathophysiology is unknown, and diagnosis is often difficult. Most cases are often recognized retrospectively. There is no standardized treatment and management for Gorham's disease. We report a case of an 18-year-old male presenting with a pathologic fracture in the humerus shaft diagnosed with Gorham's disease. Patient was treated with autogenous vascularized fibular graft with wide excision and a 10 years followup after first surgery.

  4. The fate of fibular osteotomies performed during high tibial osteotomy.

    Science.gov (United States)

    Bicer, Elcil Kaya; Basa, Can Doruk; Gunay, Huseyin; Aydogdu, Semih; Sur, Hakki

    2016-08-01

    High tibial osteotomy (HTO) is an important treatment alternative in isolated single compartment knee osteoarthritis. To achieve adequate mechanical axis corrections in the lower extremity fibula is also osteotomized concomitantly. The aim of this study was to compare the union rates of proximal and diaphyseal fibular osteotomies accompanying high tibial osteotomies. Sixty-seven knees of sixty-three patients who had undergone HTO were retrospectively evaluated. The patients were grouped according to the level of the fibular osteotomy (FO). In group I, the level of FO was proximal, and in group II, it was at the level of junction of middle and distal third of diaphysis. The union rates of FOs at two different levels were compared. The influence of the presence of displacement at the osteotomy site and apposition between bone ends on union was also evaluated. Fifty-nine of sixty-seven FOs (88.06 %) were united. The union rate of proximal FOs was significantly greater than diaphyseal osteotomies (p < 0.0001); 97.9 % of proximal FOs were united, whereas this ratio was 65 % for the diaphyseal FOs. The presence of displacement at the FO and apposition between bone ends significantly influenced the bony union rate (p values 0.035 and <0.0001, respectively). Union rates and nonunion characteristics of FO might differ according to its level, apposition of bone ends, and contact area. The fate of FO might also affect the union of HTO.

  5. Reconstruction of large limb bone defects with a double-barrel free vascularized fibular graft

    Institute of Scientific and Technical Information of China (English)

    BI Zheng-gang; HAN Xing-guang; FU Chun-jiang; CAO Yang; YANG Cheng-lin

    2008-01-01

    Background The use of a free,vascularized fibular graft is an important technique for the reconstruction of large defects in long bones.The technique has many advantages in strong,tubular bones; a more reliable vascular anatomy with a large vascular diameter and long pedicle is used,minimizing donor-site morbidity.Due to limitations in both fibular anatomy and mechanics,they cannot effectively be used to treat large limb bone defects due to their volume and strength.Methods From 1990 to 2001,16 clinical cases of large bone defects were treated using vascularized double-barrel fibular grafts.Patients were evaluated for an average of 10 months after surgery.Results All the patients achieved bony union; the average bone union took 10 months post surgery,and no stress fractures occurred.Compared with single fibular grafts,the vascularized double-barrel fibular grafts greatly facilitate bony union and are associated with fewer complications,suggesting that the vascularized double-barrel fibular graft is a valuable procedure for the correction of large bone defects in large,long bones in addition to enhancing bone intensity.Conclusions The vascularized double-barrel fibular graft is superior to the single fibular graft in stimulating osteogenous activity and biological mechanics for the correction of very large bone defects in large,long bones.Free vascularized folded double-barrel fibular grafts can not only fill up large bone defects,but also improve the intensity margin.Therefore,this study also widens its application and enlarges the treatment targets.However,in the case of bone deformability,special attention should be paid to bone fixation and protection of donor and recipient sites.

  6. Vascularized fibular graft in infected tibial bone loss

    Directory of Open Access Journals (Sweden)

    C Cheriyan Kovoor

    2011-01-01

    Full Text Available Background : The treatment options of bone loss with infections include bone transport with external fixators, vascularized bone grafts, non-vascularized autogenous grafts and vascularized allografts. The research hypothesis was that the graft length and intact ipsilateral fibula influenced hypertrophy and stress fracture. We retrospectively studied the graft hypertrophy in 15 patients, in whom vascularized fibular graft was done for post-traumatic tibial defects with infection. Materials and Methods : 15 male patients with mean age 33.7 years (range 18 - 56 years of post traumatic tibial bone loss were analysed. The mean bony defect was 14.5 cm (range 6.5 - 20 cm. The mean length of the graft was 16.7 cm (range 11.5 - 21 cm. The osteoseptocutaneous flap (bone flap with attached overlying skin flap from the contralateral side was used in all patients except one. The graft was fixed to the recipient bone at both ends by one or two AO cortical screws, supplemented by a monolateral external fixator. A standard postoperative protocol was followed in all patients. The hypertrophy percentage of the vascularized fibular graft was calculated by a modification of the formula described by El-Gammal. The followup period averaged 46.5 months (range 24 - 164 months. The Pearson correlation coefficient (r was worked out, to find the relationship between graft length and hypertrophy. The t-test was performed to find out if there was any significant difference in the graft length of those who had a stress fracture and those who did not and to find out whether there was any significant difference in hypertrophy with and without ipsilateral fibula union. The Chi square test was performed to identify whether there was any association between the stress fracture and the fibula union. Given the small sample size we have not used any statistical analysis to determine the relation between the percentage of the graft hypertrophy and stress fracture. Results : Graft

  7. NEGLECTED FRACTURE NECK OF FEMUR OPERATED WITH NON VASCULARISED FIBULAR GRAFT

    Directory of Open Access Journals (Sweden)

    Kamareddy

    2014-11-01

    Full Text Available Neglected fracture neck of femur is a common presentation in developing countries like India. We report a case of 58years old male patient which was successfully managed at our institute. Treatment options vary from arthroplasty and osteotomy (with or without graft to osteosynthesis using various implants and grafting techniques (muscle pedicle, vascularized, and non-vascularised fibular graft. We performed a non vascularised fibular graft with cancellous screw fixation. Patient had a satisfactory bony union without any avascular changes. We emphasize that Non vascularised fibular graft is a treatment option for surgical management of fracture neck of femur.

  8. Mandibular odontogenic myxoma. Reconstructive considerations by means of the vascularized fibular free flap.

    Science.gov (United States)

    González García, Raúl; Rodríguez Campo, Francisco J; Naval Gías, Luis; Muñoz Guerra, Mario F; Sastre Pérez, Jesús; Díaz González, Francisco J

    2006-11-01

    The odontogenic myxoma is a rare entity located in mandible and upper maxilla. Due to its local aggressiveness, wide surgical excision is mandatory. Several surgical techniques have been described for the reconstruction of segmental mandibular defects. In comparison with other free flaps, the vascularized free fibular flap (VFFF) supports the longest amount of bone and, due to the nature of the vascular supply a complete freedom in location of the osteotomy is present. A precise mandibular arc can be performed following bone resection. We suggest the performance of the in situ VFFF technique in order to recreate mandibular contour by means of several osteotomies, while the pedicle is still attached to the leg. Substantial decrease in surgical time is obtained. With the double-barrel technique and subsequent osseointegrated implants, good results are obtained in the reconstruction of dentate patients without maxillary atrophy. We present two new cases of large odontogenic mandibular myxoma. Wide surgical excision by means of hemimandibulectomies and subsequent reconstruction with VFFF were performed.

  9. [Treatment of congenital pseudarthrosis of tibia by vascularized fibular graft].

    Science.gov (United States)

    Poul, J; Veselý, J; Gál, P; Bajerová, J; Justan, I

    2006-01-01

    The aim of the study was to evaluate the results in a group of patients with congenital pseudarthrosis of the tibia treated by transfer of a vascularized fibular graft from the contralateral extremity. The group included three boys and two girls aged 2 to 8 years at the time of surgery. In two patients, the vascularized graft transfer was preceded by other operations. All patients but one had Crawford type IV pseudarthrosis. The signs of peripheral neurofibromatosis were found in four of the five patients. The operation was carried out by two surgical teams, i. e., orthopedic and microsurgery (plastic surgery) specialists. Deep dissection of the pseudarthrosis was performed down to healthy, well vascularized tissue; a vascularized pedicle bone graft was harvested from the contralateral fibula. The graft was inserted and anchored intramedullarily in both tibial fragments, and stability was provided with a K-wire introduced through the calcaneus. Subsequently, the vascular pedicle of the fibular graft was joined to the surrounding vessels (anterior tibial artery and anterior tibial vein). The extremity was immobilized in plaster cast and later a KAFO brace was applied. Graft union partially failed in the proximal end of the graft due to bone resorption of both the graft and the proximal tibial fragment in two patients. This was successfully treated by additional spongioplasty. In all patients bony union was achieved at an average time of 9.8 months (range, 6 to 21 months). An increase by more than 100 % in the diameter of the transplanted fibula was recorded in four patients. The increase, which was of course related to follow-up time, was a clear proof of primary graft vascularization. The use of vascularized fibular graft harvested from the contralateral extremity showed high effectiveness in comparison with other methods. This was in agreement with the relevant literature reports. This method can be used regardless of patients' age and our experience showed that

  10. Clinical features of a rare anatomical variation of the posterior tibial and fibular arteries

    Directory of Open Access Journals (Sweden)

    Pedro Oliveira Portilho

    Full Text Available Abstract The posterior tibial artery normally arises from tibial-fibular trunk at the popliteal fossa, together with the fibular artery. The classic course of the posterior tibial artery is to run between the triceps surae muscle and muscles of the posterior compartment of the leg before continuing its course posteriorly to the medial malleolus, while the fibular artery runs through the lateral margin of the leg. Studies of both arteries are relevant to the fields of angiology, vascular surgery and plastic surgery. To the best of our knowledge, we report the first case of an anastomosis between the posterior tibial artery and the fibular artery in their distal course. The two arteries joined in an unusual “X” format, before division of the posterior tibial artery into plantar branches. We also provide a literature review of unusual variations and assess the clinical and embryological aspects of both arteries in order to contribute to further investigations regarding these vessels.

  11. "Mini paddle" for monitoring the fibular free flap in mandibular reconstruction.

    Science.gov (United States)

    Al Qattan, M M; Boyd, J B

    1994-01-01

    The use of a "mini" skin paddle to monitor the fibular free flap for mandibular reconstruction is described. The paddle is easy to inset, can be excised later under local anesthesia, and yet is adequate for postoperative monitoring.

  12. [Treatment of tibial pseudoarthrosis. Complications after intramedullary, allogeneic fibular grafting].

    Science.gov (United States)

    Helfen, T; Prall, W C; Mutschler, W; Thaller, P H

    2015-04-01

    A 24-year-old woman underwent cosmetic bilateral tibial lengthening with severe complications. In all, 15 operations, including allogeneic fibular grafting of both tibia, were required to treat unstable bilateral non-union, malalignment, and osteomyelitis of the right tibia.The present article describes the surgical strategy of revision to achieve good recovery with full consolidation and proper alignment of the lower leg. Furthermore, the indications for allogeneic bone grafting, which was described by Erich Lexer 100 years ago, are discussed. For surgical revision, a T-external fixator was used on the right leg, while a customized tibial nail was used on the left leg. Using these techniques, full consolidation and proper alignment was achieved. Allogeneic bone grafts in upper extremity defects cannot be recommended.

  13. Anterograde Intra-Arterial Urokinase Injection for Salvaging Fibular Free Flap

    OpenAIRE

    Dae-Sung Lee; Sun-Il Jung; Deok-Woo Kim; Eun-Sang Dhong

    2013-01-01

    We present a case of a 57-year-old male patient who presented with squamous cell carcinoma on his mouth floor with cervical and mandibular metastases. Wide glossectomy with intergonial mandibular ostectomy, and sequential reconstruction using fibular osteomyocutaneous free flap were planned. When the anastomosis between the peroneal artery of the fibular free flap and the right lingual artery was performed, no venous flow was observed at the vena comitans. Then re-anastomosis followed by topi...

  14. Fibular flap for mandible reconstruction in osteoradionecrosis of the jaw: selection criteria of fibula flap

    OpenAIRE

    Kim, Ji-Wan; Hwang, Jong-Hyun; Ahn, Kang-Min

    2016-01-01

    Background Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better recons...

  15. Molecular development of fibular reduction in birds and its evolution from dinosaurs.

    Science.gov (United States)

    Botelho, João Francisco; Smith-Paredes, Daniel; Soto-Acuña, Sergio; O'Connor, Jingmai; Palma, Verónica; Vargas, Alexander O

    2016-03-01

    Birds have a distally reduced, splinter-like fibula that is shorter than the tibia. In embryonic development, both skeletal elements start out with similar lengths. We examined molecular markers of cartilage differentiation in chicken embryos. We found that the distal end of the fibula expresses Indian hedgehog (IHH), undergoing terminal cartilage differentiation, and almost no Parathyroid-related protein (PTHrP), which is required to develop a proliferative growth plate (epiphysis). Reduction of the distal fibula may be influenced earlier by its close contact with the nearby fibulare, which strongly expresses PTHrP. The epiphysis-like fibulare however then separates from the fibula, which fails to maintain a distal growth plate, and fibular reduction ensues. Experimental downregulation of IHH signaling at a postmorphogenetic stage led to a tibia and fibula of equal length: The fibula is longer than in controls and fused to the fibulare, whereas the tibia is shorter and bent. We propose that the presence of a distal fibular epiphysis may constrain greater growth in the tibia. Accordingly, many Mesozoic birds show a fibula that has lost its distal epiphysis, but remains almost as long as the tibia, suggesting that loss of the fibulare preceded and allowed subsequent evolution of great fibulo-tibial disparity.

  16. Clinical Results and Complications of Lower Limb Lengthening for Fibular Hemimelia: A Report of Eight Cases.

    Science.gov (United States)

    Mishima, Kenichi; Kitoh, Hiroshi; Iwata, Koji; Matsushita, Masaki; Nishida, Yoshihiro; Hattori, Tadashi; Ishiguro, Naoki

    2016-05-01

    Fibular hemimelia is a rare but the most common congenital long bone deficiency, encompassing a broad range of anomalies from isolated fibular hypoplasia up to substantial femoral and tibial shortening with ankle deformity and foot deficiency. Most cases of fibular hemimelia manifest clinically significant leg length discrepancy (LLD) with time that requires adequate correction by bone lengthening for stable walking. Bone lengthening procedures, especially those for pathological bones, are sometimes associated with severe complications, such as delayed consolidation, fractures, and deformities of the lengthened bones, leading to prolonged healing time and residual LLD at skeletal maturity. The purpose of this study was to review our clinical results of lower limb lengthening for fibular hemimelia.This study included 8 Japanese patients who diagnosed with fibular hemimelia from physical and radiological findings characteristic of fibular hemimelia and underwent single or staged femoral and/or tibial lengthening during growth or after skeletal maturity. LLD, state of the lengthened callus, and bone alignment were evaluated with full-length radiographs of the lower limb. Previous interventions, associated congenital anomalies, regenerate fractures were recorded with reference to medical charts and confirmed on appropriate radiographs. Successful lengthening was defined as the healing index <50 days/cm without regenerate fractures.A significant difference was observed in age at surgery between successful and unsuccessful lengthening. The incidence of regenerate fractures was significantly correlated with callus maturity before frame removal. LLD was corrected within 11 mm, whereas mechanical axis deviated laterally.Particular attention should be paid to the status of callus maturation and the mechanical axis deviation during the treatment period in fibular hemimelia.

  17. Is distal fibular fracture an absolute contraindication to free fibular flap harvesting? A review of evidence in the literature and illustration by a successful case.

    Science.gov (United States)

    Chan, Richie Chiu-Lung; Wei, Fu-Chan; Wong, Jason Kin Fai; Wu, Chao-Min

    2015-01-01

    Despite the advantages of a fibula flap, many surgeons would often be hesitant in its use in patients with a history of distal fibular fracture. The chief concern is the potential vascular damage sustained during the injury. From our experience, however, we noticed that the blood supply of various components of a fibula flap rarely relies on its distal part alone. Avoiding the use of this flap may unnecessarily forgo the optimal reconstructive option in many patients. Free fibula flap was harvested from a 41-year-old man who had a history of left fibula fracture 10 years before surgery. The fracture was treated with open reduction with internal fixation. The plate was removed 1 year after the trauma surgery. We used this fractured and healed fibula to reconstruct the intraoral and mandibular defect after tumor extirpation. The harvesting process was straight-forward and the flap survived uneventfully. On the basis of our experience and current evidence in the literature, we believe that a history of previous fibular fracture should not be considered as an absolute contraindication for free fibular flap harvesting. With a good knowledge of the lower limb anatomy and appropriate patient selection, the fibular flap can still be a safe option that incurs no additional risk.

  18. Harvesting the free fibular graft: A modified approach

    Directory of Open Access Journals (Sweden)

    Amitava Narayan Mukherjee

    2011-01-01

    Full Text Available Background: The conventional technique of free non-vascularized fibular grafting is attended with some amount of morbidity and a long scar. We report a technique with little interference to the surrounding soft tissues to harvest more than one-third of whole length fibula. Patients and Methods: Thirty four patients of average age 23.5 years (range 8 to 51 years having various pathologies like simple bone cysts (n=9, fibrous dysplasias (n=6, giant cell tumors (n=7, fracture non-union (n=10 and aneurysmal bone cysts (n=2 were taken up for the study. The fibula were harvested by two separate incisions, 1 cm each at proximal and distal extent of proposed donor site for taking out of graft after elevating the periosteum circumferentially using a periosteum stripper. Compression bandage and above knee plaster immobilization was applied to reduce the dead space collection . Results: The mean followup is 34 months. The patients were evaluated clinicoradiology. Thirty three patients showed good results. One patient had fair result due to delayed wound healing from hematoma which was treated surgically. Conclusion: The approach of harvesting fibula suggested by author reduces donor site morbidity and is safer than conventional approach.

  19. Leg morbidity and function following fibular free flap harvest.

    Science.gov (United States)

    Shpitzer, T; Neligan, P; Boyd, B; Gullane, P; Gur, E; Freeman, J

    1997-05-01

    Over a period of 3 years, 50 consecutive free fibular flaps for mandibular reconstruction were performed on 47 patients. In 38 patients (81%) a skin paddle was included with the flap to provide either mucosal lining or skin cover; in 9 patients (19%) bone alone was used. Thirty-one patients (66%) required a skin graft to close the donor defect in the leg. Donor leg morbidity and function were determined by patient questionnaire and by physical examination. Forty-one donor sites in 40 patients were available for long-term follow-up. The follow-up ranged from 4 to 39 months with an average of 17 months. Immediate postoperative infection occurred in the donor site of 1 patient (2%) and required additional surgery. There was no other immediate donor site complications when closure required skin grafting. Eleven patients (27%) had late donor site morbidity, consisting of motor weakness of the great toe in 5 patients, ankle instability and/or stiffness in 3 patients, donor site pain in 1 patient, and edema in 2 patients. All complications were graded as mild in severity by the patient and by the examiner. In this series, although most donor site defects required skin grafting, short- and long-term morbidity was minimal. After a short rehabilitation period, all patients were fully able to engage in all daily and recreational activities.

  20. [Variation of the fibular part of the plantar aponeurosis among present-day Japanese].

    Science.gov (United States)

    Hiramoto, Y

    1983-03-01

    The plantar aponeurosis consists of the tibial and fibular parts. It is already known that the form of the fibular part markedly varies according to individuals. However, there have been few anatomical observations on this variation and none have statistically analysed it. This paper is concerned with the variation of the fibular part of the aponeurosis. Observations were carried out by dissecting thirty-nine present-day Japanese cadavers. The variations observed were classified into four types according to the Loth's method. It was clarified by means of the Chi-square test that the percentage of the medial fibre bundle is significantly higher in present-day Japanese than in Europeans, that is up to 20.5%. It was also found that the top portion of the medial fibre bundle, if it exists, is the origin of a part of the transverse head of the adductor pollicis muscle and the flexor digiti minimi brevis muscle in some cases.

  1. Desmoplastic fibroma of ulna: Excision and reconstruction of olecranon with a fibular graft

    Directory of Open Access Journals (Sweden)

    Tarun Goyal

    2013-01-01

    Full Text Available Desmoplastic fibroma is a rare, well differentiated, locally aggressive fibrous tumor usually arising from soft tissues, and rarely from bones. Involvement of forearm bones is extremely unusual. We present a large desmoplastic fibroma of right ulna in a 15-year-old male. The tumor was excised with a wide margin, and the bony defect was reconstructed with nonvascular autologous fibular graft. Reconstruction of the olecranon process was attempted using the fibular head and the remaining olecranon. At 2-years followup, there was no recurrence, flexion extension arc of the elbow joint was 40°-130° and there was no restriction of activities of daily living.

  2. Chromosome 18q22.2-->qter deletion and a congenital anomaly syndrome with multiple vertebral segmentation defects.

    OpenAIRE

    Dowton, S B; Hing, A V; Sheen-Kaniecki, V; Watson, M. S.

    1997-01-01

    Multiple vertebral segmentation defects occur in a group of conditions variably associated with anomalies of other organ systems. This report describes a female child in whom a deletion of chromosome 18 (18q22.2-->qter) is associated with congenital anomalies including multiple vertebral segmentation defects resembling sporadic spondylocostal dysplasia. The child also has unilateral renal agenesis and unilateral fibular aplasia. The association of severe multiple vertebral segmentation defect...

  3. Mal de Hansen, anticorpos antifosfolípides e obstrução das artérias fibulares Leprosy, antiphospholipid antibodies and bilateral fibular arteries obstruction

    Directory of Open Access Journals (Sweden)

    Liz Wallin

    2009-04-01

    Full Text Available Pacientes com Mal de Hansen (MH podem se apresentar com quadro clínico e laboratorial sugestivo de doenças reumáticas, o que exige um exercício cuidadoso de diagnósticos diferenciais. Descreve-se aqui o caso de uma jovem com MH que se apresentou com lesões cutâneas sugestivas de vasculite, obstrução de vasos fibulares, FAN e anticorpos antifosfolípides positivos sem muitos estigmas da doença cutânea, ilustrando essa dificuldade.Patients with Hansen's disease (HD may present themselves with clinical and laboratorial features that resemble rheumatic disorders. This requires a careful exercise of differential diagnosis. We describe here a case of a young woman with HD that presented with vasculitic like lesions, fibular vessels obstruction, ANA and antiphospholipid antibodies without typical signs of cutaneous disease, illustrating this clinical difficulty.

  4. Fibular Allograft and Demineralized Bone Matrix for the Treatment of Slipped Capital Femoral Epiphysis.

    Science.gov (United States)

    Murray, Travis; Morscher, Melanie A; Krahe, Amy M; Adamczyk, Mark J; Weiner, Dennis S

    2016-05-01

    Previous studies documented the use of fibular allograft in the treatment of slipped capital femoral epiphysis (SCFE) with bone graft epiphysiodesis (BGE). This study describes the results of using a 10-mm diameter premilled fibular allograft packed with demineralized bone matrix placed across the physis in an open surgical approach under image intensification. A review identified 45 cases of BGE using fibular allograft and demineralized bone matrix in 34 patients with a diagnosis of SCFE performed by a single surgeon during an 8-year period. Thirty-four cases (25 patients) had at least 1 year of follow-up and were included in the study. Medical records were reviewed for complications, subsequent surgeries, and time to physeal closure. Of the 34 cases included, there were no cases of acute chondrolysis. Complications included 1 case of bone graft extrusion that required surgical replacement and 1 re-slip requiring surgical stabilization. Five cases of avascular necrosis (AVN) were encountered (1 unstable slip with total head AVN, and 4 stable slips with 3 total head and 1 partial head AVN). In 1 patient, small loose bony fragments were noted on postoperative radiographs that appeared outside of the articular surface of the hip and were asymptomatic. Two patients encountered wound healing issues that resolved with appropriate wound care. In light of the occurrence of AVN in stable cases, BGE with autogenous corticocancellous graft is preferable to BGE with autologous fibular graft for the treatment of SCFE. [Orthopedics. 2016; 39(3):e519-e525.].

  5. Supramalleolar Osteotomy With or Without Fibular Osteotomy for Varus Ankle Arthritis.

    Science.gov (United States)

    Hongmou, Zhao; Xiaojun, Liang; Yi, Li; Hongliang, Liu; Junhu, Wang; Cheng, Liu

    2016-09-01

    Supramalleolar osteotomy (SMOT) is an alternative operative procedure for the management of early and midstage varus ankle arthritis. However, whether fibular osteotomy is needed is controversial. The purpose of the current study was to evaluate the functional and radiologic outcomes of pre- and postoperative SMOT, and to compare the outcomes between patients with and without fibular osteotomy. Forty-one Takakura stage 2 and 3 varus ankle osteoarthritis patients treated with SMOT were included. Fourteen males and 27 females with a mean age of 50.7 (range, 32-71) years were followed with a mean of 36.6 (range, 17-61) months. There were 22 cases with fibular osteotomy and 19 without. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, Maryland foot score, and Ankle Osteoarthritis Score (AOS) were used for pre- and postoperative functional evaluation. The tibial articular surface angle (TAS), talar tilt (TT), tibiocrural angle (TC), and tibial lateral surface angle (TLS) were evaluated pre- and postoperatively. At the last follow-up, the mean AOFAS score (from 50.8 to 83.1 points) and Maryland score (from 58.3 to 81.6 points) in overall were improved (P osteotomy. However, in the fibular osteotomy group, TT was decreased (P osteotomy may be necessary in cases with large TT and small TC angles. Level III, retrospective comparative study. © The Author(s) 2016.

  6. Increased rates of wound complications with locking plates in distal fibular fractures

    NARCIS (Netherlands)

    T. Schepers (Tim); E.M.M. van Lieshout (Esther); M.R.D. Vries; M. van der Elst (Maarten)

    2011-01-01

    textabstractIntroduction: There is a growing use of locking compression plates in fracture surgery. The current study was undertaken to investigate the wound complication rates of locking versus non-locking plates in distal fibular fractures. Patients and methods: During a 6-year study period all co

  7. [Variations in the calcaneo-fibular ligament (lig. calcaneofibulare). Application to the kinematics of the ankle].

    Science.gov (United States)

    Trouilloud, P; Dia, A; Grammont, P; Gelle, M C; Autissier, J M

    1988-03-01

    The authors observe variations in the calcaneo-fibular ligament because this ligament controls two articulations, the talo-crural and the subtalar. This study is based on the dissection of the ankle of 20 specimens. The calcaneo-fibular ligament is reinforced by the ventral and lateral talo-calcaneus ligaments with variations. 3 types of disposition have been described. Type A: A lateral talo-calcaneal ligament reinforces the calcaneo-fibular ligament. These two ligaments are divergent on the proximal, medial, or distal part. Type B: There is an independent lateral talo-calcaneal ligament forward of the calcaneo-fibular ligament. Type C: A ventral talo-calcaneal ligament is observed, parallel to the interosseous ligament. The authors consider the consequences of variation in the lateral ligaments of the ankle for the functioning of the tibio-tarsal articulation, the subtalar articulation and the astragalo-scaphoid articulation in order to propose specific radiographic examination of the kinematics of the ankle.

  8. Fibular free flap reconstruction for the management of advanced bilateral mandibular osteoradionecrosis.

    Science.gov (United States)

    Shan, Xiao-Feng; Li, Ru-Huang; Lu, Xu-Guang; Cai, Zhi-Gang; Zhang, Jie; Zhang, Jian-Guo

    2015-03-01

    Fibular osteoseptocutaneous flap has been widely used for unilateral mandibular reconstruction. However, reports about the effects of fibular osteoseptocutaneous flap for the reconstruction of bilateral mandibular defects are limited. In this study, we used free vascularized fibular flaps to successfully manage bilateral mandibular osteoradionecrosis(ORN) in 5 patients. Functional aspects were evaluated during the reconstruction process. All 5 patients had bilateral refractory ORN of the mandible and underwent radical resection between 2003 and 2011. The reconstruction surgery was performed in 2 stages using 2 free fibular flaps in 3 patients. In the other 2 patients, reconstruction was performed in a single stage using 2 separate flaps prepared from a single fibula. All patients had a healthy mandibular symphysis and meniscus of the temporomandibular joint, and these structures were preserved during the reconstruction.Of the 10 defects involving the mandible sides, 9 were successfully reconstructed. One microvascular composite flap failed because of radiation injury to the arterial endothelium at the recipient site. After the treatments, all patients had good esthetic and functional outcomes. Preoperative clinical features such as trismus and dysphagia were also markedly improved. Our surgical method may be an effective alternative for the clinical management of advanced bilateral mandibular ORN.

  9. Do stress fractures induce hypertrophy of the grafted fibula? A report of three cases received free vascularized fibular graft treatment for tibial defects

    Institute of Scientific and Technical Information of China (English)

    Yong Qi; Hong-Tao Sun; Yue-Guang Fan; Fei-Meng Li; Zhou-Sheng Lin

    2016-01-01

    The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons.Free vascularized fibular grafting (FVFG) is considered to be a reliable reconstructive procedure.Stress fractures are a common complication following this surgery,and hypertrophy is the main physiological change of the grafted fibula.The exact mechanism of hypertrophy is not completely known.To the best of our knowledge,no studies have examined the possible relationship between stress fractures and hypertrophy.We herein report three cases of patients underwent FVFG.Two of them developed stress fractures and significant hypertrophy,while the remaining patient developed neither stress fractures nor significant hypertrophy.This phenomenon indicates that a relationship may exist between stress fractures and hypertrophy of the grafted fibula,specifically,that the presence of a stress fracture may initiate the process of hypertrophy.

  10. Do stress fractures induce hypertrophy of the grafted fibula? A report of three cases received free vascularized fibular graft treatment for tibial defects.

    Science.gov (United States)

    Qi, Yong; Sun, Hong-Tao; Fan, Yue-Guang; Li, Fei-Meng; Lin, Zhou-Sheng

    2016-06-01

    The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting (FVFG) is considered to be a reliable reconstructive procedure. Stress fractures are a common complication following this surgery, and hypertrophy is the main physiological change of the grafted fibula. The exact mechanism of hypertrophy is not completely known. To the best of our knowledge, no studies have examined the possible relationship between stress fractures and hypertrophy. We herein report three cases of patients underwent FVFG. Two of them developed stress fractures and significant hypertrophy, while the remaining patient developed neither stress fractures nor significant hypertrophy. This phenomenon indicates that a relationship may exist between stress fractures and hypertrophy of the grafted fibula, specifically, that the presence of a stress fracture may initiate the process of hypertrophy.

  11. Step-by-step surgical technique for mandibular reconstruction with fibular free flap: application of digital technology in virtual surgical planning.

    Science.gov (United States)

    Succo, G; Berrone, M; Battiston, B; Tos, P; Goia, F; Appendino, P; Crosetti, E

    2015-06-01

    At present, mandibular reconstruction with a fibular free flap is the gold standard for functional and esthetic rehabilitation after oncological surgery. The purpose of this study was to describe the computer-assisted mandibular reconstruction procedure adopting the customized solution Synthes ProPlan CMF. The study reports five consecutive patients with benign or malignant disease requiring mandibular reconstruction using a microvascular fibular free flap, pre-operative virtual planning, construction of cutting guides and customized laser pre-bent titanium plates. The surgical technique is discussed in a step-by-step fashion. The average post-operative hospital stay was 18 ± 3 days. Ischemia time was recorded in all five cases, with an average of 75 ± 8 min. No problems were encountered in any surgical step and there were no major complications. Excellent precision of cutting guides and a good fit of pre-bent plates were found on both the mandible and fibula. There was excellent precision in bone to bone contact and position between mandible and fibula graft. Measurement data from the pre-operative and post-operative CT scans were compared. The average difference (Δ) between programed segment lengths and CT control segment lengths was 0.098 ± 0.077 cm. Microsurgical mandibular reconstruction using a virtual surgical planning yields significantly shorter ischemia times and allows more precise osteotomies. The technology is becoming increasingly recognized for its ability to optimize surgical outcomes and minimize operating time. Considering that the extent of resection can be wider than predicted, this results in safer modeling of the fibula only after frozen sections have demonstrated the radicality of resection.

  12. Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures

    Science.gov (United States)

    Saltzman, Bryan M.; Erickson, Brandon J.; Harris, Joshua D.; Gupta, Anil K.; Mighell, Mark; Romeo, Anthony A.

    2016-01-01

    Background: Proximal humerus fractures are common problems plaguing the elderly population. Purpose: The purposes of this study were to determine the outcomes of fibular strut allografts in treatment of proximal humerus fractures with open reduction internal fixation (ORIF) and to present the authors’ preferred surgical technique. The hypothesis was that the use of fibular strut allografts in treating proximal humerus fractures with ORIF will provide low reoperation rates with acceptable outcomes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was registered with PROSPERO and performed with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines using 3 publicly available free databases. Therapeutic clinical outcome investigations reporting arthroscopic elbow outcomes with levels of evidence 1 through 4 were eligible for inclusion. All study, subject, and surgical technique demographics were analyzed and compared between continents and countries. Statistics were calculated using Student t tests, 1-way analysis of variance, chi-square tests, and 2-proportion Z tests. Results: Four studies met the inclusion criteria. While there is great heterogeneity existing in the literature surrounding use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures, current evidence shows a humeral head screw penetration rate of 3.7% with acceptable functional outcome scores, with a reoperation rate of 4.4% at a weighted mean 80.78 weeks (1.55 years) of postoperative follow-up. Conclusion: There is great heterogeneity that exists in the literature surrounding the use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures. Current evidence shows a screw penetration rate of 3.7% with acceptable functional outcome scores, demonstrating fibular strut allograft is a viable option for treating proximal humerus fractures. PMID:27504463

  13. Patterns of astragalar fibular facet orientation in extant and fossil primates and their evolutionary implications.

    Science.gov (United States)

    Boyer, Doug M; Seiffert, Erik R

    2013-07-01

    A laterally sloping fibular facet of the astragalus (=talus) has been proposed as one of few osteological synapomorphies of strepsirrhine primates, but the feature has never been comprehensively quantified. We describe a method for calculating fibular facet orientation on digital models of astragali as the angle between the planes of the fibular facet and the lateral tibial facet. We calculated this value in a sample that includes all major extant primate clades, a diversity of Paleogene primates, and nonprimate euarchontans (n = 304). Results show that previous characterization of a divide between extant haplorhines and strepsirrhines is accurate, with little overlap even when individual data points are considered. Fibular facet orientation is conserved in extant strepsirrhines despite major differences in locomotion and body size, while extant anthropoids are more variable (e.g., low values for catarrhines relative to non-callitrichine platyrrhines). Euprimate outgroups exhibit a mosaic of character states with Cynocephalus having a more obtuse strepsirrhine-like facet and sampled treeshrews and plesiadapiforms having more acute haplorhine-like facets. Surprisingly, the earliest species of the adapiform Cantius have steep haplorhine-like facets as well. We used a Bayesian approach to reconstruct the evolution of fibular facet orientation as a continuous character across a supertree of living and extinct primates. Mean estimates for crown Primatomorpha (97.9°), Primates (99.5°), Haplorhini (98.7°), and Strepsirrhini (108.2°) support the hypothesis that the strepsirrhine condition is derived, while lower values for crown Anthropoidea (92.8°) and Catarrhini (88.9°) are derived in the opposite direction.

  14. The role of fibular for supramalleolar osteotomy in treatment of varus ankle arthritis: a biomechanical and clinical study.

    Science.gov (United States)

    Zhao, Hongmou; Liang, Xiaojun; Li, Yi; Yu, Guangrong; Niu, Wenxin; Zhang, Yan

    2016-10-24

    Supramalleolar osteotomy (SMOT) is a well-accepted treatment method for mid-stage varus ankle osteoarthritis (OA). However, few studies have examined the role of fibular osteotomy in SMOT. The objective of the current study was to compare the biomechanical and clinical outcomes of SMOT with and without fibular osteotomy. Eight cadaveric lower legs with 10° varus/valgus SMOT models were tested using a Tekscan ankle sensor. Tibiotalar joint contact with and without fibular osteotomy conditions were compared. Forty-one varus ankle OA patients treated with SMOT were included; 22 underwent fibular osteotomy, and 19 did not. The Maryland foot score and radiological angles were used for clinical evaluation. The mean contact area and pressure did not differ significantly between normal and varus/valgus conditions with the fibula preserved. After fibular osteotomy, the mean contact area decreased and the mean contact pressure increased significantly in varus and valgus conditions (P osteotomy in varus/valgus conditions. After a mean follow-up of 36.6 months (range 17-61), there was no significant difference in the Maryland scores of the two groups. However, in the fibular osteotomy group, the talar tilt angle decreased (P osteotomy facilitates the translation of tibiotalar contact pressure and is helpful for varus ankle realignment in patients with large talar tilts and small tibiocrural angles.

  15. MINIMUM INCISION PERCUTANEOUS PLATE OSTEOSYNTHESIS FOR DISTAL FIBULAR FRACTURES: A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Ramkumar Reddy

    2015-09-01

    Full Text Available Distal fibular fractures are usually communitted and most of the times osteoporotic especially if they are occurring in females and in geriatric age group. These fractures are usu ally associated with other fractures, which necessitates them to be fixed accurately. Owing to the fact that distal fragment is subcutaneous with scanty soft tissue over bone, which pose these fracture fixations become difficult by open methods in view of wound healing. A prospective study of 26 patients with distal fibular fractures were treated with MIPPO with hook plate were healed with less complications and better outcome. With this background we suggest a minimally invasive incision over proximal frag ment where sufficient soft tissue cover is present. From there pushing the special hook plate subperiosteally to distal fragment, hooking the tip of fibula and fixing the proximal fragment after reduction gives a simple and effective stable fixation

  16. [Harvesting technique of chimeric multiple paddles fibular flap for wide oromandibular defects].

    Science.gov (United States)

    Foy, J-P; Qassemyar, Q; Assouly, N; Temam, S; Kolb, F

    2016-08-01

    Carcinological head and neck reconstruction still remains a challenge due to the volume and varied tissues needed. Large and wide oromandibular defects require, not just the bone but also soft tissues for the pelvilingual reconstruction and therefore, a second free flap may become necessary in addition to a fibular flap. The option of an unique chimeric flap based on the fibular artery and its branches is less known whereas it offers the advantage of a unique flap with bone, muscle and multiple skin paddles, independent of each other. The aim of this technical note is to present step by step the surgical procedure of this chimeric flap and share this method that avoids a second free flap.

  17. [Alveolar ridge atrophy. The free vascularized fibular flap as alternative treatment in severe alveolar atrophy].

    Science.gov (United States)

    Rohner, Dennis

    2006-01-01

    Implant-supported overdentures are the goal of treatment of the edentulous atrophic jaw. To gain adequate height there is in some instances need for additional bone augmentation. Ridge augmentation using a free vascularised fibular flap is one of the newer techniques. Prefabrication of fibular flaps, as described in this article, is a two-stage procedure to overcome the problems of osseointegration and missing attached gingiva. Accurate pre-operative 3-D-model planning, implant placement and vestibuloplasty in the first stage allow for occlusion driven reconstruction and immediate function in the second stage after a delay of six weeks. Based on our clinical experience the technique and the results are discussed.

  18. Fibular grafting with cannulated hip screw fixation in late femoral neck fracture in young adults

    Directory of Open Access Journals (Sweden)

    Goyal R

    2006-01-01

    Full Text Available Background: We reviewed the operative results of fibular bone graft with cannulated hip screw fixation in femoral neck fracture in young adults. Method: Sixteen young adults with femoral neck fracture were treated by fibular bone graft with cannulated hip screw fixation. All the fractures were more than 3 weeks old. Results: Results were assessed in 15 patients while one patient died due to complications not related to surgery. Union occurred in all 15 patients. One patient had intra-operative complication in the form of screw cut out with graft in the joint space. The average fallow up was 24.4 months. Out of 15 patients assessed clinico-radiologically 11 showed good results, 3 had fair while 1 had poor result. Conclusion: We conclude that this is a simple and cost effective procedure for late femoral fleck fracture in young adults with good results.

  19. Fibular free flap with arteria peronea magna: the role of preoperative balloon occlusion.

    Science.gov (United States)

    Rahmel, Benjamin B; Snow, Thomas M; Batstone, Martin D

    2011-03-01

    The free fibular osteocutaneous flap is a commonly used donor for reconstruction of mandibular defects. Vascular abnormalities and leg trauma are relative contraindications to the use of a fibular free flap. Peroneal arteria magna (PAM) is one such vascular abnormality that may preclude the use of the graft due to the high risk of lower-limb ischemia. Lower-limb angiography is the standard for assessing the lower-limb vascular anatomy; however, the indications remain controversial. Although balloon occlusion has been used to assess the vascular supply in distal bypass surgery, there have no reported cases of balloon occlusion to assess the viability of the distal extremity with PAM. Intraoperative assessment of vascular anatomy with an aborted harvest can lead to significant morbidity and cost. Balloon occlusion provides a relatively safe and minimally invasive technique for assessment of potential lower-limb ischemia in patients with PAM.

  20. A standardized formula for aesthetic mandibular reconstruction using an osteocutaneous fibular free flap.

    Science.gov (United States)

    Kim, Soung Min; Amponsah, Emmanuel K; Kim, Hui Young; Kwon, Ik Jae; Myoung, Hoon; Lee, Jong Ho

    2016-09-01

    Ameloblastoma is the most common benign odontogenic tumor of the jaw, and expansional growth of a huge untreated ameloblastoma can result in disturbances in facial aesthetics and function, such as difficulty with mouth opening, swallowing, chewing, breathing, neurologic deficits, and pathologic fractures. Radical wide resection with safety margins and subsequent reconstruction is generally recommended. A fibular free flap (FFF) is commonly used to reconstruct the mandible in order to adequately restore both aesthetic appearance and function. The aim of this brief clinical report is to present a case of huge ameloblastoma after wide resection with free safety margins, and describe the immediate one-step mandibular reconstruction using a vascularized composite FFF. The sterolithographic( rapid prototype, RP) model, a wax pattern of the resected mandible, and a surgical fibular stent made from the wax pattern were constructed preoperatively. We suggest a standardized surgical protocol for mandibular reconstruction with FFF.

  1. Reconstruction of a complex midfacial defect with the folded fibular free flap and osseointegrated implants.

    Science.gov (United States)

    Anthony, J P; Foster, R D; Sharma, A B; Kearns, G J; Hoffman, W Y; Pogrel, M A

    1996-08-01

    Refinements in microsurgical techniques, plate fixation, and osseointegration have changed the conceptual approach to midface reconstruction. Free tissue transfer has emerged as the ideal method of reconstructing complex midfacial defects. Single-stage bony restoration of the palate and orbital rim using the folded fibular osteocutaneous free flap is described. The fibular free flap is our first choice for reconstructing complex midfacial defects. The thin, soft, pliable tissue is ideal for intraoral and palatal reconstructions. The bone can be tailored precisely to fit any desired shape, and forms a sturdy support for both orbital and dental prostheses. With a single flap, rapid and reliable restoration of midfacial appearance, orbital support, and palatal function can be achieved.

  2. Weber B Distal Fibular Fracture Diagnosed by Point of Care Ultrasound in the Emergency Department

    OpenAIRE

    Makinen, James

    2016-01-01

    We report the case of a 45 year-old woman who presented to the Emergency Department (ED) after an acute ankle inversion injury. After history and physical exam suggested a potential fracture, point of care (POC) ultrasound demonstrated a cortical defect of the distal fibula, consistent with fracture. Plain radiography failed to demonstrate a fracture. Later, the fracture was identified as a Weber B distal fibular fracture by stress-view radiography. This case reviews the evaluation of acute a...

  3. Residual malformations and leg length discrepancy after treatment of fibular hemimelia

    Directory of Open Access Journals (Sweden)

    Soucacos Panayotis N

    2011-09-01

    Full Text Available Abstract Background Fibular hemimelia has been reported as the most common congenital longitudinal deficiency of the long bones. Previous studies have focused on the best treatment options for this congenital condition. There is very little to our knowledge in the literature focused on residual persisting malformations and leg length discrepancy after treatment. Methods Seven patients presenting fibular hemimelia in eight fibulae received treatment between years 1988 and 2001. Pre-treatment average leg length discrepancy was 5.3 cm. All patients presented associated congenital deformities of the ipsilateral leg. Six patients received surgical treatment. Average post-treatment follow up was 9.7 years. Residual malformations and leg length discrepancy were recorded for all patients. It is a retrospective case series study at one institution by two of the presenting authors as senior surgeons. Results Average leg length gained after successful bone lengthening in six patients was 5.06 cm. Although there was a significant functional improvement, a number of residual malformations and leg length inequality was recorded. Residual average leg length discrepancy of 3.1 cm was observed in five patients who completed surgical treatment. Five patients presented a limp. Residual anterior-medial bowing of the tibia was observed in four patients. Calf atrophy was present in all seven patients. Valgus deformity of the ankle was remained in two patients. Conclusions Treatment of fibular hemimelia, even in cases graded as successful, showed to be accompanied by a number of persisting residual deformities and recurrent leg length inequality. Although the number of patients is limited, the high rate of this phenomenon is indicative of the significance of the report. The family and the patients themselves should have the right expectations and will be more co-operative when well informed about this instance. A report of common post-treatment residual deformities

  4. Reconstruction with fibular osteocutaneous free flap in patients with mandibular osteoradionecrosis

    OpenAIRE

    Kim, Min Gyun; Lee, Seung Tae; Park, Joo Yong; Choi, Sung Weon

    2015-01-01

    Background Osteoradionecrosis is a delayed complication from radiation therapy which causes chronic pain, infection and constant deformity after necrosis. Most of the osteoradionecrosis occurs spontaneously or after the primary oncologic surgery, dental extraction or by trauma of prosthesis. The treatment of osteoradionecrosis relies on both conservative measures and surgical measures. The fibular osteocutaneous free flap has become more popular choice for reconstruction of maxillofacial defe...

  5. Dual fibular grafting - A new technique of fixation of the femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Yadav S

    2005-01-01

    Full Text Available Background: To achieve osteosynthesis of femoral neck fractures is a challenge to the treating surgeon. Plethora of devices and methods has been described. Method: A new technique of achieving union of femoral neck fractures by dual-fibular fixation has been reported in 150 patients. The age of the patients ranged from 6-75 years. Results: Nearly two-third of these were Garden type II and III with an average follow-up of 120 months. In this series 67% had good to excellent long term results. Conclusion: Two fibular struts provide autologous bone, filling the whole of the osteopenic femoral neck and prevent the rotational forces. Since the total fixation is biologically active, the technique has proved advantageous even when stable / desirable reduction is not possible and adequate fixation is not achieved, because of posterior communition at the fracture site or due to osteoporosis. Being autologous bone, the twin-fibular graft is advantageous even when there is ′subsequent loss of reduction′ of the fracture. It is, therefore, suggested that this simple, inexpensive and biological technique has many advantages over the existing methods of fixation of these fractures.

  6. Fibular flap for mandibular reconstruction: are there old tricks for an old dog?

    Science.gov (United States)

    Pitak-Arnnop, P; Hemprich, A; Dhanuthai, K; Pausch, N C

    2013-02-01

    Fibular free flap is considered as an "old dog" in reconstructive surgery because it was first described by Taylor and his colleagues in 1975, and was then introduced for mandibular reconstruction by Hidalgo in 1989. There are some "tricks" for fibular free flap that have been used and recognized in many European maxillofacial surgical units over the past decade. These include: 1) harvesting the distal fibula when recipient vessels are distant; 2) flap selection based on the anatomy of perforators; 3) use of the skin paddle for postoperative flap monitoring; 4) protection of the flap's soft-tissue cuff; 5) preventing venous thrombosis which is essential to reduce flap complications; 6) aligning fibular struts and protecting the vascular pedicle when the double-barrel technique is used; 7) minimizing the gap between the double-barrel struts and implementing a long-term follow-up of dental implants; 8) selecting osteosynthesis materials; and 9) learning curve and clinical competence in microvascular reconstruction. We also reviewed current data from the literature, which would be useful for maxillofacial reconstructive surgeons. With these tricks, one can teach an "old dog" "old tricks".

  7. Acquired blepharoptosis

    NARCIS (Netherlands)

    Oosterhuis, HJGH

    1996-01-01

    A review is given of the aetiology and possible treatment of acquired (non-congenital) blepharoptosis, which is a common but not specific sign of neurological disease: The diagnostic categories of upper eyelid drooping are scheduled as (a) pseudo-ptosis due to a local process or overactivity of eye

  8. Acquired blepharoptosis

    NARCIS (Netherlands)

    Oosterhuis, HJGH

    1996-01-01

    A review is given of the aetiology and possible treatment of acquired (non-congenital) blepharoptosis, which is a common but not specific sign of neurological disease: The diagnostic categories of upper eyelid drooping are scheduled as (a) pseudo-ptosis due to a local process or overactivity of eye

  9. 带血管腓骨移植的远期疗效报告%Long term results of vascularized fibular graft

    Institute of Scientific and Technical Information of China (English)

    刘亚平; 程国良; 潘达德; 杨志贤; 方光荣; 曲智勇; 林彬; 汤海萍; 杜泽新

    2001-01-01

    in different types of bone defects. Nine patients with congenital pseudoarthrosis of tibia had the limb function restored in 65% and one had nonunion of fibular graft, 3 fractures(7 times), and 5 angular deformities. Three patients with congenital radial deficiency had 62% restoration of the limb function. All of them showed early closure of epiphyses of the grafted fibulae. Five cases with osteomyelitis and bone defects combined soft tissue deficiency had 94% restoration of the limb function, and only one occurred fracture of fibular graft. One case with soft tissue defect and concomitant ulnar defect, ulnar nerve and median nerve injury, 67% function of limb was recovered, and union of fibula graft was good. 100% function of limb was recovered in 1 case with cavernoma of radius and without occurring valgus deformity of donor site. Conclusion The vascularized fibular graft is a good method for repairing long segmental defects of bone. Combined with other tissue flap, the operation can reconstruct bone defect and fulfil the cover of soft tissue. For congenital tibia pseudoarthrosis and radial deficiency, the long term results are not so satisfactory.

  10. Acquired Methemoglobinaemia

    Directory of Open Access Journals (Sweden)

    Adil Al-Lawati

    2012-05-01

    Full Text Available Acquired methemoglobinaemia is a relatively rare condition and, therefore infrequently encountered in acute medical practice. Suspicion of the condition may be triggered when the measured PaO2 is ‘out of keeping’ with the oxygen saturations that are discovered with pulse oximetry. We describe two separate cases of acquired methemoglobinaemia secondary to the recreational use of alkyl nitrites (’poppers’. The patients presented at separate times to two different teaching hospitals in London, UK. The similarity of these cases has led the authors to conclude that a raised awareness of this potentially fatal condition, and its association with a widely-available recreational drug, is necessary to ensure a correct and timely diagnosis.

  11. Chromosome 18q22.2-->qter deletion and a congenital anomaly syndrome with multiple vertebral segmentation defects.

    Science.gov (United States)

    Dowton, S B; Hing, A V; Sheen-Kaniecki, V; Watson, M S

    1997-05-01

    Multiple vertebral segmentation defects occur in a group of conditions variably associated with anomalies of other organ systems. This report describes a female child in whom a deletion of chromosome 18 (18q22.2-->qter) is associated with congenital anomalies including multiple vertebral segmentation defects resembling sporadic spondylocostal dysplasia. The child also has unilateral renal agenesis and unilateral fibular aplasia. The association of severe multiple vertebral segmentation defects with 18q- in this patient suggests the possibility that a gene important for somite formation or vertebral differentiation maps to this segment of chromosome 18.

  12. Acquired Techniques

    DEFF Research Database (Denmark)

    Lunde Nielsen, Espen; Halse, Karianne

    2013-01-01

    Acquired Techniques - a Leap into the Archive, at Aarhus School of Architecture. In collaboration with Karianne Halse, James Martin and Mika K. Friis. Following the footsteps of past travelers this is a journey into tools and techniques of the architectural process. The workshop will focus upon...... architectural production as a conglomerate of various analogue and digital methods, and provide the basics, the tips/tricks - and how the tool themselves becomes operational for spatial/thematic investigations. Eventually, this will become a city, exhibition and phamplet inhabited by the (by...

  13. Transferring motor branches from proximal tibial nerve for treatment of high fibular nerve injuries: an anatomical study%胫神经肌支转位治疗高位腓总神经损伤的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    陈维波; 缪道一

    2012-01-01

    Objective To observe the anatomy of proximal tibial nerve, so as to assess the feasibility of transferring motor branches from proximal tibial nerve for treatment of the high fibular nerve or long-segment injuries. Methods Totally 23 sides of lower limbs from 12 adult cadavers were included in the present study. The branching pattern, length, diameter of motor branches of the tibial nerve in the proximal leg, location of original point relative to fibular head level and the distance from original point to the fibular neck were examined. Intraneural dissection from the bifurcation of the common fibular nerve to the proximal (deep fibular nerve and superficial fibular nerve) was performed, and then the maximum dissected length and the diameter of deep fibular nerves were observed. The deep fibular nerve was severed at the top site and simulating transfer was performed; the feasibility of suturing the motor branches from proximal tibial nerve and the deep fibular nerve was assessed. Results There were three main motor branches at the proximal leg, including the branches to the lateral and medial head of the gastrocnemius and to the soleus muscle, with the length being (36. 3 ± 9. 6) mm, (44. 7±8. 6) mm and (53. 2 ± 9. 9) mm, respectively. The maximum length of intraneural dissection of the common fibular nerve was (59. 3 ± 7. 2) mm. After dissection, the branches to the soleus muscle and the lateral head of the gastrocnemius were long enough for direct nerve suture with the deep fibular division in all cadavers without tension. The branches to the medial head of the gastrocnemius were long enough for nerve suture in 21 sides (91. 3%). Conclusion After intraneural dissection of the common fibular nerve, the motor branches from proximal tibial nerve can be transferred to restore the deep fibular nerve for treating high fibular nerve injuries. The branch to the soleus muscle is the best choice considering its length and diameter.%目的 对近端胫神经的肌支

  14. Limb Preservation in Recurrent Giant Cell Tumour of Distal End of Radius with Fibular Graft Fracture: Role of Ulnocarpal Arthrodesis.

    Science.gov (United States)

    Kumar, Narinder

    2015-01-01

    Giant cell tumors of distal radius are locally aggressive tumors with a high rate of recurrence. Though surgery remains the mainstay of treatment, reconstruction remains a challenge in cases of recurrence. Recurrences of GCT in autogenous fibular grafts have been rarely reported and pathological fractures through such grafts are even rarer. Ulnocarpal arthrodesis has never been described as a limb preservation procedure in such a recurrent lesion in distal radius with pathological fracture through a well incorporated fibular graft. A case of pathological fracture in a well incorporated autogenous non-vascularized fibular bone graft in recurrent GCT of distal radius and its successful management with ulnocarpal arthrodesis is reported. In such a scenario where other reconstructive options like allograft or prosthetic reconstructions are not likely to succeed, ulnocarpal arthrodesis may be considered as a salvage procedure.

  15. Major donor area complication after a mandibular reconstruction with an osseous fibular free flap: pseudo-compartment syndrome.

    Science.gov (United States)

    Kuvat, Samet Vasfi; Keklik, Barş; Özden, Burcu Celet; Uçar, Adem; Cizmeci, Orhan

    2012-03-01

    The popularity of the fibular free flap in mandibular reconstructions is persisting, and major donor area complications rarely occur after fibular free flap operations. Still, we have observed a pseudo-compartment syndrome in a 52-year-old patient on the 12th postoperative day after a mandibular reconstruction with a fibular free flap. When an obstruction in the deep venous system (deep vein thrombosis) was observed in the Doppler ultrasound-guided imaging, the patient has been taken to the operating room for an emergency surgery and the donor area has been completely reopened (in the manner of a fasciotomy). After this procedure, the circulation in the foot appeared to return to normal. The exposed muscles of the patient, who was started on a low-molecular-weight heparin treatment for the deep vein thrombosis, have been closed with skin grafts on the 10th day. No functional loss was observed during the 2-month follow-up period.

  16. Infant bone age estimation based on fibular shaft length: model development and clinical validation

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Andy; Stamoulis, Catherine; Bixby, Sarah D.; Breen, Micheal A.; Connolly, Susan A.; Kleinman, Paul K. [Boston Children' s Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2016-03-15

    Bone age in infants (<1 year old) is generally estimated using hand/wrist or knee radiographs, or by counting ossification centers. The accuracy and reproducibility of these techniques are largely unknown. To develop and validate an infant bone age estimation technique using fibular shaft length and compare it to conventional methods. We retrospectively reviewed negative skeletal surveys of 247 term-born low-risk-of-abuse infants (no persistent child protection team concerns) from July 2005 to February 2013, and randomized them into two datasets: (1) model development (n = 123) and (2) model testing (n = 124). Three pediatric radiologists measured all fibular shaft lengths. An ordinary linear regression model was fitted to dataset 1, and the model was evaluated using dataset 2. Readers also estimated infant bone ages in dataset 2 using (1) the hemiskeleton method of Sontag, (2) the hemiskeleton method of Elgenmark, (3) the hand/wrist atlas of Greulich and Pyle, and (4) the knee atlas of Pyle and Hoerr. For validation, we selected lower-extremity radiographs of 114 normal infants with no suspicion of abuse. Readers measured the fibulas and also estimated bone ages using the knee atlas. Bone age estimates from the proposed method were compared to the other methods. The proposed method outperformed all other methods in accuracy and reproducibility. Its accuracy was similar for the testing and validating datasets, with root-mean-square error of 36 days and 37 days; mean absolute error of 28 days and 31 days; and error variability of 22 days and 20 days, respectively. This study provides strong support for an infant bone age estimation technique based on fibular shaft length as a more accurate alternative to conventional methods. (orig.)

  17. Success of dental implants in vascularised fibular osteoseptocutaneous flaps used as onlay grafts after marginal mandibulectomy.

    Science.gov (United States)

    Chang, Y-M; Pan, Y-H; Shen, Y-F; Chen, J-K; ALDeek, N F; Wei, F-C

    2016-12-01

    We have evaluated the survival of dental implants placed in vascularised fibular flap onlay grafts placed over marginal mandibulectomies and the effects on marginal bone loss of different types of soft tissue around implants under functional loading. From 2001-2009 we studied a total of 11 patients (1 woman and10 men), three of whom had had ameloblastoma and eight who had had squamous cell carcinomas resected. A total of 38 dental implants were placed either at the time of transfer of the vascularised fibular ostoseptocutaneous flaps (nine patients with 30 implants) or secondarily (two patients with eight implants). Four patients were given palatal mucosal grafts to replace intraoral skin flaps around the dental implants (n=13), and the other seven had the skin flaps around the dental implants thinned (n=25) at the second stage of implantation of the osteointegrated teeth. All vascularised fibular osteoseptocutaneous flaps were successfully transferred, and all implants survived a mean (range) of 73 (33-113) months after occlusal functional loading. The mean (SD) marginal bone loss was 0.5 (0.3) mm on both mesial and distal sides in patients who had palatal mucosal grafts, but 1.8 (1.6) mm, and 1.7 (1.5) mm, respectively, on the mesial and distal sides in the patients who had had thinning of their skin flaps. This difference is significant (p=0.008) with less resorption of bone in the group who had palatal mucosal grafts. Palatal mucosa around the implants helps to reduce resorption of bone after functional loading of implants.

  18. Reconstruction of the cervical spine with two osteocutaneous fibular flap after radiotherapy and resection of osteoclastoma

    DEFF Research Database (Denmark)

    Kaltoft, Britta; Kruse, Anders; Jensen, Lisa Toft

    2012-01-01

    (CT) scan showed insufficient bony fusion of both anterior and posterior bone grafts, and the posterior wound had not healed. A second osteocutaneous fibular flap was placed bilaterally from the occipital squama to the posterior elements of Th1, closing the wound defect. Apart from the occipital...... to C3. Two months later, rupture of the pharyngeal wall was noted with exposure of the anterior cage. A few days later, the posterior scar ruptured. The anterior cage was removed and the pharyngeal wall was sutured. Revision of the posterior wound was performed, leaving the implants in place. To secure...

  19. Chondroblastoma in a metatarsal treated with autogenous fibular graft: a case report.

    Science.gov (United States)

    Dhatt, Sarvdeep S; Bhagwat, Kishan R; Kumar, Vishal; Dhillon, Mandeep Singh

    2012-01-01

    Chondroblastoma is a relatively rare tumor that mimics giant cell tumor and displays a predilection for long bones. In the present report, we describe the case of a benign chondroblastoma localized to the second metatarsal in a 20-year-old male who presented with a 2-year history of painless left foot swelling. Treatment of the tumor involved excision of the second metatarsal with use of an autologous structural fibular bone graft to stabilize the metatarsus and second toe. After 27 months of follow-up, the patient was ambulating well in regular shoes, with no clinical or radiographic evidence of tumor recurrence.

  20. Nonvascularized fibular grafting in nonunion of femoral neck fracture: A systematic review

    Directory of Open Access Journals (Sweden)

    Sujit Kumar Tripathy

    2016-01-01

    Full Text Available Nonunion of femoral neck fractures following primary fixation and neglected femoral neck fracture in young adults is a challenging task. Every effort should be directed toward hip joint salvage in these patients. Among different available options of hip salvage, nonvascularized fibular graft (NVFG osteosynthesis is simple, easy to perform, and a successful technique. In this review, the available literature on NVFG in neglected and nonunion femoral neck fractures has been analyzed. After review of 15 articles on NVFG, the average nonunion rate was estimated to be 7.86% (range 0-31%. Six articles that evaluated the preoperative and postoperative osteonecrosis reported improvement in 50% patients. The clinical and/or functional outcome was good to excellent in 56-96% patients following fibular osteosynthesis. Few complications such as coxa vara deformity, limb shortening, and intraarticular penetration of the graft or hardware have been reported. However, there are minimal donor site morbidities such as mild ankle pain, transient loss of toe flexors and extensors and transient lateral popliteal nerve palsy.

  1. Early outcomes of proximal humerus fracture fixation with locking plate and intramedullary fibular strut graft.

    Science.gov (United States)

    Tan, Edwin; Lie, Denny; Wong, M K

    2014-09-01

    Proximal humerus fractures are commonly encountered in elderly patients. Surgical treatment demonstrates high complication rates, including varus construct collapse and screw cutout. In this study, the authors evaluate the clinical outcome of locking plate fixation with intramedullary fibular strut graft augmentation as a primary surgical treatment in the prevention of early collapse and screw cutout. A total of 9 patients were evaluated. Surgery was performed for displaced proximal humerus fractures between April and December 2011. Patients were either class 2, 3, or 4, according to Neer classification. Mean patient age was 75.4 years. Preoperative and immediate, 6-week, and 3-month postoperative radiographs were evaluated. Head-shaft angles were measured to assess for varus collapse and displacement. Range of motion, complication rates, and functional recovery were also evaluated. Patients underwent open reduction and internal fixation with placement of an intramedullary fibular strut graft. Fixation was achieved with a Philos plate (Synthes, Oberdorf, Switzerland). Reduction and fixation were evaluated with radiographs. Passive exercises and range of motion were allowed immediately postoperatively, and all patients achieved active abduction and forward flexion 6 weeks postoperatively. Shoulder radiographs taken 12 weeks postoperatively revealed no loss of reduction or screw cutout. The introduction of the locking plate has improved outcomes. The addition of an intramedullary strut graft has shown improved preliminary results. Maintained reduction was observed in all 9 patients in the early postoperative period, and good functional motion was achieved. No incidence of screw cutout was recorded.

  2. Outcome of eight-plate hemiepiphysiodesis on genu valgum and height correction in bilateral fibular hemimelia.

    Science.gov (United States)

    Das, Sakti; Ganesh, G Shankar; Pradhan, Sudhakar; Mohanty, Ram N

    2014-01-01

    Fibular hemimelia is the most common lower extremity congenital longitudinal deficiency leading to cosmetic deformity, pain, and gait disturbance. Eight-plate hemiepiphysiodesis has proven to be successful in correcting angular deformity of the knee; it is an easy surgical technique and yields a more rapid rate of correction. The aim of this study was to determine the effectiveness of eight-plate hemiepiphysiodesis in bilateral genu valgum resulting from fibular hemimelia and overall height improvement in two girls and four boys with a mean age of 22 months who were followed up for a period of 18 months. The variables studied were arm span, the total height ratio, intermalleolar distance, tibiofemoral angle, and activity. All the parameters improved significantly. The mean improvement in the valgus was 7.41°. The mean intermalleolar distance reduced by 19.5 cm, and all patients achieved a significant improvement in lower limb function. Although there was significant improvement in total height, it still lagged behind arm span at the time of final follow-up. The results of eight-plate hemiepiphysiodesis were found to be satisfactory. We conclude that it is a reasonable treatment option for young patients with an adequate growth potential.

  3. Vascularization of the peroneal muscles. Critical evaluation in fibular free flap harvesting.

    Science.gov (United States)

    Villarreal, P M; Monje, F; Gañán, Y; Junquera, L M; Morillo, A J

    2004-12-01

    This anatomical study was carried out in order to discover the etiology of partial necrosis of the peroneus longus and brevis muscles after fibular osteocutaneous flap harvest. The vascular supply to the lateral compartment peroneal muscles was investigated in 10 fresh cadaveric lower limbs. The peroneal muscles are supplied by two principal sources arteries, the anterior tibial artery (ATA) and the peroneal artery (PA). The ATA is the dominant artery and supplies the proximal and middle thirds of these muscles. The PA is considered to be a supplementary vascular source and supplies the distal thirds of these muscles. After harvesting the PA in a fibular flap, regions of the peroneal muscles preoperatively vascularized by its branches become supplied through the anastomotic "choke" vessels between the ATA and the PA. Primary closure of the cutaneous defect increases the possibility of developing a pseudo-compartment syndrome with necrosis of the more precariously vascularized portions of the peroneal muscles. This complication is difficult to diagnosis early and the reason why we advocate that direct skin closure following composite harvest must be avoided. Moreover, conservation of the inferior and superior lateral branches of the ATA is imperative in order to preserve the peroneal muscles vascularization.

  4. Anterograde Intra-Arterial Urokinase Injection for Salvaging Fibular Free Flap

    Directory of Open Access Journals (Sweden)

    Dae-Sung Lee

    2013-05-01

    Full Text Available We present a case of a 57-year-old male patient who presented with squamous cell carcinoma on his mouth floor with cervical and mandibular metastases. Wide glossectomy with intergonial mandibular ostectomy, and sequential reconstruction using fibular osteomyocutaneous free flap were planned. When the anastomosis between the peroneal artery of the fibular free flap and the right lingual artery was performed, no venous flow was observed at the vena comitans. Then re-anastomosis followed by topical application of papaverine and lidocaine was attempted. However, the blood supply was not recovered. Warm saline irrigation over 30 minutes was also useless. Microvascular thromboses of donor vessels were clinically suspected, so a solution of 100,000 units of urokinase was infused once through a 26-gauge angiocatheter inserted into the recipient artery just at the arterial anastomotic site, until the solution gushed out through the flap vena comitans. Immediately after the application of urokinase, arterial flow and venous return were restored. There were no complications during the follow-up period of 11 months. We believe that vibrating injuries from the reciprocating saw during osteotomies and flap insetting might be the cause of microvascular thromboses. The use of urokinase may provide a viable option for the treatment of suspicious intraoperative arterial thrombosis.

  5. Anterograde intra-arterial urokinase injection for salvaging fibular free flap.

    Science.gov (United States)

    Lee, Dae-Sung; Jung, Sun-Il; Kim, Deok-Woo; Dhong, Eun-Sang

    2013-05-01

    We present a case of a 57-year-old male patient who presented with squamous cell carcinoma on his mouth floor with cervical and mandibular metastases. Wide glossectomy with intergonial mandibular ostectomy, and sequential reconstruction using fibular osteomyocutaneous free flap were planned. When the anastomosis between the peroneal artery of the fibular free flap and the right lingual artery was performed, no venous flow was observed at the vena comitans. Then re-anastomosis followed by topical application of papaverine and lidocaine was attempted. However, the blood supply was not recovered. Warm saline irrigation over 30 minutes was also useless. Microvascular thromboses of donor vessels were clinically suspected, so a solution of 100,000 units of urokinase was infused once through a 26-gauge angiocatheter inserted into the recipient artery just at the arterial anastomotic site, until the solution gushed out through the flap vena comitans. Immediately after the application of urokinase, arterial flow and venous return were restored. There were no complications during the follow-up period of 11 months. We believe that vibrating injuries from the reciprocating saw during osteotomies and flap insetting might be the cause of microvascular thromboses. The use of urokinase may provide a viable option for the treatment of suspicious intraoperative arterial thrombosis.

  6. Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis.

    Science.gov (United States)

    Wang, Xiaohu; Wei, Lei; Lv, Zhi; Zhao, Bin; Duan, Zhiqing; Wu, Wenjin; Zhang, Bin; Wei, Xiaochun

    2017-02-01

    Objective To explore the effects of proximal fibular osteotomy as a new surgery for pain relief and improvement of medial joint space and function in patients with knee osteoarthritis. Methods From January 2015 to May 2015, 47 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis were retrospectively followed up. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively. Results Medial pain relief was observed in almost all patients after proximal fibular osteotomy. Most patients exhibited improved walking postoperatively. Weight-bearing lower extremity radiographs showed an average increase in the postoperative medial knee joint space. Additionally, obvious correction of alignment was observed in the whole lower extremity radiographs in 8 of 47 patients. Conclusions The present study demonstrates that proximal fibular osteotomy effectively relieves pain and improves joint function in patients with medial compartment osteoarthritis at a mean of 13.38 months postoperatively.

  7. Scorpion image segmentation system

    Science.gov (United States)

    Joseph, E.; Aibinu, A. M.; Sadiq, B. A.; Bello Salau, H.; Salami, M. J. E.

    2013-12-01

    Death as a result of scorpion sting has been a major public health problem in developing countries. Despite the high rate of death as a result of scorpion sting, little report exists in literature of intelligent device and system for automatic detection of scorpion. This paper proposed a digital image processing approach based on the floresencing characteristics of Scorpion under Ultra-violet (UV) light for automatic detection and identification of scorpion. The acquired UV-based images undergo pre-processing to equalize uneven illumination and colour space channel separation. The extracted channels are then segmented into two non-overlapping classes. It has been observed that simple thresholding of the green channel of the acquired RGB UV-based image is sufficient for segmenting Scorpion from other background components in the acquired image. Two approaches to image segmentation have also been proposed in this work, namely, the simple average segmentation technique and K-means image segmentation. The proposed algorithm has been tested on over 40 UV scorpion images obtained from different part of the world and results obtained show an average accuracy of 97.7% in correctly classifying the pixel into two non-overlapping clusters. The proposed 1system will eliminate the problem associated with some of the existing manual approaches presently in use for scorpion detection.

  8. 腓血管蒂腓骨嵌合组织瓣设计的解剖学基础%Anatomical basis for design of the chimeric fibular composite flap based on the peroneal artery

    Institute of Scientific and Technical Information of China (English)

    谢志平; 庄跃宏; 郑和平; 章一新; 梁成; 郝攀登; 张发惠

    2014-01-01

    Objective To provide anatomical basis for design of the chimeric fibular composite flap based on the peroneal artery. Methods 30 cadaveric lower extremities were used for this study. The fibular head and the lateral malleolus were used as the landmarks and the calves were divided into the upper, middle and lower segments, respectively. Dissection of the calves was carried out and the following contents were investigated: ① The origin, course and branches of the peroneal arteries; ② The number of the musculocutaneous or septocutaneous perforators of the three segments and the periosteal branches from the peroneal arteries. Results The peroneal artery originated from the tibial artery and travelled immediately posteriorly to the fibular bone after it coursed to the middle segment of the fibular. It continued as the lateral calcaneal artery, giving off the branches to nourish the adjacent bones, muscles, and the skin on the lateral aspect of the lower leg. Among the branches given off, 2 to 8 branches were to the periosteum of the middle and lower 1/3 of the fibular bone, averaging 0.5 to 1.1 in diameter, which were termed fibular periosteal arteries; 1 to 3 branches were to the middle and lower 1/3 of the tibial periosteum, averaging 0.6 to 0.8 in diameter, which were termed tibial periostal arteries; 4 to 8 branches were the musculocutaneous or septocutnaoues perforators supplying the skin on the lateral aspect of the middle and lower segments of the lower leg. After piercing the deep fascia, the septocutaneous perforators anastomosed with the perforators from the anterior and posterior tibial arteries. Conclusions It is anatomically feasible to harvest the chimeric fibular composite flap based on the peroneal artery, depending on the practical clinical needs;one type or multiple types of chimeric flaps can be harvested to reconstruct combined defects of bone and soft tissue.%目的:为腓血管蒂腓骨嵌合组织瓣设计提供解剖学依据。方法用30

  9. Complications and Risk after Mandibular Reconstruction with Fibular Free Flaps in Patients with Oral Squamous Cell Carcinoma: A Retrospective Cohort Study.

    Science.gov (United States)

    Lodders, J N; Schulten, E A J M; de Visscher, J G A M; Forouzanfar, T; Karagozoglu, K H

    2016-07-01

    Background We retrospectively analyzed the incidence and types of postoperative complications after mandibular continuity reconstructions with fibular free flaps (FFF) in patients with oral squamous cell carcinoma (OSCC) and identified potential risk factors for postoperative complications. Methods Data were retrieved from the medical records in the Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands from April 1995 to September 2013, and were statistically analyzed. Results In this study, 85 patients were included in whom 86 FFFs were used for mandibular reconstruction. Thirty-seven patients (43%) developed ≥ 1 surgical complication and 9 patients (10.5%) developed ≥ 1 systemic complication. Three patients (3.5%) developed total flap failure and six patients (7.0%) developed partial flap failure. Surgical complications were correlated with tobacco use, partial glossectomy, type of mandibular defect, and anatomic staging. Systemic complications were associated with age > 60 years and Charlson comorbidity index > 2. Hospitalization > 30 days was associated with type of mandibular defect. Conclusions The use of the FFF for reconstructing mandibular continuity defects in OSCC patients may be associated with postoperative complications. Patients with coexisting medical conditions and anterior mandibular defects have an increased risk for developing complications. Patients who undergo segmental mandibular resection including a partial glossectomy could have a reduced risk for complications.

  10. Structural bone allografts with intramedullary vascularized fibular autografts for the treatment of massive bone defects in extremities

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To report the clinical outcome of repairing massive bone defects biologically in limbs by homeochronous using structural bone allografts with intramedullary vascularized fibular auto-grafts. Methods: From January 2001 to December 2005. large bone defects in 19 patients (11 men and 8 women, aged 6 to 35 years) were repaired by structural bone allografts with intramedullary vascularized fibular autografts in the homeochronous period. The range of the length of bone defects was 11 to 25 cm (mean 17. 6 cm), length of vascularized free fibular was 15 to 29 cm (mean 19. 2 cm), length of massive bone allografts was 11 to 24 cm (mean 17. 1 cm). Location of massive bone defects was in humerus(n = 1), in femur(n = 9) and in tibia(n = 9), respectively. Results: After 9 to 69 months (mean 38. 2 months) follow-up, wounds of donor and recipient sites were healed in Ⅰ stage, monitoring-flaps were alive, eject reaction of massive bone allografts were slight, no complications in donor limbs. Fifteen patients had the evidence of radiographic union 3 to 6 months after surgery, 3 cases united 8 months later, and the remained one case of malignant synovioma in distal femur recurred and amputated the leg 2. 5 months, post-operatively. Five patients had been removed internal fixation, complete bone unions were found one year postoperatively. None of massive bone allografts were absorbed or collapsed at last follow-up. Conclusion: The homeochronous usage of structural bone allograft with an intramedullary vascularized fibular au-tograft can biologically obtain a structure with the immediate mechanical strength of the allograft, a potential result of revascularization through the vascularized fibula, and accelerate bone union not only between fibular autograft and the host but also between massive bone allograft and the host.

  11. Fibular allograft and anterior plating for dislocations/fractures of the cervical spine

    Directory of Open Access Journals (Sweden)

    Ramnarain A

    2008-01-01

    Full Text Available Background: Subaxial cervical spine dislocations are common and often present with neurological deficit. Posterior spinal fusion has been the gold standard in the past. Pain and neck stiffness are often the presenting features and may be due to failure of fixation and extension of fusion mass. Anterior spinal fusion which is relatively atraumatic is thus favored using autogenous grafts and cages with anterior plate fixation. We evaluated fresh frozen fibular allografts and anterior plate fixation for anterior fusion in cervical trauma. Materials and Methods: Sixty consecutive patients with single-level dislocations or fracture dislocations of the subaxial cervical spine were recruited in this prospective study following a motor vehicle accident. There were 38 males and 22 females. The mean age at presentation was 34 years (range 19-67 years. The levels involved were C5/6 ( n = 36, C4/5 ( n = 15, C6/7 ( n = 7 and C3/4 ( n = 2. There were 38 unifacet dislocations with nine posterior element fractures and 22 were bifacet dislocations. Twenty-two patients had neurological deficit. Co-morbidities included hypertension ( n = 6, non-insulin-dependent diabetes mellitus ( n = 2 and asthma ( n = 1. All patients were initially managed on skull traction. Following reduction further imaging included Computerized Tomography and Magnetic Resonance Imaging. Patients underwent anterior surgery (discectomy, fibular allograft and plating. All patients were immobilized in a Philadelphia collar for eight weeks (range 7-12 weeks. Eight patients were lost to follow-up within a year. Follow-up clinical and radiological examinations were performed six-weekly for three months and subsequently at three-monthly intervals for 12 months. Pain was analyzed using the visual analogue scale (VAS. The mean follow-up was 19 months (range 14-39 months. Results: Eight lost to followup, hence 52 patients were considered for final evaluation. The neurological recovery was 1.1 Frankel

  12. Metatarsal Reconstruction with a Fibular Osteocutaneous Flap: A Novel Approach Utilizing Virtual Surgical Planning

    Directory of Open Access Journals (Sweden)

    Hugo St. Hilaire, MD, DDS

    2014-11-01

    Full Text Available Summary: Craniofacial reconstruction remains the main application for virtual surgical planning (VSP. We present a case in which this technology was applied to reconstruct a bony defect of the first metatarsal bone from a gunshot injury. VSP was used to facilitate a 1-stage reconstruction with a fibular osteocutaneous flap. A template of the reconstructed bone was designed based on the virtual mirror-image, noninjured bone. Prefabricated cutting guides facilitated precise shaping of the vascularized bone accounting for location of perforators. Successful reconstruction of the metatarsal bone was achieved with excellent functional outcomes. We believe that VSP can be a valuable tool in reconstruction of metatarsal bones by facilitating precise intraoperative shaping and anatomic orientation of the vascularized flap and reducing flap ischemia and operative time.

  13. Vertical distraction osteogenesis of fibular free flap in mandibular prosthetic rehabilitation: a case report.

    Science.gov (United States)

    Marchetti, Claudio; Degidi, Marco; Scarano, Antonio; Piattelli, Adriano

    2002-06-01

    A 17-year-old boy underwent three cycles of chemotherapy and a subsequent mandibular resection for a Ewing's sarcoma of the left body and ramus. The mandible was immediately reconstructed with a microvascular osteomuscular fibular flap. One year after the mandibular reconstruction, distraction osteogenesis of the anterior portion of the fibula was performed using a Martin distractor according to the Hoffmeister technique. Bone lengthening was achieved at a rate of 1 mm/day by turning the device twice each day for 12 days. Subsequently, we waited for 70 days for bone consolidation to occur. After 6 additional weeks, five Maestro implants were placed into the distracted fibula. Bone specimens were retrieved with a trephine bur during implant placement. Mature bone was present after 70 days and after 6 months. The bone height increase was 12 mm.

  14. Chronic Sclerosing Osteomyelitis of the Mandible Treated with Hemimandibulectomy and Fibular Free Flap Reconstruction.

    Science.gov (United States)

    Singh, Shubhi; Graham, M Elise; Bullock, Martin; Rigby, M H; Taylor, S Mark; Trites, Jonathan R B; Hart, Robert D

    2015-12-01

    Primary chronic osteomyelitis of the mandible is a rare condition that presents with a long-standing chronic facial swelling over the mandible, pain with mastication, and trismus. With no clinically appreciated acute phase, the aetiology often remains unknown. Many patients achieve adequate symptom control with broad-spectrum antibiotics, hyperbaric oxygen therapy and surgical debridement, or decortication of bone sequestration. However, because of the rarity of primary chronic osteomyelitis and the extensive involvement of the mandible that can result, we present a case of a 32-year-old woman with chronic disease of the left mandible requiring a left hemimandibulectomy and fibular free flap reconstruction. Few such cases have been reported in the literature, which require such extensive resection and reconstruction to control long-standing symptoms.

  15. A Case of Nonisland Pedicled Foot Fillet Flap for Below-Knee Amputation Stump Wound: Treatment Option for Compartment Syndrome after Fibular Free Flap Surgery

    OpenAIRE

    Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2014-01-01

    Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. An extensive chronic leg wound resulted, which was treated with multiple debridements and finally with below-knee amputation. Successful coverage of the below-knee amputation stump was ...

  16. Oral rehabilitation with dental implants and quality of life following mandibular reconstruction with free fibular flap.

    Science.gov (United States)

    Jacobsen, Hans-Christian; Wahnschaff, Falko; Trenkle, Thomas; Sieg, Peter; Hakim, Samer G

    2016-01-01

    Bony reconstruction of jaw defects using the free fibular flap and dental rehabilitation mostly requires insertion of dental implants within the transferred fibula bone. The aim of this paper was to discuss results of the implant stability with data on the possible benefit for the patient's quality of life after such treatment. For clinical outcome of implants, we evaluated 26 patients with a total number of 94 dental implants after a follow-up period of 12 to 132 months. A group of 38 patients who underwent mandibular reconstruction with free fibular flap could be included in the life-quality study. Evaluation included 23 patients with and 15 patients without implant-borne restoration. The quality of life was assessed using the standard QLQ C-30 questionnaire and the H&N35 module of the European Organisation for Research and Treatment of Cancer (EORTC). Of implants, 94.7 % were stable at the time of investigation and could be used for prosthesis. Patients with dental implants reported improvement of life quality along with better scores in most function and symptom scales; however, only values for global health status (QL2), absence of dyspnea (DY) and absence of feeding tube (HNFE) were significantly better than in the control group. Dental implant insertion in fibula grafts along with implant-borne restoration is a proven concept and might lead to improved quality of life following ablative surgery of the jaw. The effect on the quality of life is not as predictable as on the implant stability. Patients with bony defects of the jaw require bony reconstruction. This allows further masticatory rehabilitation using dental implants and might lead to improved quality of life.

  17. Free fibular strut graft in neglected femoral neck fractures in adult

    Directory of Open Access Journals (Sweden)

    Azam Md Quamar

    2009-01-01

    Full Text Available Background: Neglected femoral neck fracture in adults still poses a formidable challenge. Existing treatment options varies from osteotomy (with or without graft to osteosynthesis using various implants and grafting techniques (muscle pedicle, vascularized, and nonvascularized fibula. The aim of this study was to assess outcome of nonvascularized fibular strut graft and cancellous screw fixation in neglected femoral neck fractures in the younger age group. Materials and Methods: Medical records of 32 patients of neglected femoral neck fracture, in the age group of 22-45 years (mean 37.8 years, operated between May 1994 to December 2001, were retrospectively reviewed. After the application of inclusion and exclusion criteria, 28 patients having three years minimum follow-up (mean 4.6 years were included. Delay between injury and operation varied from four weeks to 42 weeks (mean 16.4 weeks. Closed reduction was achieved in 17 patients; open reduction through Watson-Jones anterolateral approach was performed in the remaining 15 patients in whom closed reduction failed. The fracture was transfixed with three parallel guide wires. Appropriate sized cannulated lag screw (7 mm was then inserted in two of the wires. Selection of the third guide wire for fibula depended on the space available in both anteroposterior and lateral view. Results: Satisfactory bony union was obtained in 25 patients, of whom in four cases, the union occurred in 10-20° (mean 15° of varus. Nonunion occurred in three patients (9.37%, and aseptic necrosis occurred in another six patients (18.75%. Of the 25 patients where union was achieved, five patients showed excellent results; 14 good and six had poor functional result, as evaluated using modified Anglen criteria. Conclusion: Nonvascularized fibular strut graft along with cancellous screws provides a dependable and technically less-demanding alternative procedure for neglected femoral neck fractures in young adults. Fibula

  18. Metallic Fixation of Mandibular Segmental Defects: Graft Immobilization and Orofacial Functional Maintenance

    Science.gov (United States)

    Shayesteh Moghaddam, Narges; Jahadakbar, Ahmadreza; Amerinatanzi, Amirhesam; Elahinia, Mohammad; Miller, Michael

    2016-01-01

    Background: The aim of this study is to investigate the behavior of the healthy mandible under maximum molar bite force to demonstrate the problems associated with the current standard of care procedures for mandibular segmental defect reconstruction (ie, use of Ti–6Al–4V hardware and either a single- or double-barrel fibular graft). With current Ti–6Al–4V mandibular reconstruction hardware, there is a significant stiffness mismatch among the hardware, graft, and the remaining host anatomy. How the distribution of mechanical forces through the mandible is altered after a segmental bone loss and reconstruction is incompletely understood. Methods: We studied a healthy adult mandible for stress, strain, and reaction force distribution during normal mastication. Stress distribution of this model was then used to study problems encountered after mandibular segmental defect reconstructive surgery. We model the use of both single- and double-barrel fibular grafts to repair the loss of the left M1–3 containing segment of the mandible. These simulations were done using 2 sets of plates with different thicknesses. Results: We found that the stiffness mismatching between the fixation hardware and the graft and host bone causes stress shielding of that bone and stress concentrations in the fixation hardware and screws. These effects are expected, especially during the bone healing period. However, long term, this abnormal stress–strain distribution may lead to either the hardware’s failure due to stress concentration or graft failure due to bone resorption as a result of stress shielding. We found that the stress–strain distribution is more normal with a double-barrel fibular graft. Additionally, we found that thinner fixation plates can reduce stress shielding. Conclusion: The proposed model can be used to evaluate the performance and optimization of the fixation device.

  19. Segmentation: Identification of consumer segments

    DEFF Research Database (Denmark)

    Høg, Esben

    2005-01-01

    It is very common to categorise people, especially in the advertising business. Also traditional marketing theory has taken in consumer segments as a favorite topic. Segmentation is closely related to the broader concept of classification. From a historical point of view, classification has its...... and analysed possible segments in the market. Results show that the statistical model used identified two segments - a segment of so-called "fish lovers" and another segment called "traditionalists". The "fish lovers" are very fond of eating fish and they actually prefer fish to other dishes...... origin in other sciences as for example biology, anthropology etc. From an economic point of view, it is called segmentation when specific scientific techniques are used to classify consumers to different characteristic groupings. What is the purpose of segmentation? For example, to be able to obtain...

  20. Ununited fracture neck of femur treated with closed reduction and internal fixation with cancellous screw and fibular strut graft

    Directory of Open Access Journals (Sweden)

    Singh Daria

    2006-01-01

    Full Text Available Background: Ununited fracture neck of femur in young adults has been tackled in various ways. Methods: Twenty five patients of ununited fracture neck of femur in age group 21-55 years were treated by closed reduction, cancellous screw fixation and fibular strut graft and followed up for 2-6 years. Time gap between injury and operation was 6 weeks to 58 weeks. Five cases were previously fixed with various fixation devices. Results: Osseous union was achieved in 24 cases with average time of 18.16 weeks. Main complication encountered in follow-up was avascular necrosis of femoral head, others were joint stiffness and shortening. Functional end results were good to excellent in 24 cases. Conclusion: Closed reduction with internal fixation by cancellous screw and fibular strut grafting is easy and useful procedure.

  1. Posterolateral Corner Reconstruction Alone Using a Fibular-Based Technique in a Patient with Persistent Unstable Revision Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Joseph T. Cline

    2015-01-01

    Full Text Available Posterolateral rotatory instability is a relatively uncommon cause of unstable total knee arthroplasty (TKA. In most cases, surgical treatment requires revision TKA into a more constrained design or thicker polyethylene liner. We present a case of a patient with unstable TKA who remained unstable after increasing thickness of the polyethylene liner and undergoing more constrained TKA. After several revision surgeries, the patient was still unstable. Posterolateral corner reconstruction with a fibular-based technique using a tibialis anterior allograft was performed. At 1-year follow-up, the patient was stable and asymptomatic and with excellent function. A soft-tissue procedure only (fibular-based posterolateral corner reconstruction can be effective at restoring posterolateral rotatory stability in a patient with persistent instability after revision TKA.

  2. Talocrural dislocation with associated weber type C fibular fracture in a collegiate football player: a case report.

    Science.gov (United States)

    Ricci, R Daniel; Cerullo, James; Blanc, Robert O; McMahon, Patrick J; Buoncritiani, Anthony M; Stone, David A; Fu, Freddie H

    2008-01-01

    To present the case of a talocrural dislocation with a Weber type C fibular fracture in a National Collegiate Athletic Association Division I football athlete. The athlete, while attempting to make a tackle during a game, collided with an opponent, who in turn stepped on the lateral aspect of the athlete's ankle, resulting in forced ankle eversion and external rotation. On-field evaluation showed a laterally displaced talocrural dislocation. Immediate reduction was performed in the athletic training room to maintain skin integrity. Post-reduction radiographs revealed a Weber type C fibular fracture and increased medial joint clear space. A below-knee, fiberglass splint was applied to stabilize the ankle joint complex. Subtalar dislocation, Maisonneuve fracture, malleolar fracture, deltoid ligament rupture, syndesmosis disruption. The sports medicine staff immediately splinted and transported the athlete to the athletic training room to reduce the dislocation. The athlete then underwent an open reduction and internal fixation procedure to stabilize the injury: 2 syndesmosis screws and a fibular plate were placed to keep the ankle joint in an anatomically reduced position. With the guidance of the athletic training staff, the athlete underwent an accelerated physical rehabilitation protocol in an effort to return to sport as quickly and safely as possible. Most talocrural dislocations and associated Weber type C fibular fractures are due to motor vehicle accidents or falls. We are the first to describe this injury in a Division I football player and to present a general rehabilitation protocol for a high-level athlete. Sports medicine practitioners must recognize that this injury can occur in the athletic environment. Prompt reduction, early surgical intervention, sufficient resources, and an accelerated rehabilitation protocol all contributed to a successful outcome in the patient.

  3. [Postoperative monitoring of free fibular grafts by dynamic magnetic resonance imaging. Preliminary results in three cases of mandibular reconstruction].

    Science.gov (United States)

    Bey, E; Paranque, A; Pharaboz, C; Cariou, J L

    2001-02-01

    The vascularized free fibular graft has been used in mandibular reconstructive surgery since 1975. This technique has been progressively developed, and it is now the procedure of choice for mandibular reconstruction although in certain postoperative circumstances it can be difficult if not impossible to monitor bone vitality. However, bone vascularization can be detected by dynamic magnetic resonance imaging (MRI), as this technique has been experimentally and clinically validated in the early diagnosis of osteonecrosis. The aim of this study was to evaluate the efficacy of MRI for the postoperative monitoring of vascularized free fibular grafts in human mandibular reconstruction. Dynamic contrast-enhanced MRI was used to study the variation in contrast over time following injection of gadolinium contrast medium, and to evaluate the degree of bone marrow perfusion of the fibular graft. This variation in signal intensity was visualized in the form of a curve, i.e., a perfusion curve for the bone marrow region. An examination was performed in three patients at different postoperative times and under different conditions. In one case, MRI confirmed the presence of fibula blood supply in spite of the necrosis of the adjacent fascio-adipose layer. In this article, the methodological difficulties have been discussed, particularly as regards data processing, and the present results have been compared with the findings in the literature. Dynamic MRI is a simple, reliable, non-invasive technique and its use in the postoperative monitoring of bone marrow perfusion and vascularized free fibular grafts permits a determination of the status of the latter following surgery, i.e., whether there is an adequate blood supply or not.

  4. Total maxillary reconstruction using a double-barreled and double skin paddle fibular flap after total maxillectomy.

    Science.gov (United States)

    de la Parra, Miguel; Sanchez, Gerardo; Lopez, Jaime; Perez, Adrian; Naal, Norberto

    2013-11-01

    Chondroblastomas are rare entities accounting for approximately 1% of all primary bone tumors. We describe a case of a 7-year-old girl with a giant chondroblastoma of the maxilla, treated with bilateral class III maxillectomy and reconstruction with a double-barreled and double skin paddle fibular free flap. We show evidence of an excellent aesthetic outcome at 6 months' follow up with no evidence of tumor recurrence.

  5. Computer-assisted versus traditional freehand technique in fibular free flap mandibular reconstruction: a morphological comparative study.

    Science.gov (United States)

    De Maesschalck, Thibault; Courvoisier, Delphine S; Scolozzi, Paolo

    2017-01-01

    The purpose of the study was to compare the accuracy of computer-assisted surgery (CAS) and the traditional freehand technique for fibular free flap mandibular reconstruction as well as to evaluate the accuracy of the CAS planning. The medical records of 18 patients who underwent mandibular reconstruction with fibular free flap were reviewed. The CAS group (n = 7) benefited from virtual surgical planning and custom patient-specific plates and surgical cutting guides. The Control group (n = 11) was treated by conventional surgery. Morphometric comparison was done by calculating the differences in specific linear and angular parameters on pre- and postoperative CT-scans for both groups by using ProPlan CMF(®) software. Symmetry was also assessed by calculating the ratio of the affected versus the nonaffected side. In the CAS group, planned and postoperative CT-scans were compared to evaluate accuracy. The morphometric comparison showed no statistically significant differences between the groups except for the axial angle on the nonaffected side (mean difference 1.0° in the CAS group versus 2.9° in the Control group; p = 0.03). Ratios of the affected side over the nonaffected side showed no differences between the two groups. In the CAS group, the accuracy assessment showed a mean distance deviation of 2.3 mm for mandibular osteotomies and 1.9 mm for fibular osteotomies. Our results indicated that CAS and the conventional freehand techniques were comparable in their ability to provide a satisfactory morphological fibular free flap mandibular reconstruction. Moreover, the accuracy of the CAS technique was within the range reported in the literature.

  6. Repositioning template for mandibular reconstruction with fibular free flap: an alternative technique to pre-plating and virtual surgical planning

    OpenAIRE

    Berrone, M.; Crosetti, E.; Succo, G

    2014-01-01

    SUMMARY Oral malignancies involving the mandibular bone require a complex reconstructive plan. Mandibular reconstruction with a fibular free flap is currently considered the best choice for functional and aesthetic rehabilitation after oncological surgery. This flap can be modelled with multiple osteotomies and can provide bone, muscle and skin for composite reconstruction. One of the most delicate aspects of mandibular reconstruction is the technique of bone modelling; the risk of prolonging...

  7. Comparison of outcome of microvascular bony head and neck reconstructions using the fibular free flap and the iliac crest flap.

    Science.gov (United States)

    Mücke, Thomas; Loeffelbein, Denys J; Kolk, Andreas; Wagenpfeil, Stefan; Kanatas, Anastasios; Wolff, Klaus-Dietrich; Mitchell, David A; Kesting, Marco R

    2013-09-01

    Several microvascular free flaps are available for reconstruction of the osseous components after resections for head and neck cancer. We have prospectively evaluated patients treated by bony microsurgical reconstruction to identify predictors of adverse outcomes for delayed wound healing and failure of free flaps. All patients from July 2007 to June 2011 who had reconstructions with microvascular fibular or iliac crest flaps immediately after resection of the tumour were evaluated. There were a total of 156 bony free flaps: 120 (77%) fibular and 36 (23%) iliac crest flaps. A total of 133 (85%) were successful. Delayed wound healing was more common with the iliac crest flap (p=0.01) at the intraoral site (p=0.04). Significantly more iliac crest free flaps failed (p=0.02). Anastomosis to the facial artery (p=0.05) and facial vein (p=0.04), and duration of overall operating time were associated with a significantly higher risk of failure of the flap. Patients with cancer of the head and neck who require microsurgical bony reconstruction are at increased risk of postoperative complications. Significantly more complications were found with the iliac crest flap, whereas the fibular flap was associated with a significantly longer operating time.

  8. Acquired platelet function defect

    Science.gov (United States)

    Acquired qualitative platelet disorders; Acquired disorders of platelet function ... blood clotting. Disorders that can cause problems in platelet function include: Idiopathic thrombocytopenic purpura Chronic myelogenous leukemia Multiple ...

  9. Stabilisation of the fractured fibula plays an important role in the treatment of pilon fractures: a retrospective comparison of fibular fixation methods.

    Science.gov (United States)

    Lee, Yih-Shiunn; Chen, Shu-Wen; Chen, Shih-Hao; Chen, Wen-Chiao; Lau, Ming-Jye; Hsu, Tzu-Liang

    2009-06-01

    Ninety-eight pilon fractures associated with ipsilateral distal fibular fracture were included in this study. The pilon fractures were treated by open reduction and plating. The 98 fractures were divided into three groups based on the treatment method of fractured fibula. Group A was composed of 50 fibular fractures treated by open reduction and plate fixation. Group B was composed of 23 fibular fractures treated by open reduction and pin fixation. Group C was composed of 25 fibular fractures treated conservatively by closed reduction. The radiographs were reviewed for adequacy of fracture reduction and posttraumatic arthrosis. At the end of follow-up, the clinical outcomes were evaluated using a rating scale. The three groups were similar in respect to Ruedi type, open fracture grade, and demographics (all p values >0.25). Group A showed a decreasing trend of malunion and ankle arthrosis compared to group C (p = 0.091 and p = 0.099, respectively). Group A had a better clinical outcome than group C (p = 0.008). In addition, group A showed an increasing trend of satisfactory outcome compared to group B (p = 0.096). In conclusion, for pilon fractures associated with ipsilateral fibular fractures, stabilisation of the fractured fibula plays an important role in the decrease of distal tibial malunion and post-traumatic ankle arthrosis as well as improvement of clinical outcomes.

  10. Dislocation of the fibular head in an unusual sports injury: a case report

    Directory of Open Access Journals (Sweden)

    Ahmad Riaz

    2008-05-01

    Full Text Available Abstract Introduction One of the primary functions of the proximal tibiofibular joint is slight rotation to accommodate rotational stress at the ankle. Proximal tibiofibular joint dislocation is a rare injury and accounts for less than 1% of all knee injuries. This dislocation has been reported in patients who had been engaged in football, ballet dancing, equestrian jumping, parachuting and snowboarding. Case presentation A 20-year-old man was injured whilst playing football. He felt a pop in the right knee and was subsequently unable to bear weight on it. The range of movement in his knee joint was limited. Anterior-posterior and lateral X-rays of the knee revealed anterolateral dislocation of the proximal tibiofibular joint. Comparison views confirmed the anterolateral dislocation. He had a failed manipulation under anaesthesia and the joint needed an open reduction in which the fibular head was levered back into place. Operative findings revealed a horizontal type of joint. Conclusion An exceedingly rare dislocation of a horizontal type of proximal tibiofibular joint was presented following a football injury. This dislocation was irreducible by a closed method.

  11. Histomorphometric evaluation of bone healing in rabbit fibular osteotomy model without fixation

    Directory of Open Access Journals (Sweden)

    Paixão Fabio B

    2008-01-01

    Full Text Available Abstract Background Animal models of fracture consolidation are fundamental for the understanding of the biological process of bone repair in humans, but histological studies are rare and provide only qualitative results. The objective of this article is to present the histomorphometric study of the bone healing process using an experimental model of osteotomy in rabbit fibula without interference of synthesis material. Methods Fifteen rabbits were submitted to fibular osteotomy without any fixation device. Groups of five animals were submitted to pharmacological euthanasia during a period of one (group A, two (group B and four weeks (group C after osteotomy. Histomorphometric evaluation was performed in the histological sections. Results During week one there was intense cellularity (67/field, a large amount of woven bone (75.7% and a small amount of lamellar bone (7.65%. At two weeks there was a decrease in woven bone (41.59% and an increase in lamellar bone (15.16%. At four weeks there was a decrease of cellularity (19.17/field and lamellar bone (55.56% exceeded the quantity of woven bone (31.68%. Conclusion Histomorphometric (quantitative evaluation of the present study was shown to be compatible with bone healing achieved in qualitative experimental models that have been commended in the literature.

  12. Factors that increase external pressure to the fibular head region, but not medial region, during use of a knee-crutch/leg-holder system in the lithotomy position

    Directory of Open Access Journals (Sweden)

    Mizuno J

    2015-02-01

    Full Text Available Ju Mizuno,1 Toru Takahashi2 1Department of Anesthesiology and Pain Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Faculty of Medicine, Juntendo University, Tokyo, Japan; 2Faculty of Health and Welfare Science, Okayama Prefectural University, Soja, Japan Background: Paralysis of the common peroneal nerve is one of the relatively common nerve injuries related to the lithotomy position with the use of a knee-crutch/leg-holder system. Several risk factors have been implicated in lithotomy position-related common peroneal nerve paralysis during operation.Materials and methods: In the present study, 21 young healthy volunteers participated in the investigation of the causes of the paralysis of the common peroneal nerve in the lithotomy position using a knee-crutch/leg-holder; Knee Crutch. We assessed the external pressure applied to the fibular head and medial regions using the Big-Mat pressure-distribution measurement system. Relationships between the peak contact pressure and physical characteristics, such as sex, height, weight, body mass index (BMI, and fibular head circumference, were analyzed.Results: The peak contact pressure to the fibular head region was greater for males than for females. For all subjects, significant positive correlations were observed between the peak contact pressure to the fibular head region and weight, BMI, or fibular head circumference. However, there was no significant difference between the peak contact pressure to the fibular head region and height for any subjects. Moreover, there was no sex-related difference in the peak contact pressure to the fibular medial region, and no significant differences between the peak contact pressure to the fibular medial region and height, weight, BMI, or fibular head circumference.Conclusion: External pressure to the fibular head region is greater for males than for females using a knee-crutch/leg-holder system in the lithotomy position. In addition, the external pressure

  13. Revealing Latent Value of Clinically Acquired CTs of Traumatic Brain Injury Through Multi-Atlas Segmentation in a Retrospective Study of 1,003 with External Cross-Validation.

    Science.gov (United States)

    Plassard, Andrew J; Kelly, Patrick D; Asman, Andrew J; Kang, Hakmook; Patel, Mayur B; Landman, Bennett A

    2015-03-20

    Medical imaging plays a key role in guiding treatment of traumatic brain injury (TBI) and for diagnosing intracranial hemorrhage; most commonly rapid computed tomography (CT) imaging is performed. Outcomes for patients with TBI are variable and difficult to predict upon hospital admission. Quantitative outcome scales (e.g., the Marshall classification) have been proposed to grade TBI severity on CT, but such measures have had relatively low value in staging patients by prognosis. Herein, we examine a cohort of 1,003 subjects admitted for TBI and imaged clinically to identify potential prognostic metrics using a "big data" paradigm. For all patients, a brain scan was segmented with multi-atlas labeling, and intensity/volume/texture features were computed in a localized manner. In a 10-fold cross-validation approach, the explanatory value of the image-derived features is assessed for length of hospital stay (days), discharge disposition (five point scale from death to return home), and the Rancho Los Amigos functional outcome score (Rancho Score). Image-derived features increased the predictive R(2) to 0.38 (from 0.18) for length of stay, to 0.51 (from 0.4) for discharge disposition, and to 0.31 (from 0.16) for Rancho Score (over models consisting only of non-imaging admission metrics, but including positive/negative radiological CT findings). This study demonstrates that high volume retrospective analysis of clinical imaging data can reveal imaging signatures with prognostic value. These targets are suited for follow-up validation and represent targets for future feature selection efforts. Moreover, the increase in prognostic value would improve staging for intervention assessment and provide more reliable guidance for patients.

  14. Computer-assisted orthognathic surgery combined with fibular osteomyocutaneous flap reconstruction to correct facial asymmetry and maxillary defects secondary to maxillectomy in childhood.

    Science.gov (United States)

    Zhang, Lei; Sun, Hao; Yu, Hong-bo; Yuan, Hao; Shen, Guo-fang; Wang, Xu-dong

    2013-05-01

    Maxillectomy in childhood not only causes composite primary defects but also secondary malformation of the middle and lower face. In the case presented, we introduced computer-assisted planning and simulation of orthognathic surgery combined with fibular osteomyocutaneous flap reconstruction to correct complex craniofacial deformities. Virtual orthognathic surgery and maxillary reconstruction surgery were undertaken preoperatively. LeFort I osteotomy, with bilateral sagittal split ramus osteotomy and lower border ostectomy, was performed to correct malocclusion and facial asymmetry. Maxillary reconstruction was accomplished using a fibular osteomyocutaneous flap. The patient recovered uneventfully with an adequate aesthetic appearance on 3D computed tomography. Our experience indicates that orthognathic surgery combined with fibular osteomyocutaneous flap reconstruction can used to correct complex facial asymmetry and maxillary defects secondary to maxillectomy. Computer-assisted simulation enables precise execution of the reconstruction. It shortens the free flap ischemia time and reduces the risks associated with microsurgery.

  15. Fingerprint Segmentation

    OpenAIRE

    Jomaa, Diala

    2009-01-01

    In this thesis, a new algorithm has been proposed to segment the foreground of the fingerprint from the image under consideration. The algorithm uses three features, mean, variance and coherence. Based on these features, a rule system is built to help the algorithm to efficiently segment the image. In addition, the proposed algorithm combine split and merge with modified Otsu. Both enhancements techniques such as Gaussian filter and histogram equalization are applied to enhance and improve th...

  16. Computed tomography-guided implant surgery for dental rehabilitation in mandible reconstructed with a fibular free flap: description of the technique.

    Science.gov (United States)

    De Riu, Giacomo; Meloni, Silvio Mario; Pisano, Milena; Massarelli, Olindo; Tullio, Antonio

    2012-01-01

    The fibular free flap, with or without a cutaneous component, is the gold standard for reconstructing mandibular defects. Dental prosthetic rehabilitation is possible this way, even if the prosthesis-based implant is still a challenge because of the many anatomical and prosthetic problems. We think that complications can be overcome or reduced by adopting the new methods of computed tomography (CT)-assisted implant surgery (NobelGuide, Nobel Biocare AB, Goteborg, Sweden). Here we describe the possibility of using CT-guided implant surgery with a flapless approach and immediate loading in mandibles reconstructed with fibular free flaps.

  17. Delayad Mandibular Reconstruction with Free Fibular Flap Using Rapid Prototype Modeling and Virtual Surgery Designing: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad Abadi

    2016-12-01

    Full Text Available At present, mandibular reconstruction using free fibular flap (FFF is the gold standard to restore esthetic and functional demands after ablative oncological surgery. Mandible complex anatomy creates a great challenge for surgeon to rehabilitate its form and function with a linear fibula bone. In recent year's innovation of 3Dprinter and rapid prototype modelling (RPM has increased these standards and resulted in patient specific reconstruction. Because of requiring delicate technical procedure and manufacturing technology , these methods are not widely used and review of literature shows this case report present the first application of RPM technology for delayed mandibular reconstruction in middle east countries .

  18. Segmentation Using Symmetry Deviation

    DEFF Research Database (Denmark)

    Hollensen, Christian; Højgaard, L.; Specht, L.;

    2011-01-01

    segmentations on manual contours was evaluated using concordance index and sensitivity for the hypopharyngeal patients. The resulting concordance index and sensitivity was compared with the result of using a threshold of 3 SUV using a paired t-test. Results: The anatomical and symmetrical atlas was constructed...... and sensitivity of respectively 0.43±0.15 and 0.56±0.18 was acquired. It was compared to the concordance index of segmentation using absolute threshold of 3 SUV giving respectively 0.41±0.16 and 0.51±0.19 for concordance index and sensitivity yielding p-values of 0.33 and 0.01 for a paired t-test respectively....

  19. [Rare anatomical variation of absence of the sciatic nerve: completely substituted by the tibial and common fibular nerve].

    Science.gov (United States)

    Coelho, Paulo; Melo, Catarina; Bernardes, António

    2013-01-01

    Introdução: Existem várias publicações referindo variantes anatómicas do nervo ciático, algumas associadas a síndromes clínicos (como sendo a síndrome do músculo piriforme). Neste contexto, pretendemos apresentar uma variante anatómica rara do nervo ciático.Casos clínicos: Dois cadáveres leucodérmicos, masculinos, com 74 e 78 anos, falecidos de morte natural, sem patologia do membro inferior. Em ambos os casos, observou-se ausência do nervo ciático direito, tendo os nervos tibial e fibular comum origem e trajecto independentes, desde a sua origem nas raízes lombo-sagradas até à região poplítea. O nervo ciático contralateral apresentava a anatomia habitual.Discussão: Analisando a literatura, na Medline, realçamos que apresentamos dois casos raros de ausência do nervo ciático, com origem e trajecto independentes dos nervos tibial e fibular comum. Esta variante poderá ter implicações clínicas, nomeadamente ser um factor de risco para o insucesso de bloqueios anestésicos poplíteos e para a síndrome do músculo piriforme.

  20. Single time angular deformity correction and treatment of knee instability in congenital fibular hemimelia. A case report.

    Science.gov (United States)

    Figueroa, David; Calvo, Rafael; Villalón, Ignacio E; Schmidt-Hebbel, Andrés; Figueroa, Francisco; Baar, Alejandro

    2012-08-01

    Fibular hemimelia is the most frequently occurring congenital anomaly of long bones. These patients, among other deficiencies, have a poor development of the anterior cruciate ligament (ACL). Unless it causes clinically assessed instability of the knee, nonsurgical treatment is given. When surgical treatment is required, correction of angular limb deformity must be realized prior to ACL reconstruction. We present the case of a 16-year old patient with congenital fibular hemimelia. Physical examination showed genu valgum, anteromedial rotatory instability and recurvatum of the right knee. We decided to perform surgical correction of the angular deformities and ACL reconstruction in the same surgical time. Twelve months after surgery, the patient had no evidence of clinical instability, with a range of motion from -5°-110° of the right knee. No claudication or gait instability was found. The KT-1000 arthrometer showed a difference of 2mm between both knees. The ACL reconstruction and corrective osteotomies of angular deformities performed in a single surgical procedure had a good clinical result in a 12 month follow up-period, restoring stability of the knee and allowing a normal gait cycle. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Clinical study of reconstructing the medial malleolus with free grafting of fibular head composite tendon bone flap

    Institute of Scientific and Technical Information of China (English)

    WU Shui-pei

    2008-01-01

    Objective: To explore new surgical procedure for repairing and reconstructing medial malleolus and soft tissue defect.Methods: According to the size of medial malleolus and composite soft tissue defect, vascular fibular head composite tendon bone flap free grafting using anterior tibial recurrent vessel as the perforating branch was designed to reconstruct the medial malleolar saddle and triangular ligament, and composite back broadest muscle flap free grafting was designed to repair the medical malleolar wound surface. From January 2000 to December 2006, the technique was used in 5 male patients who were injured by machine or in traffic accidents, causing bone and soft tissue defect. The size of wound surface ranged from 19 cm×12 cm to 24 cm×12 cm.Results: The wound surface was healed at the first stage in 4 cases, and the other case had infection and was cured in 6 months with anti infection therapy. Postoperative follow-ups from 6 months to 6 years showed that grafted bones and free cutaneous flaps were healed well, malleolar joints were stable, joint movement was normal, and the appearance was satisfactory. The overall outcome was good.Conclusion: Fibular head composite tendon bone flap free grafting is effective for repairing medical malleolar defect.

  2. Stabilization of mobile mandibular segments in mandibular reconstruction: use of spanning reconstruction plate.

    Science.gov (United States)

    Yap, Yan Lin; Lim, Jane; Ong, Wei Chen; Yeo, Matthew; Lee, Hanjing; Lim, Thiam Chye

    2012-09-01

    The fibular free flap is the gold standard for mandibular reconstruction. Accurate 3-dimensional contouring and precise alignment of the fibula is critical for reestablishing native occlusion and facial symmetry. Following segmental mandibulectomy, the remaining mandibular fragments become freely mobile. Various stabilization methods including external fixation, intermaxillary fixation, and preplating with reconstruction plate have been used. We describe a modification to the preplating technique. After wide resection of buccal squamous cell carcinoma, our patient had an 11-cm mandibular defect from the angle of the left mandible to the right midparasymphyseal region. A single 2.0-mm Unilock® (Synthes, Singapore) plate was used to span the defect. This was placed on the vestibular aspect of the superior border of the mandibular remnants before resection. Segmental mandibulectomy was then performed with the plate removed. The spanning plate was then reattached to provide rigid fixation. The fibular bone was contoured with a single osteotomy and reattached. The conventional technique involves molding of the plate at the inferior border of the mandible. This is time-consuming and not possible in patients with distorted mandibular contour. It is also difficult to fit the osteotomized fibula to the contoured plate. In comparison, the superiorly positioned spanning plate achieve rigid fixation of the mandible while leaving the defect completely free and unhampered by hardware, allowing space for planning osteotomies and easier fixation of the neomandible. Using this modified technique, we are able to recreate the original mandibular profile with ease.

  3. Accuracy of fibular sectioning and insertion into a rapid-prototyped bone plate, for mandibular reconstruction using CAD-CAM technology.

    Science.gov (United States)

    Ciocca, Leonardo; Marchetti, Claudio; Mazzoni, Simona; Baldissara, Paolo; Gatto, Maria Rosaria Antonella; Cipriani, Riccardo; Scotti, Roberto; Tarsitano, Achille

    2015-01-01

    Modern techniques of mandibular reconstruction, such as CAD-CAM technology and rapid prototyping, offer new means by which reconstructive surgery can be planned to optimise aesthetic outcomes and prosthetic rehabilitation. The high degree of accuracy afforded by these approaches is principally attributable to high-precision fibular sectioning and insertion of the bone into a customised bone plate. CAD-CAM mandibular reconstruction procedures using vascularised bone free-flap transfers were performed on 10 patients with benign or malignant neoplasms. Five were not treated with the aid of CAD-CAM technology, and served as the control group. Five were scheduled for maxillofacial surgery using surgical cutting guides and customised bone plates. A generalised linear model for linear measures was used to compare the accuracy of reconstruction between the two groups. A difference, even though not significant, in the lateral shift of the mesial and distal positions of the fibular units was evident between groups. CAD-CAM-generated fibular surgical guides afford improved accuracy when used to restore native anatomy, especially in the context of mandibular arch restoration, and both operating room time and related costs are reduced during fibular sectioning.

  4. Periosteal ossification of the vascular pedicle after reconstruction of continuity defects of the mandible and the maxilla with fibular free flaps: a retrospective study

    NARCIS (Netherlands)

    Karagozoglu, K.H.; Winters, H.A.H.; Forouzanfar, T.; Schulten, E.A.J.M.

    2013-01-01

    Periosteal ossification of the vascular pedicle of a fibular free flap after reconstruction of mandibular and maxillary continuity defects has been thought to be rare. The purpose of this study was to evaluate its incidence and contributory factors to its development.

  5. Periosteal ossification of the vascular pedicle after reconstruction of continuity defects of the mandible and the maxilla with fibular free flaps: a retrospective study.

    Science.gov (United States)

    Karagozoglu, K H; Winters, H A H; Forouzanfar, T; Schulten, E A J M

    2013-12-01

    Periosteal ossification of the vascular pedicle of a fibular free flap after reconstruction of mandibular and maxillary continuity defects has been thought to be rare. The purpose of this study was to evaluate its incidence and contributory factors to its development.

  6. The electrodiagnostic distinctions between chronic familial and acquired demyelinative neuropathies.

    Science.gov (United States)

    Lewis, R A; Sumner, A J

    1982-06-01

    We compared the electrodiagnostic studies of 40 patients with chronic acquired demyelinative neuropathy and 18 patients with familial demyelinative neuropathy. Patients with acquired neuropathy had differential slowing of conduction velocity when distal latencies were compared with more proximal conduction velocities in the same nerve, when equivalent segments of different nerves were compared, and when dispersion of compound motor action potentials was examined. Conduction block was noted in some patients. Patients with familial disease had uniform conduction slowly of all nerve segments, and conduction block was not seen. Chronic acquired demyelinative neuropathy is characterized by multifocal slowing of nerve conduction, whereas familial demyelinative neuropathy is characterized by uniform conduction slowing.

  7. [Segmental neurofibromatosis].

    Science.gov (United States)

    Zulaica, A; Peteiro, C; Pereiro, M; Pereiro Ferreiros, M; Quintas, C; Toribio, J

    1989-01-01

    Four cases of segmental neurofibromatosis (SNF) are reported. It is a rare entity considered to be a localized variant of neurofibromatosis (NF)-Riccardi's type V. Two cases are male and two female. The lesions are located to the head in a patient and the other three cases in the trunk. No family history nor transmission to progeny were manifested. The rest of the organs are undamaged.

  8. Acquired inflammatory demyelinating neuropathies.

    Science.gov (United States)

    Ensrud, E R; Krivickas, L S

    2001-05-01

    The acquired demyelinating neuropathies can be divided into those with an acute onset and course and those with a more chronic course. The acute neuropathies present as Guillain-Barré syndrome and include acute inflammatory demyelinating polyradiculoneuropathy (AIDP), Miller Fisher syndrome, acute motor axonal neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN), and acute pandysautonomia. The chronic neuropathies are collectively known as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and include MADSAM (multifocal acquired demyelinating sensory and motor neuropathy, also know as Lewis-Sumner syndrome) and DADS (distal acquired demyelinating symmetric neuropathy) as variants. The clinical features, pathology, pathogenesis, diagnosis, treatment, rehabilitation, and prognosis of these neuropathies are discussed.

  9. Cisto sinovial intraneural do nervo fibular: relato de caso Intraneural synovial cyst of the peroneal nerve: case report

    Directory of Open Access Journals (Sweden)

    Roberto Sergio Martins

    1997-01-01

    Full Text Available Os autores apresentam um caso de um cisto sinovial intraneural ocorrendo no nervo fibular comum. O paciente apresentou-se com quadro de dor e dificuldade para a flexão dorsal e eversão do pé sendo submetido a exploração cirúrgica com exérese do cisto. Neste estudo são discutidos a patogênese, manifestações clínicas e tratamento desta rara lesão.The authors report the case of an intraneural synovial cyst of the peroneal nerve. The initial symptom was pain and weakness of dorsiflexion and eversion of the right foot. The patient was operated on and the cyst was totally resected. The authors discuss the pathogenesis, clinical diagnosis as well as the treatment of that uncommon lesion.

  10. Modified Grice-Green subtalar arthrodesis performed using a partial fibular graft yields satisfactory results in patients with cerebral palsy.

    Science.gov (United States)

    Güven, Melih; Tokyay, Abbas; Akman, Budak; Encan, Mehmet E; Altintaş, Faik

    2016-03-01

    The aim of this study was to report the experience with the use of a modified Grice-Green technique, which was performed using a partial subperiosteal fibular bone graft because of valgus unstable foot in children with cerebral palsy. Fifteen feet of 11 patients were evaluated on the basis of the appearance of the feet, clinical symptoms, and radiographic measurements. After an average follow-up duration of 24 (9-39) months, all feet showed satisfactory clinical and radiological results. Solid fusion and sustained correction took place in all feet. The gap at the donor site was bridged with new bone in all cases. No donor-site morbidity was detected. This modification of the Grice-Green technique can be used effectively in the correction of planovalgus foot in cerebral palsy.

  11. Congenital pseudoarthrosis of the tibia – results of treatment by free fibular transfer and associated procedures – preliminary study.

    Science.gov (United States)

    Iamaguchi, Raquel B; Fucs, Patricia M M B; Carlos da Costa, Antonio; Chakkour, Ivan; Gomes, Mogar D

    2011-09-01

    We evaluated 16 children with congenital pseudoarthrosis of the tibia treated with contralateral fibular graft, with the aim to report the difficulties and clinical results in the affected limb after consolidation. Sixty-three percent of the children had characteristics of neurofibromatosis. Consolidation was achieved after the main surgery in 37%of patients, and the remainder, after multiple procedures. Consolidation time was longer for male patients. Refracture was observed in six patients and recurrence of the anterior bowing in six; four of these patients were submitted to correction. Four patients presented femur overgrowth. The average shortening of the affected leg was 3.6 cm. The proposed procedure leads to a long treatment course with many reoperations for correction of possible complications.

  12. ANATOMÍA QUIRÚRGICA DEL COLGAJO OSTEOCUTÁNEO DE PERONÉ Y SU APLICACIÓN EN RECONSTRUCCIÓN MANDIBULAR. SURGICAL ANATOMY OF THE FIBULAR OSTEOCUTANEOUS FREE FLAP IN MANDIBULAR RECONSTRUCTION

    OpenAIRE

    Juan J. Larrañaga; Luis E. Criado del Rio

    2010-01-01

    Introduction: The mandibular reconstruction is a permanent challenge as the restoration of many functions depends on it. Multiple techniques and materials have been used and, at the present, the fibular free flap is the goal standard reconstructive treatment. Objective: We studied the characteristics of the fibular flap applied to the mandibular reconstruction. Material and method: We performed a total of 18 microsurgical fibula free flap between January 2006 and April 2009; 50% of them were ...

  13. Mixed segmentation

    DEFF Research Database (Denmark)

    Bonde, Anders; Aagaard, Morten; Hansen, Allan Grutt

    This book is about using recent developments in the fields of data analytics and data visualization to frame new ways of identifying target groups in media communication. Based on a mixed-methods approach, the authors combine psychophysiological monitoring (galvanic skin response) with textual...... content analysis and audience segmentation in a single-source perspective. The aim is to explain and understand target groups in relation to, on the one hand, emotional response to commercials or other forms of audio-visual communication and, on the other hand, living preferences and personality traits...

  14. Hospital-acquired pneumonia

    Science.gov (United States)

    ... tends to be more serious than other lung infections because: People in the hospital are often very sick and cannot fight off ... prevent pneumonia. Most hospitals have programs to prevent hospital-acquired infections.

  15. Acquired Cutix Laxa

    Directory of Open Access Journals (Sweden)

    Jaswal Ritu

    1999-01-01

    Full Text Available A case of acquired cutis laxa in a male is reported. The skin became loose and started hanging in folds after the patient received therapy for piles. Relevant literature is reviewed.

  16. Acquired color vision deficiency.

    Science.gov (United States)

    Simunovic, Matthew P

    2016-01-01

    Acquired color vision deficiency occurs as the result of ocular, neurologic, or systemic disease. A wide array of conditions may affect color vision, ranging from diseases of the ocular media through to pathology of the visual cortex. Traditionally, acquired color vision deficiency is considered a separate entity from congenital color vision deficiency, although emerging clinical and molecular genetic data would suggest a degree of overlap. We review the pathophysiology of acquired color vision deficiency, the data on its prevalence, theories for the preponderance of acquired S-mechanism (or tritan) deficiency, and discuss tests of color vision. We also briefly review the types of color vision deficiencies encountered in ocular disease, with an emphasis placed on larger or more detailed clinical investigations.

  17. Consistency between emergency department and orthopedic physicians in the diagnosis and treatment of distal fibular Salter Harris I fractures.

    Science.gov (United States)

    Zomorrodi, Arezoo; Bennett, Jonathan Eric; Attia, Magdy William; Loiselle, John; Rogers, Kenneth John; Kruse, Richard

    2011-04-01

    The objective was to determine diagnostic and management differences between emergency physicians (EPs) and orthopedic physicians (OPs) for patients with distal fibular physis pain without radiographic fracture. Records from patients with emergency department ankle radiographs between January 2006 and March 2008 were reviewed. Inclusion criteria included trauma, fibular physis pain, normal radiographs, and orthopedic follow-up. Of 1343 patients, 247 met criteria. Emergency physician diagnoses included Salter Harris (SH) I fracture 198 (80%), sprain 5 (2%), other fracture 24 (10%), or other injury 20 (8%). Orthopedic physician diagnoses included SH I fracture 136 (55%), sprain 48 (19%), other fracture 56 (23%), or other injury 7 (3%). Emergency physicians were more likely to diagnose SH I fracture (P = 0.01). Thirty-six patients diagnosed with SH I fracture by EPs were diagnosed by OPs with different fractures, whereas 40 had sprains and 5 had other injuries. A total of 173 (70%) patients were diagnosed with fractures by both EPs and OPs. On the basis of orthopedists diagnosis, EPs did not diagnose 19 (8%) fractures (P = 0.8). EP treatment included splint 157 (64%), boot 82 (33%), air cast 3 (1%), or cast 5 (2%). Orthopedic physician's treatment included splint 2 (1%), boot 46 (19%), air cast 11 (4%), cast 167 (67%), or none 21 (9%). Although EPs diagnosed SH I fracture more frequently than OPs, few fractures were missed. Most patients required ongoing immobilization by OPs regardless of final diagnosis. Suspected SH I fractures should be immobilized and referred for orthopedic evaluation. Copyright © 2011 by Lippincott Williams & Wilkins

  18. [The Grice-Green subtalar arthrodesis using a fibular bone graft--follow-up of 92 patients].

    Science.gov (United States)

    Bollmann, C; Franz, A; Raabe, J

    2015-02-01

    The Grice-Green subtalar arthrodesis is considered to be a valid treatment option of severe pes planovalgus deformity especially in children with cerebral palsy. The purpose of this study was to evaluate long term results using Grice-Green procedure with a fibular bone graft. Between 3/07 and 11/12 92 patients (36 girls, 56 boys) with 127 feet underwent surgery. The average age of patients was 12.3 years (5-21 years). 68 patients had infantile cerebral palsy, 17 patients suffered from other neuromuscular diseases and 7 had idiopathic pes planovalgus deformities. The preoperative and postoperative radiographs with full weight bearing in the frontal and lateral planes were analysed. The mean follow-up was 22.6 months (6-64 months). In addition to that, 23 of the 92 patients (13 girls, 10 boys) were reviewed preoperatively, in the first year after operation and after more than 24 months. The mean lateral talocalcanear angle was reduced from 49.52 to 31.49°. The calcaneal pitch angle changed from 2.95 to 7.55°. The mean lateral talo-first-metatarsal angle improved from -36.98 to -12.32°. The mean frontal talo-first-metatarsal-base-angle increased from -28.48 to -2.64° and the TMT index from -66.46 to -14.96°. All measured angles changed significantly (p  0.05). Eight feet were not corrected completely, three feet were overcorrected. In one case the fibular graft was reabsorbed. There were degenerative changes of the talus in three cases. 14 feet developed a dorsal bunion with extension deformity of the first metatarsal bone. The Grice-Green subtalar arthrodesis improves foot alignment and can achieve a significant correction also in long-term follow-up. Georg Thieme Verlag KG Stuttgart · New York.

  19. Laboratory-acquired brucellosis

    DEFF Research Database (Denmark)

    Fabiansen, C.; Knudsen, J.D.; Lebech, A.M.

    2008-01-01

    Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9......Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9...

  20. The Envisat-1 ground segment

    Science.gov (United States)

    Harris, Ray; Ashton, Martin

    1995-03-01

    The European Space Agency (ESA) Earth Remote Sensing Satellite (ERS-1 and ERS-2) missions will be followed by the Polar Orbit Earth Mission (POEM) program. The first of the POEM missions will be Envisat-1. ESA has completed the design phase of the ground segment. This paper presents the main elements of that design. The main part of this paper is an overview of the Payload Data Segment (PDS) which is the core of the Envisat-1 ground segment, followed by two further sections which describe in more detail the facilities to be offered by the PDS for archiving and for user servcies. A further section describes some future issues for ground segment development. Logica was the prime contractor of a team of 18 companies which undertook the ESA financed architectural design study of the Envisat-1 ground segment. The outputs of the study included detailed specifications of the components that will acquire, process, archive and disseminate the payload data, together with the functional designs of the flight operations and user data segments.

  1. Segmented blockcopolymers with uniform amide segments

    NARCIS (Netherlands)

    Husken, D.; Krijgsman, J.; Gaymans, R.J.

    2004-01-01

    Segmented blockcopolymers based on poly(tetramethylene oxide) (PTMO) soft segments and uniform crystallisable tetra-amide segments (TxTxT) are made via polycondensation. The PTMO soft segments, with a molecular weight of 1000 g/mol, are extended with terephthalic groups to a molecular weight of 6000

  2. A case of nonisland pedicled foot fillet flap for below-knee amputation stump wound: treatment option for compartment syndrome after fibular free flap surgery.

    Science.gov (United States)

    Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2014-02-01

    Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. An extensive chronic leg wound resulted, which was treated with multiple debridements and finally with below-knee amputation. Successful coverage of the below-knee amputation stump was accomplished with a nonisland pedicled foot fillet flap. Various foot fillet flaps may be used acutely as a free or an island pedicled flap, but dissection of the vascular pedicle may be difficult in a chronically inflamed wound because of inflammation and adhesions to surrounding tissue. The nonisland pedicled foot fillet flap may be considered as a useful option for treatment of a chronically inflamed stump wound after below-knee amputation.

  3. Assessment of quality of life and sociocultural aspects in patients with ameloblastoma after immediate mandibular reconstruction with a fibular free flap.

    Science.gov (United States)

    Zhu, Juanfang; Yang, Yanjie; Li, Wenlu

    2014-02-01

    Our aim was to evaluate the quality of life (QoL) in patients with ameloblastoma who had been treated by immediate mandibular reconstruction with a fibular free flap, and to analyse the association between QoL and their sociocultural and medical characteristics. We assessed the QoL outcomes of 33/45 patients using the University of Washington quality of life (UW-QoL) questionnaire and the 14-item Oral Health Impact Profile (OHIP-14). Thirty-three of the 45 questionnaires were returned (73%). In the UW-QoL the best-scoring domain was "shoulder", whereas the lowest scores were for "chewing" and "activity". In the OHIP-14 the lowest-scoring domain was "handicap", followed by "social disability" and "psychological discomfort". Mandibular reconstruction with a fibular free flap significantly influenced the patients' QoL and oral function. Their sociocultural data showed that most patients had a fairly low level of education.

  4. Acquired smooth muscle hamartoma

    Directory of Open Access Journals (Sweden)

    Bari Arfan ul

    2006-01-01

    Full Text Available Smooth muscle hamartoma is an uncommon, usually congenital, cutaneous hyperplasia of the arrectores pilorum muscles. When it is acquired, it may be confused with Becker′s nevus. We report a case of this rare tumor in a 19-year-old man. The disease started several years ago as multiple small skin-colored papules that subsequently coalesced to form a large soft plaque on the back of the left shoulder. The diagnosis of acquired smooth muscle hamartoma was confirmed on histopathology. The patient was reassured about the benign nature of the lesion and was not advised any treatment.

  5. Effect of Combined Fibular Osteotomy on the Pressure of the Tibiotalar and Talofibular Joints in Supramalleolar Osteotomy of the Ankle: A Cadaveric Study.

    Science.gov (United States)

    Choi, Gi Won; Lee, Soon Hyuck; Nha, Kyung Wook; Lee, Sung Jae; Kim, Won Hyeon; Uhm, Chang-Sub

    We investigated the effect of combined fibular osteotomy on the pressure of the tibiotalar and talofibular joints in medial opening-wedge supramalleolar osteotomy. Three different tibial osteotomy gaps (6, 8, and 10 mm) were created in 10 cadaveric models, and the pressure in the tibiotalar and talofibular joints was measured under axial load before and after fibular osteotomy. The heel alignment angle and talar translation ratio were evaluated radiographically. An increase in osteotomy gap led to increases in hindfoot valgus (p = .001) and the contact and peak pressures in the talofibular joint (p = .03 and p = .004). In contrast, the contact and peak pressures in the tibiotalar joint were unchanged with an increasing osteotomy gap (p = .52 and p = .76). Fibular osteotomy reduced the contact and peak pressures in the talofibular joint (p osteotomy might be necessary in supramalleolar osteotomy for medial ankle arthritis to minimize the increase in pressure in the talofibular joint, especially when the osteotomy gap is large. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Strengthening fibular muscle for children's congenital pes equinovarus%加强腓骨肌治疗小儿先天性马蹄内翻足

    Institute of Scientific and Technical Information of China (English)

    高书林; 唐伟椿; 白德明

    2001-01-01

    目的介绍一种解决先天性马蹄内翻足肌力不平衡的手术方法和效果。方法在行足后内侧软组织松解术时,将长屈肌与腓骨长肌吻合,加强腓侧肌力。结果随访23足,22足外观满意。其中2足踝关节活动受限,1足畸形完全复发。结论畸形复发是由于腓骨肌持续无力造成的。加强腓侧肌的力量是治疗先天性马蹄内翻足的有效手术方式。%Objective To introduce a surgical treatment for muscular imbalance in congenital talipes equinovarus and its effects. Method Musculus flexor hallucis longus with musculus peroneus longus were anastomosed to strengthen fibular muscle producing posterointernal lysis for clubfoot. Results Among following up 23 feet , appearances of 22 feet were satisfactory, two feet of which were limited in motion of ankle joint, and one foot was relapsed. Conclusion Deformity recurrence results from persistent asthenia of fibular muscles. Strengthening fibular muscle is one of the effective surgical treatments for congenital talipes equinovarus.

  7. Learning to Acquire

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2015-01-01

    This paper develops a knowledge-based model of information systems (IS) integration in acquisition-based growth programs. Previous research has found important differences in the acquirers’ abilities for acquisition IS integration, and that these differences play key roles in explaining the econo...... are therefore persistent and hard to overcome for the inexperienced acquirer....

  8. Acquired cutis laxa

    Directory of Open Access Journals (Sweden)

    Musaliar S

    2003-03-01

    Full Text Available A 13-yeat-old male patient born of non consanguineous marriage with history of recurrent urticaria and angioedema for the past 2 years presented with wrinkling and laxity of the skin over the face, axilla and abdomen. Histopathology was consistent with cutis laxa. We are reporting a rare case of acquired cutis laxa due to recurrent urticaria.

  9. Acquired cutis laxa

    Directory of Open Access Journals (Sweden)

    Musaliar S

    2003-01-01

    Full Text Available A 13-yeat-old male patient born of non consanguineous marriage with history of recurrent urticaria and angioedema for the past 2 years presented with wrinkling and laxity of the skin over the face, axilla and abdomen. Histopathology was consistent with cutis laxa. We are reporting a rare case of acquired cutis laxa due to recurrent urticaria.

  10. Iris image segmentation based on phase congruency

    Science.gov (United States)

    Gao, Chao; Jiang, Da-Qin; Guo, Yong-Cai

    2006-09-01

    Iris image segmentation is very important for an iris recognition system. There are always iris noises as eyelash, eyelid, reflection and pupil in iris images. The paper proposes a virtual method of segmentation. By locating and normalizing iris images with Gabor filter, we can acquire information of image texture in a series of frequencies and orientations. Iris noise regions are determined based on phase congruency by a group of Gabor filters whose kernels are suitable for edge detection. These regions are filled according to the characteristics of iris noise. The experimental results show that the proposed method can segment iris images effectively.

  11. Iris image Segmentation Based on Phase Congruency

    Institute of Scientific and Technical Information of China (English)

    GAO Chao; JIANG Da-qin; Guo Yong-cai

    2006-01-01

    @@ Iris image segmentation is very important for an iris recognition system.There are always iris noises as eyelash,eyelid,reflection and pupil in iris images.The paper proposes a virtual method of segmentation.By locating and normalizing iris images with Gabor filter,we can acquire information of image texture in a series of frequencies and orientations.Iris noise regions are determined based on phase congruency by a group of Gabor filters whose kernels are suitable for edge detection.These regions are filled according to the characteristics of iris noise.The experimental results show that the proposed method can segment iris images effectively.

  12. Acquired methemoglobinemia in infants

    Directory of Open Access Journals (Sweden)

    Mehmet Mutlu

    2011-06-01

    Full Text Available Objective: This study aimed to determine the etiologic factors of acquired methemoglobinemia in infants younger than three months in our region. Material and Methods: This study was carried out retrospectively in infants with methemoglobinemia admitted to Karadeniz Technical University, Pediatric Clinic, during the period 2000-2009. Infants with methemoglobinemia were identified according to the medical records or ICD-10 code. Results: Nine infants with acquired methemoglobinemia (8 male, 1 female were included in the study. Seven cases were associated with the use of prilocaine for circumcision, one case with the use of prilocaine-lidocaine for local pain therapy, and one case with neonatal sepsis caused by Staphylococcus aureus.Conclusion: Prilocaine should not be used in infants less than three months of age because of the risk of methemoglobinemia. Ascorbic acid is an effective therapy if methylene blue is not obtained. It should not be forgotten that sepsis caused by S. aureus may cause methemoglobinemia in infants.

  13. Racks to acquire

    CERN Multimedia

    2004-01-01

    IT department has 25 80cm deep SCHROFF 19" racks which are no longer needed. Please contact Michel Blanc (Michel.Blanc@cern.ch, 74925 or 163223) from Monday 27th September if you are interested in acquiring some or all of these racks. Five shelf units suitable for housing up to 44 mini-tower PCs are also available. Photographs of racks and shelf units are available in the directory \\\\cern.ch\\dfs\\users\\t\\tim\\Public\\513.

  14. Acquired hypertrichosis lanuginosa

    Directory of Open Access Journals (Sweden)

    Kumar Pramod

    1993-01-01

    Full Text Available Acquired hypertirichosis lanuginose developed rapidly in a patient with no detectable malignancy. Soft, fine, downy hair growth was noticed on the face, ears, limbs and trunk. Bilaterally symmetrical vitiliginous macules were present on the ear and preauricular region. This case is reported because of its rarity, absence of any detectable malignancy and development of vitiligo, which to our knowledge has not been reported earlier.

  15. Method to acquire regions of fruit, branch and leaf from image of red apple in orchard

    Science.gov (United States)

    Lv, Jidong; Xu, Liming

    2017-07-01

    This work proposed a method to acquire regions of fruit, branch and leaf from red apple image in orchard. To acquire fruit image, R-G image was extracted from the RGB image for corrosive working, hole filling, subregion removal, expansive working and opening operation in order. Finally, fruit image was acquired by threshold segmentation. To acquire leaf image, fruit image was subtracted from RGB image before extracting 2G-R-B image. Then, leaf image was acquired by subregion removal and threshold segmentation. To acquire branch image, dynamic threshold segmentation was conducted in the R-G image. Then, the segmented image was added to fruit image to acquire adding fruit image which was subtracted from RGB image with leaf image. Finally, branch image was acquired by opening operation, subregion removal and threshold segmentation after extracting the R-G image from the subtracting image. Compared with previous methods, more complete image of fruit, leaf and branch can be acquired from red apple image with this method.

  16. Acquired versus familial demyelinative neuropathies in children.

    Science.gov (United States)

    Miller, R G; Gutmann, L; Lewis, R A; Sumner, A J

    1985-01-01

    The electrophysiologic differences between chronic acquired demyelinative neuropathy and the demyelinative form of Charcot-Marie-Tooth disease have recently been reported. The present report extends these observations to include the genetically determined demyelinating neuropathies seen in metachromatic leukodystrophy, Krabbe's leukodystrophy, and Cockayne's syndrome. The electrophysiologic features of metachromatic leukodystrophy (five patients), Krabbe's (four patients), and Cockayne's syndrome (three patients) were all similar. There was uniform slowing of conduction (both in different nerves and in different nerve segments), and conduction block was not seen. These findings are consistent with a uniform degree of demyelination in multiple nerves and throughout the entire length of individual axons. Thus, uniform slowing of nerve conduction constitutes strong evidence for a familial demyelinative neuropathy, as opposed to the multifocal slowing seen in acute and chronic acquired demyelinative neuropathy.

  17. Strategic market segmentation

    National Research Council Canada - National Science Library

    Maričić Branko R; Đorđević Aleksandar

    2015-01-01

    ..., requires segmented approach to the market that appreciates differences in expectations and preferences of customers. One of significant activities in strategic planning of marketing activities is market segmentation...

  18. Management of venous thrombosis in fibular free osseomusculocutaneous flaps used for mandibular reconstruction: clinical techniques and treatment considerations

    Directory of Open Access Journals (Sweden)

    Draenert Florian G

    2010-06-01

    Full Text Available Abstract Background Mandibular reconstruction by means of fibula transplants is the standard therapy for severe bone loss after subtotal mandibulectomy. Venous failure still represents the most common complication in free flap surgery. We present the injection of heparine into the arterial pedicle as modification of the revising both anastomoses in these cases and illustrate the application with a clinical case example. Methods Methods consist of immediate revision surgery with clot removal, heparin perfusion by direct injection in the arterial vessel of the pedicle, subsequent high dose low-molecular weight heparin therapy, and leeches. After 6 hours postoperatively, images of early flap recovery show first sings of recovery by fading livid skin color. Results The application of this technique in a patient with venous thrombosis resulted in the complete recovery of the flap 60 hours postoperatively. Other cases achieved similar success without additional lysis Therapy or revision of the arterial anastomosis. Conclusion Rescue of fibular flaps is possible even in patients with massive thrombosis if surgical revision is done quickly.

  19. Fibular dimelia and mirror polydactyly of the foot in a girl presenting additional features of the VACTERL association

    Directory of Open Access Journals (Sweden)

    Pricila Bernardi

    Full Text Available CONTEXT: The association between fibular dimelia and mirror polydactyly of the foot is considered to be a very rare lower-limb abnormality. On the other hand, VACTERL is an acronym for a nonrandom association of congenital anomalies for which the etiology is still poorly understood. CASE REPORT: The patient was a seven-month-old white girl whose mother had used misoprostol in the second month of pregnancy to induce abortion. On clinical evaluation, she was small for her age and presented hypotonia, anteverted nares, long philtrum and carp-like mouth. Her left hand had a reduction defect, with absence of the extremities of the second, third and fifth fingers and camptodactyly of the fourth finger. The ipsilateral lower limb presented significant shortening, especially rhizomelic shortening. Her left foot had a mirror configuration with seven toes and no identifiable hallux. The pelvis was hypoplastic. Esophageal atresia with tracheoesophageal fistula and imperforate anus were detected during the neonatal period. Abdominal ultrasound identified agenesis of the right kidney and left pyelocaliceal duplication. Radiographic evaluation on the left side showed iliac and femoral hypoplasia, absence of the tibia with a duplicated fibula and seven metatarsals and toes with no identifiable hallux on the foot. Echocardiography demonstrated an atrial septal defect. Based on the literature, we believe that the spectrum of malformations presented by our patient may be related to the vascular disruptive effect of the misoprostol. However, we cannot rule out the possibility that this association might simply be a coincidence.

  20. The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects

    Directory of Open Access Journals (Sweden)

    Nicki Zelenski

    2013-01-01

    Full Text Available Skeletal reconstruction after large tumor resection is challenging. The free vascularized fibular graft (FVFG offers the potential for rapid autograft incorporation as well as growing physeal transfer in pediatric patients. We retrospectively reviewed eleven pediatric patients treated with FVFG reconstructions of the upper extremity after tumor resection. Eight male and three female patients were identified, including four who underwent epiphyseal transfer. All eleven patients retained a functional salvaged limb. Nonunion and graft fracture were the most common complications relating to graft site (27%. Peroneal nerve palsy occurred in 4/11 patients, all of whom received epiphyseal transfer. Patients receiving epiphyseal transplant had a mean annual growth of 1.7 cm/year. Mean graft hypertrophy index increased by more than 10% in all cases. Although a high complication rate may be anticipated, the free vascularized fibula may be used to reconstruct large skeletal defects in the pediatric upper extremity after oncologic resection. Transferring the vascularized physis is a viable option when longitudinal growth is desired.

  1. Hydatid disease of scapula and upper third of humerus treated by en bloc excision and fibular bone grafting

    Directory of Open Access Journals (Sweden)

    Chari P

    2007-01-01

    Full Text Available 35-year-old male patient presented with gradually increasing painful swelling of the right shoulder, which was incised and drained and wound persisted as a discharging sinus on the anterolateral aspect of the deltoid region with seropurulent discharge. A clinical diagnosis of tuberculosis of the shoulder was made. Plain skiagram of the right shoulder revealed multicystic lesion involving the entire scapula and upper third of the humerus with loss of joint space and pathological fracture at the junction of upper one-third and lower two-thirds of the humerus. A clinico-radiological diagnosis of hydatid disease was made. In view of the extensive involvement of the scapula with stiff shoulder and an active sinus, a two-stage surgical procedure was performed. Stage 1 consisted of en bloc excision of the scapula, upper half of the humerus and lateral end of the clavicle. Stage II surgery, consisting of fibular bone grafting. Tablet albendazole (400 mg, thrice daily was given as systemic scolicidal agent. This case is reported in view of it′s rarity and to highlight the management.

  2. Electrophysiologic response recorded in the first dorsal interosseous muscle with stimulation of the tibial and deep fibular nerves.

    Science.gov (United States)

    Galloway, Kathleen M; Greathouse, David G; Olson, Ronald; Tracy, Mary

    2004-05-01

    Foot intrinsic muscle innervation may demonstrate some variability. The first dorsal interosseous muscle (FDI) is innervated by the deep branch of the lateral plantar nerve (LPN) from the main trunk of the tibial nerve. Contribution from the deep fibular nerve (DFN) may also play a role in the supply of the FDI. Thirty healthy adult volunteers were studied to determine the presence and type of response in the FDI with stimulation of the tibial nerve/deep branch of the LPN and DFN. Both nerves were stimulated at the ankle and knee with a surface and needle recording from the FDI. Latency, amplitude, and conduction values were recorded for each nerve. The incidence of DFN supply to the FDI was 16.6% with a mean ankle amplitude of 152 microV. The incidence of tibial nerve/deep branch of the LPN supply to the FDI was 100%, with a mean ankle amplitude of 5.11 mV. The superficial branch of the LPN is most often studied when evaluating for tarsal tunnel syndrome because the standard recording site is the abductor digiti minimi (ADM). Recording from the ADM, however, frequently produces a less than desirable waveform, and the technical challenges encountered with this site make tarsal tunnel syndrome assessment difficult. It is also possible that selective involvement of the deep branch of the LPN may occur, and if so, recording from the FDI may prove valuable. Copyright 2004 Wiley-Liss, Inc.

  3. Acquired hyperostosis syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Dihlmann, W.; Hering, L.; Bargon, G.W.

    1988-10-01

    Sterno-costo-clavicular hyperostosis (SCCH) is the most common manifestation of a syndrome, consisting of increased bone metabolism, mostly new bone formation and heterotopic ossification of fibrous tissue, which we have characterised as the acquired hyperostosis syndrome. In part I we discuss the terminology, radiological appearances, scintigraphy, clinical and laboratory findings, bacteriology, histology, nosology, complications, treatment and differential diagnosis of SCCH. Chronic recurrent multifocal osteomyelitis (CRMO) is regarded as a phaenotype of SCCH, depending on the age. CRMO occurs in children, adolescents and young adults, SCCH predominantly in middleaged and elderly adults.

  4. Acquired von Willebrand Syndrome

    Institute of Scientific and Technical Information of China (English)

    郭涛

    2005-01-01

    @@ Acquired von Willebrand syndrome (AvWS) is kind of bleeding disorder with laboratory findings similar to those in congenital yon Willebrand disease (vWD).AvWS doesn's have any personal or family history of bleeding, but is associated with certain diseases or abnormal conditions or drugs. Although AvWS is being stated as a rare disease, it has gained more and more attention during the past years. Not because of the severity of the disease, but it is more common than we thought and most patients don' t have a proper diagnosis.

  5. "Ready to Acquire"

    DEFF Research Database (Denmark)

    Yetton, Philip; Henningsson, Stefan; Bjørn-Andersen, Niels

    2013-01-01

    This article describes the experiences of Danisco (a global food ingredients company) as it followed a growth-by-acquisition business strategy, focusing on how a new CIO built the IT resources to ensure the IT organization was "ready to acquire." We illustrate how these IT capabilities expedited...... the IT integration following two acquisitions, one of which involved Danisco expanding the scale of its business and the other extending the scope. Based on insights gained from Danisco, we provide lessons for CIOs to realize business benefits when managing post-acquisition IT integration....

  6. Polyp Segmentation in NBI Colonoscopy

    Science.gov (United States)

    Gross, Sebastian; Kennel, Manuel; Stehle, Thomas; Wulff, Jonas; Tischendorf, Jens; Trautwein, Christian; Aach, Til

    Endoscopic screening of the colon (colonoscopy) is performed to prevent cancer and to support therapy. During intervention colon polyps are located, inspected and, if need be, removed by the investigator. We propose a segmentation algorithm as a part of an automatic polyp classification system for colonoscopic Narrow-Band images. Our approach includes multi-scale filtering for noise reduction, suppression of small blood vessels, and enhancement of major edges. Results of the subsequent edge detection are compared to a set of elliptic templates and evaluated. We validated our algorithm on our polyp database with images acquired during routine colonoscopic examinations. The presented results show the reliable segmentation performance of our method and its robustness to image variations.

  7. Learning-by-Being-Acquired

    DEFF Research Database (Denmark)

    Colombo, Massimo Gaetano; Moreira, Solon; Rabbiosi, Larissa

    2016-01-01

    of new teams with both inventors of the acquiring and acquired firms-and assess the impact of this integration action in the period that immediately follows the acquisition. Drawing on social identity and self-categorization theories, we argue that R&D team reorganization increases the acquired inventors......’ use of the prior stock of technological knowledge of the acquiring firm after the acquisition. Furthermore, this effect is enhanced if the focal acquired inventor has high relative innovation ability but is weakened for acquired inventors with high ingroup collaborative strength. We construct a sample...

  8. Learning-By-Being-Acquired

    DEFF Research Database (Denmark)

    Colombo, Massimo G.; Moreira, Solon; Rabbiosi, Larissa

    In this paper we study post-acquisition integration in terms of R&D team reorganization—i.e., the creation of new teams with both inventors of the acquiring and acquired firms—and assess its impact on knowledge transfer in the period that follows the acquisition. Drawing on social identity and self......-categorization theories, we argue that R&D team reorganization increases the acquired inventors’ use of the prior stock of technological knowledge of the acquiring firm after the acquisition. Furthermore, this effect is enhanced if acquired inventors have higher innovation ability relative to their acquiring peers...

  9. Segmentation Similarity and Agreement

    CERN Document Server

    Fournier, Chris

    2012-01-01

    We propose a new segmentation evaluation metric, called segmentation similarity (S), that quantifies the similarity between two segmentations as the proportion of boundaries that are not transformed when comparing them using edit distance, essentially using edit distance as a penalty function and scaling penalties by segmentation size. We propose several adapted inter-annotator agreement coefficients which use S that are suitable for segmentation. We show that S is configurable enough to suit a wide variety of segmentation evaluations, and is an improvement upon the state of the art. We also propose using inter-annotator agreement coefficients to evaluate automatic segmenters in terms of human performance.

  10. Spinal cord grey matter segmentation challenge.

    Science.gov (United States)

    Prados, Ferran; Ashburner, John; Blaiotta, Claudia; Brosch, Tom; Carballido-Gamio, Julio; Cardoso, Manuel Jorge; Conrad, Benjamin N; Datta, Esha; Dávid, Gergely; Leener, Benjamin De; Dupont, Sara M; Freund, Patrick; Wheeler-Kingshott, Claudia A M Gandini; Grussu, Francesco; Henry, Roland; Landman, Bennett A; Ljungberg, Emil; Lyttle, Bailey; Ourselin, Sebastien; Papinutto, Nico; Saporito, Salvatore; Schlaeger, Regina; Smith, Seth A; Summers, Paul; Tam, Roger; Yiannakas, Marios C; Zhu, Alyssa; Cohen-Adad, Julien

    2017-03-07

    An important image processing step in spinal cord magnetic resonance imaging is the ability to reliably and accurately segment grey and white matter for tissue specific analysis. There are several semi- or fully-automated segmentation methods for cervical cord cross-sectional area measurement with an excellent performance close or equal to the manual segmentation. However, grey matter segmentation is still challenging due to small cross-sectional size and shape, and active research is being conducted by several groups around the world in this field. Therefore a grey matter spinal cord segmentation challenge was organised to test different capabilities of various methods using the same multi-centre and multi-vendor dataset acquired with distinct 3D gradient-echo sequences. This challenge aimed to characterize the state-of-the-art in the field as well as identifying new opportunities for future improvements. Six different spinal cord grey matter segmentation methods developed independently by various research groups across the world and their performance were compared to manual segmentation outcomes, the present gold-standard. All algorithms provided good overall results for detecting the grey matter butterfly, albeit with variable performance in certain quality-of-segmentation metrics. The data have been made publicly available and the challenge web site remains open to new submissions. No modifications were introduced to any of the presented methods as a result of this challenge for the purposes of this publication.

  11. Clinical outcome of en-block resection and reconstruction with nonvascularized fibular autograft for the treatment of giant cell tumor of distal radius

    Directory of Open Access Journals (Sweden)

    Mohammad H Taraz-Jamshidi

    2014-01-01

    Full Text Available Background: Although giant cell tumor (GCT is considered to be a primary benign bone tumor, its aggressive behavior makes its diagnosis and treatment, difficult and challenging. This is especially true in distal radius where GCT appears to be more aggressive and difficult to control locally. We report our clinical outcome of en-block resection and reconstruction with non-vascularized fibular autograft in 15 patients with distal radius GCT. Materials and Methods: We retrospectively reviewed 15 patients with GCT (Grade 2 and 3 of distal radius who were treated with en-block resection and non-vascularized fibular autograft. Five of 15 were recurrent GCT treated initially with extended curettage; local adjuvant therapy and filling the cavity with cement or bone graft. We followed the patients for mean 7.2 years post operation (range: 4-11 years. Patients were evaluated post operation with clinical examination, plain radiography of distal radius and chest X-ray and/or computed tomography scan. Furthermore pain, function, range of motion and grip strength of the affected limb were evaluated and mMayo wrist score was assessed. Results: A total of 11 patients were women and 4 were men. Mean age of patients was 29 years (range: 19-48. We had no lung metastasis and bony recurrence occurred in one patient (6.6%. Nearly 53.3% of patients had excellent or good functional wrist score, 80% of the patients were free of pain or had only occasional pain and 80% of patients returned to work. Mean range of motion of the wrist was 77° of flexion-extension and mean grip strength was 70% of the normal hand. Conclusion: En-block resection of distal radius GCT and reconstruction with non-vascularized fibular autograft is an effective technique for treatment in local control of the tumor and preserving function of the limb.

  12. 咬合导板及颌间牵引钉技术在游离腓骨瓣修复下颌骨缺损中的应用%APPLICATION OF OCCLUSAL GUIDE PLATE COMBINED WITH INTERMAXILLARY FIXATION SCREW IN MANDIBULAR DEFECT REPAIR WITH FREE FIBULAR FLAP

    Institute of Scientific and Technical Information of China (English)

    杨志诚; 向旭; 严颖彬; 史平; 王超

    2013-01-01

    Objective To investigate the clinical value of occlusal guide plate combined with intermaxillary fixation screw in mandibular defect repair with free fibular flap. Methods Between August and December 2011, 7 patients with mandibular tumor were treated, including 5 cases of ameloblastoma and 2 cases of gingival cancer. Of 7 patients, 4 were males and 3 were females, aged 32-65 years (median, 50 years). Occlusal guide plate was prepared and the implanted position of intermaxillary fixation screws was determined preoperatively. Hemimandibulectomy was performed in 5 cases, half mandibular segmental resection with condyle reservation in the other 2 cases. The free fibular flaps of 11-13 cm in length were harvested for repairing mandibular defects. When the free fibular flaps were fixed, the occlusal guide plate and intermaxillary fixation screws were utilized to restorate the occlusal relation. The donor site was sutured directly. Results The average operation time was 9.5 hours (range, 7-12 hours). All free fibular flaps survived completely. All incisions at the donor site and recipient site healed by first intention. All patients were followed up 10-14 months with an average of 12.3 months. All patients had symmetrical face, good occlusal relation, normal mouth opening, and normal mandibular lateral movement, and no pain of bilateral temporomandibular joints occurred. Panoramic tomography showed good mandibular contour and the suitable emplacement of fibular flaps postoperatively. No tumor recurrence occurred during follow-up period. Conclusion When repairing the mandibular defect with free fibular flap, occlusal guide plate with intermaxillary fixation screw contributes to simplifying operation, accurate recovery of the appearance and occlusal relation, and improving the oral comfort level postoperatively.%目的 探讨咬合导板及颌间牵引钉技术在游离腓骨瓣修复下颌骨缺损中的应用价值.方法 2011年8月-12月,收治7

  13. Surgical treatment of acquired tracheocele.

    Science.gov (United States)

    Porubsky, Edward A; Gourin, Christine G

    2006-06-01

    Acquired tracheoceles are rare clinical entities that can cause a variety of chronic and recurrent aerodigestive tract symptoms. The management of acquired tracheoceles is primarily conservative, but surgical intervention may be indicated for patients with refractory symptoms. We present a case of acquired tracheocele and describe a method of successful surgical management.

  14. Implant Utilization and Time to Prosthetic Rehabilitation in Conventional and Advanced Fibular Free Flap Reconstruction of the Maxilla and Mandible.

    Science.gov (United States)

    Chuka, Richelle; Abdullah, Wael; Rieger, Jana; Nayar, Suresh; Seikaly, Hadi; Osswald, Martin; Wolfaardt, Johan

    Precisely designed jaw reconstruction rehabilitation (JRR) is important to the integrity of the jaw structure and oral functions. Advanced three-dimensional (3D) digital surgical design and simulation (SDS) techniques have the potential to reduce time to reconstructive and dental treatment completion, thereby promoting early functional oral rehabilitation. This study investigated the use of SDS in JRR procedures. A retrospective chart review was conducted on adult head and neck tumor (HNT) participants who completed JRR treatment with a fibular free flap (FFF) reconstruction. Two treatment approaches, advanced 3D SDS technique (with-SDS) and conventional, nondigitally planned technique (without-SDS), included the use of osseointegrated implants. Data were collected from adult patients treated between January 2000 and March 2014 at the Institute for Reconstructive Sciences in Medicine (iRSM). Participants were excluded if they underwent a bone-containing augmentation to the FFF reconstruction. The without-SDS group underwent a conventional, nonguided FFF reconstruction followed by nonguided implant placement. The with-SDS group underwent a guided FFF reconstruction with guided implant placement during the reconstructive surgery. The outcome measures included implant utilization (ratio of implants placed to connected) and time to prosthetic connection after FFF reconstruction. Mann-Whitney U test was used to analyze the data. The digital SDS technique (with-SDS) group completed prosthetic treatment with a significantly higher utilization of implants as well as a significantly shorter time to prosthetic delivery. SDS allows an interdisciplinary treatment team to work together to create a virtual plan that leads to greater efficiency in patient treatment time and utilization of dental implants.

  15. Pituitary Adenoma Segmentation

    CERN Document Server

    Egger, Jan; Kuhnt, Daniela; Freisleben, Bernd; Nimsky, Christopher

    2011-01-01

    Sellar tumors are approximately 10-15% among all intracranial neoplasms. The most common sellar lesion is the pituitary adenoma. Manual segmentation is a time-consuming process that can be shortened by using adequate algorithms. In this contribution, we present a segmentation method for pituitary adenoma. The method is based on an algorithm we developed recently in previous work where the novel segmentation scheme was successfully used for segmentation of glioblastoma multiforme and provided an average Dice Similarity Coefficient (DSC) of 77%. This scheme is used for automatic adenoma segmentation. In our experimental evaluation, neurosurgeons with strong experiences in the treatment of pituitary adenoma performed manual slice-by-slice segmentation of 10 magnetic resonance imaging (MRI) cases. Afterwards, the segmentations were compared with the segmentation results of the proposed method via the DSC. The average DSC for all data sets was 77.49% +/- 4.52%. Compared with a manual segmentation that took, on the...

  16. ICU-Acquired Weakness.

    Science.gov (United States)

    Jolley, Sarah E; Bunnell, Aaron E; Hough, Catherine L

    2016-11-01

    Survivorship after critical illness is an increasingly important health-care concern as ICU use continues to increase while ICU mortality is decreasing. Survivors of critical illness experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay. Newfound impairment is associated with increased health-care costs and use, reductions in health-related quality of life, and prolonged unemployment. Weakness, critical illness neuropathy and/or myopathy, and muscle atrophy are common in patients who are critically ill, with up to 80% of patients admitted to the ICU developing some form of neuromuscular dysfunction. ICU-acquired weakness (ICUAW) is associated with longer durations of mechanical ventilation and hospitalization, along with greater functional impairment for survivors. Although there is increasing recognition of ICUAW as a clinical entity, significant knowledge gaps exist concerning identifying patients at high risk for its development and understanding its role in long-term outcomes after critical illness. This review addresses the epidemiologic and pathophysiologic aspects of ICUAW; highlights the diagnostic challenges associated with its diagnosis in patients who are critically ill; and proposes, to our knowledge, a novel strategy for identifying ICUAW. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  17. Acquiring specific interpreting competence

    Directory of Open Access Journals (Sweden)

    Jana Zidar Forte

    2012-12-01

    Full Text Available In postgraduate interpreter training, the main objective of the course is to help trainees develop various competences, from linguistic, textual and cultural competence, to professional and specific interpreting competence. For simultaneous interpreting (SI, the main focus is on mastering the SI technique and strategies as well as on developing and strengthening communicative skills, which is discussed and illustrated with examples in the present paper. First, a brief overview is given of all the necessary competences of a professional interpreter with greater emphasis on specific interpreting competence for SI. In the second part of the paper, various approaches are described in terms of acquiring specific skills and strategies, specifically through a range of exercises. Besides interpreting entire speeches, practical courses should also consist of targeted exercises, which help trainees develop suitable coping strategies and mechanisms (later on almost automatisms, while at the same time "force" them to reflect on their individual learning process and interpreting performance. This provides a solid base on which trained interpreters can progress and develop their skills also after joining the professional sphere.

  18. Application of the free double-skin paddle string-type composite fibular flap in the reconstruction of the combined defects of ulna and radium%应用带双皮岛的串式腓骨瓣游离移植修复前臂尺桡骨及皮肤联合缺损

    Institute of Scientific and Technical Information of China (English)

    龚志鑫; 张英泽; 邵新中; 张桂生; 张奇; 陈伟; 高彦华

    2011-01-01

    目的 探讨带双皮岛的串式腓骨瓣游离移植修复前臂尺、桡骨及皮肤联合缺损的临床效果.方法自2005年6月至2009年7月,应用带双皮岛的串式腓骨瓣游离移植修复前臂尺、桡骨及皮肤联合缺损5例,修复尺骨的腓骨段长度4.5~7.5 cm,修复桡骨的腓骨段长度5.5~7.0 cm,皮瓣大小:5.0 cm×3.0 cm~8.0 cm×5.5 cm.术后12个月按Enneking评分系统测定患肢功能.结果 5例所应用的10块皮瓣全部成活,移植的腓骨段与尺、桡骨完全骨性愈合时间为4~6个月.术后随访时间14个月~2年,前臂旋转功能优2例、良2例、差1例,优良率为80%,按Enneking系统评分,平均为24.8分,平均恢复了肢体功能的81.3%.结论 带血供的骨移植,骨细胞保持活性,利于骨质愈合,同时,该术式可以一次手术完成前臂多部位、多组织缺损的修复,因此,应用带双皮岛的串式腓骨瓣游离移植修复前臂尺、桡骨及皮肤联合缺损,是一种比较理想的治疗方法.%Objective To investigate the outcome of the free double-skin paddle string-type composite fibular flap in the reconstruction of the combined defects of ulna and radium. Methods From June 2005 to July 2009, 5 cases with combined defects of ulna and radium were reconstructed using the free double-skin paddle string-type composite fibular flap. The length of fibular segment for the reconstruction of ulnar defect ranges from 4.5 to 7.5 cm. The length of fibular segment for the reconstruction of radial defect ranges from 5.5 to 7.0 cm. The size of the flap varies from 5.0 cm × 3.0 cm to 8.0 cm × 5.5 cm. At the 12 month follow-up, the function of reconstructed forearm was evaluated based upon Enneking scoring system.Results Ten flaps in the 5 cases all survived. The time for the transplanted fibula healed on the radium and ulna was 4-6 months. The 5 patients were followed up from 14 months to 2 years. The forearm rotation functions were excellent in 2 cases, good in 2

  19. Esthetic and functional reconstruction of the posttumoral interrupted mandible with double-barrel fibular free flap graft: rationale for a microsurgical and prosthodontic approach.

    Science.gov (United States)

    Paranque, Armand-Régis; Steve, Marc; Vazquez, Lydia; Bolleyn, Alain; Roze-Pellat, Marie-Andrée; Dohan Ehrenfest, David M

    2011-10-01

    Reconstruction after substantial osseous, cutaneous, and muscular tissue loss following a mandibular resection is a challenge. The use of a fibular free flap is an outstanding, but delicate, treatment option. These grafts, using the double-barrel technique, can achieve an almost complete reconstruction of the mandibular defect. The challenge posed by these treatments is to achieve an end result that is both functional and esthetically pleasing-an endeavor that requires a defined prosthetic plan prior to complete microsurgical reconstruction. Using a detailed clinical case, this article discusses the importance of planning the mandible reconstruction with double-barrel fibular graft in view of an implant-supported fixed partial denture. Immediate implant loading was even possible in this case. This approach allows improvement of the final esthetic and functional result of such a complex rehabilitation. Maxillofacial reconstructive surgery should seek to establish a near-as-normal anatomic situation that will allow a permanent implant rehabilitation that is both esthetic and durable.

  20. Use of latissimus dorsi flap pedicle as a T-junction to facilitate simultaneous free fibular flap inset in lower extremity salvage.

    Science.gov (United States)

    Hwang, Kyu Tae; Youn, Seungki; Kim, Jeong Tae; Lee, Seung Hoon; Ng, Siew-Weng; Kim, Youn Hwan

    2012-04-01

    Marjolin's ulcer is a very aggressive form of squamous cell carcinoma arising from chronic wounds or unstable scars. A resection margin of at least 2 cm with clear deep margin is required on removal. A 79-year-old male presented with chronic osteomyelitis of the left anterior tibial region with chronic ulceration. Biopsy revealed squamous cell carcinoma. The tumour, measuring 8 cm, was resected with surrounding unstable scar tissue including en bloc resection of the involved tibial bone, leaving the posterior cortex. Reconstruction was done with a fibular free flap from the contralateral side, but the pedicle length was too short to reach the anterior tibial vessels. To bridge the vascular gap, and to cover the soft-tissue defect, a latissimus dorsi free flap was harvested using the muscle-sparing method. The thoracodorsal vessels were used as an interpositional graft to anastomose the peroneal vessels of the fibular flap. The patient was ambulatory by 4 months, and complete bone union was seen after 6 months. During the 18-month follow-up period, there was no evidence of recurrence.

  1. GPS Control Segment

    Science.gov (United States)

    2015-04-29

    Luke J. Schaub Chief, GPS Control Segment Division 29 Apr 15 GPS Control Segment Report Documentation Page Form ApprovedOMB No. 0704-0188...00-2015 4. TITLE AND SUBTITLE GPS Control Segment 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...Center, GPS Control Segment Division,Los Angeles AFB, El Segundo,CA,90245 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S

  2. Sipunculans and segmentation

    DEFF Research Database (Denmark)

    Wanninger, Andreas; Kristof, Alen; Brinkmann, Nora

    2009-01-01

    Comparative molecular, developmental and morphogenetic analyses show that the three major segmented animal groups- Lophotrochozoa, Ecdysozoa and Vertebrata-use a wide range of ontogenetic pathways to establish metameric body organization. Even in the life history of a single specimen, different...... plasticity and potential evolutionary lability of segmentation nourishes the controversy of a segmented bilaterian ancestor versus multiple independent evolution of segmentation in respective metazoan lineages....

  3. Automatic Melody Segmentation

    NARCIS (Netherlands)

    Rodríguez López, Marcelo

    2016-01-01

    The work presented in this dissertation investigates music segmentation. In the field of Musicology, segmentation refers to a score analysis technique, whereby notated pieces or passages of these pieces are divided into “units” referred to as sections, periods, phrases, and so on. Segmentation analy

  4. Vessel-guided Airway Tree Segmentation

    DEFF Research Database (Denmark)

    Lo, P.; Sporring, J.; Ashraf, H.;

    2010-01-01

    This paper presents a method for airway tree segmentation that uses a combination of a trained airway appearance model, vessel and airway orientation information, and region growing. We propose a voxel classification approach for the appearance model, which uses a classifier that is trained...... to differentiate between airway and non-airway voxels. This is in contrast to previous works that use either intensity alone or hand crafted models of airway appearance. We show that the appearance model can be trained with a set of easily acquired, incomplete, airway tree segmentations. A vessel orientation...

  5. Reconstructive procedures for segmental resection of bone in giant cell tumors around the knee

    Directory of Open Access Journals (Sweden)

    Aggarwal Aditya

    2007-01-01

    Full Text Available Background: Segmental resection of bone in Giant Cell Tumor (GCT around the knee, in indicated cases, leaves a gap which requires a complex reconstructive procedure. The present study analyzes various reconstructive procedures in terms of morbidity and various complications encountered. Materials and Methods: Thirteen cases (M-six and F-seven; lower end femur-six and upper end tibia -seven of GCT around the knee, radiologically either Campanacci Grade II, Grade II with pathological fracture or Grade III were included. Mean age was 25.6 years (range 19-30 years. Resection arthrodesis with telescoping (shortening over intramedullary nail ( n=5, resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail ( n=3 and resection arthrodesis with intercalary fibular autograft and simultaneous limb lengthening ( n=5 were the procedure performed. Results: Shortening was the major problem following resection arthrodesis with telescoping (shortening over intramedullary nail. Only two patients agreed for subsequent limb lengthening. The rest continued to walk with shortening. Infection was the major problem in all cases of resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail and required multiple drainage procedures. Fusion was achieved after two years in two patients. In the third patient the allograft sequestrated. The patient underwent sequestrectomy, telescoping of fragments and ilizarov fixator application with subsequent limb lengthening. The patient was finally given an ischial weight relieving orthosis, 54 months after the index procedure. After resection arthrodesis with intercalary autograft and simultaneous lengthening the resultant gap (~15cm was partially bridged by intercalary nonvascularized dual fibular strut graft (6-7cm and additional corticocancellous bone graft from ipsilateral patella. Simultaneous limb lengthening with a distal tibial corticotomy was performed on an

  6. Street-Scene Tree Segmentation from Mobile Laser Scanning Data

    Science.gov (United States)

    Guan, H.; Cao, S.; Yu, Y.; Li, J.; Liu, N.; Chen, P.; Li, Y.

    2016-06-01

    Our work addresses the problem of extracting trees from mobile laser scanning data. The work is a two step-wise strategy, including terrain point removal and tree segmentation. First, a voxel-based upward growing filtering is proposed to remove terrain points from the mobile laser scanning data. Then, a tree segmentation is presented to extract individual trees via a Euclidean distance clustering approach and Voxel-based Normalized Cut (VNCut) segmentation approach. A road section data acquired by a RIEGL VMX-450 system are selected for evaluating the proposed tree segmentation method. Qualitative analysis shows that our algorithm achieves a good performance.

  7. What is a segment?

    Science.gov (United States)

    Hannibal, Roberta L; Patel, Nipam H

    2013-12-17

    Animals have been described as segmented for more than 2,000 years, yet a precise definition of segmentation remains elusive. Here we give the history of the definition of segmentation, followed by a discussion on current controversies in defining a segment. While there is a general consensus that segmentation involves the repetition of units along the anterior-posterior (a-p) axis, long-running debates exist over whether a segment can be composed of only one tissue layer, whether the most anterior region of the arthropod head is considered segmented, and whether and how the vertebrate head is segmented. Additionally, we discuss whether a segment can be composed of a single cell in a column of cells, or a single row of cells within a grid of cells. We suggest that 'segmentation' be used in its more general sense, the repetition of units with a-p polarity along the a-p axis, to prevent artificial classification of animals. We further suggest that this general definition be combined with an exact description of what is being studied, as well as a clearly stated hypothesis concerning the specific nature of the potential homology of structures. These suggestions should facilitate dialogue among scientists who study vastly differing segmental structures.

  8. Word segmentation with universal prosodic cues.

    Science.gov (United States)

    Endress, Ansgar D; Hauser, Marc D

    2010-09-01

    When listening to speech from one's native language, words seem to be well separated from one another, like beads on a string. When listening to a foreign language, in contrast, words seem almost impossible to extract, as if there was only one bead on the same string. This contrast reveals that there are language-specific cues to segmentation. The puzzle, however, is that infants must be endowed with a language-independent mechanism for segmentation, as they ultimately solve the segmentation problem for any native language. Here, we approach the acquisition problem by asking whether there are language-independent cues to segmentation that might be available to even adult learners who have already acquired a native language. We show that adult learners recognize words in connected speech when only prosodic cues to word-boundaries are given from languages unfamiliar to the participants. In both artificial and natural speech, adult English speakers, with no prior exposure to the test languages, readily recognized words in natural languages with critically different prosodic patterns, including French, Turkish and Hungarian. We suggest that, even though languages differ in their sound structures, they carry universal prosodic characteristics. Further, these language-invariant prosodic cues provide a universally accessible mechanism for finding words in connected speech. These cues may enable infants to start acquiring words in any language even before they are fine-tuned to the sound structure of their native language.

  9. Ressecção ampla e transposição fibular no tratamento do TCG da extremidade distal do rádio Wide resection and fibular transposition in the treatment of GCT on radius distal end

    Directory of Open Access Journals (Sweden)

    Alex Guedes

    2009-01-01

    Full Text Available OBJETIVO: Avaliação funcional e oncológica do tratamento do TCG do segmento distal do rádio (estadio B3 mediante ressecção ampla e reconstrução com enxerto autólogo avascular da extremidade proximal da fíbula. MÉTODOS: A função residual foi avaliada mediante escore ISOLS, medida do arco residual global do punho operado, do percentual residual da força de preensão da mão e da preensão entre o polegar e o indicador. O controle oncológico foi avaliado mediante exame clínico do membro operado e avaliação por imagens do punho e do tórax. RESULTADOS: 17 pacientes avaliados, dez do sexo feminino (58,8% e sete do sexo masculino (41,2% com idades entre 16 e 61 anos (média de 32,3 anos, todos destros. Na avaliação funcional (ISOLS observamos 11 resultados excelentes, dois bons e um ruim; os três casos que demandaram artrodese evoluíram com escore excelente. O arco residual global foi de 196,2 ± 116,6º. O arco residual do punho operada correspondeu a 58,9% do controle. A força de preensão da mão correspondeu a 55,4 ± 17,4% do controle. O percentual de "pinça" foi de 80,6 ± 14,8% do controle. Não constatamos recidiva ou metástases nesta casuística. CONCLUSÃO: A técnica propiciou resultados funcionais alentadores, assegurando o retorno dos pacientes às suas atividades. A ausência de recidiva local e/ou metástases, observada inclusive nos pacientes com seguimento mais longo, permite sugerir que a técnica parece ser segura no controle oncológico do tumor.OBJECTIVE: To functionally and oncologically assess the treatment of GCT on radius distal end (stage B3 following wide resection and reconstruction with avascular autologous graft from proximal fibular end. METHODS: The residual function was assessed using ISOLS score, measurement of the global residual arch of the operated wrist, residual percentage of the hand apprehension strength between thumb and index fingers. The oncologic monitoring was assessed by clinical

  10. Evaluation of internal carotid artery segmentation by InsightSNAP

    Science.gov (United States)

    Spangler, Emily L.; Brown, Christopher; Roberts, John A.; Chapman, Brian E.

    2007-03-01

    Quantification of cervical carotid geometry may facilitate improved clinical decision making and scientific discovery. We set out to evaluate the ability of InsightSNAP (ITK-SNAP), an open-source segmentation program for 3D medical images (http://www.itksnap.org, version 1.4), to semi-automatically segment internal carotid arteries. A sample of five individuals (three normal volunteers, and two diseased patients) were imaged with an MR exam consisting of a MOTSA TOF MRA image volume and multiple black blood images acquired with different contrast weightings. Comparisons were made to a manual segmentation created during simultaneous evaluation of the MOTSA image and the various black blood images (typically PD-weighted, T1-weighted, and T2-weighted). These individuals were selected as a training set to determine acceptable parameters for ITK-SNAP's semi-automatic level sets segmentation method. The conclusion from this training set was that the initial thresholding (assigning probabilities to the intensities of image pixels) in the image pre-processing step was most important to obtaining an acceptable segmentation. Unfortunately no consistent trends emerged in how this threshold should be chosen. Figures of percent over- and under-segmentation were computed as a means of comparing the hand segmented and semi-automatically segmented internal carotids. Overall the under-segmentation by ITK-SNAP (voxels included in the manual segmentation but not in the semiautomated segmentation) was 10.94% +/- 6.35% while the over-segmentation (voxels excluded in the manual segmentation but included in the semi-automated segmentation) was 8.16% +/- 4.40% defined by reference to the total number of voxels included in the manual segmentation.

  11. Keypoint Transfer Segmentation

    OpenAIRE

    Wachinger, C.; Toews, M.; Langs, G.; Wells, W.; Golland, P.

    2015-01-01

    We present an image segmentation method that transfers label maps of entire organs from the training images to the novel image to be segmented. The transfer is based on sparse correspondences between keypoints that represent automatically identified distinctive image locations. Our segmentation algorithm consists of three steps: (i) keypoint matching, (ii) voting-based keypoint labeling, and (iii) keypoint-based probabilistic transfer of organ label maps. We introduce generative models for th...

  12. 腓骨切开复位内固定与胫骨闭合复位外支架固定治疗胫腓骨下段粉碎性骨折%Minimally invasiw treatment of fractures of distal one-third of tibia-fibular

    Institute of Scientific and Technical Information of China (English)

    于珂; 宋锋; 戚超

    2011-01-01

    目的 探讨对胫腓骨下段粉碎性骨折微创治疗方法的效果.方法 胫腓骨下段粉碎性骨折36例,男21例,女15例;年龄12~5岁,平均38.5岁.其中闭合性骨折24例,Ⅰ度开放性骨折10例,Ⅱ度开放性骨折2例.采用单侧外固定支架与钢板螺丝钉结合微创治疗胫腓骨下段骨折.结果 本组均获6个月~1年随访,平均9个月.定期X线复查,X线片示腓骨均解剖愈合,胫骨均功能位愈合,骨折临床愈合时间平均6个月.无软组织感染和骨髓炎发生.膝关节活动度大于90°,踝关节活动度15°~30°间,并达到骨愈合标准后拆除外固定架.去固定时间12~32周,平均24周,拆除崮定后无再骨折发生.结论 对于复杂粉碎性胫腓骨下段骨折的治疗,腓骨切开复位内固定与胫骨闭合复位外支架固定,操作简单、固定可靠、手术创伤小、符合微创术式原则.这为胫腓骨下段粉碎性骨折的治疗提供了有效的治疗方法,值得进一步的推广.%Objective To observe the clinical effect of minimally invasive treatment of comminuted fractures of distal onethird of tibia-fibular. Methods 3 o patients with fractures of distal one-third of tibia-fibular,24 patients were closed.10 patients were Ⅰ-degree open fracture,2 patients were Ⅱ-degree open fracture. 21 males,15 females,with a mean age of 38.5 years(range12~65).The fractures were fixed by steel plates combined with unilateral extemal fixing frame .Results All patients were followed up 6 to 12 months(average 9 months) and acquired the bone was union.The mean time of bone union was 6 months.None of the patients had soft tissues infection and osteomyelitis.The range of motion in the knee was above 90°, The range of motion in the ankle was 15°~30°,the frame was removed after bone union ,the mean frame time was 24 weeks(12~32weeks). Conclusion Providing reliable reposion and fixation, internal fixation of fibula plus external fram fixtion of tibia is an

  13. Universal Numeric Segmented Display

    CERN Document Server

    Azad, Md Abul kalam; Kamruzzaman, S M

    2010-01-01

    Segmentation display plays a vital role to display numerals. But in today's world matrix display is also used in displaying numerals. Because numerals has lots of curve edges which is better supported by matrix display. But as matrix display is costly and complex to implement and also needs more memory, segment display is generally used to display numerals. But as there is yet no proposed compact display architecture to display multiple language numerals at a time, this paper proposes uniform display architecture to display multiple language digits and general mathematical expressions with higher accuracy and simplicity by using a 18-segment display, which is an improvement over the 16 segment display.

  14. Reconstrucción tibial: transferencia sóleo-peroné ipsilateral. Tibialización peroneal Tibial reconstruction: ipsilateral soleus-fibula transfer. Fibular tibialization

    Directory of Open Access Journals (Sweden)

    E. Revelo Jiron

    2009-12-01

    Full Text Available Las transferencias óseas peroneales en forma libre o ipsilateral han sido propuestas para la reconstrucción de grandes defectos tibiales. Están también descritas varias modificaciones al respecto, siendo una de ellas la constitución de un colgajo compuesto soleo-peroné realizado como transferencia libre. En este estudio presentamos nuestra experiencia con esta variante, pero en forma ipsilateral. logrando la reconstrucción del defecto tibial por medio de la tibialización peroneal. Escogimos realizar un colgajo compuesto soleo-peroné ipsilateral a flujo anterógrado o retrogrado para la reconstrucción de una serie personal de 14 pacientes consecutivos, 13 hombre y 1 mujer, con edad media de 30 años, y con amplios defectos tibiales y de tejidos blandos causados por accidentes de transito en 12 casos, 1 por proyectil balístico y 1 por artefacto explosivo artesanal. El promedio de tamaño del defecto tibial fue de 9.4 cm. Elegimos la forma ipsilateral por no disponer de infraestructura adecuada para realizar una transferencia libre. La serie de estudio se realizó durante el periodo comprendido entre Abril de 1995 y Abril del 2005. Todos los colgajos sobrevivieron. Dos pacientes desarrollaron pseudoartrosis. El apoyo completo y la marcha en 12 pacientes, se logró en un periodo promedio de 9 meses. El seguimiento postoperatorio ha sido de 3 a 6 años. Doce pacientes se han incorporado a la vida activa. Discutimos algunos aspectos prácticos de la técnica como resultado de la experiencia quirúrgica obtenida de esta serie personal. Consideramos que el método es fiable, fácil de realizar y proporciona excelentes resultados.Fibular flaps such as in there free form or as ipsilateral transfers have been proposed for reconstruction of large tibial defects. Several modifications have been described for the use of this flap. In this study we will present our experience using the ipsilateral transfer of an osteomuscular soleous fibular flap

  15. Star excursion balance test for assessment of dynamic instability of the ankle in patients after harvest of a fibular free flap: a two-centre study.

    Science.gov (United States)

    Shah, K C; Peehal, J P; Shah, A; Crank, S; Flora, H S

    2017-04-01

    We aimed to show that the star excursion balance test can identify instability in the ankle of patients who have had harvest of a fibular free flap. We compared the reach distance of the operated leg against that of the non-operated leg in 26 patients who had had harvest of the flap over a period of three years from August 2009 at two different centres. The goal of the test is to reach as far as possible with one leg in eight directions while balancing on the other. We also assessed the overall function of the operated leg using the Foot and Ankle Disability Index (FADI) and the American Orthopaedic Foot and Ankle Score (AOFAS). The star excursion balance test is simple and cheap, and is quick and easy to do in the outpatient department.

  16. Acquired ichthyosis with hoffman's syndrome

    Directory of Open Access Journals (Sweden)

    Sathyanarayana B

    2003-01-01

    Full Text Available A middle aged man presented with features of acquired ichthyosis with Hoffman's syndrome. Laboratory tests support hypothyodism. Myoedema and hypertrophy of muscles were present. Patient was previously treated for Pellagra.

  17. Fibular hydatid cyst

    Directory of Open Access Journals (Sweden)

    Arti Hamidreza

    2007-01-01

    Full Text Available Hydatid disease is caused by the tapeworm Echinococcus. Genus Echinococcus has different species including Echinococcus vogeli, Echinococcus granulosus and Echinococcus multilucularis . Echinococcus granulosus is the most common cause of hydatid disease in humans. This disease occurs either through direct ingestion of parasite eggs from contact with infected dogs or indirectly from the ingestion of contaminated water or food. Infestation of hydatid disease in humans most commonly occurs in the liver (55-70%, followed by the lungs (18-35%. Bone hydatidosis however is very rare (3%. We present herein a case of hydatid cyst of the fibula, which is an uncommon site for the occurrence of this disease.

  18. Segmentation of the foveal microvasculature using deep learning networks

    Science.gov (United States)

    Prentašić, Pavle; Heisler, Morgan; Mammo, Zaid; Lee, Sieun; Merkur, Andrew; Navajas, Eduardo; Beg, Mirza Faisal; Šarunić, Marinko; Lončarić, Sven

    2016-07-01

    Accurate segmentation of the retinal microvasculature is a critical step in the quantitative analysis of the retinal circulation, which can be an important marker in evaluating the severity of retinal diseases. As manual segmentation remains the gold standard for segmentation of optical coherence tomography angiography (OCT-A) images, we present a method for automating the segmentation of OCT-A images using deep neural networks (DNNs). Eighty OCT-A images of the foveal region in 12 eyes from 6 healthy volunteers were acquired using a prototype OCT-A system and subsequently manually segmented. The automated segmentation of the blood vessels in the OCT-A images was then performed by classifying each pixel into vessel or nonvessel class using deep convolutional neural networks. When the automated results were compared against the manual segmentation results, a maximum mean accuracy of 0.83 was obtained. When the automated results were compared with inter and intrarater accuracies, the automated results were shown to be comparable to the human raters suggesting that segmentation using DNNs is comparable to a second manual rater. As manually segmenting the retinal microvasculature is a tedious task, having a reliable automated output such as automated segmentation by DNNs, is an important step in creating an automated output.

  19. From interpretation to segmentation

    NARCIS (Netherlands)

    Koning, A.R.; Lier, R.J. van

    2005-01-01

    In visual perception, part segmentation of an object is considered to be guided by image-based properties, such as occurrences of deep concavities in the outer contour. However, object-based properties can also provide information regarding segmentation. In this study, outer contours and interpretat

  20. Segmentation, advertising and prices

    NARCIS (Netherlands)

    Galeotti, Andrea; Moraga González, José

    This paper explores the implications of market segmentation on firm competitiveness. In contrast to earlier work, here market segmentation is minimal in the sense that it is based on consumer attributes that are completely unrelated to tastes. We show that when the market is comprised by two

  1. Segmentation, advertising and prices

    NARCIS (Netherlands)

    Galeotti, Andrea; Moraga González, José

    2008-01-01

    This paper explores the implications of market segmentation on firm competitiveness. In contrast to earlier work, here market segmentation is minimal in the sense that it is based on consumer attributes that are completely unrelated to tastes. We show that when the market is comprised by two consume

  2. Benign segmental bronchial obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Loercher, U.

    1988-09-01

    The benigne segmental bronchial obstruction - mostly discovered on routine chest films - can well be diagnosed by CT. The specific findings in CT are the site of the bronchial obstruction, the mucocele and the localized empysema of the involved segment. Furthermore CT allows a better approach to the underlying process.

  3. Hospital benefit segmentation.

    Science.gov (United States)

    Finn, D W; Lamb, C W

    1986-12-01

    Market segmentation is an important topic to both health care practitioners and researchers. The authors explore the relative importance that health care consumers attach to various benefits available in a major metropolitan area hospital. The purposes of the study are to test, and provide data to illustrate, the efficacy of one approach to hospital benefit segmentation analysis.

  4. Segmentation Assisted Food Classification for Dietary Assessment.

    Science.gov (United States)

    Zhu, Fengqing; Bosch, Marc; Schap, Tusarebecca; Khanna, Nitin; Ebert, David S; Boushey, Carol J; Delp, Edward J

    2011-01-24

    Accurate methods and tools to assess food and nutrient intake are essential for the association between diet and health. Preliminary studies have indicated that the use of a mobile device with a built-in camera to obtain images of the food consumed may provide a less burdensome and more accurate method for dietary assessment. We are developing methods to identify food items using a single image acquired from the mobile device. Our goal is to automatically determine the regions in an image where a particular food is located (segmentation) and correctly identify the food type based on its features (classification or food labeling). Images of foods are segmented using Normalized Cuts based on intensity and color. Color and texture features are extracted from each segmented food region. Classification decisions for each segmented region are made using support vector machine methods. The segmentation of each food region is refined based on feedback from the output of classifier to provide more accurate estimation of the quantity of food consumed.

  5. MEDICAL IMAGE SEGMENTATION FOR ANATOMICAL KNOWLEDGE EXTRACTION

    Directory of Open Access Journals (Sweden)

    Ms Maya Eapen

    2014-01-01

    Full Text Available Computed Tomography-Angiography (CTA images of the abdomen, followed by precise segmentation and subsequent computation of shape based features of liver play an important role in hepatic surgery, patient/donor diagnosis during liver transplantation and at various treatment stages. Nevertheless, the issues like intensity similarity and Partial Volume Effect (PVE between the neighboring organs; left the task of liver segmentation critical. The accurate segmentation of liver helps the surgeons to perfectly classify the patients based on their liver anatomy which in turn helps them in the treatment decision phase. In this study, we propose an effective Advanced Region Growing (ARG algorithm for segmentation of liver from CTA images. The performance of the proposed technique was tested with several CTA images acquired across a wide range of patients. The proposed ARG algorithm identifies the liver regions on the images based on the statistical features (intensity distribution and orientation value. The proposed technique addressed the aforementioned issues and been evaluated both quantitatively and qualitatively. For quantitative analysis proposed method was compared with manual segmentation (gold standard. The method was also compared with standard region growing.

  6. Freehand 3D ultrasound breast tumor segmentation

    Science.gov (United States)

    Liu, Qi; Ge, Yinan; Ou, Yue; Cao, Biao

    2007-12-01

    It is very important for physicians to accurately determine breast tumor location, size and shape in ultrasound image. The precision of breast tumor volume quantification relies on the accurate segmentation of the images. Given the known location and orientation of the ultrasound probe, We propose using freehand three dimensional (3D) ultrasound to acquire original images of the breast tumor and the surrounding tissues in real-time, after preprocessing with anisotropic diffusion filtering, the segmentation operation is performed slice by slice based on the level set method in the image stack. For the segmentation on each slice, the user can adjust the parameters to fit the requirement in the specified image in order to get the satisfied result. By the quantification procedure, the user can know the tumor size varying in different images in the stack. Surface rendering and interpolation are used to reconstruct the 3D breast tumor image. And the breast volume is constructed by the segmented contours in the stack of images. After the segmentation, the volume of the breast tumor in the 3D image data can be obtained.

  7. Somatically acquired structural genetic differences

    DEFF Research Database (Denmark)

    Magaard Koldby, Kristina; Nygaard, Marianne; Christensen, Kaare;

    2016-01-01

    Structural genetic variants like copy number variants (CNVs) comprise a large part of human genetic variation and may be inherited as well as somatically acquired. Recent studies have reported the presence of somatically acquired structural variants in the human genome and it has been suggested t...... with age.European Journal of Human Genetics advance online publication, 20 April 2016; doi:10.1038/ejhg.2016.34.......Structural genetic variants like copy number variants (CNVs) comprise a large part of human genetic variation and may be inherited as well as somatically acquired. Recent studies have reported the presence of somatically acquired structural variants in the human genome and it has been suggested...... that they may accumulate in elderly individuals. To further explore the presence and the age-related acquisition of somatic structural variants in the human genome, we investigated CNVs acquired over a period of 10 years in 86 elderly Danish twins as well as CNV discordances between co-twins of 18 monozygotic...

  8. Keypoint Transfer Segmentation.

    Science.gov (United States)

    Wachinger, C; Toews, M; Langs, G; Wells, W; Golland, P

    2015-01-01

    We present an image segmentation method that transfers label maps of entire organs from the training images to the novel image to be segmented. The transfer is based on sparse correspondences between keypoints that represent automatically identified distinctive image locations. Our segmentation algorithm consists of three steps: (i) keypoint matching, (ii) voting-based keypoint labeling, and (iii) keypoint-based probabilistic transfer of organ label maps. We introduce generative models for the inference of keypoint labels and for image segmentation, where keypoint matches are treated as a latent random variable and are marginalized out as part of the algorithm. We report segmentation results for abdominal organs in whole-body CT and in contrast-enhanced CT images. The accuracy of our method compares favorably to common multi-atlas segmentation while offering a speed-up of about three orders of magnitude. Furthermore, keypoint transfer requires no training phase or registration to an atlas. The algorithm's robustness enables the segmentation of scans with highly variable field-of-view.

  9. Pancreas and cyst segmentation

    Science.gov (United States)

    Dmitriev, Konstantin; Gutenko, Ievgeniia; Nadeem, Saad; Kaufman, Arie

    2016-03-01

    Accurate segmentation of abdominal organs from medical images is an essential part of surgical planning and computer-aided disease diagnosis. Many existing algorithms are specialized for the segmentation of healthy organs. Cystic pancreas segmentation is especially challenging due to its low contrast boundaries, variability in shape, location and the stage of the pancreatic cancer. We present a semi-automatic segmentation algorithm for pancreata with cysts. In contrast to existing automatic segmentation approaches for healthy pancreas segmentation which are amenable to atlas/statistical shape approaches, a pancreas with cysts can have even higher variability with respect to the shape of the pancreas due to the size and shape of the cyst(s). Hence, fine results are better attained with semi-automatic steerable approaches. We use a novel combination of random walker and region growing approaches to delineate the boundaries of the pancreas and cysts with respective best Dice coefficients of 85.1% and 86.7%, and respective best volumetric overlap errors of 26.0% and 23.5%. Results show that the proposed algorithm for pancreas and pancreatic cyst segmentation is accurate and stable.

  10. Segmentation of consumer's markets and evaluation of market's segments

    OpenAIRE

    ŠVECOVÁ, Iveta

    2013-01-01

    The goal of this bachelor thesis was to explain a possibly segmentation of consumer´s markets for a chosen company, and to present a suitable goods offer, so it would be suitable to the needs of selected segments. The work is divided into theoretical and practical part. First part describes marketing, segmentation, segmentation of consumer's markets, consumer's market, market's segments a other terms. Second part describes an evaluation of questionnaire survey, discovering of market's segment...

  11. Image mosaic method based on SIFT features of line segment.

    Science.gov (United States)

    Zhu, Jun; Ren, Mingwu

    2014-01-01

    This paper proposes a novel image mosaic method based on SIFT (Scale Invariant Feature Transform) feature of line segment, aiming to resolve incident scaling, rotation, changes in lighting condition, and so on between two images in the panoramic image mosaic process. This method firstly uses Harris corner detection operator to detect key points. Secondly, it constructs directed line segments, describes them with SIFT feature, and matches those directed segments to acquire rough point matching. Finally, Ransac method is used to eliminate wrong pairs in order to accomplish image mosaic. The results from experiment based on four pairs of images show that our method has strong robustness for resolution, lighting, rotation, and scaling.

  12. Precise acquisition and unsupervised segmentation of multi-spectral images

    DEFF Research Database (Denmark)

    Gomez, David Delgado; Clemmensen, Line Katrine Harder; Ersbøll, Bjarne Kjær

    2007-01-01

    In this work, an integrated imaging system to obtain accurate and reproducible multi-spectral images and a novel multi-spectral image segmentation algorithm are proposed. The system collects up to 20 different spectral bands within a range that vary from 395 nm to 970 nm. The system is designed...... to acquire geometrically and chromatically corrected images in homogeneous and diffuse illumination, so images can be compared over time. The proposed segmentation algorithm combines the information provided by all the spectral bands to segment the different regions of interest. Three experiments...

  13. Neonatal Brain Tissue Classification with Morphological Adaptation and Unified Segmentation

    Directory of Open Access Journals (Sweden)

    Richard eBeare

    2016-03-01

    Full Text Available Measuring the distribution of brain tissue types (tissue classification in neonates is necessary for studying typical and atypical brain development, such as that associated with preterm birth, and may provide biomarkers for neurodevelopmental outcomes. Compared with magnetic resonance images of adults, neonatal images present specific challenges that require the development of specialized, population-specific methods. This paper introduces MANTiS (Morphologically Adaptive Neonatal Tissue Segmentation, which extends the unified segmentation approach to tissue classification implemented in Statistical Parametric Mapping (SPM software to neonates. MANTiS utilizes a combination of unified segmentation, template adaptation via morphological segmentation tools and topological filtering, to segment the neonatal brain into eight tissue classes: cortical gray matter, white matter, deep nuclear gray matter, cerebellum, brainstem, cerebrospinal fluid (CSF, hippocampus and amygdala. We evaluated the performance of MANTiS using two independent datasets. The first dataset, provided by the NeoBrainS12 challenge, consisted of coronal T2-weighted images of preterm infants (born ≤30 weeks’ gestation acquired at 30 weeks’ corrected gestational age (n= 5, coronal T2-weighted images of preterm infants acquired at 40 weeks’ corrected gestational age (n= 5 and axial T2-weighted images of preterm infants acquired at 40 weeks’ corrected gestational age (n= 5. The second dataset, provided by the Washington University NeuroDevelopmental Research (WUNDeR group, consisted of T2-weighted images of preterm infants (born <30 weeks’ gestation acquired shortly after birth (n= 12, preterm infants acquired at term-equivalent age (n= 12, and healthy term-born infants (born ≥38 weeks’ gestation acquired within the first nine days of life (n= 12. For the NeoBrainS12 dataset, mean Dice scores comparing MANTiS with manual segmentations were all above 0.7, except for

  14. Automatic Segmentation of Vessels in In-Vivo Ultrasound Scans

    DEFF Research Database (Denmark)

    Tamimi-Sarnikowski, Philip; Brink-Kjær, Andreas; Moshavegh, Ramin

    2017-01-01

    Ultrasound has become highly popular to monitor atherosclerosis, by scanning the carotid artery. The screening involves measuring the thickness of the vessel wall and diameter of the lumen. An automatic segmentation of the vessel lumen, can enable the determination of lumen diameter. This paper...... presents a fully automatic segmentation algorithm, for robustly segmenting the vessel lumen in longitudinal B-mode ultrasound images. The automatic segmentation is performed using a combination of B-mode and power Doppler images. The proposed algorithm includes a series of preprocessing steps, and performs...... a vessel segmentation by use of the marker-controlled watershed transform. The ultrasound images used in the study were acquired using the bk3000 ultrasound scanner (BK Ultrasound, Herlev, Denmark) with two transducers ”8L2 Linear” and ”10L2w Wide Linear” (BK Ultrasound, Herlev, Denmark). The algorithm...

  15. Robust system for human airway-tree segmentation

    Science.gov (United States)

    Graham, Michael W.; Gibbs, Jason D.; Higgins, William E.

    2008-03-01

    Robust and accurate segmentation of the human airway tree from multi-detector computed-tomography (MDCT) chest scans is vital for many pulmonary-imaging applications. As modern MDCT scanners can detect hundreds of airway tree branches, manual segmentation and semi-automatic segmentation requiring significant user intervention are impractical for producing a full global segmentation. Fully-automated methods, however, may fail to extract small peripheral airways. We propose an automatic algorithm that searches the entire lung volume for airway branches and poses segmentation as a global graph-theoretic optimization problem. The algorithm has shown strong performance on 23 human MDCT chest scans acquired by a variety of scanners and reconstruction kernels. Visual comparisons with adaptive region-growing results and quantitative comparisons with manually-defined trees indicate a high sensitivity to peripheral airways and a low false-positive rate. In addition, we propose a suite of interactive segmentation tools for cleaning and extending critical areas of the automatically segmented result. These interactive tools have potential application for image-based guidance of bronchoscopy to the periphery, where small, terminal branches can be important visual landmarks. Together, the automatic segmentation algorithm and interactive tool suite comprise a robust system for human airway-tree segmentation.

  16. Segmentation of antiperspirants and deodorants

    OpenAIRE

    KRÁL, Tomáš

    2009-01-01

    The goal of Master's Thesis on topic Segmentation of antiperspirants and deodorants is to discover differences in consumer's behaviour, determinate and describe segments of consumers based on these differences and propose marketing strategy for the most attractive segments. Theoretical part describes market segmentation in general, process of segmentation and segmentation criteria. Analytic part characterizes Czech market of antiperspirants and deodorants, analyzes ACNielsen market data and d...

  17. a segmentation approach

    African Journals Online (AJOL)

    kirstam

    a visitor survey was conducted at the Cape Town International Jazz ... 13Key words: dining motives, tipping, black diners, market segmentation, South .... and tipping behaviour as well as the findings from cross-cultural tipping and market.

  18. Segmental tuberculosis verrucosa cutis

    Directory of Open Access Journals (Sweden)

    Hanumanthappa H

    1994-01-01

    Full Text Available A case of segmental Tuberculosis Verrucosa Cutis is reported in 10 year old boy. The condition was resembling the ascending lymphangitic type of sporotrichosis. The lesions cleared on treatment with INH 150 mg daily for 6 months.

  19. Market segmentation: venezuelan adrs

    OpenAIRE

    Urbi Garay; Maximiliano González

    2012-01-01

    The foreign exchange controls imposed by Venezuela in 2003, constitute a natural experiment that allows researchers to observe the effects of exchange controls on stock market segmentation. This paper provides empirical evidence that, although the Venezuelan capital market as a whole was highly segmented before the controls were imposed, shares in the firm CANTV were, through its American Depositary Receipts (ADRs), partially integrated with the global market. Following the imposition of the ...

  20. Adjacent segment disease.

    Science.gov (United States)

    Virk, Sohrab S; Niedermeier, Steven; Yu, Elizabeth; Khan, Safdar N

    2014-08-01

    EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Understand the forces that predispose adjacent cervical segments to degeneration. 2. Understand the challenges of radiographic evaluation in the diagnosis of cervical and lumbar adjacent segment disease. 3. Describe the changes in biomechanical forces applied to adjacent segments of lumbar vertebrae with fusion. 4. Know the risk factors for adjacent segment disease in spinal fusion. Adjacent segment disease (ASD) is a broad term encompassing many complications of spinal fusion, including listhesis, instability, herniated nucleus pulposus, stenosis, hypertrophic facet arthritis, scoliosis, and vertebral compression fracture. The area of the cervical spine where most fusions occur (C3-C7) is adjacent to a highly mobile upper cervical region, and this contributes to the biomechanical stress put on the adjacent cervical segments postfusion. Studies have shown that after fusion surgery, there is increased load on adjacent segments. Definitive treatment of ASD is a topic of continuing research, but in general, treatment choices are dictated by patient age and degree of debilitation. Investigators have also studied the risk factors associated with spinal fusion that may predispose certain patients to ASD postfusion, and these data are invaluable for properly counseling patients considering spinal fusion surgery. Biomechanical studies have confirmed the added stress on adjacent segments in the cervical and lumbar spine. The diagnosis of cervical ASD is complicated given the imprecise correlation of radiographic and clinical findings. Although radiological and clinical diagnoses do not always correlate, radiographs and clinical examination dictate how a patient with prolonged pain is treated. Options for both cervical and lumbar spine ASD include fusion and/or decompression. Current studies are encouraging regarding the adoption of arthroplasty in spinal surgery, but more long

  1. Acquiring taste in home economics?

    DEFF Research Database (Denmark)

    Stenbak Larsen, Christian

    2015-01-01

    appreciated by the group of boys, and others again learned to stick with their idiosyncrasies when pressured by the teacher. Conclusions: Children were acquiring taste in the home economic lessons, but not only the kind of tastes that the teacher had planned for. This leads to reflections on the very complex...

  2. Acquired Equivalence Changes Stimulus Representations

    Science.gov (United States)

    Meeter, M.; Shohamy, D.; Myers, C. E.

    2009-01-01

    Acquired equivalence is a paradigm in which generalization is increased between two superficially dissimilar stimuli (or antecedents) that have previously been associated with similar outcomes (or consequents). Several possible mechanisms have been proposed, including changes in stimulus representations, either in the form of added associations or…

  3. Acquired aplastic anemia in children.

    Science.gov (United States)

    Hartung, Helge D; Olson, Timothy S; Bessler, Monica

    2013-12-01

    This article provides a practice-based and concise review of the etiology, diagnosis, and management of acquired aplastic anemia in children. Bone marrow transplantation, immunosuppressive therapy, and supportive care are discussed in detail. The aim is to provide the clinician with a better understanding of the disease and to offer guidelines for the management of children with this uncommon yet serious disorder.

  4. Post febrile acquired cutis laxa

    Directory of Open Access Journals (Sweden)

    Muthukumaran R

    1999-01-01

    Full Text Available Acquired cutis laxa following enteric fever has been described in a male in the neck region. Biopsy revealed fragmented elastic fibres in the dermis which were better visualised with special stain for elastic tissue. This case is reported for rarity of its occurrence at the localised site following febrile illness.

  5. Complement's participation in acquired immunity

    DEFF Research Database (Denmark)

    Nielsen, Claus Henrik; Leslie, Robert Graham Quinton

    2002-01-01

    in which antigen is seen, be it alone or in association with natural or induced antibodies and/or C3-complement fragments. The aim of this review is to describe the present status of our understanding of complement's participation in acquired immunity and the regulation of autoimmune responses....

  6. Acquired causes of intestinal malabsorption

    NARCIS (Netherlands)

    van der Heide, F.

    This review focuses on the acquired causes, diagnosis, and treatment of intestinal malabsorption. Intestinal absorption is a complex process that depends on many variables, including the digestion of nutrients within the intestinal lumen, the absorptive surface of the small intestine, the membrane

  7. Strategic market segmentation

    Directory of Open Access Journals (Sweden)

    Maričić Branko R.

    2015-01-01

    Full Text Available Strategic planning of marketing activities is the basis of business success in modern business environment. Customers are not homogenous in their preferences and expectations. Formulating an adequate marketing strategy, focused on realization of company's strategic objectives, requires segmented approach to the market that appreciates differences in expectations and preferences of customers. One of significant activities in strategic planning of marketing activities is market segmentation. Strategic planning imposes a need to plan marketing activities according to strategically important segments on the long term basis. At the same time, there is a need to revise and adapt marketing activities on the short term basis. There are number of criteria based on which market segmentation is performed. The paper will consider effectiveness and efficiency of different market segmentation criteria based on empirical research of customer expectations and preferences. The analysis will include traditional criteria and criteria based on behavioral model. The research implications will be analyzed from the perspective of selection of the most adequate market segmentation criteria in strategic planning of marketing activities.

  8. Skin Images Segmentation

    Directory of Open Access Journals (Sweden)

    Ali E. Zaart

    2010-01-01

    Full Text Available Problem statement: Image segmentation is a fundamental step in many applications of image processing. Skin cancer has been the most common of all new cancers detected each year. At early stage detection of skin cancer, simple and economic treatment can cure it mostly. An accurate segmentation of skin images can help the diagnosis to define well the region of the cancer. The principal approach of segmentation is based on thresholding (classification that is lied to the problem of the thresholds estimation. Approach: The objective of this study is to develop a method to segment the skin images based on a mixture of Beta distributions. We assume that the data in skin images can be modeled by a mixture of Beta distributions. We used an unsupervised learning technique with Beta distribution to estimate the statistical parameters of the data in skin image and then estimate the thresholds for segmentation. Results: The proposed method of skin images segmentation was implemented and tested on different skin images. We obtained very good results in comparing with the same techniques with Gamma distribution. Conclusion: The experiment showed that the proposed method obtained very good results but it requires more testing on different types of skin images.

  9. Tertiary center experience with primary endoscopic laryngoplasty in pediatric acquired subglottic stenosis and literature review

    Directory of Open Access Journals (Sweden)

    Jaber Alshammari

    2017-03-01

    Conclusion: Our study showed that primary endoscopic management was successful in 82.3% of cases of acquired subglottic stenosis including those with high grade stenosis and long segment of more than 12 mm in terms of the craniocaudal length. CO2 laser was an important tool to convert mature hard stenotic segment into a soft one. The latter yielded to the lateral pressure created by balloon dilatation better.

  10. Feature-space transformation improves supervised segmentation across scanners

    DEFF Research Database (Denmark)

    van Opbroek, Annegreet; Achterberg, Hakim C.; de Bruijne, Marleen

    2015-01-01

    Image-segmentation techniques based on supervised classification generally perform well on the condition that training and test samples have the same feature distribution. However, if training and test images are acquired with different scanners or scanning parameters, their feature distributions...

  11. Rediscovering market segmentation.

    Science.gov (United States)

    Yankelovich, Daniel; Meer, David

    2006-02-01

    In 1964, Daniel Yankelovich introduced in the pages of HBR the concept of nondemographic segmentation, by which he meant the classification of consumers according to criteria other than age, residence, income, and such. The predictive power of marketing studies based on demographics was no longer strong enough to serve as a basis for marketing strategy, he argued. Buying patterns had become far better guides to consumers' future purchases. In addition, properly constructed nondemographic segmentations could help companies determine which products to develop, which distribution channels to sell them in, how much to charge for them, and how to advertise them. But more than 40 years later, nondemographic segmentation has become just as unenlightening as demographic segmentation had been. Today, the technique is used almost exclusively to fulfill the needs of advertising, which it serves mainly by populating commercials with characters that viewers can identify with. It is true that psychographic types like "High-Tech Harry" and "Joe Six-Pack" may capture some truth about real people's lifestyles, attitudes, self-image, and aspirations. But they are no better than demographics at predicting purchase behavior. Thus they give corporate decision makers very little idea of how to keep customers or capture new ones. Now, Daniel Yankelovich returns to these pages, with consultant David Meer, to argue the case for a broad view of nondemographic segmentation. They describe the elements of a smart segmentation strategy, explaining how segmentations meant to strengthen brand identity differ from those capable of telling a company which markets it should enter and what goods to make. And they introduce their "gravity of decision spectrum", a tool that focuses on the form of consumer behavior that should be of the greatest interest to marketers--the importance that consumers place on a product or product category.

  12. Segmentation of Color Images Based on Different Segmentation Techniques

    Directory of Open Access Journals (Sweden)

    Purnashti Bhosale

    2013-03-01

    Full Text Available In this paper, we propose an Color image segmentation algorithm based on different segmentation techniques. We recognize the background objects such as the sky, ground, and trees etc based on the color and texture information using various methods of segmentation. The study of segmentation techniques by using different threshold methods such as global and local techniques and they are compared with one another so as to choose the best technique for threshold segmentation. Further segmentation is done by using clustering method and Graph cut method to improve the results of segmentation.

  13. Benchmark for license plate character segmentation

    Science.gov (United States)

    Gonçalves, Gabriel Resende; da Silva, Sirlene Pio Gomes; Menotti, David; Shwartz, William Robson

    2016-09-01

    Automatic license plate recognition (ALPR) has been the focus of many researches in the past years. In general, ALPR is divided into the following problems: detection of on-track vehicles, license plate detection, segmentation of license plate characters, and optical character recognition (OCR). Even though commercial solutions are available for controlled acquisition conditions, e.g., the entrance of a parking lot, ALPR is still an open problem when dealing with data acquired from uncontrolled environments, such as roads and highways when relying only on imaging sensors. Due to the multiple orientations and scales of the license plates captured by the camera, a very challenging task of the ALPR is the license plate character segmentation (LPCS) step, because its effectiveness is required to be (near) optimal to achieve a high recognition rate by the OCR. To tackle the LPCS problem, this work proposes a benchmark composed of a dataset designed to focus specifically on the character segmentation step of the ALPR within an evaluation protocol. Furthermore, we propose the Jaccard-centroid coefficient, an evaluation measure more suitable than the Jaccard coefficient regarding the location of the bounding box within the ground-truth annotation. The dataset is composed of 2000 Brazilian license plates consisting of 14000 alphanumeric symbols and their corresponding bounding box annotations. We also present a straightforward approach to perform LPCS efficiently. Finally, we provide an experimental evaluation for the dataset based on five LPCS approaches and demonstrate the importance of character segmentation for achieving an accurate OCR.

  14. Improving cerebellar segmentation with statistical fusion

    Science.gov (United States)

    Plassard, Andrew J.; Yang, Zhen; Prince, Jerry L.; Claassen, Daniel O.; Landman, Bennett A.

    2016-03-01

    The cerebellum is a somatotopically organized central component of the central nervous system well known to be involved with motor coordination and increasingly recognized roles in cognition and planning. Recent work in multiatlas labeling has created methods that offer the potential for fully automated 3-D parcellation of the cerebellar lobules and vermis (which are organizationally equivalent to cortical gray matter areas). This work explores the trade offs of using different statistical fusion techniques and post hoc optimizations in two datasets with distinct imaging protocols. We offer a novel fusion technique by extending the ideas of the Selective and Iterative Method for Performance Level Estimation (SIMPLE) to a patch-based performance model. We demonstrate the effectiveness of our algorithm, Non- Local SIMPLE, for segmentation of a mixed population of healthy subjects and patients with severe cerebellar anatomy. Under the first imaging protocol, we show that Non-Local SIMPLE outperforms previous gold-standard segmentation techniques. In the second imaging protocol, we show that Non-Local SIMPLE outperforms previous gold standard techniques but is outperformed by a non-locally weighted vote with the deeper population of atlases available. This work advances the state of the art in open source cerebellar segmentation algorithms and offers the opportunity for routinely including cerebellar segmentation in magnetic resonance imaging studies that acquire whole brain T1-weighted volumes with approximately 1 mm isotropic resolution.

  15. A toolbox for multiple sclerosis lesion segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Roura, Eloy; Oliver, Arnau; Valverde, Sergi; Llado, Xavier [University of Girona, Computer Vision and Robotics Group, Girona (Spain); Cabezas, Mariano; Pareto, Deborah; Rovira, Alex [Vall d' Hebron University Hospital, Magnetic Resonance Unit, Dept. of Radiology, Barcelona (Spain); Vilanova, Joan C. [Girona Magnetic Resonance Center, Girona (Spain); Ramio-Torrenta, Lluis [Dr. Josep Trueta University Hospital, Institut d' Investigacio Biomedica de Girona, Multiple Sclerosis and Neuroimmunology Unit, Girona (Spain)

    2015-10-15

    Lesion segmentation plays an important role in the diagnosis and follow-up of multiple sclerosis (MS). This task is very time-consuming and subject to intra- and inter-rater variability. In this paper, we present a new tool for automated MS lesion segmentation using T1w and fluid-attenuated inversion recovery (FLAIR) images. Our approach is based on two main steps, initial brain tissue segmentation according to the gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) performed in T1w images, followed by a second step where the lesions are segmented as outliers to the normal apparent GM brain tissue on the FLAIR image. The tool has been validated using data from more than 100 MS patients acquired with different scanners and at different magnetic field strengths. Quantitative evaluation provided a better performance in terms of precision while maintaining similar results on sensitivity and Dice similarity measures compared with those of other approaches. Our tool is implemented as a publicly available SPM8/12 extension that can be used by both the medical and research communities. (orig.)

  16. Prostate Cancer Segmentation Using Multispectral Random Walks

    Science.gov (United States)

    Artan, Yusuf; Haider, Masoom A.; Yetik, Imam Samil

    Several studies have shown the advantages of multispectral magnetic resonance imaging (MRI) as a noninvasive imaging technique for prostate cancer localization. However, a large proportion of these studies are with human readers. There is a significant inter and intra-observer variability for human readers, and it is substantially difficult for humans to analyze the large dataset of multispectral MRI. To solve these problems a few studies were proposed for fully automated cancer localization in the past. However, fully automated methods are highly sensitive to parameter selection and often may not produce desirable segmentation results. In this paper, we present a semi-supervised segmentation algorithm by extending a graph based semi-supervised random walker algorithm to perform prostate cancer segmentation with multispectral MRI. Unlike classical random walker which can be applied only to dataset of single type of MRI, we develop a new method that can be applied to multispectral images. We prove the effectiveness of the proposed method by presenting the qualitative and quantitative results of multispectral MRI datasets acquired from 10 biopsy-confirmed cancer patients. Our results demonstrate that the multispectral MRI noticeably increases the sensitivity and jakkard measures of prostate cancer localization compared to single MR images; 0.71 sensitivity and 0.56 jakkard for multispectral images compared to 0.51 sensitivity and 0.44 jakkard for single MR image based segmentation.

  17. Segmenting Images for a Better Diagnosis

    Science.gov (United States)

    2004-01-01

    NASA's Hierarchical Segmentation (HSEG) software has been adapted by Bartron Medical Imaging, LLC, for use in segmentation feature extraction, pattern recognition, and classification of medical images. Bartron acquired licenses from NASA Goddard Space Flight Center for application of the HSEG concept to medical imaging, from the California Institute of Technology/Jet Propulsion Laboratory to incorporate pattern-matching software, and from Kennedy Space Center for data-mining and edge-detection programs. The Med-Seg[TM] united developed by Bartron provides improved diagnoses for a wide range of medical images, including computed tomography scans, positron emission tomography scans, magnetic resonance imaging, ultrasound, digitized Z-ray, digitized mammography, dental X-ray, soft tissue analysis, and moving object analysis. It also can be used in analysis of soft-tissue slides. Bartron's future plans include the application of HSEG technology to drug development. NASA is advancing it's HSEG software to learn more about the Earth's magnetosphere.

  18. Vessel-guided airway tree segmentation

    DEFF Research Database (Denmark)

    Lo, Pechin Chien Pau; Sporring, Jon; Ashraf, Haseem

    2010-01-01

    This paper presents a method for airway tree segmentation that uses a combination of a trained airway appearance model, vessel and airway orientation information, and region growing. We propose a voxel classification approach for the appearance model, which uses a classifier that is trained...... to differentiate between airway and non-airway voxels. This is in contrast to previous works that use either intensity alone or hand crafted models of airway appearance. We show that the appearance model can be trained with a set of easily acquired, incomplete, airway tree segmentations. A vessel orientation...... similarity measure is introduced, which indicates how similar the orientation of an airway candidate is to the orientation of the neighboring vessel. We use this vessel orientation similarity measure to overcome regions in the airway tree that have a low response from the appearance model. The proposed...

  19. Point clouds segmentation as base for as-built BIM creation

    Science.gov (United States)

    Macher, H.; Landes, T.; Grussenmeyer, P.

    2015-08-01

    In this paper, a three steps segmentation approach is proposed in order to create 3D models from point clouds acquired by TLS inside buildings. The three scales of segmentation are floors, rooms and planes composing the rooms. First, floor segmentation is performed based on analysis of point distribution along Z axis. Then, for each floor, room segmentation is achieved considering a slice of point cloud at ceiling level. Finally, planes are segmented for each room, and planes corresponding to ceilings and floors are identified. Results of each step are analysed and potential improvements are proposed. Based on segmented point clouds, the creation of as-built BIM is considered in a future work section. Not only the classification of planes into several categories is proposed, but the potential use of point clouds acquired outside buildings is also considered.

  20. Occupationally Acquired American Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Maria Edileuza Felinto de Brito

    2012-01-01

    Full Text Available We report two occupationally acquired cases of American cutaneous leishmaniasis (ACL: one accidental laboratory autoinoculation by contaminated needlestick while handling an ACL lesion sample, and one acquired during field studies on bird biology. Polymerase chain reaction (PCR assays of patient lesions were positive for Leishmania, subgenus Viannia. One isolate was obtained by culture (from patient 2 biopsy samples and characterized as Leishmania (Viannia naiffi through an indirect immunofluorescence assay (IFA with species-specific monoclonal antibodies (mAbs and by multilocus enzyme electrophoresis (MLEE. Patients were successfully treated with N-methyl-glucamine. These two cases highlight the potential risks of laboratory and field work and the need to comply with strict biosafety procedures in daily routines. The swab collection method, coupled with PCR detection, has greatly improved ACL laboratory diagnosis.

  1. Nursing home-acquired pneumonia.

    Science.gov (United States)

    El Solh, Ali A

    2009-02-01

    Nursing home-acquired pneumonia (NHAP) was first described in 1978. Since then there has been much written regarding NHAP and its management despite the lack of well-designed studies in this patient population. The most characteristic features of patients with NHAP are the atypical presentation, which may lead to delay in diagnosis and therapy. The microbial etiology of pneumonia encompasses a wide spectrum that spans microbes recovered from patients with community-acquired pneumonia to organisms considered specific only to nosocomial settings. Decision to transfer a nursing home patient to an acute care facility depends on a host of factors, which include the level of staffing available at the nursing home, patients' advance directives, and complexity of treatment. The presence of risk factors for multidrug-resistant pathogens dictates approach to therapy. Prevention remains the cornerstone of reducing the incidence of disease. Despite the advance in medical services, mortality from NHAP remains high.

  2. Occupationally Acquired American Cutaneous Leishmaniasis

    Science.gov (United States)

    Felinto de Brito, Maria Edileuza; Andrade, Maria Sandra; de Almeida, Éricka Lima; Medeiros, Ângela Cristina Rapela; Werkhäuser, Roberto Pereira; de Araújo, Ana Isabele Freitas; Brandão-Filho, Sinval Pinto; Paiva de Almeida, Alzira Maria; Gomes Rodrigues, Eduardo Henrique

    2012-01-01

    We report two occupationally acquired cases of American cutaneous leishmaniasis (ACL): one accidental laboratory autoinoculation by contaminated needlestick while handling an ACL lesion sample, and one acquired during field studies on bird biology. Polymerase chain reaction (PCR) assays of patient lesions were positive for Leishmania, subgenus Viannia. One isolate was obtained by culture (from patient 2 biopsy samples) and characterized as Leishmania (Viannia) naiffi through an indirect immunofluorescence assay (IFA) with species-specific monoclonal antibodies (mAbs) and by multilocus enzyme electrophoresis (MLEE). Patients were successfully treated with N-methyl-glucamine. These two cases highlight the potential risks of laboratory and field work and the need to comply with strict biosafety procedures in daily routines. The swab collection method, coupled with PCR detection, has greatly improved ACL laboratory diagnosis. PMID:23227369

  3. CNOOC Acquires Oversea Assets Successfully

    Institute of Scientific and Technical Information of China (English)

    Hu Senlin

    2006-01-01

    @@ After last year CNOOC's bidding for buy the US energy company Unocal Corp lost out to the Chevron Corporation, it conducted the crossing-border asset-acquirement again in the beginning of this year. On Jan. 9, 2006,CNOOC Ltd signed a definitive agreement with Nigeria South Atlantic Petroleum Limited (SAPETRO) to acquire a 45 % working interest in an offshore oil developing license OML 130 in Nigeria for US$2.268 billion cash. The purchase will be funded by the internal capital resources of CNOOC Ltd. In which, US$1.75 billion will pay for buying SAPETRO, and the remaining cash will be used to pay for the early operation cost.

  4. Segmented conjugated polymers

    Indian Academy of Sciences (India)

    G Padmanaban; S Ramakrishnan

    2003-08-01

    Segmented conjugated polymers, wherein the conjugation is randomly truncated by varying lengths of non-conjugated segments, form an interesting class of polymers as they not only represent systems of varying stiffness, but also ones where the backbone can be construed as being made up of chromophores of varying excitation energies. The latter feature, especially when the chromophores are fluorescent, like in MEHPPV, makes these systems particularly interesting from the photophysics point of view. Segmented MEHPPV- samples, where x represents the mole fraction of conjugated segments, were prepared by a novel approach that utilizes a suitable precursor wherein selective elimination of one of the two eliminatable groups is affected; the uneliminated units serve as conjugation truncations. Control of the composition x of the precursor therefore permits one to prepare segmented MEHPPV- samples with varying levels of conjugation (elimination). Using fluorescence spectroscopy, we have seen that even in single isolated polymer chains, energy migration from the shorter (higher energy) chromophores to longer (lower energy) ones occurs – the extent of which depends on the level of conjugation. Further, by varying the solvent composition, it is seen that the extent of energy transfer and the formation of poorly emissive inter-chromophore excitons are greatly enhanced with increasing amounts of non-solvent. A typical S-shaped curve represents the variation of emission yields as a function of composition suggestive of a cooperative collapse of the polymer coil, reminiscent of conformational transitions seen in biological macromolecules.

  5. [Acquired disorders of color vision].

    Science.gov (United States)

    Lascu, Lidia; Balaş, Mihaela

    2002-01-01

    This article is a general view of acquired disorders of color vision. The revision of the best known methods and of the etiopathogenic classification is not very important in ophthalmology but on the other hand, the detection of the blue defect advertise and associated ocular pathology. There is a major interest in serious diseases as multiple sclerosis, AIDS, diabetes melitus, when the first ocular sign can be a defect in the color vision.

  6. Segmented heterochromia in scalp hair.

    Science.gov (United States)

    Yoon, Kyeong Han; Kim, Daehwan; Sohn, Seonghyang; Lee, Won Soo

    2003-12-01

    Segmented heterochromia of scalp hair is characterized by the irregularly alternating segmentation of hair into dark and light bands and is known to be associated with iron deficiency anemia. The authors report the case of an 11-year-old boy with segmented heterochromia associated with iron deficiency anemia. After 11 months of iron replacement, the boy's segmented heterochromic hair recovered completely.

  7. Segmentation and Quantitative Analysis of Epithelial Tissues.

    Science.gov (United States)

    Aigouy, Benoit; Umetsu, Daiki; Eaton, Suzanne

    2016-01-01

    Epithelia are tissues that regulate exchanges with the environment. They are very dynamic and can acquire virtually any shape; at the cellular level, they are composed of cells tightly connected by junctions. Most often epithelia are amenable to live imaging; however, the large number of cells composing an epithelium and the absence of informatics tools dedicated to epithelial analysis largely prevented tissue scale studies. Here we present Tissue Analyzer, a free tool that can be used to segment and analyze epithelial cells and monitor tissue dynamics.

  8. Acquired Surface Alexia in Spanish: A Case Report

    Science.gov (United States)

    Ferreres, Aldo R.; Cuitiño, Macarena Martinez; Olmedo, Alicia

    2005-01-01

    This paper reports a case study of acquired surface alexia in Spanish and discusses the most suitable tests to detect this syndrome in a writing system that is very regular for reading at the segmental and supra-segmental levels. Patient MM has surface alexia characterized by quantitatively good performance in reading words and pseudowords; accurate but slow and syllabic reading of words, nonwords and sentences; good performance in lexical decision tasks including words and nonwords; errors in lexical decision with pseudohomophones; and homophone confusions. This pattern of reading can be interpreted as a disorder in the lexical reading route and overdependence on the non-lexical route. We discuss nonlexical impairments and the interpretation of alexia and suggest tasks to identify surface alexia in a shallow orthography. PMID:16410626

  9. Automated lung segmentation algorithm for CAD system of thoracic CT

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective: To design and test the accuracy and efficiency of our lung segmentation algorithm on thoracic CT image in computer-aided diagnostic (CAD) system, especially on the segmentation between left and right lungs. Methods: We put forward the base frame of our lung segmentation firstly. Then, using optimal thresholding and mathematical morphologic methods, we acquired the rough image of lung segmentation. Finally, we presented a fast self-fit segmentation refinement algorithm, adapting to the unsuccessful left-right lung segmentation of thredsholding. Then our algorithm was used to CT scan images of 30 patients and the results were compared with those made by experts. Results: Experiments on clinical 2-D pulmonary images showed the results of our algorithm were very close to the expert's manual outlines, and it was very effective for the separation of left and right lungs with a successful segmentation ratio 94.8%. Conclusion: It is a practicable fast lung segmentation algorithm for CAD system on thoracic CT image.

  10. Application of reinforcement learning for segmentation of transrectal ultrasound images

    Directory of Open Access Journals (Sweden)

    Tizhoosh Hamid R

    2008-04-01

    Full Text Available Abstract Background Among different medical image modalities, ultrasound imaging has a very widespread clinical use. But, due to some factors, such as poor image contrast, noise and missing or diffuse boundaries, the ultrasound images are inherently difficult to segment. An important application is estimation of the location and volume of the prostate in transrectal ultrasound (TRUS images. For this purpose, manual segmentation is a tedious and time consuming procedure. Methods We introduce a new method for the segmentation of the prostate in transrectal ultrasound images, using a reinforcement learning scheme. This algorithm is used to find the appropriate local values for sub-images and to extract the prostate. It contains an offline stage, where the reinforcement learning agent uses some images and manually segmented versions of these images to learn from. The reinforcement agent is provided with reward/punishment, determined objectively to explore/exploit the solution space. After this stage, the agent has acquired knowledge stored in the Q-matrix. The agent can then use this knowledge for new input images to extract a coarse version of the prostate. Results We have carried out experiments to segment TRUS images. The results demonstrate the potential of this approach in the field of medical image segmentation. Conclusion By using the proposed method, we can find the appropriate local values and segment the prostate. This approach can be used for segmentation tasks containing one object of interest. To improve this prototype, more investigations are needed.

  11. Optimally segmented magnetic structures

    DEFF Research Database (Denmark)

    Insinga, Andrea Roberto; Bahl, Christian; Bjørk, Rasmus;

    ], or are applicable only to analytically solvable geometries[4]. In addition, some questions remained fundamentally unanswered, such as how to segment a given design into N uniformly magnetized pieces.Our method calculates the globally optimal shape and magnetization direction of each segment inside a certain......We present a semi-analytical algorithm for magnet design problems, which calculates the optimal way to subdivide a given design region into uniformly magnetized segments.The availability of powerful rare-earth magnetic materials such as Nd-Fe-B has broadened the range of applications of permanent...... designarea with an optional constraint on the total amount of magnetic material. The method can be applied to any objective functional which is linear respect to the field, and with any combination of linear materials. Being based on an analytical-optimization approach, the algorithm is not computationally...

  12. Segmentation of complex document

    Directory of Open Access Journals (Sweden)

    Souad Oudjemia

    2014-06-01

    Full Text Available In this paper we present a method for segmentation of documents image with complex structure. This technique based on GLCM (Grey Level Co-occurrence Matrix used to segment this type of document in three regions namely, 'graphics', 'background' and 'text'. Very briefly, this method is to divide the document image, in block size chosen after a series of tests and then applying the co-occurrence matrix to each block in order to extract five textural parameters which are energy, entropy, the sum entropy, difference entropy and standard deviation. These parameters are then used to classify the image into three regions using the k-means algorithm; the last step of segmentation is obtained by grouping connected pixels. Two performance measurements are performed for both graphics and text zones; we have obtained a classification rate of 98.3% and a Misclassification rate of 1.79%.

  13. Microscopic Halftone Image Segmentation

    Institute of Scientific and Technical Information of China (English)

    WANG Yong-gang; YANG Jie; DING Yong-sheng

    2004-01-01

    Microscopic halftone image recognition and analysis can provide quantitative evidence for printing quality control and fault diagnosis of printing devices, while halftone image segmentation is one of the significant steps during the procedure. Automatic segmentation on microscopic dots by the aid of the Fuzzy C-Means (FCM) method that takes account of the fuzziness of halftone image and utilizes its color information adequately is realized. Then some examples show the technique effective and simple with better performance of noise immunity than some usual methods. In addition, the segmentation results obtained by the FCM in different color spaces are compared, which indicates that the method using the FCM in the f1f2f3 color space is superior to the rest.

  14. GPS Control Segment Improvements

    Science.gov (United States)

    2015-04-29

    Systems Center GPS Control Segment Improvements Mr. Tim McIntyre GPS Product Support Manager GPS Ops Support and Sustainment Division Peterson...DATE 29 APR 2015 2. REPORT TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE GPS Control Segment Improvements 5a. CONTRACT...ORGANIZATION NAME(S) AND ADDRESS(ES) Air Force Space Command,Space and Missile Systems Center, GPS Ops Support and Sustainment Division,Peterson AFB,CO,80916 8

  15. Statistical Images Segmentation

    Directory of Open Access Journals (Sweden)

    Corina Curilă

    2008-05-01

    Full Text Available This paper deals with fuzzy statistical imagesegmentation. We introduce a new hierarchicalMarkovian fuzzy hidden field model, which extends to thefuzzy case the classical Pérez and Heitz hard model. Twofuzzy statistical segmentation methods related with themodel proposed are defined in this paper and we show viasimulations that they are competitive with, in some casesthan, the classical Maximum Posterior Mode (MPMbased methods. Furthermore, they are faster, which willshould facilitate extensions to more than two hard classesin future work. In addition, the model proposed isapplicable to the multiscale segmentation andmultiresolution images fusion problems.

  16. Beginning Word Recognition: Benefits of Training by Segmentation and Whole Word Methods.

    Science.gov (United States)

    Levy, Betty Ann; Lysynchuk, Linda

    1997-01-01

    Compares effectiveness of four different methods for acquiring initial reading vocabulary--onset plus vowel, rimes, phoneme segmentation and blending, and simple repetition of whole words. Finds that beginning nonreaders acquired the trained words fastest in the onset and rime conditions, and most slowly in the whole word condition. Finds the same…

  17. Long-term follow-up on the use of vascularized fibular graft for the treatment of congenital pseudarthrosis of the tibia

    Directory of Open Access Journals (Sweden)

    Kojima Tetsuo

    2008-03-01

    Full Text Available Abstract Background Congenital pseudoarthrosis of the tibia (CPT is one of the most difficult conditions to treat. Methods Five girls and 3 boys with CPT were treated by vascularized fibular grafting (VFG. The average age at VFG was 7.0 years (range: 1.9–11.5 years with an average follow-up term of 11.7 years (range: 4.9–19.6 years. Five of the children had undergone multiple operations before VFG, while the other 3 had no such history. Results Bone consolidation was obtained in all cases after an average term of 6.6 months (range: 4–10 months; this was with the first VFG in 7 cases but with the second VFG in 1 case. Complication of stress fracture and ankle pain occurred in 1 and 3 cases, respectively, only in cases undergoing multiple operations. Leg-length discrepancy was more prominent in the patients with multiple previous operations (mean: 7.5 cm, than in the cases with no prior surgery (mean: 0.7 cm. Conclusion The long-term results of VFG for CPT were excellent, especially in the cases, with no prior surgery. VFG should be considered as a primary treatment option for CPT.

  18. Axiographic results of CAD/CAM-assisted microvascular, fibular free flap reconstruction of the mandible: A prospective study of 21 consecutive cases.

    Science.gov (United States)

    Ritschl, Lucas M; Mücke, Thomas; Fichter, Andreas M; Roth, Maximilian; Kaltenhauser, Clemens; Pho Duc, Jean Marc; Kesting, Marco R; Wolff, Klaus-Dietrich; Loeffelbein, Denys J

    2017-01-01

    Virtual planning and guided reconstruction of the mandible following ablative surgery have become standard procedures in reconstructive surgery. Many advantages regarding operation time, morphology, bony fit, and consolidation have been described, but analyses of the functional outcome of virtually planned mandibular reconstructions are lacking. We prospectively analyzed 21 consecutive cases of mandibular reconstructions using CAD/CAM-assisted microvascular, fibular free flaps in operations between July 2014 and January 2016 at a single center. Axiographic measurements were performed preoperatively and at 10 days and 3 months postoperatively and were correlated with clinical findings. Uni- and multivariate regression analyses were performed to determine the association between possible predictor variables on functional outcomes. Overall, no statistical differences between the t1 and t3 measurements were seen in the analyzed variables. The univariate analysis showed a significant influence of indication and pre- and postoperative irradiation only on mouth opening (p = 0.018, p = 0.026, and p = 0.049). Timing, the number of osteotomies, and the incidence of wound healing disturbances had no significant influence on postoperative function (p = 0.753, p = 0.69 and p = 0.776). In particular, cases without malignancy or preoperative irradiation benefitted from the integration of the CAD/CAM technique and showed good functional outcomes.

  19. Acquired Upper Extremity Growth Arrest.

    Science.gov (United States)

    Gauger, Erich M; Casnovsky, Lauren L; Gauger, Erica J; Bohn, Deborah C; Van Heest, Ann E

    2017-01-01

    This study reviewed the clinical history and management of acquired growth arrest in the upper extremity in pediatric patients. The records of all patients presenting from 1996 to 2012 with radiographically proven acquired growth arrest were reviewed. Records were examined to determine the etiology and site of growth arrest, management, and complications. Patients with tumors or hereditary etiology were excluded. A total of 44 patients (24 boys and 20 girls) with 51 physeal arrests who presented at a mean age of 10.6 years (range, 0.8-18.2 years) were included in the study. The distal radius was the most common site (n=24), followed by the distal humerus (n=8), metacarpal (n=6), distal ulna (n=5), proximal humerus (n=4), radial head (n=3), and olecranon (n=1). Growth arrest was secondary to trauma (n=22), infection (n=11), idiopathy (n=6), inflammation (n=2), compartment syndrome (n=2), and avascular necrosis (n=1). Twenty-six patients (59%) underwent surgical intervention to address deformity caused by the physeal arrest. Operative procedures included ipsilateral unaffected bone epiphysiodesis (n=21), shortening osteotomy (n=10), lengthening osteotomy (n=8), excision of physeal bar or bone fragment (n=2), angular correction osteotomy (n=1), and creation of single bone forearm (n=1). Four complications occurred; 3 of these required additional procedures. Acquired upper extremity growth arrest usually is caused by trauma or infection, and the most frequent site is the distal radius. Growth disturbances due to premature arrest can be treated effectively with epiphysiodesis or osteotomy. In this series, the specific site of anatomic growth arrest was the primary factor in determining treatment. [Orthopedics. 2017; 40(1):e95-e103.]. Copyright 2016, SLACK Incorporated.

  20. Sipunculans and segmentation

    DEFF Research Database (Denmark)

    Wanninger, Andreas; Kristof, Alen; Brinkmann, Nora

    2009-01-01

    Comparative molecular, developmental and morphogenetic analyses show that the three major segmented animal groups- Lophotrochozoa, Ecdysozoa and Vertebrata-use a wide range of ontogenetic pathways to establish metameric body organization. Even in the life history of a single specimen, different m...

  1. [Segmental testicular infarction].

    Science.gov (United States)

    Ripa Saldías, L; Guarch Troyas, R; Hualde Alfaro, A; de Pablo Cárdenas, A; Ruiz Ramo, M; Pinós Paul, M

    2006-02-01

    We report the case of a 47 years old man previously diagnosed of left hidrocele. After having a recent mild left testicular pain, an ultrasonografic study revealed a solid hipoecoic testicular lesion rounded by a big hidrocele, suggesting a testicular neoplasm. Radical inguinal orchiectomy was made and pathologic study showed segmental testicular infarction. No malignancy was found. We review the literature of the topic.

  2. Dictionary Based Image Segmentation

    DEFF Research Database (Denmark)

    Dahl, Anders Bjorholm; Dahl, Vedrana Andersen

    2015-01-01

    We propose a method for weakly supervised segmentation of natural images, which may contain both textured or non-textured regions. Our texture representation is based on a dictionary of image patches. To divide an image into separated regions with similar texture we use an implicit level sets...

  3. Pneumonia acquired in the Community

    Directory of Open Access Journals (Sweden)

    María Caridad Fragoso Marchante

    2007-06-01

    Full Text Available A bibliographical revision of the main aspects in the diagnosis and treatment of the patients suffering from pneumonia acquired in the community is carried out. Microorganisms responsible for this type of pneumonia are mention in this paper as well as the available diagnostic methods for germs isolation. Different guidelines for diagnosis and treatment of this disease published by several medical societies and scientific institutions are analyzed by means of a review of the stratification index of the patients used in each of them. Aspects related to the duration of the treatment and the possible causes associated with the unfavorable evolution are stated.

  4. Foodborne listeriosis acquired in hospitals.

    Science.gov (United States)

    Silk, Benjamin J; McCoy, Morgan H; Iwamoto, Martha; Griffin, Patricia M

    2014-08-15

    Listeriosis is characterized by bacteremia or meningitis. We searched for listeriosis case series and outbreak investigations published in English by 2013, and assessed the strength of evidence for foodborne acquisition among patients who ate hospital food. We identified 30 reports from 13 countries. Among the case series, the median proportion of cases considered to be hospital-acquired was 25% (range, 9%-67%). The median number of outbreak-related illnesses considered to be hospital-acquired was 4.0 (range, 2-16). All patients were immunosuppressed in 18 of 24 (75%) reports with available data. Eight outbreak reports with strong evidence for foodborne acquisition in a hospital implicated sandwiches (3 reports), butter, precut celery, Camembert cheese, sausage, and tuna salad (1 report each). Foodborne acquisition of listeriosis among hospitalized patients is well documented internationally. The number of listeriosis cases could be reduced substantially by establishing hospital policies for safe food preparation for immunocompromised patients and by not serving them higher-risk foods.

  5. Pruritic acquired nevus of Ota.

    Science.gov (United States)

    Quenan, S; Strueven, V; Saxer, N; Laffitte, E; Kaya, G; Krischer, J; Hafezi, F; Le Gal, F-A

    2013-01-01

    Nevus of Ota is a unilateral, asymptomatic cutaneous and mucosal hyperpigmentation of the face that is congenital or may appear during childhood. We present a case of symptomatic acquired nevus of Ota in an adult, associated with intense pruritus, not described in the literature so far. A 32-year-old woman presented with brownish mottled macules which appeared on her face progressively over 8 days, following the distribution of the first and second divisions of the left trigeminal nerve and partially covering the iris and sclera of the left eye. She reported an intense pruritus in this area. We performed a biopsy on the left forehead, which confirmed the diagnosis of nevus of Ota. Specific stains and immunohistochemistry revealed increased numbers of mast cells. Ophthalmological tests showed acute acquired melanocytosis of the left iris and sclera. The origin of the nevus is still unclear. Several hypotheses suggest a reactivation of melanocytes during their migration from the neural crest. The pruritus reported in our patient may be explained by the increased quantity of mast cells observed in the lesion and/or neuronal stimulation of the ophthalmic and maxillary divisions of the fifth cranial nerve.

  6. Segmentation in Tardigrada and diversification of segmental patterns in Panarthropoda.

    Science.gov (United States)

    Smith, Frank W; Goldstein, Bob

    2016-10-31

    The origin and diversification of segmented metazoan body plans has fascinated biologists for over a century. The superphylum Panarthropoda includes three phyla of segmented animals-Euarthropoda, Onychophora, and Tardigrada. This superphylum includes representatives with relatively simple and representatives with relatively complex segmented body plans. At one extreme of this continuum, euarthropods exhibit an incredible diversity of serially homologous segments. Furthermore, distinct tagmosis patterns are exhibited by different classes of euarthropods. At the other extreme, all tardigrades share a simple segmented body plan that consists of a head and four leg-bearing segments. The modular body plans of panarthropods make them a tractable model for understanding diversification of animal body plans more generally. Here we review results of recent morphological and developmental studies of tardigrade segmentation. These results complement investigations of segmentation processes in other panarthropods and paleontological studies to illuminate the earliest steps in the evolution of panarthropod body plans.

  7. Cytomegalovirus retinitis associated with acquired immunodeficiency syndrome

    Institute of Scientific and Technical Information of China (English)

    GENG Shuang; YE Jun-jie; ZHAO Jia-liang; LI Tai-sheng; HAN Yang

    2011-01-01

    Background Cytomegalovirus (CMV) retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome (AIDS). This study aimed to investigate the fundus characteristics, systemic manifestations and therapeutic outcomes of CMV retinitis associated with AIDS.Methods It was a retrospective case series. CMV retinitis was present in 39 eyes (25 patients). Best corrected visual acuities, anterior segment, fundus features, fundus fluorescence angiography (FFA) and CD4+ T-lymphocyte counts of the patients with CMV retinitis associated with AIDS were analyzed. Intravitreal injections of ganciclovir (400 μg) were performed in 4 eyes (2 patients).Results Retinal vasculitis, dense, full-thickness, yellow-white lesions along vascular distribution with irregular granules at the border, and hemorrhage on the retinal surface were present in 28 eyes. The vitreous was clear or mildly opaque.Late stage of the retinopathy was demonstrated in 8 eyes characterized as atrophic retina, sclerotic and attenuated vessels, retinal pigment epithelium (RPE) atrophy, and optic nerve atrophy. Retinal detachment was found in 3 eyes. The average CD4+ T-lymphocyte count in peripheral blood of the patients with CMV retinitis was (30.6±25.3) ×106/L (range,(0-85) × 106/L). After intravitreal injections of ganciclovir, visual acuity was improved and fundus lesions regressed.Conclusions CMV retinitis is the most severe and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis without clear cause, human immunodeficiency virus (HIV) serology should be performed. Routine eye examination is also indicated in HIV positive patients.

  8. Two-level evaluation on sensor interoperability of features in fingerprint image segmentation.

    Science.gov (United States)

    Yang, Gongping; Li, Ying; Yin, Yilong; Li, Ya-Shuo

    2012-01-01

    Features used in fingerprint segmentation significantly affect the segmentation performance. Various features exhibit different discriminating abilities on fingerprint images derived from different sensors. One feature which has better discriminating ability on images derived from a certain sensor may not adapt to segment images derived from other sensors. This degrades the segmentation performance. This paper empirically analyzes the sensor interoperability problem of segmentation feature, which refers to the feature's ability to adapt to the raw fingerprints captured by different sensors. To address this issue, this paper presents a two-level feature evaluation method, including the first level feature evaluation based on segmentation error rate and the second level feature evaluation based on decision tree. The proposed method is performed on a number of fingerprint databases which are obtained from various sensors. Experimental results show that the proposed method can effectively evaluate the sensor interoperability of features, and the features with good evaluation results acquire better segmentation accuracies of images originating from different sensors.

  9. Automated Segmentation and Retrieval System for CT Head Images

    Science.gov (United States)

    Tong, Hau-Lee; Ahmad Fauzi, Mohammad Faizal; Komiya, Ryoichi

    In this paper, automatic segmentation and retrieval of medical images are presented. For the segmentation, different unsupervised clustering techniques are employed to partition the Computed Tomography (CT) brain images into three regions, which are the abnormalities, cerebrospinal fluids (CSF) and brain matters. The novel segmentation method proposed is a dual level segmentation approach. The first level segmentation, which purpose is to acquire abnormal regions, uses the combination of fuzzy c-means (FCM) and k-means clustering. The second level segmentation performs either the expectation-maximization (EM) technique or the modified FCM with population-diameter independent (PDI) to segment the remaining intracranial area into CSF and brain matters. The system automatically determines which algorithm to be utilized in order to produce optimum results. The retrieval of the medical images is based on keywords such as "no abnormal region", "abnormal region(s) adjacent to the skull" and "abnormal region(s) not adjacent to the skull". Medical data from collaborating hospital are experimented and promising results are observed.

  10. Market segmentation: Venezuelan ADRs

    Directory of Open Access Journals (Sweden)

    Urbi Garay

    2012-12-01

    Full Text Available The control on foreign exchange imposed by Venezuela in 2003 constitute a natural experiment that allows researchers to observe the effects of exchange controls on stock market segmentation. This paper provides empirical evidence that although the Venezuelan capital market as a whole was highly segmented before the controls were imposed, the shares in the firm CANTV were, through their American Depositary Receipts (ADRs, partially integrated with the global market. Following the imposition of the exchange controls this integration was lost. Research also documents the spectacular and apparently contradictory rise experienced by the Caracas Stock Exchange during the serious economic crisis of 2003. It is argued that, as it happened in Argentina in 2002, the rise in share prices occurred because the depreciation of the Bolívar in the parallel currency market increased the local price of the stocks that had associated ADRs, which were negotiated in dollars.

  11. Complement's participation in acquired immunity

    DEFF Research Database (Denmark)

    Nielsen, Claus Henrik; Leslie, Robert Graham Quinton

    2002-01-01

    of the B cell receptor for antigen (BCR), a complex composed of the iC3b/C3d fragment-binding complement type 2 receptor (CR2, CD21) and its signaling element CD19 and the IgG-binding receptor FcgammaRIIb (CD32). The positive or negative outcome of signaling through this triad is determined by the context...... in which antigen is seen, be it alone or in association with natural or induced antibodies and/or C3-complement fragments. The aim of this review is to describe the present status of our understanding of complement's participation in acquired immunity and the regulation of autoimmune responses....

  12. Lymphoma in acquired generalized lipodystrophy.

    Science.gov (United States)

    Brown, Rebecca J; Chan, Jean L; Jaffe, Elaine S; Cochran, Elaine; DePaoli, Alex M; Gautier, Jean-Francois; Goujard, Cecile; Vigouroux, Corinne; Gorden, Phillip

    2016-01-01

    Acquired generalized lipodystrophy (AGL) is a rare disease thought to result from autoimmune destruction of adipose tissue. Peripheral T-cell lymphoma (PTCL) has been reported in two AGL patients. We report five additional cases of lymphoma in AGL, and analyze the role of underlying autoimmunity and recombinant human leptin (metreleptin) replacement in lymphoma development. Three patients developed lymphoma during metreleptin treatment (two PTCL and one ALK-positive anaplastic large cell lymphoma), and two developed lymphomas (mycosis fungoides and Burkitt lymphoma) without metreleptin. AGL is associated with high risk for lymphoma, especially PTCL. Autoimmunity likely contributes to this risk. Lymphoma developed with or without metreleptin, suggesting metreleptin does not directly cause lymphoma development; a theoretical role of metreleptin in lymphoma progression remains possible. For most patients with AGL and severe metabolic complications, the proven benefits of metreleptin on metabolic disease will likely outweigh theoretical risks of metreleptin in lymphoma development or progression.

  13. Bejel: acquirable only in childhood?

    Science.gov (United States)

    Rothschild, Bruce M; Rothschild, Christine; Naples, Virginia; Billard, Michel; Panero, Barbara

    2006-10-01

    Bejel clearly has a long history in the Middle East and the Sudan, but was it transmitted to Europe? As the major manifestation of bejel is presence of periosteal reaction in 20-40% of afflicted populations, absence of significant population frequency of periosteal reaction in Europe would exclude that diagnosis. Examination of skeletal populations from continental Europe revealed no significant periosteal reaction at the time of and immediately subsequent to the Crusades. Thus, there is no evidence for bejel in Europe, in spite of clear contact (the mechanism of bejel transmission in children) between warring groups, at least during the Crusades. This supports the hypothesis that bejel is a childhood-acquired disease and apparently cannot be contracted in adulthood.

  14. Plume Comparisons between Segmented Channel Hall Thrusters

    Science.gov (United States)

    Niemack, Michael; Staack, David; Raitses, Yevgeny; Fisch, Nathaniel

    2001-10-01

    Angular ion flux plume measurements were taken in several configurations of segmented channel Hall thrusters. The configurations differed by the placement of relatively short rings made from materials with different conductive and secondary electron emission properties along the boron nitride ceramic channel of the thrusters (these have been shown to affect the plume [1]). The ion fluxes are compared with ion trajectory simulations based on plasma potential data acquired with a high speed emissive probe [2]. Preliminary results indicate that in addition to the physical properties of the segments, the plume angle can be strongly affected by the placement of segmented rings relative to the external and internal walls of the channel. [1] Y. Raitses, L. Dorf, A. Litvak and N. J. Fisch, Journal of Applied Physics 88, 1263, 2000 [2] D. Staack, Y. Raitses, N. J. Fisch, Parametric Investigations of Langmuir Probe Induced Perturbations in a Hall Thruster, DPP01 Poster Presentation This work was supported by the U.S. DOE Contract No. DE-ACO2-76-CHO3073.

  15. Connecting textual segments

    DEFF Research Database (Denmark)

    Brügger, Niels

    2017-01-01

    In “Connecting textual segments: A brief history of the web hyperlink” Niels Brügger investigates the history of one of the most fundamental features of the web: the hyperlink. Based on the argument that the web hyperlink is best understood if it is seen as another step in a much longer and broader......-alone computers and in local and global digital networks....

  16. Treatment of soft tissue and tibia defects by using vascularized fibular skeletal flaps%吻合血管的腓骨皮瓣治疗胫骨合并软组织缺损

    Institute of Scientific and Technical Information of China (English)

    王伟; 周业金

    2011-01-01

    Aim To explore the curative effect of vascularized fibular skeletal flaps from the other side in treatment of soft tissue and tibia defects. Methods A total of 13 patients with severe comminuted fractures of tibia,skin and soft tissue defects were reconstructed by using the opposite vascularized fibular skeletal flaps at first stage after thorough debridement. Results All patients were followed up for 17 ~24 months,and severe comminuted fractures of tibia was healed. No amputation was needed and no chronic osteomyelitis occurred.The circulation of revascularized limbs was good and the contour and function were restored satisfactorily. Conclusion It is a reliable choice to reconstruct the defect of the soft tissue and tibia by using contralateral vascularized fibular skeletal flaps.%目的 探讨应用对侧游离腓骨皮瓣移植治疗胫骨及胫前软组织缺损的疗效.方法 对创伤所致胫骨合并胫前软组织缺损的13例患者,在彻底清创后,一期行吻合血管的腓骨皮瓣移植重建.结果 经17~24 个月随访,移植的腓骨皮瓣全部成活,无1例出现截肢及慢性骨髓炎,下肢外形、功能均恢复满意.结论 胫骨骨缺损,同时合并软组织缺损的病人,给予对侧吻合血管的腓骨骨皮瓣移植,在临床上是一种较为可靠的方法.

  17. Market segmentation in behavioral perspective.

    OpenAIRE

    Wells, V.K.; Chang, S. W.; Oliveira-Castro, J.M.; Pallister, J.

    2010-01-01

    A segmentation approach is presented using both traditional demographic segmentation bases (age, social class/occupation, and working status) and a segmentation by benefits sought. The benefits sought in this case are utilitarian and informational reinforcement, variables developed from the Behavioral Perspective Model (BPM). Using data from 1,847 consumers and from a total of 76,682 individual purchases, brand choice and price and reinforcement responsiveness were assessed for each segment a...

  18. 12 CFR 583.1 - Acquire.

    Science.gov (United States)

    2010-01-01

    ... AND LOAN HOLDING COMPANIES § 583.1 Acquire. The term acquire means to acquire, directly or indirectly, ownership or control through an acquisition of shares, an acquisition of assets or assumption of liabilities, a merger or consolidation, or any similar transaction....

  19. Market Segmentation for Information Services.

    Science.gov (United States)

    Halperin, Michael

    1981-01-01

    Discusses the advantages and limitations of market segmentation as strategy for the marketing of information services made available by nonprofit organizations, particularly libraries. Market segmentation is defined, a market grid for libraries is described, and the segmentation of information services is outlined. A 16-item reference list is…

  20. Segmenting the Adult Education Market.

    Science.gov (United States)

    Aurand, Tim

    1994-01-01

    Describes market segmentation and how the principles of segmentation can be applied to the adult education market. Indicates that applying segmentation techniques to adult education programs results in programs that are educationally and financially satisfying and serve an appropriate population. (JOW)

  1. Market Segmentation for Information Services.

    Science.gov (United States)

    Halperin, Michael

    1981-01-01

    Discusses the advantages and limitations of market segmentation as strategy for the marketing of information services made available by nonprofit organizations, particularly libraries. Market segmentation is defined, a market grid for libraries is described, and the segmentation of information services is outlined. A 16-item reference list is…

  2. Segmenting the Adult Education Market.

    Science.gov (United States)

    Aurand, Tim

    1994-01-01

    Describes market segmentation and how the principles of segmentation can be applied to the adult education market. Indicates that applying segmentation techniques to adult education programs results in programs that are educationally and financially satisfying and serve an appropriate population. (JOW)

  3. Cues That Language Users Exploit to Segment Speech

    Institute of Scientific and Technical Information of China (English)

    陈冰茹

    2015-01-01

    <正>The capability to segment words from fluent speech is an important step for learning and acquiring a language(Jusczyk,1999).Therefore,a number of researches and studies have focused on various cues that language learners exploit to locate word boundaries.During the half century,it has been discussed that there are mainly four crucial cues can be used by listeners to segment words in speech.Particularly,they are:(1)Prosody(Echols et al.1997;Jusczyk et al.1996):(2)Statistical and distributional regularities(Brent et al.1996;Saffran et al.1996);(3)Phonotactics(Brent et al.1996;Myers et al.1996);

  4. Effects of Ovariectomy and Corticosteroid-Induced Osteoporosis on the Osteoinductivity of rhBMP-2 in a Segmental Long-Bone Defect Model.

    Science.gov (United States)

    Lee, Jae Hyup; Baek, Hae-Ri; Lee, Kyung-Mee; Zheng, Guang Bin; Shin, Sung Joon; Shim, Hee-Jong

    2015-08-01

    This study used the segmental long-bone defect model to assess the effects of osteoporosis on the formation of new bones and the osteoinductivity of recombinant human bone morphogenetic protein-2 (rhBMP-2). Seventy-two female Sprague-Dawley rats were divided into two groups: an osteoporosis group with ovariectomies and dexamathasone intramuscular injections and a sham group. When they reached 22 weeks in age, each group was further divided into two groups and a 5-mm defect was made in both fibular mid-shafts of each rat. One fibula in each rat was picked randomly and was injected with 0.05 mL of hydrogel carrier; the opposite fibula was injected with the same carrier mixed with rhBMP-2 (10 μg). After rearing for a further 5 and 9 weeks, the ratios of the lengths of the newly formed bones in the fibular defects were determined using micro-CT and undecalcified histology. The sham rhBMP-2-injected group-in all of the 5- and 9-week-kept groups-showed a significantly higher bridging bone formation ratio than the other three groups. The osteoporosis rhBMP-2-injected group showed a significantly higher ratio than both the non-rhBMP-2-injected sham hydrogel and the osteoporosis hydrogel groups. The comparison of the micro-CT parameters of the newly formed bones showed that the sham rhBMP-2 group at both 5 and 9 weeks compared with the osteoporosis rhBMP-2 group had significantly higher percentage bone volumes, trabecular thicknesses, and trabecular numbers, in addition to significantly lower specific surfaces, trabecular pattern factors, and structural model indices. The histology results showed that the sham-rhBMP-2 group began forming bridging bones in the defect areas at 5 weeks, and at 9 weeks, trabeculae and marrow spaces were observed. However, the osteoporosis rhBMP-2 group exhibited a relatively minor level of new bone and trabecula formation. Consequently, the rhBMP-2 group showed significantly increased bone formation in the osteoporosis rat fibular defect

  5. Autologous grafts of double-strut fibular cortical bone plate to treat the fractures and defects of distal femur: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    CHEN Xu

    2012-02-01

    Full Text Available 【Abstract】We reported a 23-year-old man who was involved in a high-speed motorcycle accident. He sustained a closed fracture at the right distal femur. The primary fracture happened on February 2008. He underwent open reduction and internal fixation with cloverleaf plate. And one hundred days after the surgery, the proximal screws were pulled-out, but the bone union was not achieved. Treatment consisted of exchanging the cloverleaf plate with a locking compression plate and using an auto-iliac bone graft to fill the nonunion gap. In July 2009, the patient had a sharp pain in the right lower limb. The X-ray revealed that the plate implanted last year was broken, causing a nonunion at the fracture site. Immediately the plate and screws were removed and an intramedullary nail was inserted reversely from the distal femur as well as a 7 cm long bone from the right fibula was extracted and longitudinally split into two pieces to construct cortical bone plates. Then we placed them laterally and medially to fracture site, drilled two holes respectively, and fastened them with suture. We carried on auto-iliac bone grafting with the nonunion bone grafts. The follow-up at 15 months after operation showed that the treatment was successful, X-ray confirmed that there was no rotation and no angular or short deformity. We briefly reviewed the literature regarding such an unusual presentation and discussed in details the possible etiology and the advantages of autologous double-strut fibular grafts to cope with such an intractable situation. Key words: Femur; Transplantation, autologous; Bone screws

  6. Autologous grafts of double-strut fibular cortical bone plate to treat the fractures and defects of distal femur: a case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    CHEN Xu; LI Jian-jun; KONG Zhan; YANG Dong-xiang; YUAN Xiang-nan

    2011-01-01

    We reported a 23-year-old man who was involved in a high-speed motorcycle accident. He sustained a closed fracture at the right distal femur. The primary fracture happened on February 2008. He underwent open reduction and internal fixation with cloverleaf plate. And one hundred days after the surgery, the proximal screws were pulled-out, but the bone union was not achieved. Treat ment consisted of exchanging the cloverleaf plate with a locking compression plate and using an auto-iliac bone graft to fill the nonunion gap. In July 2009, the patient had a sharp pain in the right lower limb. The X-ray revealed that the plate implanted last year was broken, causing a nonunion at the fracture site. Immediately the plate and screws were removed and an intramedullary nail was inserted reversely from the distal femur as well as a 7 cm long bone from the right fibula was extracted and longitudinally split into two pieces to construct cortical bone plates. Then we placed them laterally and medially to fracture site, drilled two holes respectively, and fastened them with suture. We carried on auto-iliac bone grafting with the nonunion bone grafts. The follow-up at 15 months after operation showed that the treatment was successful, X-ray confirmed that there was no rotation and no angular or short deformity. We briefly reviewed the literature regarding such an unusual presentation and discussed in details the possible etiology and the advantages of autologous double-strut fibular grafts to cope with such an intractable situation.

  7. Functional Outcome of CAD/CAM-Assisted versus Conventional Microvascular, Fibular Free Flap Reconstruction of the Mandible: A Retrospective Study of 30 Cases.

    Science.gov (United States)

    Ritschl, Lucas M; Mücke, Thomas; Fichter, Andreas; Güll, Florian D; Schmid, Christopher; Duc, Jean Marc Pho; Kesting, Marco R; Wolff, Klaus-Dietrich; Loeffelbein, Denys J

    2017-01-18

    Background Different advantages of virtually planned and guided mandibular reconstructions have been described. Functional analyses and comparisons with conventionally reconstructed patients. Methods We retrospectively analyzed 30 cases of mandibular reconstructions that involved virtually planned or conventional microvascular, fibular free flaps that occurred between April 2011 and December 2014 at a single center. The results were also compared with a healthy cohort of 30 participants. Axiographic measurements were performed postoperatively, and uni- and multivariate regressions analyses were performed to determine the association between possible predictor variables on functional outcome. Results Operation time, hospital stay, number of osteotomies, incidence of postoperative temporomandibular joint pain, noise, and tension did not differ significantly between the conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) groups (each p > 0.05). Mouth opening and protrusion and laterotrusion also did not differ significantly (each p > 0.05) but were significantly reduced compared with the healthy group. Univariate analysis showed a significant influence of postoperative irradiation on mouth opening and laterotrusion in the conventional group (p = 0.047 and p = 0.028). In addition, multivariate analysis showed a significant influence of indication and number of osteotomies on laterotrusion (p = 0.005 and p = 0.043). Uni and multivariate analyses revealed a significant influence of indication, preoperative irradiation, and number of osteotomies on protrusion and mouth opening in the CAD/CAM group (p = 0.016, p = 0.044, and p = 0.028). Conclusion CAD/CAM-assisted reconstructions of the mandible give comparable functional results with those of the conventional technique, but no functional superiority has been established. Nevertheless, the integration of virtual planning and guided surgery is definitely

  8. Segmentation and separation of venous vasculatures in liver CT images

    Science.gov (United States)

    Wang, Lei; Hansen, Christian; Zidowitz, Stephan; Hahn, Horst K.

    2014-03-01

    Computer-aided analysis of venous vasculatures including hepatic veins and portal veins is important in liver surgery planning. The analysis normally consists of two important pre-processing tasks: segmenting both vasculatures and separating them from each other by assigning different labels. During the acquisition of multi-phase CT images, both of the venous vessels are enhanced by injected contrast agent and acquired either in a common phase or in two individual phases. The enhanced signals established by contrast agent are often not stably acquired due to non-optimal acquisition time. Inadequate contrast and the presence of large lesions in oncological patients, make the segmentation task quite challenging. To overcome these diffculties, we propose a framework with minimal user interactions to analyze venous vasculatures in multi-phase CT images. Firstly, presented vasculatures are automatically segmented adopting an efficient multi-scale Hessian-based vesselness filter. The initially segmented vessel trees are then converted to a graph representation, on which a series of graph filters are applied in post-processing steps to rule out irrelevant structures. Eventually, we develop a semi-automatic workow to refine the segmentation in the areas of inferior vena cava and entrance of portal veins, and to simultaneously separate hepatic veins from portal veins. Segmentation quality was evaluated with intensive tests enclosing 60 CT images from both healthy liver donors and oncological patients. To quantitatively measure the similarities between segmented and reference vessel trees, we propose three additional metrics: skeleton distance, branch coverage, and boundary surface distance, which are dedicated to quantifying the misalignment induced by both branching patterns and radii of two vessel trees.

  9. Inherited or acquired metabolic disorders.

    Science.gov (United States)

    Eichler, Florian; Ratai, Eva; Carroll, Jason J; Masdeu, Joseph C

    2016-01-01

    This chapter starts with a description of imaging of inherited metabolic disorders, followed by a discussion on imaging of acquired toxic-metabolic disorders of the adult brain. Neuroimaging is crucial for the diagnosis and management of a number of inherited metabolic disorders. Among these, inherited white-matter disorders commonly affect both the nervous system and endocrine organs. Magnetic resonance imaging (MRI) has enabled new classifications of these disorders that have greatly enhanced both our diagnostic ability and our understanding of these complex disorders. Beyond the classic leukodystrophies, we are increasingly recognizing new hereditary leukoencephalopathies such as the hypomyelinating disorders. Conventional imaging can be unrevealing in some metabolic disorders, but proton magnetic resonance spectroscopy (MRS) may be able to directly visualize the metabolic abnormality in certain disorders. Hence, neuroimaging can enhance our understanding of pathogenesis, even in the absence of a pathologic specimen. This review aims to present pathognomonic brain MRI lesion patterns, the diagnostic capacity of proton MRS, and information from clinical and laboratory testing that can aid diagnosis. We demonstrate that applying an advanced neuroimaging approach enhances current diagnostics and management. Additional information on inherited and metabolic disorders of the brain can be found in Chapter 63 in the second volume of this series.

  10. Comparison of automated and manual segmentation of hippocampus MR images

    Science.gov (United States)

    Haller, John W.; Christensen, Gary E.; Miller, Michael I.; Joshi, Sarang C.; Gado, Mokhtar; Csernansky, John G.; Vannier, Michael W.

    1995-05-01

    The precision and accuracy of area estimates from magnetic resonance (MR) brain images and using manual and automated segmentation methods are determined. Areas of the human hippocampus were measured to compare a new automatic method of segmentation with regions of interest drawn by an expert. MR images of nine normal subjects and nine schizophrenic patients were acquired with a 1.5-T unit (Siemens Medical Systems, Inc., Iselin, New Jersey). From each individual MPRAGE 3D volume image a single comparable 2-D slice (matrix equals 256 X 256) was chosen which corresponds to the same coronal slice of the hippocampus. The hippocampus was first manually segmented, then segmented using high dimensional transformations of a digital brain atlas to individual brain MR images. The repeatability of a trained rater was assessed by comparing two measurements from each individual subject. Variability was also compared within and between subject groups of schizophrenics and normal subjects. Finally, the precision and accuracy of automated segmentation of hippocampal areas were determined by comparing automated measurements to manual segmentation measurements made by the trained rater on MR and brain slice images. The results demonstrate the high repeatability of area measurement from MR images of the human hippocampus. Automated segmentation using high dimensional transformations from a digital brain atlas provides repeatability superior to that of manual segmentation. Furthermore, the validity of automated measurements was demonstrated by a high correlation with manual segmentation measurements made by a trained rater. Quantitative morphometry of brain substructures (e.g. hippocampus) is feasible by use of a high dimensional transformation of a digital brain atlas to an individual MR image. This method automates the search for neuromorphological correlates of schizophrenia by a new mathematically robust method with unprecedented sensitivity to small local and regional differences.

  11. Signs of segmentation?

    DEFF Research Database (Denmark)

    Ilsøe, Anna

    2012-01-01

    This article addresses the contribution of decentralized collective bargaining to the development of different forms of flexicurity for different groups of employees on the Danish labour market. Based on five case studies of company-level bargaining on flexible working hours in Danish industry...... the text of the agreements. On the other hand, less flexible employees often face difficulties in meeting the demands of the agreements and may ultimately be forced to leave the company and rely on unemployment benefits and active labour market policies. In a flexicurity perspective, this development seems...... to imply a segmentation of the Danish workforce regarding hard and soft versions of flexicurity....

  12. Noncooperative Iris Segmentation

    Directory of Open Access Journals (Sweden)

    Elsayed Mostafa

    2012-01-01

    Full Text Available In noncooperative iris recognition one should deal with uncontrolled behavior of the subject as well as uncontrolled lighting conditions. That means eyelids and eyelashes occlusion, non uniform intensities, reflections, imperfect focus, and orientation among the others are to be considered. To cope with this situation a noncooperative iris segmentation algorithm based on numerically stable direct least squares fitting of ellipses model and modified Chan-Vese model (local binary fitting energy with variational level set formulation is to be proposed. The proposed algorithm is tested using CASIA-IrisV3.

  13. The LOFT Ground Segment

    DEFF Research Database (Denmark)

    Bozzo, E.; Antonelli, A.; Argan, A.;

    2014-01-01

    targets per orbit (~90 minutes), providing roughly ~80 GB of proprietary data per day (the proprietary period will be 12 months). The WFM continuously monitors about 1/3 of the sky at a time and provides data for about ~100 sources a day, resulting in a total of ~20 GB of additional telemetry. The LOFT...... we summarize the planned organization of the LOFT ground segment (GS), as established in the mission Yellow Book 1 . We describe the expected GS contributions from ESA and the LOFT consortium. A review is provided of the planned LOFT data products and the details of the data flow, archiving...

  14. Progressive specification rather than intercalation of segments during limb regeneration.

    Science.gov (United States)

    Roensch, Kathleen; Tazaki, Akira; Chara, Osvaldo; Tanaka, Elly M

    2013-12-13

    An amputated salamander limb regenerates the correct number of segments. Models explaining limb regeneration were largely distinct from those for limb development, despite the presence of common patterning molecules. Intercalation has been an important concept to explain salamander limb regeneration, but clear evidence supporting or refuting this model was lacking. In the intercalation model, the first blastema cells acquire fingertip identity, creating a gap in positional identity that triggers regeneration of the intervening region from the stump. We used HOXA protein analysis and transplantation assays to show that axolotl limb blastema cells acquire positional identity in a proximal-to-distal sequence. Therefore, intercalation is not the primary mechanism for segment formation during limb regeneration in this animal. Patterning in development and regeneration uses similar mechanisms.

  15. 17 CFR 210.8-04 - Financial statements of businesses acquired or to be acquired.

    Science.gov (United States)

    2010-04-01

    ... businesses acquired or to be acquired. (a) If a business combination has occurred or is probable, financial... section. The required financial statements of related businesses may be presented on a combined basis for... financial statements of the business acquired or to be acquired and the smaller reporting company's...

  16. 17 CFR 210.8-06 - Real estate operations acquired or to be acquired.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Real estate operations acquired or to be acquired. 210.8-06 Section 210.8-06 Commodity and Securities Exchanges SECURITIES AND... Statements of Smaller Reporting Companies § 210.8-06 Real estate operations acquired or to be acquired. If...

  17. OASIS is Automated Statistical Inference for Segmentation, with applications to multiple sclerosis lesion segmentation in MRI.

    Science.gov (United States)

    Sweeney, Elizabeth M; Shinohara, Russell T; Shiee, Navid; Mateen, Farrah J; Chudgar, Avni A; Cuzzocreo, Jennifer L; Calabresi, Peter A; Pham, Dzung L; Reich, Daniel S; Crainiceanu, Ciprian M

    2013-01-01

    Magnetic resonance imaging (MRI) can be used to detect lesions in the brains of multiple sclerosis (MS) patients and is essential for diagnosing the disease and monitoring its progression. In practice, lesion load is often quantified by either manual or semi-automated segmentation of MRI, which is time-consuming, costly, and associated with large inter- and intra-observer variability. We propose OASIS is Automated Statistical Inference for Segmentation (OASIS), an automated statistical method for segmenting MS lesions in MRI studies. We use logistic regression models incorporating multiple MRI modalities to estimate voxel-level probabilities of lesion presence. Intensity-normalized T1-weighted, T2-weighted, fluid-attenuated inversion recovery and proton density volumes from 131 MRI studies (98 MS subjects, 33 healthy subjects) with manual lesion segmentations were used to train and validate our model. Within this set, OASIS detected lesions with a partial area under the receiver operating characteristic curve for clinically relevant false positive rates of 1% and below of 0.59% (95% CI; [0.50%, 0.67%]) at the voxel level. An experienced MS neuroradiologist compared these segmentations to those produced by LesionTOADS, an image segmentation software that provides segmentation of both lesions and normal brain structures. For lesions, OASIS out-performed LesionTOADS in 74% (95% CI: [65%, 82%]) of cases for the 98 MS subjects. To further validate the method, we applied OASIS to 169 MRI studies acquired at a separate center. The neuroradiologist again compared the OASIS segmentations to those from LesionTOADS. For lesions, OASIS ranked higher than LesionTOADS in 77% (95% CI: [71%, 83%]) of cases. For a randomly selected subset of 50 of these studies, one additional radiologist and one neurologist also scored the images. Within this set, the neuroradiologist ranked OASIS higher than LesionTOADS in 76% (95% CI: [64%, 88%]) of cases, the neurologist 66% (95% CI: [52%, 78

  18. Acquired immune deficiency syndrome: review.

    Science.gov (United States)

    Scully, C; Cawson, R A; Porter, S R

    1986-07-19

    Acquired immunodeficiency syndrome (AIDS) is reviewed for dental practitioners, with an emphasis on oral findings; the clinical course, diagnosis, reporting, treatment, prognosis, transmission, and epidemiology are also covered. HIV infection has an incubation period that may be associated with glandular fever, a prodrome called AIDS-Related Complex (ARC) characterized by lymphadenopathy, low fever, weight loss, night sweats, diarrhea, oral candidosis, nonproductive cough and recurrent infections. AIDS is characterized by opportunistic infections. Over 50% present with pneumocystis carinii pneumonia, 21% with Kaposi's sarcoma, and 6% have both. The AIDS virus causes direct neurological symptoms in some cases. Oral candidosis (thrush) in a young male without a local cause such as xerostomia or immune suppression is strongly suggestive of AIDS. Other oral manifestations are severe herpes simplex, varicella-zoster, Epstein-Barr virus, cytomegalovirus, venereal warts, aphthous ulceration, mycobacterial oral ulcers, oral histoplasmosis, sinusitis and osteomyelitis of the jaw. Hairy leukoplakia, usually seen on the lateral border of the tongue, is probably caused by Epstein-Barr virus. Kaposi's sarcoma, an endothelial cell tumor, is characteristic of AIDS, and in 50% of patients is oral or perioral. Cervical lymph node enlargement will be seen in those with ARC as well as AIDS. No guidelines have been issued by the Department of Health and Social Security for dental surgeons in the UK for reporting AIDS cases. Although HIV virions have been isolated from saliva, there are no known incidents of transmission via saliva. HIV is less likely to be transmitted by needle stick injuries than, for example hepatitis B (25% risk), especially if the blood is from a carrier rather than a full blown AIDS case.

  19. Segmented Target Design

    Science.gov (United States)

    Merhi, Abdul Rahman; Frank, Nathan; Gueye, Paul; Thoennessen, Michael; MoNA Collaboration

    2013-10-01

    A proposed segmented target would improve decay energy measurements of neutron-unbound nuclei. Experiments like this have been performed at the National Superconducting Cyclotron Laboratory (NSCL) located at Michigan State University. Many different nuclei are produced in such experiments, some of which immediately decay into a charged particle and neutron. The charged particles are bent by a large magnet and measured by a suite of charged particle detectors. The neutrons are measured by the Modular Neutron Array (MoNA) and Large Multi-Institutional Scintillation Array (LISA). With the current target setup, a nucleus in a neutron-unbound state is produced with a radioactive beam impinged upon a beryllium target. The resolution of these measurements is very dependent on the target thickness since the nuclear interaction point is unknown. In a segmented target using alternating layers of silicon detectors and Be-targets, the Be-target in which the nuclear reaction takes place would be determined. Thus the experimental resolution would improve. This poster will describe the improvement over the current target along with the status of the design. Work supported by Augustana College and the National Science Foundation grant #0969173.

  20. Segmentation of choroidal neovascularization in fundus fluorescein angiograms.

    Science.gov (United States)

    Abdelmoula, Walid M; Shah, Syed M; Fahmy, Ahmed S

    2013-05-01

    Choroidal neovascularization (CNV) is a common manifestation of age-related macular degeneration (AMD). It is characterized by the growth of abnormal blood vessels in the choroidal layer causing blurring and deterioration of the vision. In late stages, these abnormal vessels can rupture the retinal layers causing complete loss of vision at the affected regions. Determining the CNV size and type in fluorescein angiograms is required for proper treatment and prognosis of the disease. Computer-aided methods for CNV segmentation is needed not only to reduce the burden of manual segmentation but also to reduce inter- and intraobserver variability. In this paper, we present a framework for segmenting CNV lesions based on parametric modeling of the intensity variation in fundus fluorescein angiograms. First, a novel model is proposed to describe the temporal intensity variation at each pixel in image sequences acquired by fluorescein angiography. The set of model parameters at each pixel are used to segment the image into regions of homogeneous parameters. Preliminary results on datasets from 21 patients with Wet-AMD show the potential of the method to segment CNV lesions in close agreement with the manual segmentation.

  1. Evaluating the impact of image preprocessing on iris segmentation

    Directory of Open Access Journals (Sweden)

    José F. Valencia-Murillo

    2014-08-01

    Full Text Available Segmentation is one of the most important stages in iris recognition systems. In this paper, image preprocessing algorithms are applied in order to evaluate their impact on successful iris segmentation. The preprocessing algorithms are based on histogram adjustment, Gaussian filters and suppression of specular reflections in human eye images. The segmentation method introduced by Masek is applied on 199 images acquired under unconstrained conditions, belonging to the CASIA-irisV3 database, before and after applying the preprocessing algorithms. Then, the impact of image preprocessing algorithms on the percentage of successful iris segmentation is evaluated by means of a visual inspection of images in order to determine if circumferences of iris and pupil were detected correctly. An increase from 59% to 73% in percentage of successful iris segmentation is obtained with an algorithm that combine elimination of specular reflections, followed by the implementation of a Gaussian filter having a 5x5 kernel. The results highlight the importance of a preprocessing stage as a previous step in order to improve the performance during the edge detection and iris segmentation processes.

  2. Segmentation precision of abdominal anatomy for MRI-based radiotherapy.

    Science.gov (United States)

    Noel, Camille E; Zhu, Fan; Lee, Andrew Y; Yanle, Hu; Parikh, Parag J

    2014-01-01

    The limited soft tissue visualization provided by computed tomography, the standard imaging modality for radiotherapy treatment planning and daily localization, has motivated studies on the use of magnetic resonance imaging (MRI) for better characterization of treatment sites, such as the prostate and head and neck. However, no studies have been conducted on MRI-based segmentation for the abdomen, a site that could greatly benefit from enhanced soft tissue targeting. We investigated the interobserver and intraobserver precision in segmentation of abdominal organs on MR images for treatment planning and localization. Manual segmentation of 8 abdominal organs was performed by 3 independent observers on MR images acquired from 14 healthy subjects. Observers repeated segmentation 4 separate times for each image set. Interobserver and intraobserver contouring precision was assessed by computing 3-dimensional overlap (Dice coefficient [DC]) and distance to agreement (Hausdorff distance [HD]) of segmented organs. The mean and standard deviation of intraobserver and interobserver DC and HD values were DC(intraobserver) = 0.89 ± 0.12, HD(intraobserver) = 3.6mm ± 1.5, DC(interobserver) = 0.89 ± 0.15, and HD(interobserver) = 3.2mm ± 1.4. Overall, metrics indicated good interobserver/intraobserver precision (mean DC > 0.7, mean HD segmentation precision for abdominal sites. These findings support the utility of MRI for abdominal planning and localization, as emerging MRI technologies, techniques, and onboard imaging devices are beginning to enable MRI-based radiotherapy.

  3. Segmentation of the Infant Food Market

    OpenAIRE

    Hrůzová, Daniela

    2015-01-01

    The theoretical part covers general market segmentation, namely the marketing importance of differences among consumers, the essence of market segmentation, its main conditions and the process of segmentation, which consists of four consecutive phases - defining the market, determining important criteria, uncovering segments and developing segment profiles. The segmentation criteria, segmentation approaches, methods and techniques for the process of market segmentation are also described in t...

  4. Segmentation of the Infant Food Market

    OpenAIRE

    Hrůzová, Daniela

    2015-01-01

    The theoretical part covers general market segmentation, namely the marketing importance of differences among consumers, the essence of market segmentation, its main conditions and the process of segmentation, which consists of four consecutive phases - defining the market, determining important criteria, uncovering segments and developing segment profiles. The segmentation criteria, segmentation approaches, methods and techniques for the process of market segmentation are also described in t...

  5. 三种人体数据集的腓骨瓣三维可视化应用研究%Application of 3D visnalization models of fibular flap developed by three human digital datasets

    Institute of Scientific and Technical Information of China (English)

    豆勇刚; 余斌; 钟梅; 金丹; 黎健伟; 张元智; 裴国献

    2008-01-01

    目的 研究三种人体数据集的腓骨瓣三维可视化应用. 方法 ①健康自愿者2人,经肘静脉注射造影剂,使用64排多层螺旋CT进行双下肢扫描,观察腓动脉及其分支分布及彼此间的吻合情况,将下肢二维灰度.DICOM格式图像以三维体数据的形式输入计算机,应用Amira4.1软件对腓动脉及腓骨的结构进行三维重建并立体显示.②取新鲜捐献尸体1具,采用改良的明胶-氧化铅灌注术经腹主动脉灌注,灌注后对双下肢行连续螺旋CT扫描,观察腓动脉及其分支的分布情况.利用Amira4.1软件对腓动脉及其分支结构进行三维重建并立体显示.③应用"虚拟中国人"(VCH)男性3号数据集,在薄层断面图像上观察小腿主要解剖结构,应用Amira4.1软件对小腿主要结构进行计算机三维重建并立体显示. 结果 运用Amira4.1图像处理软件,在三维表面重建的图像中可清晰地观察到外科腓骨瓣各解剖结构的形态,特别是腓动脉的分支情况和体表的投影得到很好的显示.利用软件的Movie Maker模板创建电影文件,将其制作为电影,画面清晰流畅,可直观、立体地显示形态特征. 结论 三种数据集重建的图像可以提供正常腓骨瓣三维动态解剖,对腓骨瓣的临床试验、基础研究、临床训练和手术规划具有重要应用价值.%Objective To explore application of the 3D visualization models of fibular flap developed by 3 human digital datasets. Methods First, 2 adult volunteers underwent contrast-enhance CT angiography of lower limbs using a 64-row multi-slice spiral CT after injection of Ultravist (3.5ml/s) through the median cubital vein. The 2D images from the scanning in DICOM format were transformed into three-dimensional data by computer. The structures of fibular flap were observed and digital visualization models of fibular flap were established by three-dimensional computerixed reconstruction out of these data using Amira 4. 1

  6. Cerebral vessels segmentation for light-sheet microscopy image using convolutional neural networks

    Science.gov (United States)

    Hu, Chaoen; Hui, Hui; Wang, Shuo; Dong, Di; Liu, Xia; Yang, Xin; Tian, Jie

    2017-03-01

    Cerebral vessel segmentation is an important step in image analysis for brain function and brain disease studies. To extract all the cerebrovascular patterns, including arteries and capillaries, some filter-based methods are used to segment vessels. However, the design of accurate and robust vessel segmentation algorithms is still challenging, due to the variety and complexity of images, especially in cerebral blood vessel segmentation. In this work, we addressed a problem of automatic and robust segmentation of cerebral micro-vessels structures in cerebrovascular images acquired by light-sheet microscope for mouse. To segment micro-vessels in large-scale image data, we proposed a convolutional neural networks (CNNs) architecture trained by 1.58 million pixels with manual label. Three convolutional layers and one fully connected layer were used in the CNNs model. We extracted a patch of size 32x32 pixels in each acquired brain vessel image as training data set to feed into CNNs for classification. This network was trained to output the probability that the center pixel of input patch belongs to vessel structures. To build the CNNs architecture, a series of mouse brain vascular images acquired from a commercial light sheet fluorescence microscopy (LSFM) system were used for training the model. The experimental results demonstrated that our approach is a promising method for effectively segmenting micro-vessels structures in cerebrovascular images with vessel-dense, nonuniform gray-level and long-scale contrast regions.

  7. 带血管腓骨头移植治疗桡骨远端骨肿瘤%Vascularized fibular head transplantation for treatment of distal radius bone neoplasms

    Institute of Scientific and Technical Information of China (English)

    叶永杰; 阳波; 岑石强; 黄富国; 罗斌; 银毅; 陈刚; 冯应树

    2012-01-01

    目的 观察带血管腓骨头移植治疗桡骨远端骨肿瘤的临床疗效.方法 自2007年6月至2010年12月,应用带血管腓骨头移植治疗桡骨远端良性复发肿瘤及恶性骨肿瘤患者6例,年龄17~ 53岁,平均32.5岁.其中3例患者为多次手术后复发.患者均知情同意后,行肿瘤En-bolc 切除,采用带血管腓骨头移植重建骨缺损及桡腕关节,同时行内固定术,移植腓骨长度为11~ 16 cm.结果 6例患者均获得随访,随访时间6个月至3年,平均19个月.手术切口Ⅰ期愈合,无感染发生,移植腓骨均获骨性愈合,部分患者已行内固定取出.Mayo腕关节功能评分为55~90分,平均82分.Gartland-Werley腕关节功能评分:优1例,良4例,中1例;优良率83.3%.结论 带血管腓骨头移植用于修复桡骨远端肿瘤性骨缺损是可行的,尤其是对于桡腕关节的骨支架支撑重建具有其独特的优点,但仍需积累更多病例及更长期的随访,以观察远期效果.%Objective To evaluate the clinical outcomes of autologous vascularized fibular head transfer for repair of distal radius bone defects caused by bone tumor.Methods From June 2007 to December 2010 vascularized fibular head transfer was used in the treatment of distal radius bone defect caused by resection of benign recurrent tumors and malignant bone tumors in 6 patients.Patient ages were 17 to 53 years,with a mean of 32.5 years.Three patients had multiple tumor recurrence.After informed consent was obtained,tumor Enbolc excision was carried out.The bone defect and wrist joint surface was repaired using vascularized fibular head transfer with intemal fixation.The transplanted fibula was 11 to 16 cm in length.Results All 6 patients were follow-up for6 months to 3 years,with an average of 19 months.Primary wound healing was aclieved in all cases without infection.Healing and integration of the transplanted fibular head was observed and internal fixation removed in some patients.Mayo wrist

  8. TSSOM:Transmembrane Segments Prediction by Self—Organizing Map

    Institute of Scientific and Technical Information of China (English)

    LIUQi; ZHUYisheng; WANGBaohua; LIYixue

    2003-01-01

    A novel method ealled TSSOM(Transmembrane segments prediction by self-organizing map)is presented in the paper.The main idea of the method lies in the application of self-organizing feature map together with special visualization techniques to classify the multivariate "time" series of transmembrane proteins into flve classes.Through the analysis of resulting trajectories on the map,frequent patterns of transmembrane segments are detected and even some kind of "new"knowledge about membrane insertion mechanism is acquired.The discovered patterns and the knowledge are then used to predict transmembrane segments for auery sequence.The prediction results not only show that the method is powerful,but also prove that the patterns and the knowledge about the interaction bwtween the patterns are effective and acceptable.

  9. Segmentation of the mouse hippocampal formation in magnetic resonance images.

    Science.gov (United States)

    Richards, Kay; Watson, Charles; Buckley, Rachel F; Kurniawan, Nyoman D; Yang, Zhengyi; Keller, Marianne D; Beare, Richard; Bartlett, Perry F; Egan, Gary F; Galloway, Graham J; Paxinos, George; Petrou, Steven; Reutens, David C

    2011-10-01

    The hippocampal formation plays an important role in cognition, spatial navigation, learning, and memory. High resolution magnetic resonance (MR) imaging makes it possible to study in vivo changes in the hippocampus over time and is useful for comparing hippocampal volume and structure in wild type and mutant mice. Such comparisons demand a reliable way to segment the hippocampal formation. We have developed a method for the systematic segmentation of the hippocampal formation using the perfusion-fixed C57BL/6 mouse brain for application in longitudinal and comparative studies. Our aim was to develop a guide for segmenting over 40 structures in an adult mouse brain using 30 μm isotropic resolution images acquired with a 16.4 T MR imaging system and combined using super-resolution reconstruction.

  10. Image Mosaic Method Based on SIFT Features of Line Segment

    Directory of Open Access Journals (Sweden)

    Jun Zhu

    2014-01-01

    Full Text Available This paper proposes a novel image mosaic method based on SIFT (Scale Invariant Feature Transform feature of line segment, aiming to resolve incident scaling, rotation, changes in lighting condition, and so on between two images in the panoramic image mosaic process. This method firstly uses Harris corner detection operator to detect key points. Secondly, it constructs directed line segments, describes them with SIFT feature, and matches those directed segments to acquire rough point matching. Finally, Ransac method is used to eliminate wrong pairs in order to accomplish image mosaic. The results from experiment based on four pairs of images show that our method has strong robustness for resolution, lighting, rotation, and scaling.

  11. Cryptosporidiosis in the acquired immune deficiency syndrome.

    Science.gov (United States)

    Cooper, D A; Wodak, A; Marriot, D J; Harkness, J L; Ralston, M; Hill, A; Penny, R

    1984-10-01

    Cryptosporidiosis was found in a patient with the acquired immune deficiency syndrome. The microbiological and morphological features of this newly recognized opportunistic infection are distinctive and diagnostic.

  12. Acquired Dyslexia and Dysgraphia in Chinese

    Directory of Open Access Journals (Sweden)

    Wengang Yin

    2005-01-01

    Full Text Available Understanding how the mappings between orthography and phonology in alphabetic languages are learned, represented and processed has been enhanced by the cognitive neuropsychological investigation of patients with acquired reading and writing disorders. During the past decade, this methodology has been extended to understanding reading and writing in Chinese leading to new insights about language processing, dyslexia and dysgraphia. The aim of this paper is to review reports of patients who have acquired dyslexia and acquired dysgraphia in Chinese and describe the functional architecture of the reading and writing system. Our conclusion is that the unique features of Chinese script will determine the symptoms of acquired dyslexia and dysgraphia in Chinese.

  13. EFFICIENT IRIS SEGMENTATION BASED ON EYELID DETECTION

    Directory of Open Access Journals (Sweden)

    ABDULJALIL RADMAN

    2013-08-01

    Full Text Available This paper proposes a computationally efficient eyelid detection algorithm for detecting eyelid boundaries in iris images acquired under less constrained imaging conditions. The proposed eyelid detection algorithm is developed based on the live-wire technique. The major advantage of the proposed algorithm is its computational simplicity as compared to the prior eyelid detection algorithms. The saturation color features of the sclera region of the HSI color space of the iris image are exploited to determine the two intersection points between each eyelid and the outer iris boundary. The strongly connected edges between these two points are detected using the live wire technique that is likely to be the eyelid boundary. The experimental results obtained from UBIRIS.v1 database reveal that the eyelid detection algorithm which proposed in this paper improves the segmentation accuracy for the less constrained iris images.

  14. Segmented heat exchanger

    Science.gov (United States)

    Baldwin, Darryl Dean; Willi, Martin Leo; Fiveland, Scott Byron; Timmons, Kristine Ann

    2010-12-14

    A segmented heat exchanger system for transferring heat energy from an exhaust fluid to a working fluid. The heat exchanger system may include a first heat exchanger for receiving incoming working fluid and the exhaust fluid. The working fluid and exhaust fluid may travel through at least a portion of the first heat exchanger in a parallel flow configuration. In addition, the heat exchanger system may include a second heat exchanger for receiving working fluid from the first heat exchanger and exhaust fluid from a third heat exchanger. The working fluid and exhaust fluid may travel through at least a portion of the second heat exchanger in a counter flow configuration. Furthermore, the heat exchanger system may include a third heat exchanger for receiving working fluid from the second heat exchanger and exhaust fluid from the first heat exchanger. The working fluid and exhaust fluid may travel through at least a portion of the third heat exchanger in a parallel flow configuration.

  15. Schizophrenia as segmental progeria

    Science.gov (United States)

    Papanastasiou, Evangelos; Gaughran, Fiona; Smith, Shubulade

    2011-01-01

    Schizophrenia is associated with a variety of physical manifestations (i.e. metabolic, neurological) and despite psychotropic medication being blamed for some of these (in particular obesity and diabetes), there is evidence that schizophrenia itself confers an increased risk of physical disease and early death. The observation that schizophrenia and progeroid syndromes share common clinical features and molecular profiles gives rise to the hypothesis that schizophrenia could be conceptualized as a whole body disorder, namely a segmental progeria. Mammalian cells employ the mechanisms of cellular senescence and apoptosis (programmed cell death) as a means to control inevitable DNA damage and cancer. Exacerbation of those processes is associated with accelerated ageing and schizophrenia and this warrants further investigation into possible underlying biological mechanisms, such as epigenetic control of the genome. PMID:22048679

  16. Probabilistic retinal vessel segmentation

    Science.gov (United States)

    Wu, Chang-Hua; Agam, Gady

    2007-03-01

    Optic fundus assessment is widely used for diagnosing vascular and non-vascular pathology. Inspection of the retinal vasculature may reveal hypertension, diabetes, arteriosclerosis, cardiovascular disease and stroke. Due to various imaging conditions retinal images may be degraded. Consequently, the enhancement of such images and vessels in them is an important task with direct clinical applications. We propose a novel technique for vessel enhancement in retinal images that is capable of enhancing vessel junctions in addition to linear vessel segments. This is an extension of vessel filters we have previously developed for vessel enhancement in thoracic CT scans. The proposed approach is based on probabilistic models which can discern vessels and junctions. Evaluation shows the proposed filter is better than several known techniques and is comparable to the state of the art when evaluated on a standard dataset. A ridge-based vessel tracking process is applied on the enhanced image to demonstrate the effectiveness of the enhancement filter.

  17. Automated medical image segmentation techniques

    Directory of Open Access Journals (Sweden)

    Sharma Neeraj

    2010-01-01

    Full Text Available Accurate segmentation of medical images is a key step in contouring during radiotherapy planning. Computed topography (CT and Magnetic resonance (MR imaging are the most widely used radiographic techniques in diagnosis, clinical studies and treatment planning. This review provides details of automated segmentation methods, specifically discussed in the context of CT and MR images. The motive is to discuss the problems encountered in segmentation of CT and MR images, and the relative merits and limitations of methods currently available for segmentation of medical images.

  18. Automatic segmentation of pulmonary segments from volumetric chest CT scans.

    NARCIS (Netherlands)

    Rikxoort, E.M. van; Hoop, B. de; Vorst, S. van de; Prokop, M.; Ginneken, B. van

    2009-01-01

    Automated extraction of pulmonary anatomy provides a foundation for computerized analysis of computed tomography (CT) scans of the chest. A completely automatic method is presented to segment the lungs, lobes and pulmonary segments from volumetric CT chest scans. The method starts with lung segmenta

  19. And the Winner is – Acquired

    DEFF Research Database (Denmark)

    Henkel, Joachim; Rønde, Thomas; Wagner, Marcus

    value in case of success—that is, a more radical innovation. In the second stage, successful entrants bid to be acquired by the incumbent. We assume that entrants cannot survive on their own, so being acquired amounts to a ‘prize’ in a contest. We identify an equilibrium in which the incumbent chooses...

  20. Shape-Memory Properties of Segmented Polymers Containing Aramid Hard Segments and Polycaprolactone Soft Segments

    Directory of Open Access Journals (Sweden)

    Arno Kraft

    2010-06-01

    Full Text Available A series of segmented multiblock copolymers containing aramid hard segments and extended polycaprolactone soft segments (with an Mn of 4,200 or 8,200 g mol–1 was prepared and tested for their shape-memory properties. Chain extenders were essential to raise the hard segment concentration so that an extended rubbery plateau could be observed. Dynamic mechanical thermal analysis provided a useful guide in identifying (i the presence of a rubbery plateau, (ii the flow temperature, and (iii the temperature when samples started to deform irreversibly.

  1. Iris segmentation using variational level set method

    Science.gov (United States)

    Roy, Kaushik; Bhattacharya, Prabir; Suen, Ching Y.

    2011-04-01

    Continuous efforts have been made to process degraded iris images for enhancement of the iris recognition performance in unconstrained situations. Recently, many researchers have focused on developing the iris segmentation techniques, which can deal with iris images in a non-cooperative environment where the probability of acquiring unideal iris images is very high due to gaze deviation, noise, blurring, and occlusion by eyelashes, eyelids, glasses, and hair. Although there have been many iris segmentation methods, most focus primarily on the accurate detection of iris images captured in a closely controlled environment. The novelty of this research effort is that we propose to apply a variational level set-based curve evolution scheme that uses a significantly larger time step to numerically solve the evolution partial differential equation (PDE) for segmentation of an unideal iris image accurately, and thereby, speeding up the curve evolution process drastically. The iris boundary represented by the variational level set may break and merge naturally during evolution, and thus, the topological changes are handled automatically. The proposed variational model is also robust against poor localization and weak iris/sclera boundaries. In order to solve the size irregularities occurring due to arbitrary shapes of the extracted iris/pupil regions, a simple method is applied based on connection of adjacent contour points. Furthermore, to reduce the noise effect, we apply a pixel-wise adaptive 2D Wiener filter. The verification and identification performance of the proposed scheme is validated on three challenging iris image datasets, namely, the ICE 2005, the WVU Unideal, and the UBIRIS Version 1.

  2. Optimally segmented permanent magnet structures

    DEFF Research Database (Denmark)

    Insinga, Andrea Roberto; Bjørk, Rasmus; Smith, Anders

    2016-01-01

    We present an optimization approach which can be employed to calculate the globally optimal segmentation of a two-dimensional magnetic system into uniformly magnetized pieces. For each segment the algorithm calculates the optimal shape and the optimal direction of the remanent flux density vector...

  3. Upper medium segment cooling down

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>The sluggish growth of the passenger car market in top provinces was also reflected in a depression of the upper medium segment. In Jan-Apr, 2008, the top 3 upper medium models accounting for nearly 40% of this segment performed poorly, with the Passat-Lingyu and the Accord decreasing. The Camry also saw a decrease in three top provinces: Guangdong,

  4. Essays in International Market Segmentation

    NARCIS (Netherlands)

    Hofstede, ter F.

    1999-01-01

    The primary objective of this thesis is to develop and validate new methodologies to improve the effectiveness of international segmentation strategies. The current status of international market segmentation research is reviewed in an introductory chapter, which provided a number of methodological

  5. Adaptive Segmentation for Scientific Databases

    NARCIS (Netherlands)

    Ivanova, M.G.; Kersten, M.L.; Nes, N.J.

    2008-01-01

    In this paper we explore database segmentation in the context of a column-store DBMS targeted at a scientific database. We present a novel hardware- and scheme-oblivious segmentation algorithm, which learns and adapts to the workload immediately. The approach taken is to capitalize on (intermediate)

  6. Dermatology case: segmental lichen aureus

    OpenAIRE

    Fernandes, I.; S. Carvalho; Machado, S.; Alves,R.; Selores, M.

    2012-01-01

    ABSTRACT The authors describe a clinical case of a six-year-old boy with history of a segmental brownish maculopapular skin eruption on his left thoracic and lumbar wall, since the last four months. Based on clinical and histological findings he was diagnosed with segmental lichen aureus.

  7. Essays in international market segmentation

    NARCIS (Netherlands)

    Hofstede, ter F.

    1999-01-01

    The primary objective of this thesis is to develop and validate new methodologies to improve the effectiveness of international segmentation strategies. The current status of international market segmentation research is reviewed in an introductory chapter, which provided a number of

  8. Adaptive segmentation for scientific databases

    NARCIS (Netherlands)

    Ivanova, M.; Kersten, M.L.; Nes, N.

    2008-01-01

    In this paper we explore database segmentation in the context of a column-store DBMS targeted at a scientific database. We present a novel hardware- and scheme-oblivious segmentation algorithm, which learns and adapts to the workload immediately. The approach taken is to capitalize on (intermediate)

  9. Market segmentation using perceived constraints

    Science.gov (United States)

    Jinhee Jun; Gerard Kyle; Andrew Mowen

    2008-01-01

    We examined the practical utility of segmenting potential visitors to Cleveland Metroparks using their constraint profiles. Our analysis identified three segments based on their scores on the dimensions of constraints: Other priorities--visitors who scored the highest on 'other priorities' dimension; Highly Constrained--visitors who scored relatively high on...

  10. The Importance of Marketing Segmentation

    Science.gov (United States)

    Martin, Gillian

    2011-01-01

    The rationale behind marketing segmentation is to allow businesses to focus on their consumers' behaviors and purchasing patterns. If done effectively, marketing segmentation allows an organization to achieve its highest return on investment (ROI) in turn for its marketing and sales expenses. If an organization markets its products or services to…

  11. Market Segmentation: An Instructional Module.

    Science.gov (United States)

    Wright, Peter H.

    A concept-based introduction to market segmentation is provided in this instructional module for undergraduate and graduate transportation-related courses. The material can be used in many disciplines including engineering, business, marketing, and technology. The concept of market segmentation is primarily a transportation planning technique by…

  12. Segmentation: Slicing the Urban Pie.

    Science.gov (United States)

    Keim, William A.

    1981-01-01

    Explains market segmentation and defines undifferentiated, concentrated, and differentiated marketing strategies. Describes in detail the marketing planning process at the Metropolitan Community Colleges. Focuses on the development and implementation of an ongoing recruitment program designed for the market segment composed of business employees.…

  13. Adaptive segmentation for scientific databases

    NARCIS (Netherlands)

    Ivanova, M.; Kersten, M.L.; Nes, N.

    2008-01-01

    In this paper we explore database segmentation in the context of a column-store DBMS targeted at a scientific database. We present a novel hardware- and scheme-oblivious segmentation algorithm, which learns and adapts to the workload immediately. The approach taken is to capitalize on (intermediate)

  14. Subcortical brain segmentation of two dimensional T1-weighted data sets with FMRIB's Integrated Registration and Segmentation Tool (FIRST

    Directory of Open Access Journals (Sweden)

    Michael Amann

    2015-01-01

    Full Text Available Brain atrophy has been identified as an important contributing factor to the development of disability in multiple sclerosis (MS. In this respect, more and more interest is focussing on the role of deep grey matter (DGM areas. Novel data analysis pipelines are available for the automatic segmentation of DGM using three-dimensional (3D MRI data. However, in clinical trials, often no such high-resolution data are acquired and hence no conclusions regarding the impact of new treatments on DGM atrophy were possible so far. In this work, we used FMRIB's Integrated Registration and Segmentation Tool (FIRST to evaluate the possibility of segmenting DGM structures using standard two-dimensional (2D T1-weighted MRI. In a cohort of 70 MS patients, both 2D and 3D T1-weighted data were acquired. The thalamus, putamen, pallidum, nucleus accumbens, and caudate nucleus were bilaterally segmented using FIRST. Volumes were calculated for each structure and for the sum of basal ganglia (BG as well as for the total DGM. The accuracy and reliability of the 2D data segmentation were compared with the respective results of 3D segmentations using volume difference, volume overlap and intra-class correlation coefficients (ICCs. The mean differences for the individual substructures were between 1.3% (putamen and −25.2% (nucleus accumbens. The respective values for the BG were −2.7% and for DGM 1.3%. Mean volume overlap was between 89.1% (thalamus and 61.5% (nucleus accumbens; BG: 84.1%; DGM: 86.3%. Regarding ICC, all structures showed good agreement with the exception of the nucleus accumbens. The results of the segmentation were additionally validated through expert manual delineation of the caudate nucleus and putamen in a subset of the 3D data. In conclusion, we demonstrate that subcortical segmentation of 2D data are feasible using FIRST. The larger subcortical GM structures can be segmented with high consistency. This forms the basis for the application of

  15. The LOFT Ground Segment

    CERN Document Server

    Bozzo, E; Argan, A; Barret, D; Binko, P; Brandt, S; Cavazzuti, E; Courvoisier, T; Herder, J W den; Feroci, M; Ferrigno, C; Giommi, P; Götz, D; Guy, L; Hernanz, M; Zand, J J M in't; Klochkov, D; Kuulkers, E; Motch, C; Lumb, D; Papitto, A; Pittori, C; Rohlfs, R; Santangelo, A; Schmid, C; Schwope, A D; Smith, P J; Webb, N A; Wilms, J; Zane, S

    2014-01-01

    LOFT, the Large Observatory For X-ray Timing, was one of the ESA M3 mission candidates that completed their assessment phase at the end of 2013. LOFT is equipped with two instruments, the Large Area Detector (LAD) and the Wide Field Monitor (WFM). The LAD performs pointed observations of several targets per orbit (~90 minutes), providing roughly ~80 GB of proprietary data per day (the proprietary period will be 12 months). The WFM continuously monitors about 1/3 of the sky at a time and provides data for about ~100 sources a day, resulting in a total of ~20 GB of additional telemetry. The LOFT Burst alert System additionally identifies on-board bright impulsive events (e.g., Gamma-ray Bursts, GRBs) and broadcasts the corresponding position and trigger time to the ground using a dedicated system of ~15 VHF receivers. All WFM data are planned to be made public immediately. In this contribution we summarize the planned organization of the LOFT ground segment (GS), as established in the mission Yellow Book 1 . We...

  16. Evolution of segmented strings

    CERN Document Server

    Gubser, Steven S

    2016-01-01

    I explain how to evolve segmented strings in de Sitter and anti-de Sitter spaces of any dimension in terms of forward-directed null displacements. The evolution is described entirely in terms of discrete hops which do not require a continuum spacetime. Moreover, the evolution rule is purely algebraic, so it can be defined not only on ordinary real de Sitter and anti-de Sitter, but also on the rational points of the quadratic equations that define these spaces. For three-dimensional anti-de Sitter space, a simpler evolution rule is possible that descends from the Wess-Zumino-Witten equations of motion. In this case, one may replace three-dimensional anti-de Sitter space by a non-compact discrete subgroup of SL(2,R) whose structure is related to the Pell equation. A discrete version of the BTZ black hole can be constructed as a quotient of this subgroup. This discrete black hole avoids the firewall paradox by a curious mechanism: even for large black holes, there are no points inside the horizon until one reach...

  17. Segment Based Camera Calibration

    Institute of Scientific and Technical Information of China (English)

    马颂德; 魏国庆; 等

    1993-01-01

    The basic idea of calibrating a camera system in previous approaches is to determine camera parmeters by using a set of known 3D points as calibration reference.In this paper,we present a method of camera calibration in whih camera parameters are determined by a set of 3D lines.A set of constraints is derived on camea parameters in terms of perspective line mapping.Form these constraints,the same perspective transformation matrix as that for point mapping can be computed linearly.The minimum number of calibration lines is 6.This result generalizes that of Liu,Huang and Faugeras[12] for camera location determination in which at least 8 line correspondences are required for linear computation of camera location.Since line segments in an image can be located easily and more accurately than points,the use of lines as calibration reference tends to ease the computation in inage preprocessing and to improve calibration accuracy.Experimental results on the calibration along with stereo reconstruction are reported.

  18. Stochastic Modelling as a Tool for Seismic Signals Segmentation

    Directory of Open Access Journals (Sweden)

    Daniel Kucharczyk

    2016-01-01

    Full Text Available In order to model nonstationary real-world processes one can find appropriate theoretical model with properties following the analyzed data. However in this case many trajectories of the analyzed process are required. Alternatively, one can extract parts of the signal that have homogenous structure via segmentation. The proper segmentation can lead to extraction of important features of analyzed phenomena that cannot be described without the segmentation. There is no one universal method that can be applied for all of the phenomena; thus novel methods should be invented for specific cases. They might address specific character of the signal in different domains (time, frequency, time-frequency, etc.. In this paper we propose two novel segmentation methods that take under consideration the stochastic properties of the analyzed signals in time domain. Our research is motivated by the analysis of vibration signals acquired in an underground mine. In such signals we observe seismic events which appear after the mining activity, like blasting, provoked relaxation of rock, and some unexpected events, like natural rock burst. The proposed segmentation procedures allow for extraction of such parts of the analyzed signals which are related to mentioned events.

  19. Colgajo libre osteoseptocutáneo de peroné en la reconstrucción primaria de la radionecrosis masiva mandibular Fibular osteoseptocutaneous free flap in the primary reconstruction after massive radionecrosis of the mandible

    Directory of Open Access Journals (Sweden)

    P. Infante Cossío

    2004-06-01

    Full Text Available Resumen: Una de las complicaciones más serias del uso de la radioterapia en el tratamiento del carcinoma epidermoide de la cavidad oral, es la osteorradionecrosis. En este trabajo, presentamos cuatro pacientes afectos de osteorradionecrosis masiva de la mandíbula que habían fracasado inicialmente con medidas conservadoras y que fueron tratados con resección radical y reconstrucción primaria con un colgajo libre osteoseptocutáneo de peroné. El defecto mandibular tras la resección ósea midió una media de 10 cm e incluyó mucosa intraoral, piel o ambos. En dos casos de reconstrucción, se empleó el colgajo libre de peroné con doble paleta para reconstruir defectos extensos intra y extraorales. Se realizaron osteotomías en el peroné vascularizado en todos los casos para recrear el contorno mandibular. Todos los colgajos sobrevivieron completamente. Tres pacientes curaron primariamente con buenos resultados estéticos y funcionales. Una paciente falleció en el primer mes tras la operación por una pancreatitis aguda y fallo renal. En un paciente se han insertado implantes osteointegrados. En nuestra experiencia, el colgajo libre osteoseptocutáneo de peroné puede ser una opción ideal para la reconstrucción en un solo tiempo de defectos complejos mandibulares compuestos en pacientes afectos de osteorradionecrosis masiva.Abstract: Osteoradionecrosis is one of the most serious complications after radiation therapy of squamous carcinoma of the oral cavity. In this article, we report four cases of massive osteoradionecrosis of the mandible, all of whom had failed initial conservative management and treated with radical resection and primary reconstructed with fibular osteoseptocutaneous free flap. Mandible defects after radical resection were around 10 cm long and included intraoral mucosa, skin or both. A doubled-paddle peroneal tissue transfer was used in two cases for reconstruction of an extensive extra- or intraoral defects. The

  20. The effect of pose variability and repeated reliability of segmental centres of mass acquisition when using 3D photonic scanning.

    Science.gov (United States)

    Chiu, Chuang-Yuan; Pease, David L; Sanders, Ross H

    2016-12-01

    Three-dimensional (3D) photonic scanning is an emerging technique to acquire accurate body segment parameter data. This study established the repeated reliability of segmental centres of mass when using 3D photonic scanning (3DPS). Seventeen male participants were scanned twice by a 3D whole-body laser scanner. The same operators conducted the reconstruction and segmentation processes to obtain segmental meshes for calculating the segmental centres of mass. The segmental centres of mass obtained from repeated 3DPS were compared by relative technical error of measurement (TEM). Hypothesis tests were conducted to determine the size of change required for each segment to be determined a true variation. The relative TEMs for all segments were less than 5%. The relative changes in centres of mass at ±1.5% for most segments can be detected (p 3D photonic scanning and emphasised that the error for arm segments need to be considered while using this technique to acquire centres of mass.

  1. Sometimes spelling is easier than phonemic segmentation

    NARCIS (Netherlands)

    Bon, W.H.J. van; Duighuisen, H.C.M.

    1995-01-01

    Poor spellers from the Netherlands segmented and spelled the same words on different occasions. If they base their spellings on the segmentations that they produce in the segmentation task, the correlation between segmentation and spelling scores should be high, and segmentation should not be more d

  2. A Segmental Framework for Representing Signs Phonetically

    Science.gov (United States)

    Johnson, Robert E.; Liddell, Scott K.

    2011-01-01

    The arguments for dividing the signing stream in signed languages into sequences of phonetic segments are compelling. The visual records of instances of actually occurring signs provide evidence of two basic types of segments: postural segments and trans-forming segments. Postural segments specify an alignment of articulatory features, both manual…

  3. Segments and segmental properties in cross-language perception: Korean perception of English obstruents in various prosodic locations

    Science.gov (United States)

    de Jong, Kenneth; Silbert, Noah; Park, Hanyong

    2004-05-01

    Experimental models of cross-language perception and second-language acquisition (such as PAM and SLM) typically treat language differences in terms of whether the two languages share phonological segmental categories. Linguistic models, by contrast, generally examine properties which cross classify segments, such as features, rules, or prosodic constraints. Such models predict that perceptual patterns found for one segment will generalize to other segments of the same class. This paper presents perceptual identifications of Korean listeners to a set of voiced and voiceless English stops and fricatives in various prosodic locations to determine the extent to which such generality occurs. Results show some class-general effects; for example, voicing identification patterns generalize from stops, which occur in Korean, to nonsibilant fricatives, which are new to Korean listeners. However, when identification is poor, there are clear differences between segments within the same class. For example, in identifying stops and fricatives, both point of articulation and prosodic position bias perceptions; coronals are more often labeled fricatives, and syllable initial obstruents are more often labeled stops. These results suggest that class-general perceptual patterns are not a simple consequence of the structure of the perceptual system, but need to be acquired by factoring out within-class differences.

  4. Multiatlas segmentation as nonparametric regression.

    Science.gov (United States)

    Awate, Suyash P; Whitaker, Ross T

    2014-09-01

    This paper proposes a novel theoretical framework to model and analyze the statistical characteristics of a wide range of segmentation methods that incorporate a database of label maps or atlases; such methods are termed as label fusion or multiatlas segmentation. We model these multiatlas segmentation problems as nonparametric regression problems in the high-dimensional space of image patches. We analyze the nonparametric estimator's convergence behavior that characterizes expected segmentation error as a function of the size of the multiatlas database. We show that this error has an analytic form involving several parameters that are fundamental to the specific segmentation problem (determined by the chosen anatomical structure, imaging modality, registration algorithm, and label-fusion algorithm). We describe how to estimate these parameters and show that several human anatomical structures exhibit the trends modeled analytically. We use these parameter estimates to optimize the regression estimator. We show that the expected error for large database sizes is well predicted by models learned on small databases. Thus, a few expert segmentations can help predict the database sizes required to keep the expected error below a specified tolerance level. Such cost-benefit analysis is crucial for deploying clinical multiatlas segmentation systems.

  5. Automatic liver segmentation method featuring a novel filter for multiphase multidetector-row helical computed tomography.

    Science.gov (United States)

    Hirose, Tomohiro; Nitta, Norihisa; Tsudagawa, Masaru; Takahashi, Masashi; Murata, Kiyoshi

    2011-01-01

    To introduce an automatic liver segmentation method that includes a novel filter for multiphase multidetector-row helical computed tomography. We acquired 3-phase multidetector-row computed tomographic scans that included unenhanced, arterial, and portal phases. The liver was segmented using our novel adaptive linear prediction filter designed to reduce the difference between filter input and output values in the liver region and to increase these values outside the liver region. The segmentation algorithm produced a mean dice similarity coefficient (DSC) value of 91.4%. The application of our adaptive linear prediction filter was effective in automatically extracting liver regions.

  6. Iris Pattern Segmentation using Automatic Segmentation and Window Technique

    OpenAIRE

    Swati Pandey; Prof. Rajeev Gupta

    2013-01-01

    A Biometric system is an automatic identification of an individual based on a unique feature or characteristic. Iris recognition has great advantage such as variability, stability and security. In thispaper, use the two methods for iris segmentation -An automatic segmentation method and Window method. Window method is a novel approach which comprises two steps first finds pupils' center andthen two radial coefficients because sometime pupil is not perfect circle. The second step extract the i...

  7. Principles of Video Segmentation Scenarios

    Directory of Open Access Journals (Sweden)

    M. R. KHAMMAR

    2013-05-01

    Full Text Available Video segmentation is the first step toward automatic video processing such as browsing, retrieval, and indexing. Many algorithms and techniques have been proposed a few years ago. They can cover the topic of video segmentation from different angles and it is beneficial to review the most important properties of them in brief in order to clarify the subject and find out the latest challenges and drawbacks. In this paper, the important parameters which are involved in video segmentation are discussed and video shot detection systems are compared together.

  8. Multiple Segmentation of Image Stacks

    DEFF Research Database (Denmark)

    Smets, Jonathan; Jaeger, Manfred

    2014-01-01

    We propose a method for the simultaneous construction of multiple image segmentations by combining a recently proposed “convolution of mixtures of Gaussians” model with a multi-layer hidden Markov random field structure. The resulting method constructs for a single image several, alternative...... segmentations that capture different structural elements of the image. We also apply the method to collections of images with identical pixel dimensions, which we call image stacks. Here it turns out that the method is able to both identify groups of similar images in the stack, and to provide segmentations...

  9. Enhancing Medicares Hospital Acquired Conditions Policy

    Data.gov (United States)

    U.S. Department of Health & Human Services — The current Medicare policy of non-payment to hospitals for Hospital Acquired Conditions (HAC) seeks to avoid payment for preventable complications identified within...

  10. Common acquired kidney diseases in children

    African Journals Online (AJOL)

    5. Common acquired kidney diseases in children. Examination of the urine is probably the most ... rheumatic fever and APSGN should not ... remains unknown. ... Volume overload may also cause ..... systematic review of observational studies.

  11. Hospital-Acquired Condition Reduction Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2014, CMS began reducing Medicare payments for subsection (d) hospitals that rank in the worst performing quartile with respect to hospital-acquired...

  12. The evolution of costly acquired immune memory

    National Research Council Canada - National Science Library

    Best, Alex; Hoyle, Andy

    2013-01-01

    A key feature of the vertebrate adaptive immune system is acquired immune memory, whereby hosts launch a faster and heightened response when challenged by previously encountered pathogens, preventing full infection...

  13. 7 CFR 926.10 - Acquire.

    Science.gov (United States)

    2010-01-01

    ... of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE DATA COLLECTION, REPORTING AND RECORDKEEPING REQUIREMENTS APPLICABLE TO CRANBERRIES NOT SUBJECT TO THE CRANBERRY MARKETING ORDER § 926.10 Acquire....

  14. Enhancing Medicares Hospital Acquired Conditions Policy

    Data.gov (United States)

    U.S. Department of Health & Human Services — The current Medicare policy of non-payment to hospitals for Hospital Acquired Conditions (HAC) seeks to avoid payment for preventable complications identified within...

  15. How to Extract the Geometry and Topology from Very Large 3D Segmentations

    CERN Document Server

    Andres, Bjoern; Kroeger, Thorben; Hamprecht, Fred A

    2010-01-01

    Segmentation is often an essential intermediate step in image analysis. A volume segmentation characterizes the underlying volume image in terms of geometric information--segments, faces between segments, curves in which several faces meet--as well as a topology on these objects. Existing algorithms encode this information in designated data structures, but require that these data structures fit entirely in Random Access Memory (RAM). Today, 3D images with several billion voxels are acquired, e.g. in structural neurobiology. Since these large volumes can no longer be processed with existing methods, we present a new algorithm which performs geometry and topology extraction with a runtime linear in the number of voxels and log-linear in the number of faces and curves. The parallelizable algorithm proceeds in a block-wise fashion and constructs a consistent representation of the entire volume image on the hard drive, making the structure of very large volume segmentations accessible to image analysis. The paral...

  16. A framework for automatic segmentation in three dimensions of microstructural tomography data

    DEFF Research Database (Denmark)

    Jørgensen, Peter Stanley; Hansen, Karin Vels; Larsen, Rasmus;

    2010-01-01

    Routine use of quantitative three dimensional analysis of material microstructure by in particular, focused ion beam (FIB) serial sectioning is generally restricted by the time consuming task of manually delineating structures within each image slice or the quality of manual and automatic...... segmentation schemes. We present here a framework for performing automatic segmentation of complex microstructures using a level set method. The technique is based on numerical approximations to partial differential equations to evolve a 3D surface to capture the phase boundaries. Vector fields derived from...... the experimentally acquired data are used as the driving forces. The framework performs the segmentation in 3D rather than on a slice by slice basis. It naturally supplies sub-voxel precision of segmented surfaces and allows constraints on the surface curvature to enforce a smooth surface in the segmentation. Two...

  17. Acquired uniparental disomy in myeloproliferative neoplasms.

    Science.gov (United States)

    Score, Joannah; Cross, Nicholas C P

    2012-10-01

    The finding of somatically acquired uniparental disomy, where both copies of a chromosome pair or parts of chromosomes have originated from one parent, has led to the discovery of several novel mutated genes in myeloproliferative neoplasms and related disorders. This article examines how the development of single nucleotide polymorphism array technology has facilitated the identification of regions of acquired uniparental disomy and has led to a much greater understanding of the molecular pathology of these heterogeneous diseases.

  18. The evolution of costly acquired immune memory

    OpenAIRE

    Best, A.; Hoyle, A

    2013-01-01

    A key feature of the vertebrate adaptive immune system is acquired immune memory, whereby hosts launch a faster and heightened response when challenged by previously encountered pathogens, preventing full infection. Here, we use a mathematical model to explore the role of ecological and epidemiological processes in shaping selection for costly acquired immune memory. Applying the framework of adaptive dynamics to the classic SIR (Susceptible-Infected-Recovered) epidemiological model, we focus...

  19. Acquiring Evolving Technologies: Web Services Standards

    Science.gov (United States)

    2016-06-30

    2006 Carnegie Mellon University Acquiring Evolving Technologies: Web Services Standards Harry L. Levinson Software Engineering Institute Carnegie...Acquiring Evolving Technologies: Web Services Standards 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...NUMBER OF PAGES 22 19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Standard Form

  20. Acquired pure red cell aplasia in children

    Directory of Open Access Journals (Sweden)

    Sujata R Dafale

    2012-01-01

    Full Text Available Acquired Pure Red Cell Aplasia (PRCA is a rare occurrence in children.This is a case of an eight year old girl child who developed acquired PRCA secondary to long term intake of sodium Valproate. This case is reported to review the causes of PRCA in children and to reconsider the use of drugs of longer duration in children and adults.

  1. Acquiring Secure Systems Through Information Economics

    Science.gov (United States)

    2015-05-01

    Acquiring Secure Systems Through Information Economics Chad Dacus Research Professor of Defense Economics Air Force Research Institute Dr. Pano...to 00-00-2015 4. TITLE AND SUBTITLE Acquiring Secure Systems Through Information Economics 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...If adversary can hack into mission essential software/hardware, then mission is compromised • Mission assurance requires materiel solutions, educated

  2. An Active Contour for Range Image Segmentation

    OpenAIRE

    Khaldi Amine; Merouani Hayet Farida

    2012-01-01

    In this paper a new classification of range image segmentation method is proposed according to the criterion of homogeneity which obeys the segmentation, then, a deformable model-type active contour “Snake” is applied to segment range images.

  3. Ensemble segmentation using efficient integer linear programming.

    Science.gov (United States)

    Alush, Amir; Goldberger, Jacob

    2012-10-01

    We present a method for combining several segmentations of an image into a single one that in some sense is the average segmentation in order to achieve a more reliable and accurate segmentation result. The goal is to find a point in the "space of segmentations" which is close to all the individual segmentations. We present an algorithm for segmentation averaging. The image is first oversegmented into superpixels. Next, each segmentation is projected onto the superpixel map. An instance of the EM algorithm combined with integer linear programming is applied on the set of binary merging decisions of neighboring superpixels to obtain the average segmentation. Apart from segmentation averaging, the algorithm also reports the reliability of each segmentation. The performance of the proposed algorithm is demonstrated on manually annotated images from the Berkeley segmentation data set and on the results of automatic segmentation algorithms.

  4. Clinical stucly of two methods about fixation in open tibial and fibular fractures%开放性胫腓骨骨折2种固定方式临床分析

    Institute of Scientific and Technical Information of China (English)

    陈记明; 夏时雨; 杨志; 黎喆

    2012-01-01

    目的 探讨外固定支架及加压钢板内固定治疗开放性胫腓骨骨折的临床疗效.方法 对61例开放性胫腓骨骨折清创复位后,分别采用外固定支架固定31例(A组),加压钢板固定30例(B组).结果 A、B组优良率分为90.3%、76.7%,A组优良率明显优于B组(P﹤0.05).结论 外固定支架是治疗开放性胫腓骨骨折首选手术方式,特别适用于Ⅲ型及骨折波及关节面或靠近关节面的开放性胫腓骨骨折.%Objective To explore the clinical efficacy of external fixation and compression plate internal fixation in treatment of open tibial and fibular fractures. Methods 61 cases of open tibial and fibular fracture debridement after reset, were treated with external fixation in 31 cases ( group A ), and compression plate fixation in 30 cases ( group B ). Results The excellent rate of Group Aand GroupB were90. 3% 76. 7% , and significant differences was found between the two groups ( P < 0. 05 ). Conclusion External fixation is the preferred treatment of open fractures of tibia and fibula preferred operation, which especially suitable for type Ⅲ and fracture affects the articular surface or near the articular surface of open fracture of tibia and fibula.

  5. Image Segmentation Based on Support Vector Machine

    Institute of Scientific and Technical Information of China (English)

    XU Hai-xiang; ZHU Guang-xi; TIAN Jin-wen; ZHANG Xiang; PENG Fu-yuan

    2005-01-01

    Image segmentation is a necessary step in image analysis. Support vector machine (SVM) approach is proposed to segment images and its segmentation performance is evaluated.Experimental results show that: the effects of kernel function and model parameters on the segmentation performance are significant; SVM approach is less sensitive to noise in image segmentation; The segmentation performance of SVM approach is better than that of back-propagation multi-layer perceptron (BP-MLP) approach and fuzzy c-means (FCM) approach.

  6. Accurate and Fast Iris Segmentation

    Directory of Open Access Journals (Sweden)

    G. AnnaPoorani,

    2010-06-01

    Full Text Available A novel iris segmentation approach for noisy iris is proposed in this paper. The proposed approach comprises of specular reflection removal, pupil localization, iris localization and eyelid localization. Reflection map computation is devised to get the reflection ROI of eye image using adaptive threshold technique. Bilinear interpolation is used to fill these reflection points in the eye image. Variant of edge-based segmentation technique is adopted to detect the pupil boundary from the eye image. Gradient based heuristic approach is devised to detect the iris boundary from theeye image. Eyelid localization is designed to detect the eyelids using the edge detection and curve fitting. Feature sequence combined into spatial domain segments the iris texture patterns properly. Empirical results show that the proposed approach is effective and suitable to deal with the noisy eye image for iris segmentation.

  7. Metrology of IXO Mirror Segments

    Science.gov (United States)

    Chan, Kai-Wing

    2011-01-01

    For future x-ray astrophysics mission that demands optics with large throughput and excellent angular resolution, many telescope concepts build around assembling thin mirror segments in a Wolter I geometry, such as that originally proposed for the International X-ray Observatory. The arc-second resolution requirement posts unique challenges not just for fabrication, mounting but also for metrology of these mirror segments. In this paper, we shall discuss the metrology of these segments using normal incidence metrological method with interferometers and null lenses. We present results of the calibration of the metrology systems we are currently using, discuss their accuracy and address the precision in measuring near-cylindrical mirror segments and the stability of the measurements.

  8. Neural network for image segmentation

    Science.gov (United States)

    Skourikhine, Alexei N.; Prasad, Lakshman; Schlei, Bernd R.

    2000-10-01

    Image analysis is an important requirement of many artificial intelligence systems. Though great effort has been devoted to inventing efficient algorithms for image analysis, there is still much work to be done. It is natural to turn to mammalian vision systems for guidance because they are the best known performers of visual tasks. The pulse- coupled neural network (PCNN) model of the cat visual cortex has proven to have interesting properties for image processing. This article describes the PCNN application to the processing of images of heterogeneous materials; specifically PCNN is applied to image denoising and image segmentation. Our results show that PCNNs do well at segmentation if we perform image smoothing prior to segmentation. We use PCNN for obth smoothing and segmentation. Combining smoothing and segmentation enable us to eliminate PCNN sensitivity to the setting of the various PCNN parameters whose optimal selection can be difficult and can vary even for the same problem. This approach makes image processing based on PCNN more automatic in our application and also results in better segmentation.

  9. Medical image segmentation by MDP model

    Science.gov (United States)

    Lu, Yisu; Chen, Wufan

    2011-11-01

    MDP (Dirichlet Process Mixtures) model is applied to segment medical images in this paper. Segmentation can been automatically done without initializing segmentation class numbers. The MDP model segmentation algorithm is used to segment natural images and MR (Magnetic Resonance) images in the paper. To demonstrate the accuracy of the MDP model segmentation algorithm, many compared experiments, such as EM (Expectation Maximization) image segmentation algorithm, K-means image segmentation algorithm and MRF (Markov Field) image segmentation algorithm, have been done to segment medical MR images. All the methods are also analyzed quantitatively by using DSC (Dice Similarity Coefficients). The experiments results show that DSC of MDP model segmentation algorithm of all slices exceed 90%, which show that the proposed method is robust and accurate.

  10. Communicative functions integrate segments in prosodies and prosodies in segments.

    Science.gov (United States)

    Kohler, Klaus J

    2011-01-01

    This paper takes a new look at the traditionally established divide between sounds and prosodies, viewing it as a useful heuristics in language descriptions that focus on the segmental make- up of words. It pleads for a new approach that bridges this reified compartmentalization of speech in a more global communicative perspective. Data are presented from a German perception experiment in the framework of the Semantic Differential that shows interdependence of f0 contours and the spectral characteristics of a following fricative segment, for the expression of semantic functions along the scales questioning - asserting, excited - calm, forceful - not forceful, contrary - agreeable. The results lead to the conclusion that segments shape prosodies and are shaped by them in varying ways in the coding of semantic functions. This implies that the analysis of sentence prosodies needs to integrate the manifestation of segments, just as the analysis of segments needs to consider their prosodic embedding. In communicative interaction, speakers set broad prosodic time windows of varying sizes, and listeners respond to them. So, future phonetic research needs to concentrate on speech analysis in such windows.

  11. Segmentation precision of abdominal anatomy for MRI-based radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Noel, Camille E.; Zhu, Fan; Lee, Andrew Y.; Yanle, Hu; Parikh, Parag J., E-mail: pparikh@radonc.wustl.edu

    2014-10-01

    The limited soft tissue visualization provided by computed tomography, the standard imaging modality for radiotherapy treatment planning and daily localization, has motivated studies on the use of magnetic resonance imaging (MRI) for better characterization of treatment sites, such as the prostate and head and neck. However, no studies have been conducted on MRI-based segmentation for the abdomen, a site that could greatly benefit from enhanced soft tissue targeting. We investigated the interobserver and intraobserver precision in segmentation of abdominal organs on MR images for treatment planning and localization. Manual segmentation of 8 abdominal organs was performed by 3 independent observers on MR images acquired from 14 healthy subjects. Observers repeated segmentation 4 separate times for each image set. Interobserver and intraobserver contouring precision was assessed by computing 3-dimensional overlap (Dice coefficient [DC]) and distance to agreement (Hausdorff distance [HD]) of segmented organs. The mean and standard deviation of intraobserver and interobserver DC and HD values were DC{sub intraobserver} = 0.89 ± 0.12, HD{sub intraobserver} = 3.6 mm ± 1.5, DC{sub interobserver} = 0.89 ± 0.15, and HD{sub interobserver} = 3.2 mm ± 1.4. Overall, metrics indicated good interobserver/intraobserver precision (mean DC > 0.7, mean HD < 4 mm). Results suggest that MRI offers good segmentation precision for abdominal sites. These findings support the utility of MRI for abdominal planning and localization, as emerging MRI technologies, techniques, and onboard imaging devices are beginning to enable MRI-based radiotherapy.

  12. Segmentation Scheme for Safety Enhancement of Engineered Safety Features Component Control System

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sangseok; Sohn, Kwangyoung [Korea Reliability Technology and System, Daejeon (Korea, Republic of); Lee, Junku; Park, Geunok [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-05-15

    Common Caused Failure (CCF) or undetectable failure would adversely impact safety functions of ESF-CCS in the existing nuclear power plants. We propose the segmentation scheme to solve these problems. Main function assignment to segments in the proposed segmentation scheme is based on functional dependency and critical function success path by using the dependency depth matrix. The segment has functional independence and physical isolation. The segmentation structure is that prohibit failure propagation to others from undetectable failures. Therefore, the segmentation system structure has robustness to undetectable failures. The segmentation system structure has functional diversity. The specific function in the segment defected by CCF, the specific function could be maintained by diverse control function that assigned to other segments. Device level control signals and system level control signals are separated and also control signal and status signals are separated due to signal transmission paths are allocated independently based on signal type. In this kind of design, single device failure or failures on signal path in the channel couldn't result in the loss of all segmented functions simultaneously. Thus the proposed segmentation function is the design scheme that improves availability of safety functions. In conventional ESF-CCS, the single controller generates the signal to control the multiple safety functions, and the reliability is achieved by multiplication within the channel. This design has a drawback causing the loss of multiple functions due to the CCF (Common Cause Failure) and single failure Heterogeneous controller guarantees the diversity ensuring the execution of safety functions against the CCF and single failure, but requiring a lot of resources like manpower and cost. The segmentation technology based on the compartmentalization and functional diversification decreases the CCF and single failure nonetheless the identical types of

  13. Methods of evaluating segmentation characteristics and segmentation of major faults

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kie Hwa; Chang, Tae Woo; Kyung, Jai Bok [Seoul National Univ., Seoul (Korea, Republic of)] (and others)

    2000-03-15

    Seismological, geological, and geophysical studies were made for reasonable segmentation of the Ulsan fault and the results are as follows. One- and two- dimensional electrical surveys revealed clearly the fault fracture zone enlarges systematically northward and southward from the vicinity of Mohwa-ri, indicating Mohwa-ri is at the seismic segment boundary. Field Geological survey and microscope observation of fault gouge indicates that the Quaternary faults in the area are reactivated products of the preexisting faults. Trench survey of the Chonbuk fault Galgok-ri revealed thrust faults and cumulative vertical displacement due to faulting during the late Quaternary with about 1.1-1.9 m displacement per event; the latest event occurred from 14000 to 25000 yrs. BP. The seismic survey showed the basement surface os cut by numerous reverse faults and indicated the possibility that the boundary between Kyeongsangbukdo and Kyeongsannamdo may be segment boundary.

  14. Posterior segment ocular manifestations of HIV/AIDS patients.

    Science.gov (United States)

    Chiotan, C; Radu, L; Serban, R; Cornăcel, C; Cioboată, M; Anghelie, A

    2014-09-15

    Human immunodeficiency virus (HIV) has the ability to affect any organ in the body. In 70% of HIV -infected patients ocular manifestations were observed, these, in the vast majority reflect the systemic disease and may be the first signs of disseminated infections. The purpose of this paper is to determine the prevalence of posterior segment ocular manifestations in HIV / AIDS (Acquired Immunodeficiency Syndrome) patients. The study is retrospective, conducted in the Cabinet of Ophthalmology of "Matei Bals" Infectious Diseases Hospital in Bucharest, during the period 1 August 2007 - 1 August 2013 . Each patient was examined thoroughly at the biomicroscope ocular slit by using 90D microscope lens and 20D indirect lens after the administration of topical mydriatics. 348 patients with HIV/AIDS and ocular disorders were followed. There was a high number of children and young people with HIV who had eye disorders (194 patients aged between 14 and 25 years). 44.25% of patients had posterior segment ocular damage, 17.55% of them had the anterior segment affected. 22.90% of the 131 patients with compromised posterior segment microangiopathy have been diagnosed with HIV / AIDS. Doctors should be aware of the existence of ocular damage in HIV / AIDS and to emphasize the importance of regular ophthalmologic examination of patients with HIV / AIDS.

  15. Asymmetric similarity-weighted ensembles for image segmentation

    DEFF Research Database (Denmark)

    Cheplygina, V.; Van Opbroek, A.; Ikram, M. A.

    2016-01-01

    the images, thus representative data might not be available. Transfer learning techniques can be used to account for these differences, thus taking advantage of all the available data acquired with different protocols. We investigate the use of classifier ensembles, where each classifier is weighted...... according to the similarity between the data it is trained on, and the data it needs to segment. We examine 3 asymmetric similarity measures that can be used in scenarios where no labeled data from a newly introduced scanner or scanning protocol is available. We show that the asymmetry is informative...... and the direction of measurement needs to be chosen carefully. We also show that a point set similarity measure is robust across different studies, and outperforms state-of-the-art results on a multi-center brain tissue segmentation task....

  16. Genetics in Ophthalmology II–Anterior Segment Diseases

    Directory of Open Access Journals (Sweden)

    Canan Aslı Utine

    2012-10-01

    Full Text Available Genetic diseases are congenital or acquired hereditary diseases that result from structural/functional disorders of the human genome. Today, the genetic factors that play a role in many diseases are being highlighted with the rapid progress in the field of genetics science. It becomes increasingly important that physicians from all disciplines have knowledge about the basic principles of genetics, patterns of inheritance, etc., so that they can follow the new developments. In genetic eye diseases, ophthalmologists should know the basic clinical and recently rapidly developing genetic characteristics of these diseases in order to properly approach the diagnosis and treatment and to provide genetic counseling. In this paper, anterior segment eye diseases of genetic origin are reviewed, and aniridia, anterior segment dysgenesis, glaucoma, corneal dystrophies, cataract, ectopia lentis, myopia, and other refractive errors are covered. (Turk J Ophthalmol 2012; 42: 378-85

  17. Underwater acoustic image segmentation based on deformable template

    Institute of Scientific and Technical Information of China (English)

    SANG Enfang; LIU Zhuofu

    2005-01-01

    In order to solve the problem of deformation and blurred edge in underwater acoustic image segmentation, an approach based on the deformable template is presented. Compared with the energy minimization of the Snake model, the energy function is redefined by adding a shape restriction. This improves the noise-resistance ability so that robustness and high segmentation efficiency are acquired. The energy optimization problem is tackled using the Dijkstra Algorithm. This method has been successfully tested on the filled-in acoustic images.The results show that this algorithm is efficient, precise and very immune to image deformation and noise when compared to results obtained from the Snake model and several traditional optimization methods.

  18. Análise da influência da bandagem funcional de tornozelo no tempo de reação do fibular longo em sujeitos saudáveis Analysis of ankle taping influence in the peroneal reaction time in healthy subjects

    Directory of Open Access Journals (Sweden)

    Maurício Couto Meurer

    2010-06-01

    Full Text Available OBJETIVOS: O objetivo deste estudo foi analisar a influência da bandagem funcional de tornozelo no tempo de reação do fibular longo de indivíduos sadios. MÉTODOS: A amostra foi composta por oito indivíduos do gênero masculino, fisicamente ativos, sem histórias prévias de lesões de tornozelo e, com os resultados negativos aos testes de instabilidade articular de tornozelo. Foram usados como instrumentos da pesquisa, a bandagem funcional de tornozelo tipo bota fechada, para realizar o teste uma plataforma capaz de inclinar 30o no plano frontal simulando a entorse lateral do tornozelo e um eletromiógrafo de oito canais (Bortec Electronics Incorporation, Canadá para aquisições dos sinais eletromiográficos. Os sinais EMG foram coletados juntamente com o sinal da plataforma (sincronismo. A coleta dos dados foi realizada em dois momentos, primeiramente sem a bandagem e logo após com a bandagem. RESULTADOS: Os indivíduos tinham idade média de 23,3 anos (± 2,8, massa corpórea de 74,4kg (± 9,4, estatura de 1,7m (± 0,4 e IMC de 23,7kg/m2 (± 2,4. O estudo encontrou diferença estatisticamente significativa p = 0,018 na situação da bandagem funcional de tornozelo com diminuição do tempo de reação do fibular longo. CONCLUSÃO: Acreditamos que esta melhora se deva ao íntimo contato da bandagem com os receptores cutâneos do tornozelo, aumentando a ativação do reflexo fibular, com consequente ganho proprioceptivo e, assim, aumentando a habilidade dos sujeitos em responder a situações súbitas de entorses. O estudo demonstrou diminuição no tempo de reação do fibular longo de indivíduos sadios com o uso da bandagem funcional de tornozelo quando submetidos à inclinação lateral súbita do tornozelo.OBJECTIVE: The aim of this study was to analyze the influence of the ankle functional tape on long fibular reaction time in health subjects. METHODS: The sample was composed of eight physically active male subjects, without ankle

  19. Plugin procedure in segmentation and application to hyperspectral image segmentation

    CERN Document Server

    Girard, R

    2010-01-01

    In this article we give our contribution to the problem of segmentation with plug-in procedures. We give general sufficient conditions under which plug in procedure are efficient. We also give an algorithm that satisfy these conditions. We give an application of the used algorithm to hyperspectral images segmentation. Hyperspectral images are images that have both spatial and spectral coherence with thousands of spectral bands on each pixel. In the proposed procedure we combine a reduction dimension technique and a spatial regularisation technique. This regularisation is based on the mixlet modelisation of Kolaczyck and Al.

  20. Automatic segmentation of psoriasis lesions

    Science.gov (United States)

    Ning, Yang; Shi, Chenbo; Wang, Li; Shu, Chang

    2014-10-01

    The automatic segmentation of psoriatic lesions is widely researched these years. It is an important step in Computer-aid methods of calculating PASI for estimation of lesions. Currently those algorithms can only handle single erythema or only deal with scaling segmentation. In practice, scaling and erythema are often mixed together. In order to get the segmentation of lesions area - this paper proposes an algorithm based on Random forests with color and texture features. The algorithm has three steps. The first step, the polarized light is applied based on the skin's Tyndall-effect in the imaging to eliminate the reflection and Lab color space are used for fitting the human perception. The second step, sliding window and its sub windows are used to get textural feature and color feature. In this step, a feature of image roughness has been defined, so that scaling can be easily separated from normal skin. In the end, Random forests will be used to ensure the generalization ability of the algorithm. This algorithm can give reliable segmentation results even the image has different lighting conditions, skin types. In the data set offered by Union Hospital, more than 90% images can be segmented accurately.

  1. Prevention of hospital-acquired hyponatraemia

    DEFF Research Database (Denmark)

    Lunøe, Mathilde; Overgaard-Steensen, C

    2015-01-01

    for prevention of hospital-acquired hyponatraemia is an understanding of what determines plasma sodium concentration (P-[Na(+) ]) in the individual patient. P-[Na(+) ] is determined by balances of water and cations according to Edelman. This paper discusses the mechanisms influencing water and cation balances...... like Ringer-acetate/Ringer-lactate can increase the intracranial pressure dramatically. Consequently, 0.9 % NaCl is recommended as first-line fluid for such patients. CONCLUSIONS: The occurrence of hospital-acquired hyponatraemia may be reduced by prescribing fluids, type and amount, with the same...

  2. Identifying Benefit Segments among College Students.

    Science.gov (United States)

    Brown, Joseph D.

    1991-01-01

    Using concept of market segmentation (dividing market into distinct groups requiring different product benefits), surveyed 398 college students to determine benefit segments among students selecting a college to attend and factors describing each benefit segment. Identified one major segment of students (classroomers) plus three minor segments…

  3. U.S. Army Custom Segmentation System

    Science.gov (United States)

    2007-06-01

    segmentation is individual or intergroup differences in response to marketing - mix variables. Presumptions about segments: •different demands in a...product or service category, •respond differently to changes in the marketing mix Criteria for segments: •The segments must exist in the environment

  4. Discourse segmentation and ambiguity in discourse structure

    NARCIS (Netherlands)

    Hoek, J.; Evers-Vermeul, J.; Sanders, T.J.M.

    2016-01-01

    Discourse relations hold between two or more text segments. The process of discourse annotation not only involves determining what type of relation holds between segments, but also indicating the segments themselves. Often, segmentation and annotation are treated as individual steps, and separate gu

  5. An interactive segmentation method based on superpixel

    DEFF Research Database (Denmark)

    Yang, Shu; Zhu, Yaping; Wu, Xiaoyu

    2015-01-01

    This paper proposes an interactive image-segmentation method which is based on superpixel. To achieve fast segmentation, the method is used to establish a Graphcut model using superpixels as nodes, and a new energy function is proposed. Experimental results demonstrate that the authors' method has...... excellent performance in terms of segmentation accuracy and computation efficiency compared with other segmentation algorithm based on pixels....

  6. Automatic segmentation of mammogram and tomosynthesis images

    Science.gov (United States)

    Sargent, Dusty; Park, Sun Young

    2016-03-01

    Breast cancer is a one of the most common forms of cancer in terms of new cases and deaths both in the United States and worldwide. However, the survival rate with breast cancer is high if it is detected and treated before it spreads to other parts of the body. The most common screening methods for breast cancer are mammography and digital tomosynthesis, which involve acquiring X-ray images of the breasts that are interpreted by radiologists. The work described in this paper is aimed at optimizing the presentation of mammography and tomosynthesis images to the radiologist, thereby improving the early detection rate of breast cancer and the resulting patient outcomes. Breast cancer tissue has greater density than normal breast tissue, and appears as dense white image regions that are asymmetrical between the breasts. These irregularities are easily seen if the breast images are aligned and viewed side-by-side. However, since the breasts are imaged separately during mammography, the images may be poorly centered and aligned relative to each other, and may not properly focus on the tissue area. Similarly, although a full three dimensional reconstruction can be created from digital tomosynthesis images, the same centering and alignment issues can occur for digital tomosynthesis. Thus, a preprocessing algorithm that aligns the breasts for easy side-by-side comparison has the potential to greatly increase the speed and accuracy of mammogram reading. Likewise, the same preprocessing can improve the results of automatic tissue classification algorithms for mammography. In this paper, we present an automated segmentation algorithm for mammogram and tomosynthesis images that aims to improve the speed and accuracy of breast cancer screening by mitigating the above mentioned problems. Our algorithm uses information in the DICOM header to facilitate preprocessing, and incorporates anatomical region segmentation and contour analysis, along with a hidden Markov model (HMM) for

  7. Study on effect of segments erection tolerance and wedge-shaped segment on segment ring in shield tunnel

    Institute of Scientific and Technical Information of China (English)

    CHEN Jun-sheng; MO Hai-hong

    2006-01-01

    Deformation and dislocations of segments of shield tunnel in construction stage have apparent effect on tunnel structure stress and even cause local cracks and breakage in tunnel. 3D finite element method was used to analyze two segment ring models under uniform injected pressure: (1) segment ring without wedge-shaped segment, which has 16 types of preinstall erection tolerance; (2) segment ring with wedge-shaped segment, which has no preinstall erection tolerance. The analysis results indicate that different erection tolerances can cause irregular deformation in segment ring under uniform injected pressure, and that the tolerance values are enlarged further. Wedge-shaped segment apparently affects the overall deformation of segment ring without erection tolerances. The uniform injected pressure can cause deformation of ring with wedge-shaped segment irregular,and dislocations also appear in this situation. The stress of segment with erection tolerances is much larger than that of segment without erection tolerances. Enlarging the central angle of wedge-shaped segment can make the irregular deformation and dislocations of segments smaller. The analysis results also provide basis for erection tolerance control and improvement of segment constitution.

  8. Automatic segmentation for brain MR images via a convex optimized segmentation and bias field correction coupled model.

    Science.gov (United States)

    Chen, Yunjie; Zhao, Bo; Zhang, Jianwei; Zheng, Yuhui

    2014-09-01

    Accurate segmentation of magnetic resonance (MR) images remains challenging mainly due to the intensity inhomogeneity, which is also commonly known as bias field. Recently active contour models with geometric information constraint have been applied, however, most of them deal with the bias field by using a necessary pre-processing step before segmentation of MR data. This paper presents a novel automatic variational method, which can segment brain MR images meanwhile correcting the bias field when segmenting images with high intensity inhomogeneities. We first define a function for clustering the image pixels in a smaller neighborhood. The cluster centers in this objective function have a multiplicative factor that estimates the bias within the neighborhood. In order to reduce the effect of the noise, the local intensity variations are described by the Gaussian distributions with different means and variances. Then, the objective functions are integrated over the entire domain. In order to obtain the global optimal and make the results independent of the initialization of the algorithm, we reconstructed the energy function to be convex and calculated it by using the Split Bregman theory. A salient advantage of our method is that its result is independent of initialization, which allows robust and fully automated application. Our method is able to estimate the bias of quite general profiles, even in 7T MR images. Moreover, our model can also distinguish regions with similar intensity distribution with different variances. The proposed method has been rigorously validated with images acquired on variety of imaging modalities with promising results.

  9. Estudo biomecânico em flexão da coluna cervical de cadáveres humanos submetida à corpectomia e estabilização com enxerto de fíbula Cervical spine flexion biomechanical study in cadaver submitted to resection of vertebral body and stabilization with fibular graft

    Directory of Open Access Journals (Sweden)

    Adriano Marchetto

    2002-06-01

    Full Text Available Este estudo apresenta e discute os resultados da análise biomecânica, radiográfica e anatômica de 20 peças de coluna cervical de cadáveres humanos, submetidas à corpectomia de C5, discectomia adjacente e estabilização com enxerto de fíbula. Os ensaios em flexão foram realizados em Máquina Universal de Testes. Nenhuma fratura ou extrusão do enxerto foi observada. A falha mecânica ocorreu na interface corpo vertebral-enxerto fibular, caracterizada por fratura dos corpos vertebrais adjacentes em 11 experimentos e afundamento da esponjosa em nove. O ligamento longitudinal posterior e o complexo ligamentar posterior não foram lesados em nenhuma das peças. Concluem que, em estudo experimental, o enxerto de fíbula é resistente e proporciona estabilidade imediata à coluna cervical quando submetido a carga em flexão.The authors present and discuss the results of a biomechanical, radiographic and anatomical analysis of 20 specimens, obtained from human cadaver of cervical spine submitted to C5 corpectomy, adjacent discectomy and stabilization with fibular graft. The flexion tests were carried out in the Test Universal Machine. Fracture or graft extrusion was not observed. Mechanical failure was observed in the vertebral body-fibular graft interface, characterized by fracture of the adjacent vertebral bodies in 11 experiments and depression of the cancellous bone in nine. The posterior longitudinal ligament and the posterior ligamental complex were not injured in any of the specimens. The authors concluded that, in an experimental study, the fibular graft is resistant and provides immediate stability to the cervical spine when submitted to flexion load.

  10. Shot Segmentation for Binocular Stereoscopic Video Based on Spatial-Temporal Feature Clustering

    Science.gov (United States)

    Duan, Feng-feng

    2016-12-01

    Shot segmentation is the key to content-based analysis, index and retrieval of binocular stereoscopic video. To solve the problem of low accuracy of stereoscopic video shot segmentation in which the segmentation method of 2D video is used to segment monocular video sequence, and the disadvantages of some stereoscopic video shot segmentation methods, a shot segmentation method for binocular stereoscopic video based on spatial-temporal feature clustering (STFC) is proposed. In the method, the features of color and brightness of left video frames in temporal domain as well as the depth feature acquired by matching of left and right frames in spatial domain is extracted. The feature differences between frames are calculated and quantified. Then the clustering of feature differences in three-dimensional space is executed, and the optimization and iteration of the classes are implemented to achieve the division of shot boundary. The experimental results show that the proposed method can effectively solve the problems of error and omission, especially the inaccuracy of smooth shot detection in binocular stereo video shot segmentation when compared with the latest existing algorithm. The higher accuracy of segmentation can be achieved.

  11. Unsupervised segmentation with dynamical units.

    Science.gov (United States)

    Rao, A Ravishankar; Cecchi, Guillermo A; Peck, Charles C; Kozloski, James R

    2008-01-01

    In this paper, we present a novel network to separate mixtures of inputs that have been previously learned. A significant capability of the network is that it segments the components of each input object that most contribute to its classification. The network consists of amplitude-phase units that can synchronize their dynamics, so that separation is determined by the amplitude of units in an output layer, and segmentation by phase similarity between input and output layer units. Learning is unsupervised and based on a Hebbian update, and the architecture is very simple. Moreover, efficient segmentation can be achieved even when there is considerable superposition of the inputs. The network dynamics are derived from an objective function that rewards sparse coding in the generalized amplitude-phase variables. We argue that this objective function can provide a possible formal interpretation of the binding problem and that the implementation of the network architecture and dynamics is biologically plausible.

  12. Compliance with Segment Disclosure Initiatives

    DEFF Research Database (Denmark)

    Arya, Anil; Frimor, Hans; Mittendorf, Brian

    2013-01-01

    Regulatory oversight of capital markets has intensified in recent years, with a particular emphasis on expanding financial transparency. A notable instance is efforts by the Financial Accounting Standards Board that push firms to identify and report performance of individual business units...... (segments). This paper seeks to address short-run and long-run consequences of stringent enforcement of and uniform compliance with these segment disclosure standards. To do so, we develop a parsimonious model wherein a regulatory agency promulgates disclosure standards and either permits voluntary...... compliance or mandates strict compliance from firms. Under voluntary compliance, a firm is able to credibly withhold individual segment information from its competitors by disclosing data only at the aggregate firm level. Consistent with regulatory hopes, we show that mandatory compliance enhances welfare...

  13. Vehicle License Plate Character Segmentation

    Institute of Scientific and Technical Information of China (English)

    Mei-Sen Pan; Jun-Biao Yan; Zheng-Hong Xiao

    2008-01-01

    Vehicle license plate (VLP) character segmentation is an important part of the vehicle license plate recognition system (VLPRS). This paper proposes a least square method (LSM) to treat horizontal tilt and vertical tilt in VLP images. Auxiliary lines are added into the image (or the tilt-corrected image) to make the separated parts of each Chinese character to be an interconnected region. The noise regions will be eliminated after two fusing images are merged according to the minimum principle of gray values.Then, the characters are segmented by projection method (PM) and the final character images are obtained. The experimental results show that this method features fast processing and good performance in segmentation.

  14. Segmental Rescoring in Text Recognition

    Science.gov (United States)

    2014-02-04

    ttm № tes/m, m* tmvr mowm* a Smyrna Of l δrtA£ACf02S’ A w m - y i p m AmiKSiS € f № ) C № № m .. sg6#?«rA fiθN ; Atφ h Sft№’·’Spxn mm m fim f№b t&m&mm...applying a Hidden Markov Model (HMM) recognition approach. Generating the plurality text hypotheses for the image forming includes generating a first...image. Applying segmental analysis to a segmentation determined by a first OCR engine, such as a segmentation determined by a Hidden Markov Model (HMM

  15. A Novel Iris Segmentation Scheme

    Directory of Open Access Journals (Sweden)

    Chen-Chung Liu

    2014-01-01

    Full Text Available One of the key steps in the iris recognition system is the accurate iris segmentation from its surrounding noises including pupil, sclera, eyelashes, and eyebrows of a captured eye-image. This paper presents a novel iris segmentation scheme which utilizes the orientation matching transform to outline the outer and inner iris boundaries initially. It then employs Delogne-Kåsa circle fitting (instead of the traditional Hough transform to further eliminate the outlier points to extract a more precise iris area from an eye-image. In the extracted iris region, the proposed scheme further utilizes the differences in the intensity and positional characteristics of the iris, eyelid, and eyelashes to detect and delete these noises. The scheme is then applied on iris image database, UBIRIS.v1. The experimental results show that the presented scheme provides a more effective and efficient iris segmentation than other conventional methods.

  16. 17 CFR 210.3-05 - Financial statements of businesses acquired or to be acquired.

    Science.gov (United States)

    2010-04-01

    ... General Instructions As to Financial Statements § 210.3-05 Financial statements of businesses acquired or... financial statements of related businesses may be presented on a combined basis for any periods they are... registered to be offered to the security holders of the business to be acquired, the financial...

  17. Segmentation in dermatological hyperspectral images: dedicated methods

    OpenAIRE

    Koprowski, Robert; Olczyk, Paweł

    2016-01-01

    Background Segmentation of hyperspectral medical images is one of many image segmentation methods which require profiling. This profiling involves either the adjustment of existing, known image segmentation methods or a proposal of new dedicated methods of hyperspectral image segmentation. Taking into consideration the size of analysed data, the time of analysis is of major importance. Therefore, the authors proposed three new dedicated methods of hyperspectral image segmentation with special...

  18. Segmentation by Large Scale Hypothesis Testing - Segmentation as Outlier Detection

    DEFF Research Database (Denmark)

    Darkner, Sune; Dahl, Anders Lindbjerg; Larsen, Rasmus

    2010-01-01

    locally. We propose a method based on large scale hypothesis testing with a consistent method for selecting an appropriate threshold for the given data. By estimating the background distribution we characterize the segment of interest as a set of outliers with a certain probability based on the estimated...

  19. SExSeg: SExtractor segmentation

    Science.gov (United States)

    Coe, Dan

    2015-08-01

    SExSeg forces SExtractor (ascl:1010.064) to run using a pre-defined segmentation map (the definition of objects and their borders). The defined segments double as isophotal apertures. SExSeg alters the detection image based on a pre-defined segmenation map while preparing your "analysis image" by subtracting the background in a separate SExtractor run (using parameters you specify). SExtractor is then run in "double-image" mode with the altered detection image and background-subtracted analysis image.

  20. Acquired alexia with agraphia syndrome in childhood.

    Science.gov (United States)

    Paquier, Philippe F; De Smet, Hyo Jung; Mariën, Peter; Poznanski, Nathalie; Van Bogaert, Patrick

    2006-04-01

    The acquired alexia with agraphia syndrome is a conspicuous disorder of reading and writing in the absence of significant other language impairments that has mainly been recorded in adults. Pure cases are rare, with most patients displaying mild aphasic deficits. In children, acquired reading and writing disorders are generally reported as part of more encompassing aphasic syndromes affecting oral and written language equally, for example, Broca or Wernicke aphasia. Documented instances of predominant acquired reading and writing disorders in childhood are exceptional. We report an 11-year-old, right-handed boy who sustained a left temporoparieto-occipital hematoma following rupture of an arteriovenous malformation and who consecutively presented with the acquired alexia with agraphia syndrome associated with word-finding difficulties. Neuropsychologic and neurolinguistic data showed that there was no concomitant Gerstmann and/or angular gyrus syndrome. Th e recoveryfrom the anomia was quite favorable, but recovery of written language was more protracted and acted on the patient's further scholastic achievement. This case is reminiscent of a historical childhood case reported in 1939 and is consonant with adult cases in terms of lesion location and semiologic picture.

  1. Community-Acquired Pneumonia in Indonesia

    NARCIS (Netherlands)

    H. Farida (Helmia)

    2015-01-01

    markdownabstract__Abstract__ __Background:__ Knowledge about the etiology and management of community-acquired pneumonia (CAP) in Indonesia is lacking. __Methods:__ Hospital-based and a population-based cohort studies were carried out during 2007-2011 in Semarang, Indonesia. __Results:__

  2. Sexually acquired Salmonella Typhi urinary tract infection.

    Science.gov (United States)

    Wielding, Sally; Scott, Gordon

    2016-05-01

    We report a case of isolated urinary Salmonella enterica serotype Typhi in an HIV-positive man who has sex with men. He was clinically well and blood and stool cultures were negative, indicating that this may have been a sexually acquired urinary tract infection.

  3. Acquired double pylorus:A case report

    Institute of Scientific and Technical Information of China (English)

    Qing-Yu Chen; Yan Chen; Liang; Jing Wang; Qin Du; Jian-Ting Cai; Jia-Min Chen

    2012-01-01

    Double pylorus is one of the rare anomalies of the gastrointestinal tract, it can be congenital or acquired. In this case we report a case of double pylorus because of chronic peptic ulcer. Upper GI endoscopy revealed gastroduodenal fistula located on the lesser curve of the antrum, the patient's symptoms were improved rapidly by intensive antiulcer treatment.

  4. Acquired antibiotic resistance genes:an overview

    NARCIS (Netherlands)

    Hoek, A.H. van; Mevius, D.; Guerra, B.; Mullany, P.; Robberts, A.P.

    2011-01-01

    In this review an overview is given on antibiotic resistance (AR) mechanisms with special attentions to the AR genes described so far preceded by a short introduction on the discovery and mode of action of the different classes of antibiotics. As this review is only dealing with acquired resistance,

  5. Acquired antibiotic resistance genes: an overview

    NARCIS (Netherlands)

    Hoek, van A.H.; Mevius, D.J.; Guerra, B.; Mullany, P.; Roberts, A.P.; Aarts, H.J.

    2011-01-01

    In this review an overview is given on antibiotic resistance (AR) mechanisms with special attentions to the AR genes described so far preceded by a short introduction on the discovery and mode of action of the different classes of antibiotics. As this review is only dealing with acquired resistance,

  6. Mitral valve repair in acquired dextrocardia.

    Science.gov (United States)

    Elmistekawy, Elsayed; Chan, Vincent; Hynes, Mark; Mesana, Thierry

    2015-10-01

    Surgical correction of valvular heart disease in patients with dextrocardia is extremely rare. We report a surgical case of mitral valve repair in a patient with acquired dextrocardia. Successful mitral valve repair was performed through a right lateral thoracotomy. We describe our surgical strategy and summarize the literature.

  7. Acute acquired comitant esotropia of childhood

    DEFF Research Database (Denmark)

    Hesgaard, Helena; Vinding, Troels

    2015-01-01

    PURPOSE: To identify characteristics of pediatric patients who develop acute acquired comitant esotropia (AACE) with and without intracranial disease. METHODS: We reviewed the charts of 48 children consecutively referred to the hospital with AACE during a 13-year period. Inclusion criteria were...

  8. Monitoring Agitated Behavior After acquired Brain Injury

    DEFF Research Database (Denmark)

    Aadal, Lena; Mortensen, Jesper; Nielsen, Jørgen Feldbaek

    2016-01-01

    Purpose: To describe the onset, duration, intensity, and nursing shift variation of agitated behavior in patients with acquired brain injury (ABI) at a rehabilitation hospital. Design: Prospective descriptive study. Methods: A total of 11 patients with agitated behavior were included. Agitated...

  9. Immunomodulation in community-acquired pneumonia

    NARCIS (Netherlands)

    Remmelts, H.H.F.

    2013-01-01

    Community-acquired pneumonia (CAP) is a common disease with considerable morbidity and mortality, despite effective antibiotic treatment. In this thesis, we showed that the major causative microorganisms in CAP trigger distinct inflammatory response profiles in the host. While an inflammatory respon

  10. Acquired Demyelinating Syndromes and Pediatric Multiple Sclerosis

    NARCIS (Netherlands)

    I.A. Ketelslegers (Immy)

    2014-01-01

    markdownabstract__Abstract__ Acquired inflammatory demyelinating diseases of the central nervous system (CNS) cause damage to myelin sheaths and typically result in white matter lesions due to inflammation, myelin loss and axonal pathology. Clinically, this may result in transient, relapsing or pro

  11. Does chromatin remodeling mark systemic acquired resistance?

    NARCIS (Netherlands)

    Burg, van den H.A.; Takken, F.L.W.

    2009-01-01

    The recognition of plant pathogens activates local defense responses and triggers a long-lasting systemic acquired resistance (SAR) response. Activation of SAR requires the hormone salicylic acid (SA), which induces SA-responsive gene expression. Recent data link changes in gene expression to chroma

  12. Acquired antibiotic resistance genes:an overview

    NARCIS (Netherlands)

    Hoek, A.H. van; Mevius, D.; Guerra, B.; Mullany, P.; Robberts, A.P.

    In this review an overview is given on antibiotic resistance (AR) mechanisms with special attentions to the AR genes described so far preceded by a short introduction on the discovery and mode of action of the different classes of antibiotics. As this review is only dealing with acquired resistance,

  13. Acquired antibiotic resistance genes: an overview

    NARCIS (Netherlands)

    Hoek, van A.H.; Mevius, D.J.; Guerra, B.; Mullany, P.; Roberts, A.P.; Aarts, H.J.

    2011-01-01

    In this review an overview is given on antibiotic resistance (AR) mechanisms with special attentions to the AR genes described so far preceded by a short introduction on the discovery and mode of action of the different classes of antibiotics. As this review is only dealing with acquired resistance,

  14. Acquired nasal deformities in fighter pilots.

    Science.gov (United States)

    Schreinemakers, Joyce R C; van Amerongen, Pieter; Kon, Moshe

    2010-07-01

    Fighter pilots may develop slowly progressive deformities of their noses during their flying careers. The spectrum of deformities that may be acquired ranges from soft tissue to osseous changes. The main cause is the varying pressure exerted by the oxygen mask on the skin and bony pyramid of the nose during flying.

  15. Chronic Acquired Demyelinating Polyneuropathy following Renal Transplantation

    OpenAIRE

    Younger, D. S.; Stuart Orsher

    2013-01-01

    The clinical, laboratory, and treatment findings of a patient with chronic acquired demyelinating polyneuropathy (CADP) in association with renal transplantation are described. Like the present case, many such patients have been described under the rubric of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

  16. Severe acquired anaemia in Africa: new concepts

    NARCIS (Netherlands)

    M. Boele van Hensbroek; F. Jonker; I. Bates

    2011-01-01

    Severe anaemia is common in Africa. It has a high mortality and particularly affects young children and pregnant women. Recent research provides new insights into the mechanisms and causes of severe acquired anaemia and overturns accepted dogma. Deficiencies of vitamin B12 and vitamin A, but not of

  17. ACQUIRED CUTIS LAXA WITH RECURRENT URTICARIA

    Directory of Open Access Journals (Sweden)

    Ganaparthi

    2015-05-01

    Full Text Available A 30 year old male patient presented with progressive laxity and wrinkling of skin over the face for past 10 years, patient also gives history of recurrent urticaria since 12 years. Skin biopsy using Verhoff Van Gieson stain suggestive of cutis laxa. We are reporting a rare case of acquired cutis laxa with recurrent urticaria

  18. Robust Machine Learning-Based Correction on Automatic Segmentation of the Cerebellum and Brainstem.

    Science.gov (United States)

    Wang, Jun Yi; Ngo, Michael M; Hessl, David; Hagerman, Randi J; Rivera, Susan M

    2016-01-01

    Automated segmentation is a useful method for studying large brain structures such as the cerebellum and brainstem. However, automated segmentation may lead to inaccuracy and/or undesirable boundary. The goal of the present study was to investigate whether SegAdapter, a machine learning-based method, is useful for automatically correcting large segmentation errors and disagreement in anatomical definition. We further assessed the robustness of the method in handling size of training set, differences in head coil usage, and amount of brain atrophy. High resolution T1-weighted images were acquired from 30 healthy controls scanned with either an 8-channel or 32-channel head coil. Ten patients, who suffered from brain atrophy because of fragile X-associated tremor/ataxia syndrome, were scanned using the 32-channel head coil. The initial segmentations of the cerebellum and brainstem were generated automatically using Freesurfer. Subsequently, Freesurfer's segmentations were both manually corrected to serve as the gold standard and automatically corrected by SegAdapter. Using only 5 scans in the training set, spatial overlap with manual segmentation in Dice coefficient improved significantly from 0.956 (for Freesurfer segmentation) to 0.978 (for SegAdapter-corrected segmentation) for the cerebellum and from 0.821 to 0.954 for the brainstem. Reducing the training set size to 2 scans only decreased the Dice coefficient ≤0.002 for the cerebellum and ≤ 0.005 for the brainstem compared to the use of training set size of 5 scans in corrective learning. The method was also robust in handling differences between the training set and the test set in head coil usage and the amount of brain atrophy, which reduced spatial overlap only by segmentation and corrective learning provides a valuable method for accurate and efficient segmentation of the cerebellum and brainstem, particularly in large-scale neuroimaging studies, and potentially for segmenting other neural regions as

  19. Women segmentation based on contraceptive use.

    Science.gov (United States)

    El-zanaty, F H

    1994-06-01

    In the past, the Egyptian Information, Education and Communication Center (IEC) SIS/IEC Center has used research findings to develop messages on the health benefits of family planning to mothers and children, proper use of contraceptive methods, and the need for acquiring correct information. A recent analysis of the 1995 Egypt Demographic and Health Survey data on 9153 currently married women aged 15-49 aimed to generate preliminary audience segments and profiles of different groups of current users, never users, and discontinuers of family planning methods so the Center can develop messages on family planning and birth spacing. 47.1% of all women in the analysis currently used contraception. 19.8% had used contraception, but did not do so currently. 33.1% had never used contraception. The leading factors affecting contraceptive use were husband's approval, husband-wife communications, desire for more children, and religion. Based on what was learned from discontinuers, the Center made two general conclusions. It needs to design special messages targeting discontinuers or never users. These special messages need to concern the groups' knowledge about different family planning methods, side effects, birth spacing methods, and birth limiting methods. Husband involvement in family planning is essential. Thus, the Center needs to develop special messages geared to men. To do so, however, a cluster analysis for husbands would be helpful in message development.

  20. 30 Cases of Distal Fibular Co,,inuted Fracture Treated with Fibula Hook Plate%腓骨钩钢板治疗腓骨远端粉碎性骨折30例

    Institute of Scientific and Technical Information of China (English)

    何精选; 覃松; 邹凯; 刘骏

    2015-01-01

    Objective To investigate the effect of fibula hook plate in the treatment of distal fibular comminuted fracture. Methods 30 patients with distal fibular comminuted fracture were treated with fibula hook plate from Feb. 2012 to Apr. 2014. The function of ankle joint was evaluated after operation. Complications like wound infection,non-union of fracture,internal fixation failure were observed. Results All the cases were followed up for 12 to 36 months (an average of 24 months). No obvious fracture line could be seen on the radiographs 4 to 6 weeks after operation. Clinical healing was achieved 12 to 24 weeks after operation. All surgical incisions healed adequately. There were no instability of ankle. According to AOFAS ankle joint scoring scale system,the final result was scored from 45 to 94(av-erage 87. 1). There were excellent in 16 cases,good in 9,fair in 3,and poor in 2 cases. The excellent and good rate was 83. 3% . Conclusion Fibula hook plate has the advantages of short operation time,small injury trauma,firm fixa-tion and functional recovery satisfaction in the treatment of distal fibular comminuted fracture.%目的:探讨腓骨钩钢板治疗腓骨远端粉碎性骨折的经验及临床疗效。方法2012年2月~2014年4月,对30例腓骨远端闭合性粉碎性骨折行切开复位腓骨钩钢板内固定术,术后对踝关节功能进行评分,并观察并发症如伤口感染、骨折不愈合、内固定失败等的发生情况。结果所有病例均得到完整随访,随访时间12~36(平均24)个月。术后4~6周 X 线片均可见骨折线模糊;术后12~24周均达到临床愈合。伤口均一期愈合,无踝关节不稳。AOFAS 评分踝关节功能评分为45~94(平均87.1)分,其中优16例,良9例,可3例,差2例,优良率83.3%。结论对于腓骨远端粉碎性骨折,腓骨钩钢板具有手术时间短,手术创伤小、复位好、固定牢固、术后功能恢复满意等优点。

  1. Research Progress on Image Segmentation

    Science.gov (United States)

    1981-06-01

    AUTHOR. HANON A.R. AND RISEMAM E- 𔃻. TITLE G SE MENTATION OF NATURA’ CNIE PAGE 6 REFERENCES FOR< IMAGE...PUBLICAIION-DAIA : 1976 KEY-WORDS : IMAGE SEGMENTATION AU’ihOR I KRUGER K. P., THOMPSON W. B, AND TURNER A. F, TITLE COMPUTER DIAGNOSIS OF TNEUMOCONIOSIS

  2. Increasing Enrollment through Benefit Segmentation.

    Science.gov (United States)

    Goodnow, Betty

    1982-01-01

    The applicability of benefit segmentation, a market research technique which groups people according to benefits expected from a program offering, was tested at the College of DuPage. Preferences and demographic characteristics were analyzed and program improvements adopted, increasing enrollment by 20 percent. (Author/SK)

  3. Leaf segmentation in plant phenotyping

    NARCIS (Netherlands)

    Scharr, Hanno; Minervini, Massimo; French, Andrew P.; Klukas, Christian; Kramer, David M.; Liu, Xiaoming; Luengo, Imanol; Pape, Jean Michel; Polder, Gerrit; Vukadinovic, Danijela; Yin, Xi; Tsaftaris, Sotirios A.

    2016-01-01

    Image-based plant phenotyping is a growing application area of computer vision in agriculture. A key task is the segmentation of all individual leaves in images. Here we focus on the most common rosette model plants, Arabidopsis and young tobacco. Although leaves do share appearance and shape cha

  4. Age Differences in Language Segmentation.

    Science.gov (United States)

    Stine-Morrow, Elizabeth A L; Payne, Brennan R

    2016-01-01

    Reading bears the evolutionary footprint of spoken communication. Prosodic contour in speech helps listeners parse sentences and establish semantic focus. Readers' regulation of input mirrors the segmentation patterns of prosody, such that reading times are longer for words at the ends of syntactic constituents. As reflected in these "micropauses," older readers are often found to segment text into smaller chunks. The mechanisms underlying these micropauses are unclear, with some arguing that they derive from the mental simulation of prosodic contour and others arguing they reflect higher-level language comprehension mechanisms (e.g., conceptual integration, consolidation with existing knowledge, ambiguity resolution) that are common across modality and support the consolidation of the memory representation. The authors review evidence based on reading time and comprehension performance to suggest that (a) age differences in segmentation derive both from age-related declines in working memory, as well as from crystallized ability and knowledge, which have the potential to grow in adulthood, and that (b) shifts in segmentation patterns may be a pathway through which language comprehension is preserved in late life.

  5. XRA image segmentation using regression

    Science.gov (United States)

    Jin, Jesse S.

    1996-04-01

    Segmentation is an important step in image analysis. Thresholding is one of the most important approaches. There are several difficulties in segmentation, such as automatic selecting threshold, dealing with intensity distortion and noise removal. We have developed an adaptive segmentation scheme by applying the Central Limit Theorem in regression. A Gaussian regression is used to separate the distribution of background from foreground in a single peak histogram. The separation will help to automatically determine the threshold. A small 3 by 3 widow is applied and the modal of the local histogram is used to overcome noise. Thresholding is based on local weighting, where regression is used again for parameter estimation. A connectivity test is applied to the final results to remove impulse noise. We have applied the algorithm to x-ray angiogram images to extract brain arteries. The algorithm works well for single peak distribution where there is no valley in the histogram. The regression provides a method to apply knowledge in clustering. Extending regression for multiple-level segmentation needs further investigation.

  6. Multiple Segment Factorial Vignette Designs

    Science.gov (United States)

    Ganong, Lawrence H.; Coleman, Marilyn

    2006-01-01

    The multiple segment factorial vignette design (MSFV) combines elements of experimental designs and probability sampling with the inductive, exploratory approach of qualitative research. MSFVs allow researchers to investigate topics that may be hard to study because of ethical or logistical concerns. Participants are presented with short stories…

  7. Segmental Colitis Complicating Diverticular Disease

    Directory of Open Access Journals (Sweden)

    Guido Ma Van Rosendaal

    1996-01-01

    Full Text Available Two cases of idiopathic colitis affecting the sigmoid colon in elderly patients with underlying diverticulosis are presented. Segmental resection has permitted close review of the histopathology in this syndrome which demonstrates considerable similarity to changes seen in idiopathic ulcerative colitis. The reported experience with this syndrome and its clinical features are reviewed.

  8. Body segments and growth hormone.

    OpenAIRE

    Bundak, R; Hindmarsh, P C; Brook, C. G.

    1988-01-01

    The effects of human growth hormone treatment for five years on sitting height and subischial leg length of 35 prepubertal children with isolated growth hormone deficiency were investigated. Body segments reacted equally to treatment with human growth hormone; this is important when comparing the effect of growth hormone on the growth of children with skeletal dysplasias or after spinal irradiation.

  9. Increasing Enrollment through Benefit Segmentation.

    Science.gov (United States)

    Goodnow, Betty

    1982-01-01

    The applicability of benefit segmentation, a market research technique which groups people according to benefits expected from a program offering, was tested at the College of DuPage. Preferences and demographic characteristics were analyzed and program improvements adopted, increasing enrollment by 20 percent. (Author/SK)

  10. Segmenting Trajectories by Movement States

    NARCIS (Netherlands)

    Buchin, M.; Kruckenberg, H.; Kölzsch, A.; Timpf, S.; Laube, P.

    2013-01-01

    Dividing movement trajectories according to different movement states of animals has become a challenge in movement ecology, as well as in algorithm development. In this study, we revisit and extend a framework for trajectory segmentation based on spatio-temporal criteria for this purpose. We adapt

  11. Multiple Segment Factorial Vignette Designs

    Science.gov (United States)

    Ganong, Lawrence H.; Coleman, Marilyn

    2006-01-01

    The multiple segment factorial vignette design (MSFV) combines elements of experimental designs and probability sampling with the inductive, exploratory approach of qualitative research. MSFVs allow researchers to investigate topics that may be hard to study because of ethical or logistical concerns. Participants are presented with short stories…

  12. Dictionary Based Segmentation in Volumes

    DEFF Research Database (Denmark)

    Emerson, Monica Jane; Jespersen, Kristine Munk; Jørgensen, Peter Stanley

    Method for supervised segmentation of volumetric data. The method is trained from manual annotations, and these annotations make the method very flexible, which we demonstrate in our experiments. Our method infers label information locally by matching the pattern in a neighborhood around a voxel ...... to a dictionary, and hereby accounts for the volume texture....

  13. Segmentation of Synchrotron Radiation micro-Computed Tomography Images using Energy Minimization via Graph Cuts

    Energy Technology Data Exchange (ETDEWEB)

    Meneses, Anderson A.M. [Federal University of Western Para (Brazil); Physics Institute, Rio de Janeiro State University (Brazil); Giusti, Alessandro [IDSIA (Dalle Molle Institute for Artificial Intelligence), University of Lugano (Switzerland); Almeida, Andre P. de, E-mail: apalmeid@gmail.com [Physics Institute, Rio de Janeiro State University (Brazil); Nuclear Engineering Program, Federal University of Rio de Janeiro (Brazil); Nogueira, Liebert; Braz, Delson [Nuclear Engineering Program, Federal University of Rio de Janeiro (Brazil); Almeida, Carlos E. de [Radiological Sciences Laboratory, Rio de Janeiro State University (Brazil); Barroso, Regina C. [Physics Institute, Rio de Janeiro State University (Brazil)

    2012-07-15

    The research on applications of segmentation algorithms to Synchrotron Radiation X-Ray micro-Computed Tomography (SR-{mu}CT) is an open problem, due to the interesting and well-known characteristics of SR images, such as the phase contrast effect. The Energy Minimization via Graph Cuts (EMvGC) algorithm represents state-of-art segmentation algorithm, presenting an enormous potential of application in SR-{mu}CT imaging. We describe the application of the algorithm EMvGC with swap move for the segmentation of bone images acquired at the ELETTRA Laboratory (Trieste, Italy). - Highlights: Black-Right-Pointing-Pointer Microstructures of Wistar rats' ribs are investigated with Synchrotron Radiation {mu}CT imaging. Black-Right-Pointing-Pointer The present work is part of a research on the effects of radiotherapy on the thoracic region. Black-Right-Pointing-Pointer Application of the Energy Minimization via Graph Cuts algorithm for segmentation is described.

  14. SAR and Oblique Aerial Optical Image Fusion for Urban Area Image Segmentation

    Science.gov (United States)

    Fagir, J.; Schubert, A.; Frioud, M.; Henke, D.

    2017-05-01

    The fusion of synthetic aperture radar (SAR) and optical data is a dynamic research area, but image segmentation is rarely treated. While a few studies use low-resolution nadir-view optical images, we approached the segmentation of SAR and optical images acquired from the same airborne platform - leading to an oblique view with high resolution and thus increased complexity. To overcome the geometric differences, we generated a digital surface model (DSM) from adjacent optical images and used it to project both the DSM and SAR data into the optical camera frame, followed by segmentation with each channel. The fused segmentation algorithm was found to out-perform the single-channel version.

  15. On the creation of a segmentation library for digitized cervical and lumbar spine radiographs.

    Science.gov (United States)

    Gururajan, Arunkumar; Kamalakannan, Sridharan; Sari-Sarraf, Hamed; Shahriar, Muneem; Long, Rodney; Antani, Sameer

    2011-06-01

    In this paper, we address the issue of computer-assisted indexing in one specific case, i.e., for the 17,000 digitized images of the spine acquired during the National Health and Nutrition Examination Survey (NHANES). The crucial step in this process is to accurately segment the cervical and lumbar spine in the radiographic images. To that end, we have implemented a unique segmentation system that consists of a suite of spine-customized automatic and semi-automatic statistical shape segmentation algorithms. Using the aforementioned system, we have developed experiments to optimally generate a library of spine segmentations, which currently include 2000 cervical and 2000 lumbar spines. This work is expected to contribute toward the creation of a biomedical Content-Based Image Retrieval system that will allow retrieval of vertebral shapes by using query by image example or query by shape example.

  16. An Image Matching Algorithm Integrating Global SRTM and Image Segmentation for Multi-Source Satellite Imagery

    Directory of Open Access Journals (Sweden)

    Xiao Ling

    2016-08-01

    Full Text Available This paper presents a novel image matching method for multi-source satellite images, which integrates global Shuttle Radar Topography Mission (SRTM data and image segmentation to achieve robust and numerous correspondences. This method first generates the epipolar lines as a geometric constraint assisted by global SRTM data, after which the seed points are selected and matched. To produce more reliable matching results, a region segmentation-based matching propagation is proposed in this paper, whereby the region segmentations are extracted by image segmentation and are considered to be a spatial constraint. Moreover, a similarity measure integrating Distance, Angle and Normalized Cross-Correlation (DANCC, which considers geometric similarity and radiometric similarity, is introduced to find the optimal correspondences. Experiments using typical satellite images acquired from Resources Satellite-3 (ZY-3, Mapping Satellite-1, SPOT-5 and Google Earth demonstrated that the proposed method is able to produce reliable and accurate matching results.

  17. A New SAR Image Segmentation Algorithm for the Detection of Target and Shadow Regions

    Science.gov (United States)

    Huang, Shiqi; Huang, Wenzhun; Zhang, Ting

    2016-12-01

    The most distinctive characteristic of synthetic aperture radar (SAR) is that it can acquire data under all weather conditions and at all times. However, its coherent imaging mechanism introduces a great deal of speckle noise into SAR images, which makes the segmentation of target and shadow regions in SAR images very difficult. This paper proposes a new SAR image segmentation method based on wavelet decomposition and a constant false alarm rate (WD-CFAR). The WD-CFAR algorithm not only is insensitive to the speckle noise in SAR images but also can segment target and shadow regions simultaneously, and it is also able to effectively segment SAR images with a low signal-to-clutter ratio (SCR). Experiments were performed to assess the performance of the new algorithm on various SAR images. The experimental results show that the proposed method is effective and feasible and possesses good characteristics for general application.

  18. Ultrasound Common Carotid Artery Segmentation Based on Active Shape Model

    Directory of Open Access Journals (Sweden)

    Xin Yang

    2013-01-01

    Full Text Available Carotid atherosclerosis is a major reason of stroke, a leading cause of death and disability. In this paper, a segmentation method based on Active Shape Model (ASM is developed and evaluated to outline common carotid artery (CCA for carotid atherosclerosis computer-aided evaluation and diagnosis. The proposed method is used to segment both media-adventitia-boundary (MAB and lumen-intima-boundary (LIB on transverse views slices from three-dimensional ultrasound (3D US images. The data set consists of sixty-eight, 17 × 2 × 2, 3D US volume data acquired from the left and right carotid arteries of seventeen patients (eight treated with 80 mg atorvastatin and nine with placebo, who had carotid stenosis of 60% or more, at baseline and after three months of treatment. Manually outlined boundaries by expert are adopted as the ground truth for evaluation. For the MAB and LIB segmentations, respectively, the algorithm yielded Dice Similarity Coefficient (DSC of 94.4% ± 3.2% and 92.8% ± 3.3%, mean absolute distances (MAD of 0.26 ± 0.18 mm and 0.33 ± 0.21 mm, and maximum absolute distances (MAXD of 0.75 ± 0.46 mm and 0.84 ± 0.39 mm. It took 4.3 ± 0.5 mins to segment single 3D US images, while it took 11.7 ± 1.2 mins for manual segmentation. The method would promote the translation of carotid 3D US to clinical care for the monitoring of the atherosclerotic disease progression and regression.

  19. Automatic segmentation of lumbar vertebrae in CT images

    Science.gov (United States)

    Kulkarni, Amruta; Raina, Akshita; Sharifi Sarabi, Mona; Ahn, Christine S.; Babayan, Diana; Gaonkar, Bilwaj; Macyszyn, Luke; Raghavendra, Cauligi

    2017-03-01

    Lower back pain is one of the most prevalent disorders in the developed/developing world. However, its etiology is poorly understood and treatment is often determined subjectively. In order to quantitatively study the emergence and evolution of back pain, it is necessary to develop consistently measurable markers for pathology. Imaging based measures offer one solution to this problem. The development of imaging based on quantitative biomarkers for the lower back necessitates automated techniques to acquire this data. While the problem of segmenting lumbar vertebrae has been addressed repeatedly in literature, the associated problem of computing relevant biomarkers on the basis of the segmentation has not been addressed thoroughly. In this paper, we propose a Random-Forest based approach that learns to segment vertebral bodies in CT images followed by a biomarker evaluation framework that extracts vertebral heights and widths from the segmentations obtained. Our dataset consists of 15 CT sagittal scans obtained from General Electric Healthcare. Our main approach is divided into three parts: the first stage is image pre-processing which is used to correct for variations in illumination across all the images followed by preparing the foreground and background objects from images; the next stage is Machine Learning using Random-Forests, which distinguishes the interest-point vectors between foreground or background; and the last step is image post-processing, which is crucial to refine the results of classifier. The Dice coefficient was used as a statistical validation metric to evaluate the performance of our segmentations with an average value of 0.725 for our dataset.

  20. Joint shape segmentation with linear programming

    KAUST Repository

    Huang, Qixing

    2011-01-01

    We present an approach to segmenting shapes in a heterogenous shape database. Our approach segments the shapes jointly, utilizing features from multiple shapes to improve the segmentation of each. The approach is entirely unsupervised and is based on an integer quadratic programming formulation of the joint segmentation problem. The program optimizes over possible segmentations of individual shapes as well as over possible correspondences between segments from multiple shapes. The integer quadratic program is solved via a linear programming relaxation, using a block coordinate descent procedure that makes the optimization feasible for large databases. We evaluate the presented approach on the Princeton segmentation benchmark and show that joint shape segmentation significantly outperforms single-shape segmentation techniques. © 2011 ACM.

  1. Competition between influenza A virus genome segments.

    Directory of Open Access Journals (Sweden)

    Ivy Widjaja

    Full Text Available Influenza A virus (IAV contains a segmented negative-strand RNA genome. How IAV balances the replication and transcription of its multiple genome segments is not understood. We developed a dual competition assay based on the co-transfection of firefly or Gaussia luciferase-encoding genome segments together with plasmids encoding IAV polymerase subunits and nucleoprotein. At limiting amounts of polymerase subunits, expression of the firefly luciferase segment was negatively affected by the presence of its Gaussia luciferase counterpart, indicative of competition between reporter genome segments. This competition could be relieved by increasing or decreasing the relative amounts of firefly or Gaussia reporter segment, respectively. The balance between the luciferase expression levels was also affected by the identity of the untranslated regions (UTRs as well as segment length. In general it appeared that genome segments displaying inherent higher expression levels were more efficient competitors of another segment. When natural genome segments were tested for their ability to suppress reporter gene expression, shorter genome segments generally reduced firefly luciferase expression to a larger extent, with the M and NS segments having the largest effect. The balance between different reporter segments was most dramatically affected by the introduction of UTR panhandle-stabilizing mutations. Furthermore, only reporter genome segments carrying these mutations were able to efficiently compete with the natural genome segments in infected cells. Our data indicate that IAV genome segments compete for available polymerases. Competition is affected by segment length, coding region, and UTRs. This competition is probably most apparent early during infection, when limiting amounts of polymerases are present, and may contribute to the regulation of segment-specific replication and transcription.

  2. Subcortical infarction resulting in acquired stuttering.

    Science.gov (United States)

    Ciabarra, A M; Elkind, M S; Roberts, J K; Marshall, R S

    2000-10-01

    Stuttering is an uncommon presentation of acute stroke. Reported cases have often been associated with left sided cortical lesions, aphasia, and difficulties with other non-linguistic tests of rhythmic motor control. Three patients with subcortical lesions resulting in stuttering are discussed. In one patient the ability to perform time estimations with a computerised repetitive time estimation task was characterised. One patient had a pontine infarct with clinical evidence of cerebellar dysfunction. A second patient had a left basal ganglionic infarct and a disruption of timing estimation. A third patient had a left subcortical infarct and a mild aphasia. These findings expand the reported distribution of infarction that can result in acquired stuttering. Subcortical mechanisms of speech control and timing may contribute to the pathophysiology of acquired stuttering.

  3. Acquired portosystemic collaterals: anatomy and imaging*

    Science.gov (United States)

    Leite, Andréa Farias de Melo; Mota Jr., Américo; Chagas-Neto, Francisco Abaeté; Teixeira, Sara Reis; Elias Junior, Jorge; Muglia, Valdair Francisco

    2016-01-01

    Portosystemic shunts are enlarged vessels that form collateral pathological pathways between the splanchnic circulation and the systemic circulation. Although their causes are multifactorial, portosystemic shunts all have one mechanism in common-increased portal venous pressure, which diverts the blood flow from the gastrointestinal tract to the systemic circulation. Congenital and acquired collateral pathways have both been described in the literature. The aim of this pictorial essay was to discuss the distinct anatomic and imaging features of portosystemic shunts, as well as to provide a robust method of differentiating between acquired portosystemic shunts and similar pathologies, through the use of illustrations and schematic drawings. Imaging of portosystemic shunts provides subclinical markers of increased portal venous pressure. Therefore, radiologists play a crucial role in the identification of portosystemic shunts. Early detection of portosystemic shunts can allow ample time to perform endovascular shunt operations, which can relieve portal hypertension and prevent acute or chronic complications in at-risk patient populations. PMID:27777479

  4. Acquired portosystemic collaterals: anatomy and imaging

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Andrea Farias de Melo; Mota Junior, Americo, E-mail: andreafariasm@gmail.com [Instituto de Medicina Integral Professor Fernando Figueira de Pernambuco (IMIP), Recife, PE (Brazil); Chagas-Neto, Francisco Abaete [Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Teixeira, Sara Reis; Elias Junior, Jorge; Muglia, Valdair Francisco [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina

    2016-07-15

    Portosystemic shunts are enlarged vessels that form collateral pathological pathways between the splanchnic circulation and the systemic circulation. Although their causes are multifactorial, portosystemic shunts all have one mechanism in common - increased portal venous pressure, which diverts the blood flow from the gastrointestinal tract to the systemic circulation. Congenital and acquired collateral pathways have both been described in the literature. The aim of this pictorial essay was to discuss the distinct anatomic and imaging features of portosystemic shunts, as well as to provide a robust method of differentiating between acquired portosystemic shunts and similar pathologies, through the use of illustrations and schematic drawings. Imaging of portosystemic shunts provides subclinical markers of increased portal venous pressure. Therefore, radiologists play a crucial role in the identification of portosystemic shunts. Early detection of portosystemic shunts can allow ample time to perform endovascular shunt operations, which can relieve portal hypertension and prevent acute or chronic complications in at-risk patient populations. (author)

  5. Recognising and managing community-acquired pneumonia.

    Science.gov (United States)

    Gibson, Vanessa

    2015-11-18

    Pneumonia remains a significant cause of morbidity and mortality in the UK and yet the seriousness of the disease is underestimated. Pneumonia can be life-threatening because the delicate tissues of the alveoli and pulmonary capillaries are susceptible to damage from the inflammatory response. This damage leads to consolidation that prevents the diffusion of oxygen and carbon dioxide, and this in turn can lead to respiratory failure. This article summarises guidance on the diagnosis and management of community-acquired pneumonia, and also includes information on the prevention of pneumonia. This information should be valuable to nurses working in a variety of clinical areas since patients with community-acquired pneumonia are encountered in primary, intermediate, secondary and critical care.

  6. Acquired antibiotic resistance genes: an overview.

    Directory of Open Access Journals (Sweden)

    Angela H.A.M. van Hoek

    2011-09-01

    Full Text Available In this review an overview is given on antibiotic resistance mechanisms with special attentions to the antibiotic resistance genes described so far preceded by a short introduction on the discovery and mode of action of the different classes of antibiotics. As this review is only dealing with acquired resistance, attention is paid to mobile genetic elements such as plasmids, transposons and integrons, which are associated with antibiotic resistance genes, and involved in the dispersal of antimicrobial determinants between different bacteria.

  7. Acquired antibiotic resistance genes: an overview.

    OpenAIRE

    Hoek, Angela H.A.M. van; Dik eMevius; Beatriz eGuerra; Peter eMullany; Adam Paul Roberts; Aarts, Henk J. M.

    2011-01-01

    In this review an overview is given on antibiotic resistance mechanisms with special attentions to the antibiotic resistance genes described so far preceded by a short introduction on the discovery and mode of action of the different classes of antibiotics. As this review is only dealing with acquired resistance, attention is paid to mobile genetic elements such as plasmids, transposons and integrons, which are associated with antibiotic resistance genes, and involved in the dispersal of anti...

  8. Acquired Antibiotic Resistance Genes: An Overview

    OpenAIRE

    Hoek, Angela H.A.M. van; Mevius, Dik; Guerra, Beatriz; Mullany, Peter; Roberts, Adam Paul; Aarts, Henk J. M.

    2011-01-01

    In this review an overview is given on antibiotic resistance (AR) mechanisms with special attentions to the AR genes described so far preceded by a short introduction on the discovery and mode of action of the different classes of antibiotics. As this review is only dealing with acquired resistance, attention is also paid to mobile genetic elements such as plasmids, transposons, and integrons, which are associated with AR genes, and involved in the dispersal of antimicrobial determinants betw...

  9. The pathophysiology of acquired premature ejaculation

    OpenAIRE

    McMahon, Chris G; Jannini, Emmanuele A.; Serefoglu, Ege C.; Hellstrom, Wayne J.G.

    2016-01-01

    The second Ad Hoc International Society for Sexual Medicine (ISSM) Committee for the Definition of Premature Ejaculation defined acquired premature ejaculation (PE) as a male sexual dysfunction characterized by a the development of a clinically significant and bothersome reduction in ejaculation latency time in men with previous normal ejaculatory experiences, often to about 3 minutes or less, the inability to delay ejaculation on all or nearly all vaginal penetrations, and the presence of ne...

  10. Earth Knowledge Acquired by Middle School Students

    Science.gov (United States)

    Ride, Sally

    2008-01-01

    Earth Knowledge Acquired by Middle School Students (EarthKAM), an education activity, allows middle school students to program a digital camera on board the International Space Station to photograph a variety of geographical targets for study in the classroom. Photos are made available on the web for viewing and study by participating schools around the world. Educators use the images for projects involving Earth Science, geography, physics, and social science.

  11. The evolution of costly acquired immune memory.

    Science.gov (United States)

    Best, Alex; Hoyle, Andy

    2013-07-01

    A key feature of the vertebrate adaptive immune system is acquired immune memory, whereby hosts launch a faster and heightened response when challenged by previously encountered pathogens, preventing full infection. Here, we use a mathematical model to explore the role of ecological and epidemiological processes in shaping selection for costly acquired immune memory. Applying the framework of adaptive dynamics to the classic SIR (Susceptible-Infected-Recovered) epidemiological model, we focus on the conditions that may lead hosts to evolve high levels of immunity. Linking our work to previous theory, we show how investment in immune memory may be greatest at long or intermediate host lifespans depending on whether immunity is long lasting. High initial costs to gain immunity are also found to be essential for a highly effective immune memory. We also find that high disease infectivity and sterility, but intermediate virulence and immune period, increase selection for immunity. Diversity in host populations through evolutionary branching is found to be possible but only for a limited range of parameter space. Our model suggests that specific ecological and epidemiological conditions have to be met for acquired immune memory to evolve.

  12. Acquired Factor VIII Inhibitors: Three Cases

    Directory of Open Access Journals (Sweden)

    Tay Za Kyaw

    2013-03-01

    Full Text Available Acquired hemophilia A is a rare, but devastating bleeding disorder caused by spontaneous development of autoantibodies directed against coagulation factor VIII. In 40%-50% of patients it is associated with such conditions as the postpartum period, malignancy, use of medications, and autoimmune diseases; however, its cause is unknown in most cases. Acquired hemophilia A should be suspected in patients that present with a coagulation abnormality, and a negative personal and family history of bleeding. Herein we report 3 patients with acquired hemophilia A that had different underlying pathologies, clinical presentations, and therapeutic responses. Factor VIII inhibitor formation in case 1 occurred 6 months after giving birth; underlying disorders were not identified in cases 2 or 3. The bleeding phenotype in these patients’ ranged from no bleeding tendency with isolated prolongation of APTT (activated partial thromboplastin time to severe intramuscular hematoma and hemarthrosis necessitating recombinant activated factor VII infusion and blood components transfusion. Variable responses to immunosuppressive treatment were also observed.

  13. The pathophysiology of acquired premature ejaculation.

    Science.gov (United States)

    McMahon, Chris G; Jannini, Emmanuele A; Serefoglu, Ege C; Hellstrom, Wayne J G

    2016-08-01

    The second Ad Hoc International Society for Sexual Medicine (ISSM) Committee for the Definition of Premature Ejaculation defined acquired premature ejaculation (PE) as a male sexual dysfunction characterized by a the development of a clinically significant and bothersome reduction in ejaculation latency time in men with previous normal ejaculatory experiences, often to about 3 minutes or less, the inability to delay ejaculation on all or nearly all vaginal penetrations, and the presence of negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy. The literature contains a diverse range of biological and psychological etiological theories. Acquired PE is commonly due to sexual performance anxiety, psychological or relationship problems, erectile dysfunction (ED), and occasionally prostatitis and hyperthyroidism, consistent with the predominant organic etiology of acquired PE, men with this complaint are usually older, have a higher mean BMI and a greater incidence of comorbid disease including hypertension, sexual desire disorder, diabetes mellitus, chronic prostatitis, and ED compared to lifelong, variable and subjective PE.

  14. MRI of fetal acquired brain lesions

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, Daniela [Department of Radiodiagnostics, Medical University of Vienna (Austria)]. E-mail: daniela.prayer@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, Medical University of Vienna (Austria); Kasprian, Gregor [Department of Radiodiagnostics, Medical University of Vienna (Austria); Witzani, Linde [Department of Radiodiagnostics, Medical University of Vienna (Austria); Helmer, Hanns [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Dietrich, Wolfgang [Department of Neurosurgery, Medical University of Vienna (Austria); Eppel, Wolfgang [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Langer, Martin [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria)

    2006-02-15

    Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images.

  15. MRI of fetal acquired brain lesions.

    Science.gov (United States)

    Prayer, Daniela; Brugger, Peter C; Kasprian, Gregor; Witzani, Linde; Helmer, Hanns; Dietrich, Wolfgang; Eppel, Wolfgang; Langer, Martin

    2006-02-01

    Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images.

  16. Acquired tracheomalacia: detection by expiratory CT scan.

    Science.gov (United States)

    Aquino, S L; Shepard, J A; Ginns, L C; Moore, R H; Halpern, E; Grillo, H C; McLoud, T C

    2001-01-01

    The purpose of this work was to determine whether cross-sectional area and coronal and sagittal diameter measurements of the trachea between inspiration and end-expiration on CT are significantly different between patients with acquired tracheomalacia and those without this condition. Inspiratory and end-expiratory CT scans of the trachea of 23 normal patients and 10 patients with acquired tracheomalacia were analyzed. Percent changes in cross-sectional area, coronal, and sagittal diameters were calculated. For patients with tracheomalacia, mean percent changes in the upper and middle trachea between inspiration and expiration were 49 and 44%; mean changes in the coronal and sagittal diameters in the upper and middle tracheal were 4 and 10% and 39 and 54%, respectively. Control group mean percent changes in the upper and middle tracheal area were 12 and 14%, respectively, and mean changes in the coronal and sagittal diameters in the upper and middle trachea were 4 and 4% and 11 and 13%, respectively. Significant differences were calculated for changes in cross-sectional area and sagittal diameter between groups (p 18% change in the upper trachea and 28% change in the midtrachea between inspiration and expiration were observed; the probability of tracheomalacia was 89-100%. The probability of tracheomalacia was > 89%, especially if the change in sagittal diameter was > 28%. By measuring changes in tracheal cross-sectional area and sagittal diameters between inspiratory and end-expiratory CT, a significant difference can be identified between normal patients and those with acquired tracheomalacia.

  17. SEGMA: An Automatic SEGMentation Approach for Human Brain MRI Using Sliding Window and Random Forests

    Science.gov (United States)

    Serag, Ahmed; Wilkinson, Alastair G.; Telford, Emma J.; Pataky, Rozalia; Sparrow, Sarah A.; Anblagan, Devasuda; Macnaught, Gillian; Semple, Scott I.; Boardman, James P.

    2017-01-01

    Quantitative volumes from brain magnetic resonance imaging (MRI) acquired across the life course may be useful for investigating long term effects of risk and resilience factors for brain development and healthy aging, and for understanding early life determinants of adult brain structure. Therefore, there is an increasing need for automated segmentation tools that can be applied to images acquired at different life stages. We developed an automatic segmentation method for human brain MRI, where a sliding window approach and a multi-class random forest classifier were applied to high-dimensional feature vectors for accurate segmentation. The method performed well on brain MRI data acquired from 179 individuals, analyzed in three age groups: newborns (38–42 weeks gestational age), children and adolescents (4–17 years) and adults (35–71 years). As the method can learn from partially labeled datasets, it can be used to segment large-scale datasets efficiently. It could also be applied to different populations and imaging modalities across the life course. PMID:28163680

  18. Low-fat diets for acquired hypercholesterolaemia.

    Science.gov (United States)

    Smart, Neil A; Marshall, Belinda J; Daley, Maxine; Boulos, Elie; Windus, Janelle; Baker, Nadine; Kwok, Nigel

    2011-02-16

    Hypercholesterolaemia, characterised by raised blood cholesterol levels, is not a disease itself but a metabolic derangement that often contributes to many diseases, notably cardiovascular disease. In most cases, elevated cholesterol levels are associated with high-fat diet, especially saturated fat, coupled with an inactive lifestyle. Less commonly, raised cholesterol may be related to an inherited disorder, familial hypercholesterolaemia. This systematic review is only concerned with acquired hypercholesterolaemia. To assess the effects of low-fat diets for acquired hypercholesterolaemia and to investigate the incidence of adverse effects from low-fat dietary interventions. We planned to compare the relative effectiveness of low-fat diets with calorie-restricted diets for acquired hypercholesterolaemia. We also wanted to look into the relative effectiveness of low-fat diets and pharmacological interventions for acquired hypercholesterolaemia. Studies were obtained from computerised searches of The Cochrane Library, MEDLINE, EMBASE and databases of ongoing trials. Date of last search was February 2010. Otherwise healthy adults (equal to or greater than 18 years) with acquired (not familial) hypercholesterolaemia. We defined hypercholesterolaemia as either total cholesterol greater than 5.2 mmol/L, LDL-cholesterol greater than 3.0 mmol/L, HDL-cholesterol less than 1.0 mmol/L or a combination thereof, although investigators' definitions were also accepted. We wanted to include any low-fat dietary intervention, like low-fat and low-saturated fat diets, intended to lower serum total and LDL-cholesterol or to raise HDL-cholesterol. A low-fat diet was considered as a fat calorie intake less than 20% of the total calories. The minimum duration of the intervention had to be six months. We excluded studies in unhealthy people. Two authors were planned to independently assess risk of bias and extract data. No study met our inclusion criteria. Well designed, adequately

  19. Segmentation of hepatic artery in multi-phase liver CT using directional dilation and connectivity analysis

    Science.gov (United States)

    Wang, Lei; Schnurr, Alena-Kathrin; Zidowitz, Stephan; Georgii, Joachim; Zhao, Yue; Razavi, Mohammad; Schwier, Michael; Hahn, Horst K.; Hansen, Christian

    2016-03-01

    Segmentation of hepatic arteries in multi-phase computed tomography (CT) images is indispensable in liver surgery planning. During image acquisition, the hepatic artery is enhanced by the injection of contrast agent. The enhanced signals are often not stably acquired due to non-optimal contrast timing. Other vascular structure, such as hepatic vein or portal vein, can be enhanced as well in the arterial phase, which can adversely affect the segmentation results. Furthermore, the arteries might suffer from partial volume effects due to their small diameter. To overcome these difficulties, we propose a framework for robust hepatic artery segmentation requiring a minimal amount of user interaction. First, an efficient multi-scale Hessian-based vesselness filter is applied on the artery phase CT image, aiming to enhance vessel structures with specified diameter range. Second, the vesselness response is processed using a Bayesian classifier to identify the most probable vessel structures. Considering the vesselness filter normally performs not ideally on the vessel bifurcations or the segments corrupted by noise, two vessel-reconnection techniques are proposed. The first technique uses a directional morphological operator to dilate vessel segments along their centerline directions, attempting to fill the gap between broken vascular segments. The second technique analyzes the connectivity of vessel segments and reconnects disconnected segments and branches. Finally, a 3D vessel tree is reconstructed. The algorithm has been evaluated using 18 CT images of the liver. To quantitatively measure the similarities between segmented and reference vessel trees, the skeleton coverage and mean symmetric distance are calculated to quantify the agreement between reference and segmented vessel skeletons, resulting in an average of 0:55+/-0:27 and 12:7+/-7:9 mm (mean standard deviation), respectively.

  20. Quantification and visualization of carotid segmentation accuracy and precision using a 2D standardized carotid map.

    Science.gov (United States)

    Chiu, Bernard; Ukwatta, Eranga; Shavakh, Shadi; Fenster, Aaron

    2013-06-07

    This paper describes a framework for vascular image segmentation evaluation. Since the size of vessel wall and plaque burden is defined by the lumen and wall boundaries in vascular segmentation, these two boundaries should be considered as a pair in statistical evaluation of a segmentation algorithm. This work proposed statistical metrics to evaluate the difference of local vessel wall thickness (VWT) produced by manual and algorithm-based semi-automatic segmentation methods (ΔT) with the local segmentation standard deviation of the wall and lumen boundaries considered. ΔT was further approximately decomposed into the local wall and lumen boundary differences (ΔW and ΔL respectively) in order to provide information regarding which of the wall and lumen segmentation errors contribute more to the VWT difference. In this study, the lumen and wall boundaries in 3D carotid ultrasound images acquired for 21 subjects were each segmented five times manually and by a level-set segmentation algorithm. The (absolute) difference measures (i.e., ΔT, ΔW, ΔL and their absolute values) and the pooled local standard deviation of manually and algorithmically segmented wall and lumen boundaries were computed for each subject and represented in a 2D standardized map. The local accuracy and variability of the segmentation algorithm at each point can be quantified by the average of these metrics for the whole group of subjects and visualized on the 2D standardized map. Based on the results shown on the 2D standardized map, a variety of strategies, such as adding anchor points and adjusting weights of different forces in the algorithm, can be introduced to improve the accuracy and variability of the algorithm.

  1. Multifocal acquired demyelinating sensory and motor neuropathy presenting as a peripheral nerve tumor.

    Science.gov (United States)

    Allen, David C; Smallman, Clare A; Mills, Kerry R

    2006-09-01

    A man with multifocal acquired demyelinating sensory and motor neuropathy (MADSAM), or Lewis-Sumner syndrome, presented with a progressive left lumbosacral plexus lesion resembling a neurofibroma. After 7 years he developed a left ulnar nerve lesion with conduction block in its upper segment. Treatment with intravenous immunoglobulin improved the symptoms and signs of both lesions. We conclude that inflammatory neuropathy must be considered in the differential diagnosis of peripheral nerve tumors, and that unifocal lesions may precede multifocal involvement in MADSAM by several years. In addition, we discuss the clinical features in 9 patients attending a specialist peripheral nerve clinic and review the literature.

  2. Segmentation-based and rule-based spectral mixture analysis for estimating urban imperviousness

    Science.gov (United States)

    Li, Miao; Zang, Shuying; Wu, Changshan; Deng, Yingbin

    2015-03-01

    For detailed estimation of urban imperviousness, numerous image processing methods have been developed, and applied to different urban areas with some success. Most of these methods, however, are global techniques. That is, they have been applied to the entire study area without considering spatial and contextual variations. To address this problem, this paper explores whether two spatio-contextual analysis techniques, namely segmentation-based and rule-based analysis, can improve urban imperviousness estimation. These two spatio-contextual techniques were incorporated to a classic urban imperviousness estimation technique, fully-constrained linear spectral mixture analysis (FCLSMA) method. In particular, image segmentation was applied to divide the image to homogenous segments, and spatially varying endmembers were chosen for each segment. Then an FCLSMA was applied for each segment to estimate the pixel-wise fractional coverage of high-albedo material, low-albedo material, vegetation, and soil. Finally, a rule-based analysis was carried out to estimate the percent impervious surface area (%ISA). The developed technique was applied to a Landsat TM image acquired in Milwaukee River Watershed, an urbanized watershed in Wisconsin, United States. Results indicate that the performance of the developed segmentation-based and rule-based LSMA (S-R-LSMA) outperforms traditional SMA techniques, with a mean average error (MAE) of 5.44% and R2 of 0.88. Further, a comparative analysis shows that, when compared to segmentation, rule-based analysis plays a more essential role in improving the estimation accuracy.

  3. Lumbar spine segmentation using a statistical multi-vertebrae anatomical shape+pose model.

    Science.gov (United States)

    Rasoulian, Abtin; Rohling, Robert; Abolmaesumi, Purang

    2013-10-01

    Segmentation of the spinal column from computed tomography (CT) images is a preprocessing step for a range of image-guided interventions. One intervention that would benefit from accurate segmentation is spinal needle injection. Previous spinal segmentation techniques have primarily focused on identification and separate segmentation of each vertebra. Recently, statistical multi-object shape models have been introduced to extract common statistical characteristics between several anatomies. These models can be used for segmentation purposes because they are robust, accurate, and computationally tractable. In this paper, we develop a statistical multi-vertebrae shape+pose model and propose a novel registration-based technique to segment the CT images of spine. The multi-vertebrae statistical model captures the variations in shape and pose simultaneously, which reduces the number of registration parameters. We validate our technique in terms of accuracy and robustness of multi-vertebrae segmentation of CT images acquired from lumbar vertebrae of 32 subjects. The mean error of the proposed technique is below 2 mm, which is sufficient for many spinal needle injection procedures, such as facet joint injections.

  4. Effects of inotropic stimulation on segmental left ventricular relaxation quantified by color kinesis.

    Science.gov (United States)

    Carey, C F; Mor-Avi, V; Koch, R; Lang, R; Pérez, J E

    2000-06-15

    Although myocardial ischemia impairs left ventricular (LV) relaxation before contractile function, regional LV diastolic dysfunction is difficult to evaluate by conventional echocardiography. Because beta-adrenergic stimulation enhances myocardial relaxation, we sought to characterize segmental LV diastolic function (by color kinesis) during dobutamine stress echocardiography and compare it with independently assessed segmental systolic function. We studied 22 patients with suspected coronary artery disease with color kinesis by acquiring digital images with endocardial motion display throughout diastole. Quantification of LV segmental diastolic peak filling rate (SPFR, normalized to segmental end-diastolic area/s) was obtained at rest, low-dose, and peak dobutamine infusion in myocardial segments visualized from the short-axis and/or apical 4-chamber views. In patients with resting normal LV systolic function and a dobutamine-induced hypercontractile response (group I, n = 13 patients; 102 segments), progressive increases in SPFR (p kinesis at rest and after inotropic stimulation, allowing comparison with segmental systolic function during pharmacologic stress testing.

  5. 3D Curvelet-Based Segmentation and Quantification of Drusen in Optical Coherence Tomography Images

    Directory of Open Access Journals (Sweden)

    M. Esmaeili

    2017-01-01

    Full Text Available Spectral-Domain Optical Coherence Tomography (SD-OCT is a widely used interferometric diagnostic technique in ophthalmology that provides novel in vivo information of depth-resolved inner and outer retinal structures. This imaging modality can assist clinicians in monitoring the progression of Age-related Macular Degeneration (AMD by providing high-resolution visualization of drusen. Quantitative tools for assessing drusen volume that are indicative of AMD progression may lead to appropriate metrics for selecting treatment protocols. To address this need, a fully automated algorithm was developed to segment drusen area and volume from SD-OCT images. The proposed algorithm consists of three parts: (1 preprocessing, which includes creating binary mask and removing possible highly reflective posterior hyaloid that is used in accurate detection of inner segment/outer segment (IS/OS junction layer and Bruch’s membrane (BM retinal layers; (2 coarse segmentation, in which 3D curvelet transform and graph theory are employed to get the possible candidate drusenoid regions; (3 fine segmentation, in which morphological operators are used to remove falsely extracted elongated structures and get the refined segmentation results. The proposed method was evaluated in 20 publically available volumetric scans acquired by using Bioptigen spectral-domain ophthalmic imaging system. The average true positive and false positive volume fractions (TPVF and FPVF for the segmentation of drusenoid regions were found to be 89.15% ± 3.76 and 0.17% ± .18%, respectively.

  6. Multi-Atlas Segmentation for Abdominal Organs with Gaussian Mixture Models.

    Science.gov (United States)

    Burke, Ryan P; Xu, Zhoubing; Lee, Christopher P; Baucom, Rebeccah B; Poulose, Benjamin K; Abramson, Richard G; Landman, Bennett A

    2015-03-17

    Abdominal organ segmentation with clinically acquired computed tomography (CT) is drawing increasing interest in the medical imaging community. Gaussian mixture models (GMM) have been extensively used through medical segmentation, most notably in the brain for cerebrospinal fluid/gray matter/white matter differentiation. Because abdominal CT exhibit strong localized intensity characteristics, GMM have recently been incorporated in multi-stage abdominal segmentation algorithms. In the context of variable abdominal anatomy and rich algorithms, it is difficult to assess the marginal contribution of GMM. Herein, we characterize the efficacy of an a posteriori framework that integrates GMM of organ-wise intensity likelihood with spatial priors from multiple target-specific registered labels. In our study, we first manually labeled 100 CT images. Then, we assigned 40 images to use as training data for constructing target-specific spatial priors and intensity likelihoods. The remaining 60 images were evaluated as test targets for segmenting 12 abdominal organs. The overlap between the true and the automatic segmentations was measured by Dice similarity coefficient (DSC). A median improvement of 145% was achieved by integrating the GMM intensity likelihood against the specific spatial prior. The proposed framework opens the opportunities for abdominal organ segmentation by efficiently using both the spatial and appearance information from the atlases, and creates a benchmark for large-scale automatic abdominal segmentation.

  7. Two-Level Evaluation on Sensor Interoperability of Features in Fingerprint Image Segmentation

    Directory of Open Access Journals (Sweden)

    Ya-Shuo Li

    2012-03-01

    Full Text Available Features used in fingerprint segmentation significantly affect the segmentation performance. Various features exhibit different discriminating abilities on fingerprint images derived from different sensors. One feature which has better discriminating ability on images derived from a certain sensor may not adapt to segment images derived from other sensors. This degrades the segmentation performance. This paper empirically analyzes the sensor interoperability problem of segmentation feature, which refers to the feature’s ability to adapt to the raw fingerprints captured by different sensors. To address this issue, this paper presents a two-level feature evaluation method, including the first level feature evaluation based on segmentation error rate and the second level feature evaluation based on decision tree. The proposed method is performed on a number of fingerprint databases which are obtained from various sensors. Experimental results show that the proposed method can effectively evaluate the sensor interoperability of features, and the features with good evaluation results acquire better segmentation accuracies of images originating from different sensors.

  8. Treatment of radiation osteomyelitis of the mandible in a patient with acquired factor VIII inhibitor

    Energy Technology Data Exchange (ETDEWEB)

    Arimoto, Takamasa; Kishimoto, Hiromitsu; Matsumoto, Suwako; Kawanaka, Masao; Urabe, Masahiro; Yoshioka, Wataru [Hyogo Coll. of Medicine, Nishinomiya (Japan)

    1996-07-01

    A case of radiation osteomyelitis of mandible in a 56-year-old man with acquired factor VIII inhibitor is presented. He had undergone radiation therapy for malignant lymphoma of the tonsilar region seven years earlier, and also had received steroids to treat acquired factor VIII inhibitor for a year. On initial examination, he was given a diagnosis of phlegmon of the cheek caused by pericoronitis of the left lower wisdom tooth. To prevent the recurrence of inflammation, the wisdom tooth was extracted carefully, but radiation osteomyelitis occurred in association with a pathological fracture of the condylar head. After mini-pulse therapy with methylpredonisolone, segmental mandibulectomy and reconstruction with a titanium metal plate were performed. The postoperative course was satisfactory with no complications such as bleeding or infection. (author)

  9. Spatial localization of speech segments

    DEFF Research Database (Denmark)

    Karlsen, Brian Lykkegaard

    1999-01-01

    angle the target is likely to have originated from. The model is trained on the experimental data. On the basis of the experimental results, it is concluded that the human ability to localize speech segments in adverse noise depends on the speech segment as well as its point of origin in space...... the task of the experiment. The psychoacoustical experiment used naturally-spoken Danish consonant-vowel combinations as targets presented in diffuse speech-shaped noise at a peak SNR of -10 dB. The subjects were normal hearing persons. The experiment took place in an anechoic chamber where eight...... loudspeakers were suspended so that they surrounded the subjects in the horizontal plane. The subjects were required to push a button on a pad indicating where they had localized the target to in the horizontal plane. The response pad had twelve buttons arranged uniformly in a circle and two further buttons so...

  10. Aorta Segmentation for Stent Simulation

    CERN Document Server

    Egger, Jan; Setser, Randolph; Renapuraar, Rahul; Biermann, Christina; O'Donnell, Thomas

    2011-01-01

    Simulation of arterial stenting procedures prior to intervention allows for appropriate device selection as well as highlights potential complications. To this end, we present a framework for facilitating virtual aortic stenting from a contrast computer tomography (CT) scan. More specifically, we present a method for both lumen and outer wall segmentation that may be employed in determining both the appropriateness of intervention as well as the selection and localization of the device. The more challenging recovery of the outer wall is based on a novel minimal closure tracking algorithm. Our aortic segmentation method has been validated on over 3000 multiplanar reformatting (MPR) planes from 50 CT angiography data sets yielding a Dice Similarity Coefficient (DSC) of 90.67%.

  11. Text Segmentation Using Exponential Models

    CERN Document Server

    Beeferman, D; Lafferty, G D; Beeferman, Doug; Berger, Adam; Lafferty, John

    1997-01-01

    This paper introduces a new statistical approach to partitioning text automatically into coherent segments. Our approach enlists both short-range and long-range language models to help it sniff out likely sites of topic changes in text. To aid its search, the system consults a set of simple lexical hints it has learned to associate with the presence of boundaries through inspection of a large corpus of annotated data. We also propose a new probabilistically motivated error metric for use by the natural language processing and information retrieval communities, intended to supersede precision and recall for appraising segmentation algorithms. Qualitative assessment of our algorithm as well as evaluation using this new metric demonstrate the effectiveness of our approach in two very different domains, Wall Street Journal articles and the TDT Corpus, a collection of newswire articles and broadcast news transcripts.

  12. Dictionary Based Segmentation in Volumes

    DEFF Research Database (Denmark)

    Emerson, Monica Jane; Jespersen, Kristine Munk; Jørgensen, Peter Stanley

    2015-01-01

    We present a method for supervised volumetric segmentation based on a dictionary of small cubes composed of pairs of intensity and label cubes. Intensity cubes are small image volumes where each voxel contains an image intensity. Label cubes are volumes with voxelwise probabilities for a given...... label. The segmentation process is done by matching a cube from the volume, of the same size as the dictionary intensity cubes, to the most similar intensity dictionary cube, and from the associated label cube we get voxel-wise label probabilities. Probabilities from overlapping cubes are averaged...... and hereby we obtain a robust label probability encoding. The dictionary is computed from labeled volumetric image data based on weighted clustering. We experimentally demonstrate our method using two data sets from material science – a phantom data set of a solid oxide fuel cell simulation for detecting...

  13. Robust finger vein ROI localization based on flexible segmentation.

    Science.gov (United States)

    Lu, Yu; Xie, Shan Juan; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

    2013-10-24

    Finger veins have been proved to be an effective biometric for personal identification in the recent years. However, finger vein images are easily affected by influences such as image translation, orientation, scale, scattering, finger structure, complicated background, uneven illumination, and collection posture. All these factors may contribute to inaccurate region of interest (ROI) definition, and so degrade the performance of finger vein identification system. To improve this problem, in this paper, we propose a finger vein ROI localization method that has high effectiveness and robustness against the above factors. The proposed method consists of a set of steps to localize ROIs accurately, namely segmentation, orientation correction, and ROI detection. Accurate finger region segmentation and correct calculated orientation can support each other to produce higher accuracy in localizing ROIs. Extensive experiments have been performed on the finger vein image database, MMCBNU_6000, to verify the robustness of the proposed method. The proposed method shows the segmentation accuracy of 100%. Furthermore, the average processing time of the proposed method is 22 ms for an acquired image, which satisfies the criterion of a real-time finger vein identification system.

  14. Robust Finger Vein ROI Localization Based on Flexible Segmentation

    Directory of Open Access Journals (Sweden)

    Dong Sun Park

    2013-10-01

    Full Text Available Finger veins have been proved to be an effective biometric for personal identification in the recent years. However, finger vein images are easily affected by influences such as image translation, orientation, scale, scattering, finger structure, complicated background, uneven illumination, and collection posture. All these factors may contribute to inaccurate region of interest (ROI definition, and so degrade the performance of finger vein identification system. To improve this problem, in this paper, we propose a finger vein ROI localization method that has high effectiveness and robustness against the above factors. The proposed method consists of a set of steps to localize ROIs accurately, namely segmentation, orientation correction, and ROI detection. Accurate finger region segmentation and correct calculated orientation can support each other to produce higher accuracy in localizing ROIs. Extensive experiments have been performed on the finger vein image database, MMCBNU_6000, to verify the robustness of the proposed method. The proposed method shows the segmentation accuracy of 100%. Furthermore, the average processing time of the proposed method is 22 ms for an acquired image, which satisfies the criterion of a real-time finger vein identification system.

  15. Older People's Mobility: Segments, Factors, Trends

    DEFF Research Database (Denmark)

    Haustein, Sonja; Siren, Anu

    2015-01-01

    demographic, health-related, or transport-related factors. This paper reviews these studies and compares the segments of older people that different studies have identified. First, as a result of a systematic comparison, we identified four generic segments: (1) an active car-oriented segment; (2) a car......The expanding older population is increasingly diverse with regard to, for example, age, income, location, and health. Within transport research, this diversity has recently been addressed in studies that segment the older population into homogeneous groups based on combinations of various......-dependent segment, restricted in mobility; (3) a mobile multimodal segment; (4) and a segment depending on public transport and other services. Second, we examined the single factors used in the reviewed segmentation studies, with focus on whether there is evidence in the literature for the factors’ effect on older...

  16. Vibration damping for the Segmented Mirror Telescope

    Science.gov (United States)

    Maly, Joseph R.; Yingling, Adam J.; Griffin, Steven F.; Agrawal, Brij N.; Cobb, Richard G.; Chambers, Trevor S.

    2012-09-01

    The Segmented Mirror Telescope (SMT) at the Naval Postgraduate School (NPS) in Monterey is a next-generation deployable telescope, featuring a 3-meter 6-segment primary mirror and advanced wavefront sensing and correction capabilities. In its stowed configuration, the SMT primary mirror segments collapse into a small volume; once on location, these segments open to the full 3-meter diameter. The segments must be very accurately aligned after deployment and the segment surfaces are actively controlled using numerous small, embedded actuators. The SMT employs a passive damping system to complement the actuators and mitigate the effects of low-frequency (operating deflection shapes of the mirror and to quantify segment edge displacements; relative alignment of λ/4 or better was desired. The TMDs attenuated the vibration amplitudes by 80% and reduced adjacent segment phase mismatches to acceptable levels.

  17. HF Transverse Segmentation and Tagging Jet Capability

    CERN Document Server

    Doroshkevich, E A; Kuleshov, Sergey

    1998-01-01

    So called tagging jets and pile-up were simulated for the optimisation of the HF segmentation. The energy resolution, angular resolution and efficiency of jet reconstruction are defined for different calorimeter segmentation.

  18. Human Segmentation Using Haar-Classifier

    Directory of Open Access Journals (Sweden)

    Dharani S

    2014-07-01

    Full Text Available Segmentation is an important process in many aspects of multimedia applications. Fast and perfect segmentation of moving objects in video sequences is a basic task in many computer visions and video investigation applications. Particularly Human detection is an active research area in computer vision applications. Segmentation is very useful for tracking and recognition the object in a moving clip. The motion segmentation problem is studied and reviewed the most important techniques. We illustrate some common methods for segmenting the moving objects including background subtraction, temporal segmentation and edge detection. Contour and threshold are common methods for segmenting the objects in moving clip. These methods are widely exploited for moving object segmentation in many video surveillance applications, such as traffic monitoring, human motion capture. In this paper, Haar Classifier is used to detect humans in a moving video clip some features like face detection, eye detection, full body, upper body and lower body detection.

  19. Segmentation Method of Time-Lapse Microscopy Images with the Focus on Biocompatibility Assessment.

    Science.gov (United States)

    Soukup, Jindřich; Císař, Petr; Šroubek, Filip

    2016-06-01

    Biocompatibility testing of new materials is often performed in vitro by measuring the growth rate of mammalian cancer cells in time-lapse images acquired by phase contrast microscopes. The growth rate is measured by tracking cell coverage, which requires an accurate automatic segmentation method. However, cancer cells have irregular shapes that change over time, the mottled background pattern is partially visible through the cells and the images contain artifacts such as halos. We developed a novel algorithm for cell segmentation that copes with the mentioned challenges. It is based on temporal differences of consecutive images and a combination of thresholding, blurring, and morphological operations. We tested the algorithm on images of four cell types acquired by two different microscopes, evaluated the precision of segmentation against manual segmentation performed by a human operator, and finally provided comparison with other freely available methods. We propose a new, fully automated method for measuring the cell growth rate based on fitting a coverage curve with the Verhulst population model. The algorithm is fast and shows accuracy comparable with manual segmentation. Most notably it can correctly separate live from dead cells.

  20. Automatic segmentation of the lumen of the carotid artery in ultrasound B-mode images

    Science.gov (United States)

    Santos, André M. F.; Tavares, Jão. Manuel R. S.; Sousa, Luísa; Santos, Rosa; Castro, Pedro; Azevedo, Elsa

    2013-02-01

    A new algorithm is proposed for the segmentation of the lumen and bifurcation boundaries of the carotid artery in B-mode ultrasound images. It uses the hipoechogenic characteristics of the lumen for the identification of the carotid boundaries and the echogenic characteristics for the identification of the bifurcation boundaries. The image to be segmented is processed with the application of an anisotropic diffusion filter for speckle removal and morphologic operators are employed in the detection of the artery. The obtained information is then used in the definition of two initial contours, one corresponding to the lumen and the other to the bifurcation boundaries, for the posterior application of the Chan-vese level set segmentation model. A set of longitudinal B-mode images of the common carotid artery (CCA) was acquired with a GE Healthcare Vivid-e ultrasound system (GE Healthcare, United Kingdom). All the acquired images include a part of the CCA and of the bifurcation that separates the CCA into the internal and external carotid arteries. In order to achieve the uppermost robustness in the imaging acquisition process, i.e., images with high contrast and low speckle noise, the scanner was adjusted differently for each acquisition and according to the medical exam. The obtained results prove that we were able to successfully apply a carotid segmentation technique based on cervical ultrasonography. The main advantage of the new segmentation method relies on the automatic identification of the carotid lumen, overcoming the limitations of the traditional methods.