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Sample records for total phallic reconstruction

  1. The Phrase of the Phallic Pheminine: Beyond the "Nurturing Mother" in Feminist Composition Pedagogy.

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    Mowery, Diane

    Theories of phallic authority outlined by Jaques Lacan, Sigmund Freud, and Luce Irigaray suggest that one can effectively undo authority only from a position of authority, a position that traps feminists within the very phallic economy they hope to subvert. Attempting to avoid this trap, feminist pedagogues have made a distinction between…

  2. Rare association of female pseudohermaphroditism, phallic urethra, and posterior cloaca.

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    Macarthur, Mairi; Mahomed, Anies

    2006-03-01

    We describe a child with the rare clinical entity of female pseudohermaphroditism, accessory phallic urethra, and posterior cloaca who was successfully treated with posterior sagittal anorectovaginourethroplasty. Masculinization was limited to the external genitalia, and no chromosomal, metabolic, or adrenal abnormalities were detected. Associated pathology included bilateral vesicoureteric reflux, a non functioning dysplastic kidney, and bicornuate uterus. The investigation and surgical management of this particularly challenging combination of anomalies is detailed.

  3. Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

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    N. Lumen

    2008-01-01

    Full Text Available Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF or the pedicled anterolateral thigh flap (ALTF has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age 15 to 42 years were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months. Aesthetic and functional results were evaluated. Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula. Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion. Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps.

  4. Phallic narcissism, anal sadism, and oral discord: the case of Yukio Mishima, Part I.

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    Piven, J

    2001-12-01

    Thus far I have explored Mishima's traumatic childhood and the experiences leading him toward misogyny, phallic narcissism, and the drive to murder his own weakness and sexual vulnerability. Mishima suffered the extraordinary trauma of being separated from his parents and sequestered to the sickroom of a psychotic grandmother for the first twelve years of his life. Intense rage over abandonment and impingement engendered a disgust for femininity and the need to escape feminine messiness through homosexual pursuits. Mishima's entrenched feelings of shame and weakness gave rise to phallic narcissistic tendencies, as he idealized powerful men and eventually strove to become a powerful and beautiful male. In pursuing this erotic masculine image Mishima continued to fantasize about murdering his weak and shameful self-image, and commingled this sadistic impulse with fantasies of sexual merger with murdered love objects. Finally Mishima was the murderer erotically eradicating his sexual vulnerability as both subject and object. His suicide was a repetition of this erotic sadistic fantasy. In a further article I will continue the discussion by examining Mishima's fantasies of murdering beautiful and abandoning love objects. I will also address the complex nature of his ritual suicide as fantasy of rebirth, sexual merger, the murder of toxic introjects, and escape from death, decay, and regression to helpless infancy.

  5. Beyond Phallic Domain: Female Otherness as a Resource for Liberation: Some Notes From Lacanian Psychoanalysis and Poststructuralist Feminism.

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    Gonzalez-Barrientos, Marcela; Napolitano, Stefania

    2015-06-01

    The article explores the political derivations of psychoanalytical discourse on femininity, starting from the impact of Lacanian positions on feminist thought. The consideration of a dimension of absolute otherness of female sexuality, irreducible to masculinity and to a phallic domain--not-all phallic--theorized by Lacan in the 1970s, opens up many complex issues for the politics of women's liberation. It is a matter of living the absolute difference without either radically excluding it from the speakable or letting it be part of a romantic imagery of the otherness that perpetuates sexual hierarchy and, consequently, female subordination. Taking up the proposal of such authors as Julia Kristeva or Silvia Tubert, we suggest that the Lacanian theory offers the conceptual tools to shift from exclusion to re-volt, from the place of the Other as a pedestal for the Same to a political function of female otherness and of the "not-all" that it represents: a part of the Kultur and its difficulties, but not entangled in it to the point that it cannot bring any innovation.

  6. Higher order total variation regularization for EIT reconstruction.

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    Gong, Bo; Schullcke, Benjamin; Krueger-Ziolek, Sabine; Zhang, Fan; Mueller-Lisse, Ullrich; Moeller, Knut

    2018-01-08

    Electrical impedance tomography (EIT) attempts to reveal the conductivity distribution of a domain based on the electrical boundary condition. This is an ill-posed inverse problem; its solution is very unstable. Total variation (TV) regularization is one of the techniques commonly employed to stabilize reconstructions. However, it is well known that TV regularization induces staircase effects, which are not realistic in clinical applications. To reduce such artifacts, modified TV regularization terms considering a higher order differential operator were developed in several previous studies. One of them is called total generalized variation (TGV) regularization. TGV regularization has been successively applied in image processing in a regular grid context. In this study, we adapted TGV regularization to the finite element model (FEM) framework for EIT reconstruction. Reconstructions using simulation and clinical data were performed. First results indicate that, in comparison to TV regularization, TGV regularization promotes more realistic images. Graphical abstract Reconstructed conductivity changes located on selected vertical lines. For each of the reconstructed images as well as the ground truth image, conductivity changes located along the selected left and right vertical lines are plotted. In these plots, the notation GT in the legend stands for ground truth, TV stands for total variation method, and TGV stands for total generalized variation method. Reconstructed conductivity distributions from the GREIT algorithm are also demonstrated.

  7. [Development and current situation of reconstruction methods following total sacrectomy].

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    Huang, Siyi; Ji, Tao; Guo, Wei

    2018-05-01

    To review the development of the reconstruction methods following total sacrectomy, and to provide reference for finding a better reconstruction method following total sacrectomy. The case reports and biomechanical and finite element studies of reconstruction following total sacrectomy at home and abroad were searched. Development and current situation were summarized. After developing for nearly 30 years, great progress has been made in the reconstruction concept and fixation techniques. The fixation methods can be summarized as the following three strategies: spinopelvic fixation (SPF), posterior pelvic ring fixation (PPRF), and anterior spinal column fixation (ASCF). SPF has undergone technical progress from intrapelvic rod and hook constructs to pedicle and iliac screw-rod systems. PPRF and ASCF could improve the stability of the reconstruction system. Reconstruction following total sacrectomy remains a challenge. Reconstruction combining SPF, PPRF, and ASCF is the developmental direction to achieve mechanical stability. How to gain biological fixation to improve the long-term stability is an urgent problem to be solved.

  8. Duplication of accessory phallic urethra (urethra triplication) in the female, signaling mesenchymal interruptions of the cloacal membrane as a cause for sagittal urethral duplications.

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    van der Putte, Sebastian C J

    2009-01-01

    A specimen of accessory phallic urethra duplication (triplication) in a 32.5-week gestation female was studied histologically. The specimen demonstrated an anterior "phallic urethra" ending inside a penoclitoral organ in a megalourethra-like dilatation with a narrow epispadiac meatus and "anterior urethrocutaneous fistula" and a posterior canal opening with the anal canal. With histology suggestive of a split persistent urogenital sinus, correlation to normal development strongly suggests an error in the formation of the cloacal membrane and developing superficial cloaca at 26 to 29 days' ovulation age (2 to 4 mm), causing an isolated interruption of the membrane by mesenchyme, which by participating in the growth of the early cloaca may extend as far as the vaginal orifice later. Differences in number, position, and size of such mesenchymal interruptions can explain other duplications and triplications and offer a single alternative for the many current theories of pathogenesis, none of which are compatible with new insights in normal development.

  9. [Diversity and meaning of masculine phallic palaeolithic images in Western Europe].

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    Angulo Cuesta, J; García Diez, M

    2006-03-01

    The archaeological record necessary to understand the sexual behaviour of our ancestors from Upper Palaeolithic (38.000-8.500 B.C.) is limited. Traditionally the ethnographic information about sexuality and the relations between sexes derived from comparitions with current primitive human groups have been considered very important, although they have been evaluated more from a social and anthropological rather than biological perspective. Ice age art art, both rock and portable, is a reflection of the behaviour of palaeolithic human groups. The purpose of this text focuses on understanding the types of representations and sexual attitudes during the Upper Palaeolithic, as reflected from masculine images of phallic character. Practices of foreskin retraction, some phalli possibly circumcised, copulative acts, expressions of masturbation, instruments that have been likely been used for masturbation and other sexual scenes, some of which are difficult to interpretate, show that the sexual behaviour of the human groups of the Upper Palaeolithic were similar to ours, both from a biological and physiological viewpoint.

  10. [Advantage investigation of totally laparoscopic modified Roux-en-Y reconstruction].

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    Liu, Tianzhou; Ma, Zhiming; Sun, Pengda; Li, Jinlong; Fang, Xuedong; Tong, Ti; Zhu, Jiaming

    2016-01-01

    To investigate the clinical advantage of the application of modified Roux-en-Y reconstruction after totally laparoscopic total gastrectomy. Clinical data of 36 patients who underwent totally laparoscopic total gastrectomy with Roux-en-Y reconstruction by one medical team for gastric adenocarcinoma between January 2014 and December 2014 in the Second Hospital of Jilin University were retrospectively analyzed. Patients were divided into classic Roux-en-Y group (CRY, 16 cases) and modified Roux-en-Y group (MRY, 20 cases) according to reconstructive methods. The data concerning the intraoperative and postoperative situation in two groups were compared. Operation was successfully completed in all the cases without conversion to laparotomy. Compared to CRY group, MRY group had shorter mean operative time [(260.9 ± 21.2) min vs. (287.9 ± 19.0) min, P=0.000], shorter mean reconstruction duration [(32.4 ± 9.2] min vs. (45.4 ± 13.2) min, P=0.001] and less intraoperative bleeding [(50.9 ± 23.5) ml vs. (67.0 ± 20.5) ml, P=0.000]. Jejunum mesentery dissection and jejunum resection were not necessary in MRY group. However, there were no significant differences in lymph nodes harvested, time to flatus, hospital stay and postoperative complications between two groups. As compared to classic Roux-en-Y reconstruction, the modified Roux-en-Y reconstruction can simplify the surgical procedures and achieve similar efficacy. It is feasible and safe, and worth further promotion in clinical practice.

  11. Precise shape reconstruction by active pattern in total-internal-reflection-based tactile sensor.

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    Saga, Satoshi; Taira, Ryosuke; Deguchi, Koichiro

    2014-03-01

    We are developing a total-internal-reflection-based tactile sensor in which the shape is reconstructed using an optical reflection. This sensor consists of silicone rubber, an image pattern, and a camera. It reconstructs the shape of the sensor surface from an image of a pattern reflected at the inner sensor surface by total internal reflection. In this study, we propose precise real-time reconstruction by employing an optimization method. Furthermore, we propose to use active patterns. Deformation of the reflection image causes reconstruction errors. By controlling the image pattern, the sensor reconstructs the surface deformation more precisely. We implement the proposed optimization and active-pattern-based reconstruction methods in a reflection-based tactile sensor, and perform reconstruction experiments using the system. A precise deformation experiment confirms the linearity and precision of the reconstruction.

  12. Kinematic analysis of anterior cruciate ligament reconstruction in total knee arthroplasty

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    Liu, Hua-Wei; Ni, Ming; Zhang, Guo-Qiang; Li, Xiang; Chen, Hui; Zhang, Qiang; Chai, Wei; Zhou, Yong-Gang; Chen, Ji-Ying; Liu, Yu-Liang; Cheng, Cheng-Kung; Wang, Yan

    2016-01-01

    Background: This study aims to retain normal knee kinematics after knee replacement surgeries by reconstructing anterior cruciate ligament during total knee arthroplasty. Method: We use computational simulation tools to establish four dynamic knee models, including normal knee model, posterior cruciate ligament retaining knee model, posterior cruciate ligament substituting knee model, and anterior cruciate ligament reconstructing knee model. Our proposed method utilizes magnetic resonance images to reconstruct solid bones and attachments of ligaments, and assemble femoral and tibial components according representative literatures and operational specifications. Dynamic data of axial tibial rotation and femoral translation from full-extension to 135 were measured for analyzing the motion of knee models. Findings: The computational simulation results show that comparing with the posterior cruciate ligament retained knee model and the posterior cruciate ligament substituted knee model, reconstructing anterior cruciate ligament improves the posterior movement of the lateral condyle, medial condyle and tibial internal rotation through a full range of flexion. The maximum posterior translations of the lateral condyle, medial condyle and tibial internal rotation of the anterior cruciate ligament reconstructed knee are 15.3 mm, 4.6 mm and 20.6 at 135 of flexion. Interpretation: Reconstructing anterior cruciate ligament in total knee arthroplasty has been approved to be an more efficient way of maintaining normal knee kinematics comparing to posterior cruciate ligament retained and posterior cruciate ligament substituted total knee arthroplasty. PMID:27347334

  13. Research on compressive sensing reconstruction algorithm based on total variation model

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    Gao, Yu-xuan; Sun, Huayan; Zhang, Tinghua; Du, Lin

    2017-12-01

    Compressed sensing for breakthrough Nyquist sampling theorem provides a strong theoretical , making compressive sampling for image signals be carried out simultaneously. In traditional imaging procedures using compressed sensing theory, not only can it reduces the storage space, but also can reduce the demand for detector resolution greatly. Using the sparsity of image signal, by solving the mathematical model of inverse reconfiguration, realize the super-resolution imaging. Reconstruction algorithm is the most critical part of compression perception, to a large extent determine the accuracy of the reconstruction of the image.The reconstruction algorithm based on the total variation (TV) model is more suitable for the compression reconstruction of the two-dimensional image, and the better edge information can be obtained. In order to verify the performance of the algorithm, Simulation Analysis the reconstruction result in different coding mode of the reconstruction algorithm based on the TV reconstruction algorithm. The reconstruction effect of the reconfigurable algorithm based on TV based on the different coding methods is analyzed to verify the stability of the algorithm. This paper compares and analyzes the typical reconstruction algorithm in the same coding mode. On the basis of the minimum total variation algorithm, the Augmented Lagrangian function term is added and the optimal value is solved by the alternating direction method.Experimental results show that the reconstruction algorithm is compared with the traditional classical algorithm based on TV has great advantages, under the low measurement rate can be quickly and accurately recovers target image.

  14. A Multifactorial Analysis of Reconstruction Methods Applied After Total Gastrectomy

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    Oktay Büyükaşık

    2010-12-01

    Full Text Available Aim: The aim of this study was to evaluate the reconstruction methods applied after total gastrectomy in terms of postoperative symptomology and nutrition. Methods: This retrospective study was conducted on 31 patients who underwent total gastrectomy due to gastric cancer in 2. Clinic of General Surgery, SSK Ankara Training Hospital. 6 different reconstruction methods were used and analyzed in terms of age, sex and postoperative complications. One from esophagus and two biopsy specimens from jejunum were taken through upper gastrointestinal endoscopy from all cases, and late period morphological and microbiological changes were examined. Postoperative weight change, dumping symptoms, reflux esophagitis, solid/liquid dysphagia, early satiety, postprandial pain, diarrhea and anorexia were assessed. Results: Of 31 patients,18 were males and 13 females; the youngest one was 33 years old, while the oldest- 69 years old. It was found that reconstruction without pouch was performed in 22 cases and with pouch in 9 cases. Early satiety, postprandial pain, dumping symptoms, diarrhea and anemia were found most commonly in cases with reconstruction without pouch. The rate of bacterial colonization of the jejunal mucosa was identical in both groups. Reflux esophagitis was most commonly seen in omega esophagojejunostomy (EJ, while the least-in Roux-en-Y, Tooley and Tanner 19 EJ. Conclusion: Reconstruction with pouch performed after total gastrectomy is still a preferable method. (The Medical Bulletin of Haseki 2010; 48:126-31

  15. Total variation regularization in measurement and image space for PET reconstruction

    KAUST Repository

    Burger, M

    2014-09-18

    © 2014 IOP Publishing Ltd. The aim of this paper is to test and analyse a novel technique for image reconstruction in positron emission tomography, which is based on (total variation) regularization on both the image space and the projection space. We formulate our variational problem considering both total variation penalty terms on the image and on an idealized sinogram to be reconstructed from a given Poisson distributed noisy sinogram. We prove existence, uniqueness and stability results for the proposed model and provide some analytical insight into the structures favoured by joint regularization. For the numerical solution of the corresponding discretized problem we employ the split Bregman algorithm and extensively test the approach in comparison to standard total variation regularization on the image. The numerical results show that an additional penalty on the sinogram performs better on reconstructing images with thin structures.

  16. Iterative CT reconstruction via minimizing adaptively reweighted total variation.

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    Zhu, Lei; Niu, Tianye; Petrongolo, Michael

    2014-01-01

    Iterative reconstruction via total variation (TV) minimization has demonstrated great successes in accurate CT imaging from under-sampled projections. When projections are further reduced, over-smoothing artifacts appear in the current reconstruction especially around the structure boundaries. We propose a practical algorithm to improve TV-minimization based CT reconstruction on very few projection data. Based on the theory of compressed sensing, the L-0 norm approach is more desirable to further reduce the projection views. To overcome the computational difficulty of the non-convex optimization of the L-0 norm, we implement an adaptive weighting scheme to approximate the solution via a series of TV minimizations for practical use in CT reconstruction. The weight on TV is initialized as uniform ones, and is automatically changed based on the gradient of the reconstructed image from the previous iteration. The iteration stops when a small difference between the weighted TV values is observed on two consecutive reconstructed images. We evaluate the proposed algorithm on both a digital phantom and a physical phantom. Using 20 equiangular projections, our method reduces reconstruction errors in the conventional TV minimization by a factor of more than 5, with improved spatial resolution. By adaptively reweighting TV in iterative CT reconstruction, we successfully further reduce the projection number for the same or better image quality.

  17. Long-term follow-up of total abdominal wall reconstruction for prune belly syndrome.

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    Lesavoy, Malcolm A; Chang, Eric I; Suliman, Ahmed; Taylor, Jason; Taylor, James; Kim, Sara E; Ehrlich, Richard M

    2012-01-01

    Prune belly syndrome is a rare, congenital condition that consists of a major deficiency or hypoplasia of the abdominal wall musculature, bilateral cryptorchidism, and genitourinary tract malformations. Reconstruction of the abdominal wall in these patients has presented a challenge to plastic surgeons throughout the years. The authors previously described a technique for total abdominal wall reconstruction that permitted simultaneous urinary tract reconstruction and bilateral orchiopexy. This innovative procedure used medial advancement of the fascia in a "double-breasted" fashion with preservation of the umbilicus. The authors reviewed their experience with this particular technique in one of the largest series of patients in the literature and the series with the longest follow-up. Twenty patients underwent total abdominal wall reconstruction with simultaneous urinary tract reconstruction and orchiopexy with a mean follow-up of 20.4 years. There were no major complications noted during this period, and all patients were extremely satisfied with their postoperative result. Total abdominal wall reconstruction using the double-breasted technique in patients with prune belly syndrome is a safe and durable procedure that achieves excellent cosmetic results. Therapeutic, IV.

  18. Propping up pharma's (natural) neoliberal phallic man: pharmaceutical representations of the ideal sexuopharmaceutical user.

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    Gurevich, Maria; Leedham, Usra; Brown-Bowers, Amy; Cormier, Nicole; Mercer, Zara

    2017-04-01

    Contemporary social theorists emphasise the cultural quest for authenticity under conditions of increasing artificiality. Within this context, the body is commonly treated as an 'unfinished' surface requiring ongoing transformation to fulfil identity obligations. In this paper, we examine one such identity authentication project in the form of marketing of men's sexuopharmaceuticals. We use online pharmaceutical advertising for four approved sexuopharmaceuticals (Viagra, Cialis, STAXYN and Stendra) to describe the ideal neoliberal consumer. These campaigns underscore the robust role of pharmaceuticals in sexual authentication projects undergirded by neoliberal consumerist and aspirationalist ideals. Penile dependability as a luxury consumerist project reinvigorates traditional sexual (masculine) authentication as yoked to phallic control, by repackaging sexual enhancement medication use as a neoliberal beacon of aspirational achievements. The ideal targeted user is increasingly younger, and consumption of sexuopharmaceuticals is represented as achieving elite status and exclusive pleasures; masculine authenticity and choice; progressive relationships and a contemporary urban, fast-paced life; and a prepared yet spontaneous romantic sexuality. Women are also increasingly used in promotional materials directed at men; their responsibility centres on coaching and coaxing potential users.

  19. A new surgical procedure for phallic reconstruction in partial penis necrosis: penile elongation in combination with glanuloplasty.

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    Xiao, Kaiyan; Cheng, Kaixiang; Song, Nan

    2014-01-01

    The radial forearm flap transfer has proved to be the standard technique in penile reconstruction. However, this operation still leads to a residual scar on the forearm. In the reconstruction of partial penis necrosis, achieving a desirable appearance and functional recovery while minimizing donor-site damage remains an unsolved problem. In this study, we report our experience using penile elongation combined with glanuloplasty to rebuild the partially necrotic penis.A retrospective review of a consecutive series of 33 patients with partial penis necrosis after microwave thermotherapy (not from our hospital) from December 2008 to May 2012 was conducted at the Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital. These patients, with an age range from 20 to 36 years, first underwent a scrotal skin flap transfer to cover residual cavernosum. The penis was simultaneously elongated at the proximal end. Six months later, all patients received glanuloplasty using expanded polytetrafluoroethylene that was implanted at the distal end of transferred scrotal skin flap to create the neoglans.Anthropometric measurements of preoperative and postoperative penile length were performed with an average follow-up period of 28 months. The mean extended penile length average was 2.57 cm, ranging from 3.16 to 5.73 cm. Patients' satisfaction rate was 88%. In addition, preoperative and postoperative photographs were reviewed for objective and subjective assessment of outcome parameters such as appearance of neophallus, urination, and erogenous sensation. Most importantly, the rebuilt penis postoperatively showed almost normal shape and restoration of basic physiologic function in most of the patients, with an acceptable complication rate. These preliminary results may provide a useful strategy for the reconstruction of a partially necrotic penis using a novel, simple, and effective approach.

  20. Kinematic analysis of anterior cruciate ligament reconstruction in total knee arthroplasty

    OpenAIRE

    Liu, Hua-Wei; Ni, Ming; Zhang, Guo-Qiang; Li, Xiang; Chen, Hui; Zhang, Qiang; Chai, Wei; Zhou, Yong-Gang; Chen, Ji-Ying; Liu, Yu-Liang; Cheng, Cheng-Kung; Wang, Yan

    2016-01-01

    Background: This study aims to retain normal knee kinematics after knee replacement surgeries by reconstructing anterior cruciate ligament during total knee arthroplasty. Method: We use computational simulation tools to establish four dynamic knee models, including normal knee model, posterior cruciate ligament retaining knee model, posterior cruciate ligament substituting knee model, and anterior cruciate ligament reconstructing knee model. Our proposed method utilizes magnetic resonance ima...

  1. Orbital floor reconstruction using a tensor fascia lata sling after total maxillectomy.

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    Jung, Bok Ki; Yun, In Sik; Lee, Won Jai; Lew, Dae Hyun; Choi, Eun Chang; Lee, Dong Won

    2016-05-01

    Reconstruction after total maxillectomy with extensive orbital floor defects poses a significant challenge for the reconstruction. The aim of this study is to present the outcomes of orbital floor reconstruction using tensor fascia lata slings after total maxillectomy and to compare these results to orbital floor reconstruction using alloplastic implants. This was a retrospective analysis of 19 consecutive patients who underwent tumor resection with orbital floor removal for malignancies. Reconstructions were performed using either tensor fascia lata slings (Group A) or alloplastic implants (Group B). The early and late postoperative outcomes such as wound infection, plate exposure, ectropion, diplopia, and enophthalmos, were analyzed and compared between the two groups. Patients in group A had significantly less wound complication than in group B (p < 0.05). In group A, there were no early or late wound complications after the operation. However, in group B, five patients had infection, the plate was exposed in eight of fourteen patients, and three patients had enophthalmos. Eight patients in group B underwent reoperation to correct their complications. Reconstruction of the orbital floor with a tensor fascia lata sling offers reliable support to the globe and prevents the ophthalmic complications associated with loss of orbital support. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Accelerated gradient methods for total-variation-based CT image reconstruction

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    Joergensen, Jakob H.; Hansen, Per Christian [Technical Univ. of Denmark, Lyngby (Denmark). Dept. of Informatics and Mathematical Modeling; Jensen, Tobias L.; Jensen, Soeren H. [Aalborg Univ. (Denmark). Dept. of Electronic Systems; Sidky, Emil Y.; Pan, Xiaochuan [Chicago Univ., Chicago, IL (United States). Dept. of Radiology

    2011-07-01

    Total-variation (TV)-based CT image reconstruction has shown experimentally to be capable of producing accurate reconstructions from sparse-view data. In particular TV-based reconstruction is well suited for images with piecewise nearly constant regions. Computationally, however, TV-based reconstruction is demanding, especially for 3D imaging, and the reconstruction from clinical data sets is far from being close to real-time. This is undesirable from a clinical perspective, and thus there is an incentive to accelerate the solution of the underlying optimization problem. The TV reconstruction can in principle be found by any optimization method, but in practice the large scale of the systems arising in CT image reconstruction preclude the use of memory-intensive methods such as Newton's method. The simple gradient method has much lower memory requirements, but exhibits prohibitively slow convergence. In the present work we address the question of how to reduce the number of gradient method iterations needed to achieve a high-accuracy TV reconstruction. We consider the use of two accelerated gradient-based methods, GPBB and UPN, to solve the 3D-TV minimization problem in CT image reconstruction. The former incorporates several heuristics from the optimization literature such as Barzilai-Borwein (BB) step size selection and nonmonotone line search. The latter uses a cleverly chosen sequence of auxiliary points to achieve a better convergence rate. The methods are memory efficient and equipped with a stopping criterion to ensure that the TV reconstruction has indeed been found. An implementation of the methods (in C with interface to Matlab) is available for download from http://www2.imm.dtu.dk/~pch/TVReg/. We compare the proposed methods with the standard gradient method, applied to a 3D test problem with synthetic few-view data. We find experimentally that for realistic parameters the proposed methods significantly outperform the standard gradient method. (orig.)

  3. Performance comparison between total variation (TV)-based compressed sensing and statistical iterative reconstruction algorithms

    International Nuclear Information System (INIS)

    Tang Jie; Nett, Brian E; Chen Guanghong

    2009-01-01

    Of all available reconstruction methods, statistical iterative reconstruction algorithms appear particularly promising since they enable accurate physical noise modeling. The newly developed compressive sampling/compressed sensing (CS) algorithm has shown the potential to accurately reconstruct images from highly undersampled data. The CS algorithm can be implemented in the statistical reconstruction framework as well. In this study, we compared the performance of two standard statistical reconstruction algorithms (penalized weighted least squares and q-GGMRF) to the CS algorithm. In assessing the image quality using these iterative reconstructions, it is critical to utilize realistic background anatomy as the reconstruction results are object dependent. A cadaver head was scanned on a Varian Trilogy system at different dose levels. Several figures of merit including the relative root mean square error and a quality factor which accounts for the noise performance and the spatial resolution were introduced to objectively evaluate reconstruction performance. A comparison is presented between the three algorithms for a constant undersampling factor comparing different algorithms at several dose levels. To facilitate this comparison, the original CS method was formulated in the framework of the statistical image reconstruction algorithms. Important conclusions of the measurements from our studies are that (1) for realistic neuro-anatomy, over 100 projections are required to avoid streak artifacts in the reconstructed images even with CS reconstruction, (2) regardless of the algorithm employed, it is beneficial to distribute the total dose to more views as long as each view remains quantum noise limited and (3) the total variation-based CS method is not appropriate for very low dose levels because while it can mitigate streaking artifacts, the images exhibit patchy behavior, which is potentially harmful for medical diagnosis.

  4. A Total Variation-Based Reconstruction Method for Dynamic MRI

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    Germana Landi

    2008-01-01

    Full Text Available In recent years, total variation (TV regularization has become a popular and powerful tool for image restoration and enhancement. In this work, we apply TV minimization to improve the quality of dynamic magnetic resonance images. Dynamic magnetic resonance imaging is an increasingly popular clinical technique used to monitor spatio-temporal changes in tissue structure. Fast data acquisition is necessary in order to capture the dynamic process. Most commonly, the requirement of high temporal resolution is fulfilled by sacrificing spatial resolution. Therefore, the numerical methods have to address the issue of images reconstruction from limited Fourier data. One of the most successful techniques for dynamic imaging applications is the reduced-encoded imaging by generalized-series reconstruction method of Liang and Lauterbur. However, even if this method utilizes a priori data for optimal image reconstruction, the produced dynamic images are degraded by truncation artifacts, most notably Gibbs ringing, due to the spatial low resolution of the data. We use a TV regularization strategy in order to reduce these truncation artifacts in the dynamic images. The resulting TV minimization problem is solved by the fixed point iteration method of Vogel and Oman. The results of test problems with simulated and real data are presented to illustrate the effectiveness of the proposed approach in reducing the truncation artifacts of the reconstructed images.

  5. Three-dimensional total variation norm for SPECT reconstruction

    International Nuclear Information System (INIS)

    Persson, Mikael; Bone, Dianna; Elmqvist, H.

    2001-01-01

    The total variation (TV) norm has been described in literature as a method for reducing noise in two-dimensional (2D) images. At the same time, the TV-norm is very good at recovering edges in images, without introducing ringing or edge artefacts. It has also been proposed as a 2D regularisation function in Bayesian reconstruction, implemented in an expectation maximisation (EM) algorithm, and called TV-EM. The TV-EM was developed for 2D SPECT imaging, and the algorithm is capable of smoothing noise while maintaining edges without introducing artefacts. We have extended the TV-norm to take into account the third spatial dimension, and developed an iterative EM algorithm based on the three-dimensional (3D) TV-norm, which we call TV3D-EM. This takes into account the correlation between transaxial sections in SPECT, due to system resolution. We have compared the 2D and 3D algorithms using reconstructed images from simulated projection data. Phantoms used were a homogeneous sphere, and a 3D head phantom based on the Shepp-Logan phantom. The TV3D-EM algorithm yielded somewhat lower noise levels than TV-EM. The noise in the TV3D-EM had similar correlation in transaxial and longitudinal sections, which was not the case for TV-EM, or any 2D reconstruction method. In particular, longitudinal sections from TV3D-EM were perceived as less noisy when compared to TV-EM. The use of 3D reconstruction should also be advantageous if compensation for distant dependent collimator blurring is incorporated in the iterative algorithm

  6. Total variation superiorized conjugate gradient method for image reconstruction

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    Zibetti, Marcelo V. W.; Lin, Chuan; Herman, Gabor T.

    2018-03-01

    The conjugate gradient (CG) method is commonly used for the relatively-rapid solution of least squares problems. In image reconstruction, the problem can be ill-posed and also contaminated by noise; due to this, approaches such as regularization should be utilized. Total variation (TV) is a useful regularization penalty, frequently utilized in image reconstruction for generating images with sharp edges. When a non-quadratic norm is selected for regularization, as is the case for TV, then it is no longer possible to use CG. Non-linear CG is an alternative, but it does not share the efficiency that CG shows with least squares and methods such as fast iterative shrinkage-thresholding algorithms (FISTA) are preferred for problems with TV norm. A different approach to including prior information is superiorization. In this paper it is shown that the conjugate gradient method can be superiorized. Five different CG variants are proposed, including preconditioned CG. The CG methods superiorized by the total variation norm are presented and their performance in image reconstruction is demonstrated. It is illustrated that some of the proposed variants of the superiorized CG method can produce reconstructions of superior quality to those produced by FISTA and in less computational time, due to the speed of the original CG for least squares problems. In the Appendix we examine the behavior of one of the superiorized CG methods (we call it S-CG); one of its input parameters is a positive number ɛ. It is proved that, for any given ɛ that is greater than the half-squared-residual for the least squares solution, S-CG terminates in a finite number of steps with an output for which the half-squared-residual is less than or equal to ɛ. Importantly, it is also the case that the output will have a lower value of TV than what would be provided by unsuperiorized CG for the same value ɛ of the half-squared residual.

  7. Reconstruction of a Total Soft Palatal Defect Using

    Directory of Open Access Journals (Sweden)

    Won Jai Lee

    2012-01-01

    Full Text Available Background The soft palate functions as a valve and helps generate the oral pressurerequired for normal speech resonance. Speech problems and nasal regurgitation can resultfrom a soft palatal defect. Reduction of the size of the velopharyngeal orifice is requiredto compensate for the lack of mobility in a reconstructed soft palate. We suggest a largevolume folded free flap for reduction of the caliber and a palmaris longus tendon sling forsuspension of the reconstructed palate.Methods Six patients had total soft palate resection for tonsillar cancer and reconstructionwith a large volume folded radial forearm free flap combined with a palmaris longus sling.A single surgeon and speech therapist examined the patients with three standardizedspeech assessment tools: nasometer test, consonant articulation test, and speech acuity testperformed for speech evaluation.Results Mean nasalance score was 76.20% for sentences with nasal sounds and 43.60% forsentences with oral sounds. Hypernasality was seen for oral sound sentences. The mean scoreof the picture consonant articulation test was 84% (range, 63% to 100%. The mean scoreof the speech acuity test was 5.84 (range, 5 to 6. These mean ratings represent a satisfactorylevel of speech function.Conclusions The large volume folded free flap with a palmaris longus tendon sling for totalsoft palate reconstruction resulted in satisfactory prognosis for speech despite moderatehypernasality.

  8. NUFFT-Based Iterative Image Reconstruction via Alternating Direction Total Variation Minimization for Sparse-View CT

    Directory of Open Access Journals (Sweden)

    Bin Yan

    2015-01-01

    Full Text Available Sparse-view imaging is a promising scanning method which can reduce the radiation dose in X-ray computed tomography (CT. Reconstruction algorithm for sparse-view imaging system is of significant importance. The adoption of the spatial iterative algorithm for CT image reconstruction has a low operation efficiency and high computation requirement. A novel Fourier-based iterative reconstruction technique that utilizes nonuniform fast Fourier transform is presented in this study along with the advanced total variation (TV regularization for sparse-view CT. Combined with the alternating direction method, the proposed approach shows excellent efficiency and rapid convergence property. Numerical simulations and real data experiments are performed on a parallel beam CT. Experimental results validate that the proposed method has higher computational efficiency and better reconstruction quality than the conventional algorithms, such as simultaneous algebraic reconstruction technique using TV method and the alternating direction total variation minimization approach, with the same time duration. The proposed method appears to have extensive applications in X-ray CT imaging.

  9. A Total Variation Regularization Based Super-Resolution Reconstruction Algorithm for Digital Video

    Directory of Open Access Journals (Sweden)

    Zhang Liangpei

    2007-01-01

    Full Text Available Super-resolution (SR reconstruction technique is capable of producing a high-resolution image from a sequence of low-resolution images. In this paper, we study an efficient SR algorithm for digital video. To effectively deal with the intractable problems in SR video reconstruction, such as inevitable motion estimation errors, noise, blurring, missing regions, and compression artifacts, the total variation (TV regularization is employed in the reconstruction model. We use the fixed-point iteration method and preconditioning techniques to efficiently solve the associated nonlinear Euler-Lagrange equations of the corresponding variational problem in SR. The proposed algorithm has been tested in several cases of motion and degradation. It is also compared with the Laplacian regularization-based SR algorithm and other TV-based SR algorithms. Experimental results are presented to illustrate the effectiveness of the proposed algorithm.

  10. Reconstruction of the esophagojejunostomy by double stapling method using EEA™ OrVil™ in laparoscopic total gastrectomy and proximal gastrectomy

    OpenAIRE

    Hirahara, Noriyuki; Monma, Hiroyuki; Shimojo, Yoshihide; Matsubara, Takeshi; Hyakudomi, Ryoji; Yano, Seiji; Tanaka, Tsuneo

    2011-01-01

    Abstract Here we report the method of anastomosis based on double stapling technique (hereinafter, DST) using a trans-oral anvil delivery system (EEATM OrVilTM) for reconstructing the esophagus and lifted jejunum following laparoscopic total gastrectomy or proximal gastric resection. As a basic technique, laparoscopic total gastrectomy employed Roux-en-Y reconstruction, laparoscopic proximal gastrectomy employed double tract reconstruction, and end-to-side anastomosis was used for the cut-off...

  11. Polypropylene Darning: A New Alternative for Reconstruction of Orbital Floor after Total Maxillectomy.

    Science.gov (United States)

    Sharma, Prashant

    2015-06-01

    Removal of orbital floor is an integral part of total (radical) maxillectomy (type IIIa), which if not managed properly, may lead to some eye related distressing complications like diplopia, eyelid malposition, epiphora, dacryocystitis, enopthalmos and ectoprion. Among all, diplopia is the most distressing complication which hampers daily activity. Various options for orbital floor reconstruction are available like titanium sheet, polypropylene mesh, non-vascularized or vascularized bone graft, pedicled flaps, micro-vascular free flaps, prosthesis placement, and split skin graft followed by obturator placement. Till date no-body has tried stabilization of eye ball by 'darning' the orbital floor using non-absorbable suture. 'Polypropylene suture darning' is an easy to learn, novel method with equally good results. Five patients with potentially resectable tumors underwent total maxillectomy. I used polypropylene 3-0 round body suture and 'darning' was done at orbital floor, incorporating periosteum (if remaining) and peri-orbital fat into the sutures. Muscle flaps were done to provide bulk and palatal reconstruction. Assessment of patients was done post-operatively at day-5 i.e., before discharge and at 1 month after surgery, and also in further follow up visits. The results were very good in terms of clear vision & eye movements (directly related to 'darning'), and the aesthetic look of patients and bilateral symmetry were satisfactory (not related to darning). Darning of orbital floor by polypropylene after total maxillectomy is an easy to learn and cost-effective method of reconstruction with good results.

  12. Electron paramagnetic resonance image reconstruction with total variation and curvelets regularization

    Science.gov (United States)

    Durand, Sylvain; Frapart, Yves-Michel; Kerebel, Maud

    2017-11-01

    Spatial electron paramagnetic resonance imaging (EPRI) is a recent method to localize and characterize free radicals in vivo or in vitro, leading to applications in material and biomedical sciences. To improve the quality of the reconstruction obtained by EPRI, a variational method is proposed to inverse the image formation model. It is based on a least-square data-fidelity term and the total variation and Besov seminorm for the regularization term. To fully comprehend the Besov seminorm, an implementation using the curvelet transform and the L 1 norm enforcing the sparsity is proposed. It allows our model to reconstruct both image where acquisition information are missing and image with details in textured areas, thus opening possibilities to reduce acquisition times. To implement the minimization problem using the algorithm developed by Chambolle and Pock, a thorough analysis of the direct model is undertaken and the latter is inverted while avoiding the use of filtered backprojection (FBP) and of non-uniform Fourier transform. Numerical experiments are carried out on simulated data, where the proposed model outperforms both visually and quantitatively the classical model using deconvolution and FBP. Improved reconstructions on real data, acquired on an irradiated distal phalanx, were successfully obtained.

  13. An interior-point method for total variation regularized positron emission tomography image reconstruction

    Science.gov (United States)

    Bai, Bing

    2012-03-01

    There has been a lot of work on total variation (TV) regularized tomographic image reconstruction recently. Many of them use gradient-based optimization algorithms with a differentiable approximation of the TV functional. In this paper we apply TV regularization in Positron Emission Tomography (PET) image reconstruction. We reconstruct the PET image in a Bayesian framework, using Poisson noise model and TV prior functional. The original optimization problem is transformed to an equivalent problem with inequality constraints by adding auxiliary variables. Then we use an interior point method with logarithmic barrier functions to solve the constrained optimization problem. In this method, a series of points approaching the solution from inside the feasible region are found by solving a sequence of subproblems characterized by an increasing positive parameter. We use preconditioned conjugate gradient (PCG) algorithm to solve the subproblems directly. The nonnegativity constraint is enforced by bend line search. The exact expression of the TV functional is used in our calculations. Simulation results show that the algorithm converges fast and the convergence is insensitive to the values of the regularization and reconstruction parameters.

  14. Parameter selection in limited data cone-beam CT reconstruction using edge-preserving total variation algorithms

    Science.gov (United States)

    Lohvithee, Manasavee; Biguri, Ander; Soleimani, Manuchehr

    2017-12-01

    There are a number of powerful total variation (TV) regularization methods that have great promise in limited data cone-beam CT reconstruction with an enhancement of image quality. These promising TV methods require careful selection of the image reconstruction parameters, for which there are no well-established criteria. This paper presents a comprehensive evaluation of parameter selection in a number of major TV-based reconstruction algorithms. An appropriate way of selecting the values for each individual parameter has been suggested. Finally, a new adaptive-weighted projection-controlled steepest descent (AwPCSD) algorithm is presented, which implements the edge-preserving function for CBCT reconstruction with limited data. The proposed algorithm shows significant robustness compared to three other existing algorithms: ASD-POCS, AwASD-POCS and PCSD. The proposed AwPCSD algorithm is able to preserve the edges of the reconstructed images better with fewer sensitive parameters to tune.

  15. Patient-oriented functional results of total femoral endoprosthetic reconstruction following oncologic resection.

    Science.gov (United States)

    Jones, Kevin B; Griffin, Anthony M; Chandrasekar, Coonoor R; Biau, David; Babinet, Antoine; Deheshi, Benjamin; Bell, Robert S; Grimer, Robert J; Wunder, Jay S; Ferguson, Peter C

    2011-11-01

    Functional outcomes following oncologic total femoral endoprosthetic reconstruction (TFR) are lacking. We compared patient-oriented functional results of TFRs to proximal femur and distal femur reconstructions (PFR and DFR). We also compared function and complications with regard to knee and hip componentry. Fifty-four TFR patients were identified from three institutional prospective databases. Forty-one had fixed- and 13 had rotating-hinge knees, 37 hemiarthroplasty and 17 total hip arthroplasty componentry. Toronto Extremity Salvage Scores (TESS) for n = 27 were compared between groups and to cohorts of PFR (n = 31) and DFR (n = 85) patients using the Mann-Whitney U-test. Follow-up averaged 4 years. Mechanical complications included five hip dislocations and one femoral malrotation. Four dislocations were in fixed-hinge implants, all in those lacking abductor reattachment. TESS averaged 69.3 ± 17.8, statistically decreased from DFR (P = 0.002) and PFR patients (P = 0.036). No significant differences were detected between patients in the fixed-hinge (n = 18) and rotating-hinge (n = 9) groups (P = 0.944), or total hip (n = 8) and hemiarthroplasty (n = 19) groups (P = 0.633). TFR is reserved for extreme cases of limb salvage, portending a poor prognosis overall. Function reflects additive impairments from PFR and DFR. TFR outcomes differ little with rotating- or fixed-hinge, total hip or hemiarthroplasty implants. Copyright © 2011 Wiley Periodicals, Inc.

  16. The genus Allogamus Schmid, 1955 (Trichoptera, Limnephilidae: revised by sexual selection-driven adaptive, non-neutral traits of the phallic organ

    Directory of Open Access Journals (Sweden)

    Oláh, János

    2014-06-01

    Full Text Available Based upon our previous reviews on the phylogenetic species concept, initial split criteria and fine structure analysis here we summarize population and model thinking as support to our diverged structure matrix procedure to test simply visually or, if required, by geometric morphometrics the stability of sexual selection-driven adaptive, non-neutral traits of the phallic organ. Complexity review helped us to establish plesiomorphic and apomorphic states of parameres of the phallic organ. Fine structure diversity of the adaptive traits of paramere and the apical portion of aedeagus has been applied to revise the Allogamus genus. All the known 22 taxa, 19 species and 3 subspecies, have been revised. Apomorphic fusion of parameres and complexity evolution of aedeagus directed us to erect 2 rediagnosed species groups, 1 new species group, 4 new species subgroups, 1 new species complex, 10 new species and 4 new or revised species status as follows: Allogamus auricollis species group, rediagnosed. Allogamus antennatus new subgroup: A. antennatus (McLachlan, 1876, A. ausoniae Moretti, 1991, stat. rev., A. morettii DePietro & Cianficconi, 2001, stat. rev., A. silanus Moretti 1991, stat. nov. Allogamus auricollis new subgroup: A. alpensis Oláh, Lodovici & Valle sp. nov., A. auricollis (Pictet, 1834, A. despaxi Decamps, 1967, A. zomok Oláh & Coppa sp. nov. Allogamus hilaris new subgroup: A. hilaris (McLachlan, 1876. Allogamus ligonifer new subgroup: A. gibraltaricus Gonzalez & Ruiz, 2001, A. kefes Coppa & Oláh sp. nov., A. laureatus (Navas, 1918, A. ligonifer (McLachlan, 1876, A. pertuli Malicky, 1974, A. pupos Coppa & Oláh sp. nov. Allogamus mortoni new species complex: A. kampos Oláh & Ruiz sp. nov., A. kettos Oláh & Ruiz sp. nov., A. kurtas Oláh & Zamora-Muñoz sp. nov., A. mortoni (Navas, 1907, A. pohos Oláh & Zamora-Muñoz sp. nov., A. tuskes Oláh & Sáinz-Bariáin sp. nov. Allogamus corsicus new species group: A. corsicus (Ris, 1897. A

  17. Gastric pull-up reconstruction combined with free jejunal transfer (FJT) following total pharyngolaryngo-oesophagectomy (PLE).

    Science.gov (United States)

    Ni, Song; Zhu, Yiming; Li, Dezhi; Li, Zhengjiang; Wu, Yuehuang; Xu, Zhengang; Liu, Shaoyan

    2015-06-01

    Reconstruction following total pharyngolaryngo-oesophagectomy (PLE) still challenges surgeons because of the extreme length of removed tissue. Gastric pull-up reconstruction, one of the most common reconstructive methods after PLE, has many complications such as anastomotic fistula and gastric necrosis caused by the high anastomotic tension. However, modifications of gastric pull-up reconstruction aiming to reducing the high anastomotic tension have been less reported compared with other aspects with this technique. Here we report a modified gastric pull-up reconstruction combined with free jejunal transfer (FTJ) to reduce the anastomosis tension, and thus to reduce the risk of complications after PLE. Patients underwent a standard surgical procedure including total pharyngolaryngo-oesophagectomy and bilateral internal jugular lymph nodal clearance. A free jejunal graft about 10 cm was harvested and placed in the appropriate position between mobilized stomach and oropharynx. The anastomosis between the free jejunal graft and the gastric tube was created through a stapler. Vascular anastomosis was made between the jejunal artery and the transverse cervical artery, and between the jejunal vein and the internal jugular vein. Hand suturing technique was used in the anastomosis between jejunum and pharynx. None of the patients suffered from any complications such as anastomotic fistula. Both patients resumed early postoperative oral intake. So far, they remain free of tumor recurrence and are in good health for 46 and 18 months, respectively. Considering the tumor status and the patient condition, the gastric pull-up reconstruction combined with FJT after PLE could be a reliable choice. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  18. Novel Fourier-based iterative reconstruction for sparse fan projection using alternating direction total variation minimization

    International Nuclear Information System (INIS)

    Jin Zhao; Zhang Han-Ming; Yan Bin; Li Lei; Wang Lin-Yuan; Cai Ai-Long

    2016-01-01

    Sparse-view x-ray computed tomography (CT) imaging is an interesting topic in CT field and can efficiently decrease radiation dose. Compared with spatial reconstruction, a Fourier-based algorithm has advantages in reconstruction speed and memory usage. A novel Fourier-based iterative reconstruction technique that utilizes non-uniform fast Fourier transform (NUFFT) is presented in this work along with advanced total variation (TV) regularization for a fan sparse-view CT. The proposition of a selective matrix contributes to improve reconstruction quality. The new method employs the NUFFT and its adjoin to iterate back and forth between the Fourier and image space. The performance of the proposed algorithm is demonstrated through a series of digital simulations and experimental phantom studies. Results of the proposed algorithm are compared with those of existing TV-regularized techniques based on compressed sensing method, as well as basic algebraic reconstruction technique. Compared with the existing TV-regularized techniques, the proposed Fourier-based technique significantly improves convergence rate and reduces memory allocation, respectively. (paper)

  19. A Modified Method for Reconstruction of Chronic Rupture of the Quadriceps Tendon after Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    S Singh

    2008-11-01

    Full Text Available We describe herein a modified technique for reconstruction of chronic rupture of the quadriceps tendon in a patient with bilateral total knee replacement and distal realignment of the patella. The surgery involved the application of a Dacron graft and the ‘double eights’ technique. The patient achieved satisfactory results after surgery and we believe that this technique of reconstruction offers advantages over other methods.

  20. Long-term follow-up on total reconstruction of the temporomandibular joint - functional, psychosocial and radiological assessments in a case-series study

    DEFF Research Database (Denmark)

    Andersen, Kristian

    Long-term follow-up on total reconstruction of the temporomandibular joint - functional, psychosocial and radiological assessments in a case-series study......Long-term follow-up on total reconstruction of the temporomandibular joint - functional, psychosocial and radiological assessments in a case-series study...

  1. Reconstruction of the pelvic floor and the vagina after total pelvic exenteration using the transverse musculocutaneous gracilis flap.

    Science.gov (United States)

    Kaartinen, Ilkka S; Vuento, Maarit H; Hyöty, Marja K; Kallio, Jukka; Kuokkanen, Hannu O

    2015-01-01

    Total pelvic exenteration (TPE) is a rare operation in which the pelvic contents are removed entirely. Several options for pelvic floor and vaginal reconstruction have been described including transverse rectus abdominis musculocutaneous (TRAM) or deep inferior epigastric perforator (DIEP) flaps. The transverse musculocutaneous gracilis (TMG) flap has been introduced for breast reconstruction as a free flap. We adopted the pedicled TMG flap for reconstructions after TPE. To the best of our knowledge, this is the first report of this method in the literature. Between November 2011 and February 2014, 12 patients underwent TPE and reconstruction with unilateral (six patients) or bilateral (six patients) pedicled TMG flaps. Five patients underwent vaginal reconstruction with bilateral TMG flaps. We describe the operative procedure and the outcome of the operation in these patients. The total mean operative times for TPE with or without vaginal reconstruction were 467 ± 12 and 386 ± 59 min, respectively. The TMG flaps had enough vascular tissue and mobility for reconstructing the TPE defects. There was distal edge necrosis in one out of 18 flaps, while the rest survived completely. During the follow-up, complete wound healing with no signs of weakening of the pelvic floor was observed in all cases. Soft-tissue reconstructions are needed to reduce complications associated with TPE, to secure the pelvic floor and to reconstruct the vagina in select patients. The TMG flap is a logical flap choice that does not lead to functional deficits, complicate the abdominal ostomies or weaken the abdominal wall. It reduces the length of operation compared to that of abdominal flaps. IV, therapeutic. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Total Maxillary Reconstruction With a Bi-Paddle Double-Barrel Osteocutaneous Fibular Flap and Arteriovenous Saphenous Loop After a Globe-Sparing Total Maxillectomy Due to Osteosarcoma.

    Science.gov (United States)

    Tseng, Wan-Ling; Chang, Tzu-Yen; Hung, Kuo-Shu; Chen, Szu-Han; Hsiao, Jenn-Ren; Lee, Yao-Chou

    2017-01-01

    The titanium mesh or bone graft is usually used for orbital support after a globe-sparing total maxillectomy. However, its use can invite complications, such as infection, exposure, and absorption, especially for patients who require adjuvant radiotherapy. Here, the authors present a patient who received total maxillary reconstruction with an osteocutaneous fibular flap. A 53-year-old man with the diagnosis of maxillary osteosarcoma received a globe-sparing total maxillectomy. A bi-paddle double-barrel osteocutaneous fibular flap was used for orbital support, alveolar ridge recreation, and oro-sino-nasal separation. The short pedicle length inherent in the double-barrel design of the fibular flap was overcome by creating an arteriovenous saphenous loop. The postoperative recovery was uneventful. During the 9 months follow-up, the patient was tumor-free and satisfied with his appearance, speech, and intake functions. Reconstruction with a bi-paddle double-barrel osteocutaneous fibular flap after a globe-sparing total maxillectomy can achieve satisfactory aesthetic and functional results.

  3. Total Reconstruction of the Upper Lip Using Bilateral Nasolabial Flaps, Submental Flap, and Mucosa Graft following Complete Resection for Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    O. G. Oseni

    2015-01-01

    Full Text Available Lip reconstruction following resection for tumour or following extensive trauma may pose a challenge. This is more so when the resection is total and a complete lip has to be constructed. We present a case of lip reconstruction following a total resection of the upper lip. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal graft lining. We believe that this provides an alternative method of total upper lip reconstruction with minimal disruption of the facial aesthesis.

  4. Modified Design of Anterolateral Thigh Flap for Total Pharyngolaryngectomy Reconstruction: A Single-Center Experience.

    Science.gov (United States)

    Cheng, Li-Yen; Chen, Cha-Chun; Lin, Hwang-Chi; Jeng, Chu-Hsu; Lin, Shang-Hsi; Chen, Wei-Nung Jim; Lin, Yu-Hsien; Hao, Sheng-Po

    2018-07-01

    Defects after total pharyngolaryngectomy for hypopharyngeal cancer often require reconstruction via free tissue transfer. Recently, anterolateral thigh (ALT) flap has become the gold standard in many centers because of its advantages with respect to versatility, minimal donor-site morbidity, good speech quality, and relatively low fistula and anastomotic leakage rates. Moreover, ALT allows 2 surgical teams to work simultaneously. However, the height of the parallelogram in the ALT design for neoesophagus reconstruction is usually set at a minimum of 9.4 cm (circumference, 2πr) for smooth food passage. Because this height exceeds 8 cm, the donor site may not be closed primarily, which highly depends on the patient's body habitus and the skin tone or quality and requires other methods, such as local flap or skin graft for wound closure, which subsequently increase operating time and donor-site complication rate. Thus, we aimed to construct a simple and modified ALT design that will not only include the advantages described earlier but also provide adequate donor-site primary closure without jeopardizing complication rates. Ten patients with hypopharyngeal cancer underwent reconstructive surgery using our modified ALT design after total pharyngolaryngectomy between 2010 and 2017. Our modified ALT design converts this "classical" shape into a parallelogram so that the height of the modified design is always less than 8 cm, thus allowing for easy primary closure of the wound. The donor-site defects of all 10 patients were closed primarily. No donor-site complications and partial or total flap loss were observed. One patient experienced persistent wound infection with dehiscence, for which debridement was performed. The stricture and fistula rates were 10% (n = 1) and 20% (n = 2), respectively. The mean follow-up time is approximately 1 year. Minimizing donor-site morbidity is an important goal in reconstructive surgery. Our modified ALT flap design is simple, enabling

  5. From partial to full-face transplantation: total ablation and restoration, a change in the reconstructive paradigm.

    Science.gov (United States)

    Barret, Juan P

    2014-01-01

    The innovation of composite vascularized allotransplantation has provided plastic and reconstructive surgeons with the ultimate tool for those patients that present with facial deformities that cannot be reconstructed with classical or more traditional techniques. Transplanting normal tissues allows for a true restorative surgery. Initial experiences included the substitution of missing anatomy, whereas after the first world's full-face transplant performed in Barcelona in March 2010, a true ablative surgery with a total restoration proved to be effective. We review the world's experience and the performance of our restorative protocol to depict this change in the reconstructive paradigm of facial transplantation. Facial transplants should be performed after a careful analysis of the defect, with a comprehensive ablation plan following esthetic units with sacrifice of all required tissues with a focus of global restoration of anatomy, aesthetics and function, respecting normal functioning muscles. Nowadays, facial transplants following strict esthetic units should restore disfigurement extending to small central areas, whereas major defects may require a total ablation and restoration with full-face transplants. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Fourier-based reconstruction via alternating direction total variation minimization in linear scan CT

    International Nuclear Information System (INIS)

    Cai, Ailong; Wang, Linyuan; Yan, Bin; Zhang, Hanming; Li, Lei; Xi, Xiaoqi; Li, Jianxin

    2015-01-01

    In this study, we consider a novel form of computed tomography (CT), that is, linear scan CT (LCT), which applies a straight line trajectory. Furthermore, an iterative algorithm is proposed for pseudo-polar Fourier reconstruction through total variation minimization (PPF-TVM). Considering that the sampled Fourier data are distributed in pseudo-polar coordinates, the reconstruction model minimizes the TV of the image subject to the constraint that the estimated 2D Fourier data for the image are consistent with the 1D Fourier transform of the projection data. PPF-TVM employs the alternating direction method (ADM) to develop a robust and efficient iteration scheme, which ensures stable convergence provided that appropriate parameter values are given. In the ADM scheme, PPF-TVM applies the pseudo-polar fast Fourier transform and its adjoint to iterate back and forth between the image and frequency domains. Thus, there is no interpolation in the Fourier domain, which makes the algorithm both fast and accurate. PPF-TVM is particularly useful for limited angle reconstruction in LCT and it appears to be robust against artifacts. The PPF-TVM algorithm was tested with the FORBILD head phantom and real data in comparisons with state-of-the-art algorithms. Simulation studies and real data verification suggest that PPF-TVM can reconstruct higher accuracy images with lower time consumption

  7. CT reconstruction from few-views with anisotropic edge-guided total variance

    International Nuclear Information System (INIS)

    Rong, Junyan; Liu, Wenlei; Gao, Peng; Liao, Qimei; Jiao, Chun; Ma, Jianhua; Lu, Hongbing

    2016-01-01

    To overcome the oversmoothing drawback in the edge areas when reconstructing few-view CT with total variation (TV) minimization, in this paper, we propose an anisotropic edge-guided TV minimization framework for few-view CT reconstruction. In the framework, anisotropic TV is summed with pre-weighted image gradient and then used as the object function for minimizing. It includes edge-guided TV minimization (EGTV) and edge-guided adaptive-weighted TV minimization (EGAwTV) algorithms. For EGTV algorithm, the weights of the TV discretization term are updated by anisotropic edge information detected from the image, whereas the weights for EGAwTV are determined based on edge information and local image-intensity gradients. To solve the minimization problem of the proposed algorithm, a similar TV-based minimization implementation is developed to address the raw data fidelity and other constraints. The evaluation results using both computer simulations with the Shepp-Logan phantom and experimental data from a physical phantom demonstrate that the proposed algorithms exhibit noticeable gains in the merits of spatial resolution compared with the conventional TV and other modified TV algorithms.

  8. Uncut Esophagojejunostomy with Double Jejunal Pouch: An Alternative Reconstruction Method that Improves the Quality of Life of Patients after Total Gastrectomy.

    Science.gov (United States)

    Gong, Jia Qing; Cao, Yong Kuan; Zhang, Guo Hu; Wang, Pei Hong; Luo, Guo De

    2017-04-01

    Currently, there is no optimal digestive tract reconstruction technique well recognized by scholars after total gastrectomy. In this study, a new reconstruction method, which is modified from the classic Roux-en-Y procedure, an uncut jejunal esophageal anastomosis with double jejunal pouch (UJEA-DJP) was established, and its advantages for improving the quality of life of patients who undergo total gastrectomy were analyzed. Altogether 160 patients with gastric cancer enrolled in our center from September 2009 to March 2012 received radical D2 total gastrectomy. According to the reconstruction methods used, these patients were divided into three groups: UJEA-DJP (n = 63), Roux-en-Y (n = 45), and P-loop with Roux-en-Y esophagojejunostomy (P-RY; n = 52). The operation time for reconstruction, complications, prognostic nutritional index (PNI), and the Visick classification among the three groups were analyzed. We found that UJEA-DJP has advantages over Roux-en-Y and P-RY regarding the time of digestive tract reconstruction, incidence rates for long-term complications, postoperative nutritional index, body weight recovery, and the Visick classification for subjective feelings (p quality of life of patients after surgical procedure.

  9. Quality of life following total mastectomy with and without reconstruction versus breast-conserving surgery for breast cancer: A case-controlled cohort study.

    Science.gov (United States)

    Howes, Benjamin H L; Watson, David I; Xu, Chris; Fosh, Beverley; Canepa, Maximiliano; Dean, Nicola R

    2016-09-01

    Patient-reported outcomes and quality of life following mastectomy are not well understood. This study evaluates the quality of life following surgery for breast cancer and compares outcomes following breast-conserving surgery versus total mastectomy with or without reconstruction. A case-controlled cross-sectional study was conducted using the validated BREAST-Q™ questionnaire and a study-specific questionnaire to determine patient's views about surgical outcomes. Questionnaires were completed by patients following breast-conserving surgery and total mastectomy with or without reconstruction and by controls without breast cancer. A one-way ANOVA was used to compare mean BREAST-Q™ scores between groups and post hoc analysis using Tukey's and Kruskal-Wallis tests. BREAST-Q™ questionnaires were completed by 400 women (123 controls, 97 breast conservations, 93 mastectomies without reconstruction, 87 mastectomies with reconstruction). Women who had undergone mastectomy and reconstruction had higher scores in satisfaction with breast and sexual well-being domains compared with women who had breast-conserving surgery, and women who had total mastectomy without reconstruction had the lowest scores in these two domains. There was no difference in psychosocial well-being between the groups. Women who had undergone breast-conserving surgery scored the lowest in the physical well-being chest domain and the majority reported breast asymmetry. Our study suggests that women who undergo total mastectomy and breast reconstruction for cancer achieve a quality-of-life outcome that is at least as good as that following breast-conserving surgery. Furthermore, breast conservation has been found to be associated with lower physical well-being (i.e., more pain and discomfort) in the chest area and poorer sexual well-being outcomes. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.

  10. Endoscopic latissimus dorsi muscle flap for breast reconstruction after skin-sparing total mastectomy: report of 14 cases.

    Science.gov (United States)

    Iglesias, Martin; Gonzalez-Chapa, Diego R

    2013-08-01

    Some authors have mentioned that the endoscopic harvesting of the latissimus dorsi muscle flap for breast reconstruction is an uncommon technique that has been abandoned due to its technical complexity. Therefore, its use for immediate breast reconstruction after skin-sparing total mastectomies is reported for only a few patients, without clinical images of the reconstructed breast or of the donor site. This report describes 14 breast reconstructions using the aforementioned approach, with the latissimus dorsi muscle flap harvested by endoscopy plus the insertion of a breast implant in a single surgical procedure. The objective is to show images of the long-range clinical aesthetic results, both in the reconstructed breast and at the donor site as well as the complications so the reader can evaluate the advantages and disadvantages of the technique. From 2008 to 2011, 12 women who experienced skin-sparing total mastectomy and 2 women who underwent modified radical mastectomy were reconstructed using the aforementioned technique. The average age was 42 years (range 30-58 years), and the average body mass index was 29 kg/m(2) (range 22-34 kg/m(2)). Three patients were heavy smokers: one had undergone a previous abdominoplasty; one had hepatitis C; and one had undergone massive weight loss. Immediate reconstructions were performed for 11 patients, and 3 reconstructions were delayed. The implant volume ranged from 355 to 640 ml. The average endoscopic harvesting time was 163.5 min (range 120-240 min), and the average bleeding was 300 ml. Four patients experienced seromas at the donor site. Acceptance of the reconstructed breast was good in six cases, moderate in seven cases, and poor in one case. Acceptance of the donor site was good in 13 cases and moderate for 1 case. Endoscopic harvesting of the latissimus dorsi muscle has technical difficulties that have limited its acceptance. However, this technique offers the same quality of breast reconstruction as the

  11. Low dose CBCT reconstruction via prior contour based total variation (PCTV) regularization: a feasibility study

    Science.gov (United States)

    Chen, Yingxuan; Yin, Fang-Fang; Zhang, Yawei; Zhang, You; Ren, Lei

    2018-04-01

    Purpose: compressed sensing reconstruction using total variation (TV) tends to over-smooth the edge information by uniformly penalizing the image gradient. The goal of this study is to develop a novel prior contour based TV (PCTV) method to enhance the edge information in compressed sensing reconstruction for CBCT. Methods: the edge information is extracted from prior planning-CT via edge detection. Prior CT is first registered with on-board CBCT reconstructed with TV method through rigid or deformable registration. The edge contours in prior-CT is then mapped to CBCT and used as the weight map for TV regularization to enhance edge information in CBCT reconstruction. The PCTV method was evaluated using extended-cardiac-torso (XCAT) phantom, physical CatPhan phantom and brain patient data. Results were compared with both TV and edge preserving TV (EPTV) methods which are commonly used for limited projection CBCT reconstruction. Relative error was used to calculate pixel value difference and edge cross correlation was defined as the similarity of edge information between reconstructed images and ground truth in the quantitative evaluation. Results: compared to TV and EPTV, PCTV enhanced the edge information of bone, lung vessels and tumor in XCAT reconstruction and complex bony structures in brain patient CBCT. In XCAT study using 45 half-fan CBCT projections, compared with ground truth, relative errors were 1.5%, 0.7% and 0.3% and edge cross correlations were 0.66, 0.72 and 0.78 for TV, EPTV and PCTV, respectively. PCTV is more robust to the projection number reduction. Edge enhancement was reduced slightly with noisy projections but PCTV was still superior to other methods. PCTV can maintain resolution while reducing the noise in the low mAs CatPhan reconstruction. Low contrast edges were preserved better with PCTV compared with TV and EPTV. Conclusion: PCTV preserved edge information as well as reduced streak artifacts and noise in low dose CBCT reconstruction

  12. A new Mumford-Shah total variation minimization based model for sparse-view x-ray computed tomography image reconstruction.

    Science.gov (United States)

    Chen, Bo; Bian, Zhaoying; Zhou, Xiaohui; Chen, Wensheng; Ma, Jianhua; Liang, Zhengrong

    2018-04-12

    Total variation (TV) minimization for the sparse-view x-ray computer tomography (CT) reconstruction has been widely explored to reduce radiation dose. However, due to the piecewise constant assumption for the TV model, the reconstructed images often suffer from over-smoothness on the image edges. To mitigate this drawback of TV minimization, we present a Mumford-Shah total variation (MSTV) minimization algorithm in this paper. The presented MSTV model is derived by integrating TV minimization and Mumford-Shah segmentation. Subsequently, a penalized weighted least-squares (PWLS) scheme with MSTV is developed for the sparse-view CT reconstruction. For simplicity, the proposed algorithm is named as 'PWLS-MSTV.' To evaluate the performance of the present PWLS-MSTV algorithm, both qualitative and quantitative studies were conducted by using a digital XCAT phantom and a physical phantom. Experimental results show that the present PWLS-MSTV algorithm has noticeable gains over the existing algorithms in terms of noise reduction, contrast-to-ratio measure and edge-preservation.

  13. GPU-based fast cone beam CT reconstruction from undersampled and noisy projection data via total variation

    International Nuclear Information System (INIS)

    Jia Xun; Lou Yifei; Li Ruijiang; Song, William Y.; Jiang, Steve B.

    2010-01-01

    Purpose: Cone-beam CT (CBCT) plays an important role in image guided radiation therapy (IGRT). However, the large radiation dose from serial CBCT scans in most IGRT procedures raises a clinical concern, especially for pediatric patients who are essentially excluded from receiving IGRT for this reason. The goal of this work is to develop a fast GPU-based algorithm to reconstruct CBCT from undersampled and noisy projection data so as to lower the imaging dose. Methods: The CBCT is reconstructed by minimizing an energy functional consisting of a data fidelity term and a total variation regularization term. The authors developed a GPU-friendly version of the forward-backward splitting algorithm to solve this model. A multigrid technique is also employed. Results: It is found that 20-40 x-ray projections are sufficient to reconstruct images with satisfactory quality for IGRT. The reconstruction time ranges from 77 to 130 s on an NVIDIA Tesla C1060 (NVIDIA, Santa Clara, CA) GPU card, depending on the number of projections used, which is estimated about 100 times faster than similar iterative reconstruction approaches. Moreover, phantom studies indicate that the algorithm enables the CBCT to be reconstructed under a scanning protocol with as low as 0.1 mA s/projection. Comparing with currently widely used full-fan head and neck scanning protocol of ∼360 projections with 0.4 mA s/projection, it is estimated that an overall 36-72 times dose reduction has been achieved in our fast CBCT reconstruction algorithm. Conclusions: This work indicates that the developed GPU-based CBCT reconstruction algorithm is capable of lowering imaging dose considerably. The high computation efficiency in this algorithm makes the iterative CBCT reconstruction approach applicable in real clinical environments.

  14. GPU-based fast cone beam CT reconstruction from undersampled and noisy projection data via total variation.

    Science.gov (United States)

    Jia, Xun; Lou, Yifei; Li, Ruijiang; Song, William Y; Jiang, Steve B

    2010-04-01

    Cone-beam CT (CBCT) plays an important role in image guided radiation therapy (IGRT). However, the large radiation dose from serial CBCT scans in most IGRT procedures raises a clinical concern, especially for pediatric patients who are essentially excluded from receiving IGRT for this reason. The goal of this work is to develop a fast GPU-based algorithm to reconstruct CBCT from undersampled and noisy projection data so as to lower the imaging dose. The CBCT is reconstructed by minimizing an energy functional consisting of a data fidelity term and a total variation regularization term. The authors developed a GPU-friendly version of the forward-backward splitting algorithm to solve this model. A multigrid technique is also employed. It is found that 20-40 x-ray projections are sufficient to reconstruct images with satisfactory quality for IGRT. The reconstruction time ranges from 77 to 130 s on an NVIDIA Tesla C1060 (NVIDIA, Santa Clara, CA) GPU card, depending on the number of projections used, which is estimated about 100 times faster than similar iterative reconstruction approaches. Moreover, phantom studies indicate that the algorithm enables the CBCT to be reconstructed under a scanning protocol with as low as 0.1 mA s/projection. Comparing with currently widely used full-fan head and neck scanning protocol of approximately 360 projections with 0.4 mA s/projection, it is estimated that an overall 36-72 times dose reduction has been achieved in our fast CBCT reconstruction algorithm. This work indicates that the developed GPU-based CBCT reconstruction algorithm is capable of lowering imaging dose considerably. The high computation efficiency in this algorithm makes the iterative CBCT reconstruction approach applicable in real clinical environments.

  15. A 15-year review of midface reconstruction after total and subtotal maxillectomy: part I. Algorithm and outcomes.

    Science.gov (United States)

    Cordeiro, Peter G; Chen, Constance M

    2012-01-01

    Reconstruction of complex midfacial defects is best approached with a clear algorithm. The goals of reconstruction are functional and aesthetic. Over a 15-year period (1992 to 2006), a single surgeon (P.G.C.) performed 100 flaps to reconstruct the following midfacial defects: type I, limited maxillectomy (n = 20); type IIA, subtotal maxillectomy with resection of less than 50 percent of the palate (n = 8); type IIB, subtotal maxillectomy with resection of greater than 50 percent of the palate (n = 8); type IIIA, total maxillectomy with preservation of the orbital contents (n = 22); type IIIB, total maxillectomy with orbital exenteration (n = 23); and type IV, orbitomaxillectomy (n = 19). Free flaps were used in 94 cases (94 percent), and pedicled flaps were used in six (6 percent). One hundred flaps were performed in 96 patients (69 males, 72 percent; 27 females, 28 percent); four patients underwent a second flap reconstruction due to recurrent disease (n = 4, 4 percent). Average patient age was 49.2 years (range, 13 to 81 years). Free-flap survival was 100 percent, with one partial flap loss (1 percent). Five patients suffered systemic complications (5.2 percent), and four died within 30 days of hospitalization (4.2 percent). Over 50 percent of patients returned to normal diet and speech. Almost 60 percent were judged to have an excellent aesthetic result. Free-tissue transfer offers the most effective and reliable form of reconstruction for complex maxillectomy defects. Rectus abdominis and radial forearm free flaps in combination with immediate bone grafting or as osteocutaneous flaps consistently provide the best functional and aesthetic results. Therapeutic, IV.

  16. TOTAL EYELID RECONSTRUCTION IN A PRIMARY IMMUN O DEFICIENT WI TH G I A NT PYOGENIC GRANULOMA

    Directory of Open Access Journals (Sweden)

    Vijay Kumar

    2015-06-01

    Full Text Available Total upper and lower eyelid defect is usually secondary to the excision of malignant or benign tumours, trauma and burns. Reconstruction of this type of defect is important not only for the cosmetic result, but also for coverage of the cornea an d prevent injury to eyeball. Pyogenic granuloma is usually preceded by the history of trauma to the eyelid. But reports of giant pyogenic granuloma of both upper and lower eyelid are rare. We present here a ten year old boy diagnosed primary immune deficient with a large fungating mass over both upper and lower eyelid, which was excised and total upper and lower eyelid defect was reconstructed with paramedian forehead flap. Histopathology revealed pyogenic granuloma. Post operatively c hild had good lid movements.

  17. Constrained Total Generalized p-Variation Minimization for Few-View X-Ray Computed Tomography Image Reconstruction.

    Science.gov (United States)

    Zhang, Hanming; Wang, Linyuan; Yan, Bin; Li, Lei; Cai, Ailong; Hu, Guoen

    2016-01-01

    Total generalized variation (TGV)-based computed tomography (CT) image reconstruction, which utilizes high-order image derivatives, is superior to total variation-based methods in terms of the preservation of edge information and the suppression of unfavorable staircase effects. However, conventional TGV regularization employs l1-based form, which is not the most direct method for maximizing sparsity prior. In this study, we propose a total generalized p-variation (TGpV) regularization model to improve the sparsity exploitation of TGV and offer efficient solutions to few-view CT image reconstruction problems. To solve the nonconvex optimization problem of the TGpV minimization model, we then present an efficient iterative algorithm based on the alternating minimization of augmented Lagrangian function. All of the resulting subproblems decoupled by variable splitting admit explicit solutions by applying alternating minimization method and generalized p-shrinkage mapping. In addition, approximate solutions that can be easily performed and quickly calculated through fast Fourier transform are derived using the proximal point method to reduce the cost of inner subproblems. The accuracy and efficiency of the simulated and real data are qualitatively and quantitatively evaluated to validate the efficiency and feasibility of the proposed method. Overall, the proposed method exhibits reasonable performance and outperforms the original TGV-based method when applied to few-view problems.

  18. Total Reconstruction of Lower Eyelid in a Post-traumatic Patient ...

    African Journals Online (AJOL)

    different for upper and lower lids, as the functionality of the two lids differ. There are numerous methods of reconstruction of the eyelids. In this article, we describe a case of posttraumatic reconstruction of lower eyelid and periorbital area using a modification of the Fricke's flap. CASE REPORT AND SURGICAL. TECHNIQUE.

  19. Image reconstruction in circular cone-beam computed tomography by constrained, total-variation minimization

    International Nuclear Information System (INIS)

    Sidky, Emil Y; Pan Xiaochuan

    2008-01-01

    An iterative algorithm, based on recent work in compressive sensing, is developed for volume image reconstruction from a circular cone-beam scan. The algorithm minimizes the total variation (TV) of the image subject to the constraint that the estimated projection data is within a specified tolerance of the available data and that the values of the volume image are non-negative. The constraints are enforced by the use of projection onto convex sets (POCS) and the TV objective is minimized by steepest descent with an adaptive step-size. The algorithm is referred to as adaptive-steepest-descent-POCS (ASD-POCS). It appears to be robust against cone-beam artifacts, and may be particularly useful when the angular range is limited or when the angular sampling rate is low. The ASD-POCS algorithm is tested with the Defrise disk and jaw computerized phantoms. Some comparisons are performed with the POCS and expectation-maximization (EM) algorithms. Although the algorithm is presented in the context of circular cone-beam image reconstruction, it can also be applied to scanning geometries involving other x-ray source trajectories

  20. A Dictionary Learning Method with Total Generalized Variation for MRI Reconstruction.

    Science.gov (United States)

    Lu, Hongyang; Wei, Jingbo; Liu, Qiegen; Wang, Yuhao; Deng, Xiaohua

    2016-01-01

    Reconstructing images from their noisy and incomplete measurements is always a challenge especially for medical MR image with important details and features. This work proposes a novel dictionary learning model that integrates two sparse regularization methods: the total generalized variation (TGV) approach and adaptive dictionary learning (DL). In the proposed method, the TGV selectively regularizes different image regions at different levels to avoid oil painting artifacts largely. At the same time, the dictionary learning adaptively represents the image features sparsely and effectively recovers details of images. The proposed model is solved by variable splitting technique and the alternating direction method of multiplier. Extensive simulation experimental results demonstrate that the proposed method consistently recovers MR images efficiently and outperforms the current state-of-the-art approaches in terms of higher PSNR and lower HFEN values.

  1. Quality of life and nutritional consequences after aboral pouch reconstruction following total gastrectomy for gastric cancer: randomized controlled trial CCG1101.

    Science.gov (United States)

    Ito, Yuichi; Yoshikawa, Takaki; Fujiwara, Michitaka; Kojima, Hiroshi; Matsui, Takanori; Mochizuki, Yoshinari; Cho, Haruhiko; Aoyama, Toru; Ito, Seiji; Misawa, Kazunari; Nakayama, Hiroshi; Morioka, Yuki; Ishiyama, Akiharu; Tanaka, Chie; Morita, Satoshi; Sakamoto, Junichi; Kodera, Yasuhiro

    2016-07-01

    Total gastrectomy has detrimental effects on postoperative nutritional status and quality of life (QOL), but it is often unavoidable in the treatment of gastric cancer. Roux-en-Y (RY) is the most common reconstruction method following total gastrectomy. Trials to explore other means of reconstruction have been conducted but have failed to identify a method that is globally accepted. Aboral pouch reconstruction (AP), in which an anisoperistaltic jejunal pouch is created in the Y limb of the RY reconstruction, is considered effective and technically feasible. A prospective randomized trial was conducted to compare AP with RY. Gastric cancer patients requiring total gastrectomy for R0 resection were randomly assigned during surgery to receive either RY (n = 51) or AP (n = 49). Postoperative QOL as assessed by the EORTC QLQ-C30 and STO22, body composition, and morbidity were compared between the two reconstruction methods. The physical functioning score of the QLQ-C30 was selected as the primary endpoint. The incidences of postoperative complications were similar between the two groups (29 % in the RY group and 27 % in the AP group). No significant difference was observed in the physical functioning score, and the superiority of AP was demonstrated only for the nausea and vomiting score at 12 months (p = 0.041) and the reflux score at 1 month (p = 0.036). No significant differences were observed in body composition or serum biochemistry. Although AP was safely implemented, no increased benefits in nutritional or QOL-related parameters were observed for this method over RY within 12 months postoperatively.

  2. The transmission of stress to grafted bone inside a titanium mesh cage used in anterior column reconstruction after total spondylectomy: a finite-element analysis.

    Science.gov (United States)

    Akamaru, Tomoyuki; Kawahara, Norio; Sakamoto, Jiro; Yoshida, Akira; Murakami, Hideki; Hato, Taizo; Awamori, Serina; Oda, Juhachi; Tomita, Katsuro

    2005-12-15

    A finite-element study of posterior alone or anterior/posterior combined instrumentation following total spondylectomy and replacement with a titanium mesh cage used as an anterior strut. To compare the effect of posterior instrumentation versus anterior/posterior instrumentation on transmission of the stress to grafted bone inside a titanium mesh cage following total spondylectomy. The most recent reconstruction techniques following total spondylectomy for malignant spinal tumor include a titanium mesh cage filled with autologous bone as an anterior strut. The need for additional anterior instrumentation with posterior pedicle screws and rods is controversial. Transmission of the mechanical stress to grafted bone inside a titanium mesh cage is important for fusion and remodeling. To our knowledge, there are no published reports comparing the load-sharing properties of the different reconstruction methods following total spondylectomy. A 3-dimensional finite-element model of the reconstructed spine (T10-L4) following total spondylectomy at T12 was constructed. A Harms titanium mesh cage (DePuy Spine, Raynham, MA) was positioned as an anterior replacement, and 3 types of the reconstruction methods were compared: (1) multilevel posterior instrumentation (MPI) (i.e., posterior pedicle screws and rods at T10-L2 without anterior instrumentation); (2) MPI with anterior instrumentation (MPAI) (i.e., MPAI [Kaneda SR; DePuy Spine] at T11-L1); and (3) short posterior and anterior instrumentation (SPAI) (i.e., posterior pedicle screws and rods with anterior instrumentation at T11-L1). The mechanical energy stress distribution exerted inside the titanium mesh cage was evaluated and compared by finite-element analysis for the 3 different reconstruction methods. Simulated forces were applied to give axial compression, flexion, extension, and lateral bending. In flexion mode, the energy stress distribution in MPI was higher than 3.0 x 10 MPa in 73.0% of the total volume inside

  3. A Dictionary Learning Method with Total Generalized Variation for MRI Reconstruction

    Directory of Open Access Journals (Sweden)

    Hongyang Lu

    2016-01-01

    Full Text Available Reconstructing images from their noisy and incomplete measurements is always a challenge especially for medical MR image with important details and features. This work proposes a novel dictionary learning model that integrates two sparse regularization methods: the total generalized variation (TGV approach and adaptive dictionary learning (DL. In the proposed method, the TGV selectively regularizes different image regions at different levels to avoid oil painting artifacts largely. At the same time, the dictionary learning adaptively represents the image features sparsely and effectively recovers details of images. The proposed model is solved by variable splitting technique and the alternating direction method of multiplier. Extensive simulation experimental results demonstrate that the proposed method consistently recovers MR images efficiently and outperforms the current state-of-the-art approaches in terms of higher PSNR and lower HFEN values.

  4. Dynamic re-weighted total variation technique and statistic Iterative reconstruction method for x-ray CT metal artifact reduction

    Science.gov (United States)

    Peng, Chengtao; Qiu, Bensheng; Zhang, Cheng; Ma, Changyu; Yuan, Gang; Li, Ming

    2017-07-01

    Over the years, the X-ray computed tomography (CT) has been successfully used in clinical diagnosis. However, when the body of the patient to be examined contains metal objects, the image reconstructed would be polluted by severe metal artifacts, which affect the doctor's diagnosis of disease. In this work, we proposed a dynamic re-weighted total variation (DRWTV) technique combined with the statistic iterative reconstruction (SIR) method to reduce the artifacts. The DRWTV method is based on the total variation (TV) and re-weighted total variation (RWTV) techniques, but it provides a sparser representation than TV and protects the tissue details better than RWTV. Besides, the DRWTV can suppress the artifacts and noise, and the SIR convergence speed is also accelerated. The performance of the algorithm is tested on both simulated phantom dataset and clinical dataset, which are the teeth phantom with two metal implants and the skull with three metal implants, respectively. The proposed algorithm (SIR-DRWTV) is compared with two traditional iterative algorithms, which are SIR and SIR constrained by RWTV regulation (SIR-RWTV). The results show that the proposed algorithm has the best performance in reducing metal artifacts and protecting tissue details.

  5. An Algorithmic Approach to Total Breast Reconstruction with Free Tissue Transfer

    Directory of Open Access Journals (Sweden)

    Seong Cheol Yu

    2013-05-01

    Full Text Available As microvascular techniques continue to improve, perforator flap free tissue transfer is now the gold standard for autologous breast reconstruction. Various options are available for breast reconstruction with autologous tissue. These include the free transverse rectus abdominis myocutaneous (TRAM flap, deep inferior epigastric perforator flap, superficial inferior epigastric artery flap, superior gluteal artery perforator flap, and transverse/vertical upper gracilis flap. In addition, pedicled flaps can be very successful in the right hands and the right patient, such as the pedicled TRAM flap, latissimus dorsi flap, and thoracodorsal artery perforator. Each flap comes with its own advantages and disadvantages related to tissue properties and donor-site morbidity. Currently, the problem is how to determine the most appropriate flap for a particular patient among those potential candidates. Based on a thorough review of the literature and accumulated experiences in the author’s institution, this article provides a logical approach to autologous breast reconstruction. The algorithms presented here can be helpful to customize breast reconstruction to individual patient needs.

  6. Accelerated Brain DCE-MRI Using Iterative Reconstruction With Total Generalized Variation Penalty for Quantitative Pharmacokinetic Analysis: A Feasibility Study.

    Science.gov (United States)

    Wang, Chunhao; Yin, Fang-Fang; Kirkpatrick, John P; Chang, Zheng

    2017-08-01

    To investigate the feasibility of using undersampled k-space data and an iterative image reconstruction method with total generalized variation penalty in the quantitative pharmacokinetic analysis for clinical brain dynamic contrast-enhanced magnetic resonance imaging. Eight brain dynamic contrast-enhanced magnetic resonance imaging scans were retrospectively studied. Two k-space sparse sampling strategies were designed to achieve a simulated image acquisition acceleration factor of 4. They are (1) a golden ratio-optimized 32-ray radial sampling profile and (2) a Cartesian-based random sampling profile with spatiotemporal-regularized sampling density constraints. The undersampled data were reconstructed to yield images using the investigated reconstruction technique. In quantitative pharmacokinetic analysis on a voxel-by-voxel basis, the rate constant K trans in the extended Tofts model and blood flow F B and blood volume V B from the 2-compartment exchange model were analyzed. Finally, the quantitative pharmacokinetic parameters calculated from the undersampled data were compared with the corresponding calculated values from the fully sampled data. To quantify each parameter's accuracy calculated using the undersampled data, error in volume mean, total relative error, and cross-correlation were calculated. The pharmacokinetic parameter maps generated from the undersampled data appeared comparable to the ones generated from the original full sampling data. Within the region of interest, most derived error in volume mean values in the region of interest was about 5% or lower, and the average error in volume mean of all parameter maps generated through either sampling strategy was about 3.54%. The average total relative error value of all parameter maps in region of interest was about 0.115, and the average cross-correlation of all parameter maps in region of interest was about 0.962. All investigated pharmacokinetic parameters had no significant differences between

  7. Accelerated gradient methods for total-variation-based CT image reconstruction

    DEFF Research Database (Denmark)

    Jørgensen, Jakob Heide; Jensen, Tobias Lindstrøm; Hansen, Per Christian

    2011-01-01

    incorporates several heuristics from the optimization literature such as Barzilai-Borwein (BB) step size selection and nonmonotone line search. The latter uses a cleverly chosen sequence of auxiliary points to achieve a better convergence rate. The methods are memory efficient and equipped with a stopping...... reconstruction can in principle be found by any optimization method, but in practice the large scale of the systems arising in CT image reconstruction preclude the use of memory-demanding methods such as Newton’s method. The simple gradient method has much lower memory requirements, but exhibits slow convergence...

  8. Limited data tomographic image reconstruction via dual formulation of total variation minimization

    Science.gov (United States)

    Jang, Kwang Eun; Sung, Younghun; Lee, Kangeui; Lee, Jongha; Cho, Seungryong

    2011-03-01

    The X-ray mammography is the primary imaging modality for breast cancer screening. For the dense breast, however, the mammogram is usually difficult to read due to tissue overlap problem caused by the superposition of normal tissues. The digital breast tomosynthesis (DBT) that measures several low dose projections over a limited angle range may be an alternative modality for breast imaging, since it allows the visualization of the cross-sectional information of breast. The DBT, however, may suffer from the aliasing artifact and the severe noise corruption. To overcome these problems, a total variation (TV) regularized statistical reconstruction algorithm is presented. Inspired by the dual formulation of TV minimization in denoising and deblurring problems, we derived a gradient-type algorithm based on statistical model of X-ray tomography. The objective function is comprised of a data fidelity term derived from the statistical model and a TV regularization term. The gradient of the objective function can be easily calculated using simple operations in terms of auxiliary variables. After a descending step, the data fidelity term is renewed in each iteration. Since the proposed algorithm can be implemented without sophisticated operations such as matrix inverse, it provides an efficient way to include the TV regularization in the statistical reconstruction method, which results in a fast and robust estimation for low dose projections over the limited angle range. Initial tests with an experimental DBT system confirmed our finding.

  9. Joint reconstruction of dynamic PET activity and kinetic parametric images using total variation constrained dictionary sparse coding

    Science.gov (United States)

    Yu, Haiqing; Chen, Shuhang; Chen, Yunmei; Liu, Huafeng

    2017-05-01

    Dynamic positron emission tomography (PET) is capable of providing both spatial and temporal information of radio tracers in vivo. In this paper, we present a novel joint estimation framework to reconstruct temporal sequences of dynamic PET images and the coefficients characterizing the system impulse response function, from which the associated parametric images of the system macro parameters for tracer kinetics can be estimated. The proposed algorithm, which combines statistical data measurement and tracer kinetic models, integrates a dictionary sparse coding (DSC) into a total variational minimization based algorithm for simultaneous reconstruction of the activity distribution and parametric map from measured emission sinograms. DSC, based on the compartmental theory, provides biologically meaningful regularization, and total variation regularization is incorporated to provide edge-preserving guidance. We rely on techniques from minimization algorithms (the alternating direction method of multipliers) to first generate the estimated activity distributions with sub-optimal kinetic parameter estimates, and then recover the parametric maps given these activity estimates. These coupled iterative steps are repeated as necessary until convergence. Experiments with synthetic, Monte Carlo generated data, and real patient data have been conducted, and the results are very promising.

  10. Quantitative image reconstruction for total-body PET imaging using the 2-meter long EXPLORER scanner

    Science.gov (United States)

    Zhang, Xuezhu; Zhou, Jian; Cherry, Simon R.; Badawi, Ramsey D.; Qi, Jinyi

    2017-03-01

    The EXPLORER project aims to build a 2 meter long total-body PET scanner, which will provide extremely high sensitivity for imaging the entire human body. It will possess a range of capabilities currently unavailable to state-of-the-art clinical PET scanners with a limited axial field-of-view. The huge number of lines-of-response (LORs) of the EXPLORER poses a challenge to the data handling and image reconstruction. The objective of this study is to develop a quantitative image reconstruction method for the EXPLORER and compare its performance with current whole-body scanners. Fully 3D image reconstruction was performed using time-of-flight list-mode data with parallel computation. To recover the resolution loss caused by the parallax error between crystal pairs at a large axial ring difference or transaxial radial offset, we applied an image domain resolution model estimated from point source data. To evaluate the image quality, we conducted computer simulations using the SimSET Monte-Carlo toolkit and XCAT 2.0 anthropomorphic phantom to mimic a 20 min whole-body PET scan with an injection of 25 MBq 18F-FDG. We compare the performance of the EXPLORER with a current clinical scanner that has an axial FOV of 22 cm. The comparison results demonstrated superior image quality from the EXPLORER with a 6.9-fold reduction in noise standard deviation comparing with multi-bed imaging using the clinical scanner.

  11. Total nasal reconstruction with 3D custom made porous titanium prosthesis and free thoracodorsal artery perforator flap: A case report.

    Science.gov (United States)

    Qassemyar, Quentin; Assouly, Nathaniel; Madar, Yoni; Temam, Stéphane; Kolb, Frédéric

    2018-02-21

    Total nasal reconstruction is a challenging surgical procedure which usually involves a free flap, forehead flap, and cartilage grafts. In certain failure situations where patients do not accept the idea of anaplastology, possibilities become very limited. We report the case of a patient who underwent several reconstruction steps with multiple failures including free and local flaps and cartilage harvests which showed recurrent episodes of necrosis and infection leading to melting and collapse of reconstructed structures. Furthermore, the patient did not want any anaplastological rehabilitation. We proposed to the patient an innovative method that consists to print a three-dimensional custom-made porous titanium prosthesis, based on the original shape of his nose, to replace the cartilage support. This implant was first inserted in a thoracodorsal artery perforator flap for primary integration before the free transfer of the complete structure, two months later. The free transfer was successful without any complication. A stable reconstruction and satisfying result was obtained. The patient did not want additional surgical improvement 24 months post-operatively, and resumed his professional activities. The possibility of using three-dimensional custom titanium prostheses to replace the bone and cartilage support seems to be an interesting alternative for patients in the failure situation of nasal reconstruction. © 2018 Wiley Periodicals, Inc.

  12. [Custom-made implant for complex facial reconstruction: A case of total replacement of temporo-mandibular joint, zygomatic arch and malar bone].

    Science.gov (United States)

    Guillier, D; Moris, V; See, L-A; Girodon, M; Wajszczak, B-L; Zwetyenga, N

    2017-02-01

    Total prosthetic replacement of the temporo-mandibular joint (TMJ) has become a common procedure, but it is usually limited to the TMJ itself. We report about one case of complex prosthetic joint reconstruction extending to the neighbouring bony structures. A 57-year-old patient, operated several times for a cranio-facial fibrous dysplasia, presented with a recurring TMJ ankylosis and a complexe latero-facial bone loss on the right side. We performed a reconstruction procedure including the TMJ, the zygomatic arch and the malar bone by mean of custom made composite prosthesis (chrome-cobalt-molybdenum-titanium and polyethylene). Five years postoperatively, mouth opening, nutrition, pain and oral hygiene were significantly improved. Nowadays technical possibilities allow for complex facial alloplastic reconstructions with good medium term results. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. Evaluation of robustness of maximum likelihood cone-beam CT reconstruction with total variation regularization

    International Nuclear Information System (INIS)

    Stsepankou, D; Arns, A; Hesser, J; Ng, S K; Zygmanski, P

    2012-01-01

    The objective of this paper is to evaluate an iterative maximum likelihood (ML) cone–beam computed tomography (CBCT) reconstruction with total variation (TV) regularization with respect to the robustness of the algorithm due to data inconsistencies. Three different and (for clinical application) typical classes of errors are considered for simulated phantom and measured projection data: quantum noise, defect detector pixels and projection matrix errors. To quantify those errors we apply error measures like mean square error, signal-to-noise ratio, contrast-to-noise ratio and streak indicator. These measures are derived from linear signal theory and generalized and applied for nonlinear signal reconstruction. For quality check, we focus on resolution and CT-number linearity based on a Catphan phantom. All comparisons are made versus the clinical standard, the filtered backprojection algorithm (FBP). In our results, we confirm and substantially extend previous results on iterative reconstruction such as massive undersampling of the number of projections. Errors of projection matrix parameters of up to 1° projection angle deviations are still in the tolerance level. Single defect pixels exhibit ring artifacts for each method. However using defect pixel compensation, allows up to 40% of defect pixels for passing the standard clinical quality check. Further, the iterative algorithm is extraordinarily robust in the low photon regime (down to 0.05 mAs) when compared to FPB, allowing for extremely low-dose image acquisitions, a substantial issue when considering daily CBCT imaging for position correction in radiotherapy. We conclude that the ML method studied herein is robust under clinical quality assurance conditions. Consequently, low-dose regime imaging, especially for daily patient localization in radiation therapy is possible without change of the current hardware of the imaging system. (paper)

  14. Rates of Reconstruction Failure in Patients Undergoing Immediate Reconstruction With Tissue Expanders and/or Implants and Postmastectomy Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fowble, Barbara, E-mail: BFowble@radonc.ucsf.edu [Department of Radiation Oncology, University of California San Francisco, San Francisco, California (United States); Park, Catherine [Department of Radiation Oncology, University of California San Francisco, San Francisco, California (United States); Wang, Frederick; Peled, Anne [Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California (United States); Alvarado, Michael; Ewing, Cheryl; Esserman, Laura [Carol Franc Buck Breast Care Center, Department of Surgery, University of California San Francisco, San Francisco, California (United States); Foster, Robert; Sbitany, Hani [Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California (United States); Hanlon, Alex [University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania (United States)

    2015-07-01

    Objectives: Mastectomy rates for breast cancer have increased, with a parallel increase in immediate reconstruction. For some women, tissue expander and implant (TE/I) reconstruction is the preferred or sole option. This retrospective study examined the rate of TE/I reconstruction failure (ie, removal of the TE or I with the inability to replace it resulting in no final reconstruction or autologous tissue reconstruction) in patients receiving postmastectomy radiation therapy (PMRT). Methods and Materials: Between 2004 and 2012, 99 women had skin-sparing mastectomies (SSM) or total nipple/areolar skin-sparing mastectomies (TSSM) with immediate TE/I reconstruction and PMRT for pathologic stage II to III breast cancer. Ninety-seven percent had chemotherapy (doxorubicin and taxane-based), 22% underwent targeted therapies, and 78% had endocrine therapy. Radiation consisted of 5000 cGy given in 180 to 200 cGy to the reconstructed breast with or without treatment to the supraclavicular nodes. Median follow-up was 3.8 years. Results: Total TE/I failure was 18% (12% without final reconstruction, 6% converted to autologous reconstruction). In univariate analysis, the strongest predictor of reconstruction failure (RF) was absence of total TE/I coverage (acellular dermal matrix and/or serratus muscle) at the time of radiation. RF occurred in 32.5% of patients without total coverage compared to 9% with coverage (P=.0069). For women with total coverage, the location of the mastectomy scar in the inframammary fold region was associated with higher RF (19% vs 0%, P=.0189). In multivariate analysis, weight was a significant factor for RF, with lower weight associated with a higher RF. Weight appeared to be a surrogate for the interaction of total coverage, thin skin flaps, interval to exchange, and location of the mastectomy scar. Conclusions: RFs in patients receiving PMRT were lowered with total TE/I coverage at the time of radiation by avoiding inframammary fold incisions and

  15. Functional-analytic and numerical issues in splitting methods for total variation-based image reconstruction

    International Nuclear Information System (INIS)

    Hintermüller, Michael; Rautenberg, Carlos N; Hahn, Jooyoung

    2014-01-01

    Variable splitting schemes for the function space version of the image reconstruction problem with total variation regularization (TV-problem) in its primal and pre-dual formulations are considered. For the primal splitting formulation, while existence of a solution cannot be guaranteed, it is shown that quasi-minimizers of the penalized problem are asymptotically related to the solution of the original TV-problem. On the other hand, for the pre-dual formulation, a family of parametrized problems is introduced and a parameter dependent contraction of an associated fixed point iteration is established. Moreover, the theory is validated by numerical tests. Additionally, the augmented Lagrangian approach is studied, details on an implementation on a staggered grid are provided and numerical tests are shown. (paper)

  16. Fast magnetic resonance imaging based on high degree total variation

    Science.gov (United States)

    Wang, Sujie; Lu, Liangliang; Zheng, Junbao; Jiang, Mingfeng

    2018-04-01

    In order to eliminating the artifacts and "staircase effect" of total variation in Compressive Sensing MRI, high degree total variation model is proposed for dynamic MRI reconstruction. the high degree total variation regularization term is used as a constraint to reconstruct the magnetic resonance image, and the iterative weighted MM algorithm is proposed to solve the convex optimization problem of the reconstructed MR image model, In addtion, one set of cardiac magnetic resonance data is used to verify the proposed algorithm for MRI. The results show that the high degree total variation method has a better reconstruction effect than the total variation and the total generalized variation, which can obtain higher reconstruction SNR and better structural similarity.

  17. An in vitro analysis of medial structures and a medial soft tissue reconstruction in a constrained condylar total knee arthroplasty.

    Science.gov (United States)

    Athwal, Kiron K; El Daou, Hadi; Inderhaug, Eivind; Manning, William; Davies, Andrew J; Deehan, David J; Amis, Andrew A

    2017-08-01

    The aim of this study was to quantify the medial soft tissue contributions to stability following constrained condylar (CC) total knee arthroplasty (TKA) and determine whether a medial reconstruction could restore stability to a soft tissue-deficient, CC-TKA knee. Eight cadaveric knees were mounted in a robotic system and tested at 0°, 30°, 60°, and 90° of flexion with ±50 N anterior-posterior force, ±8 Nm varus-valgus, and ±5 Nm internal-external torque. The deep and superficial medial collateral ligaments (dMCL, sMCL) and posteromedial capsule (PMC) were transected and their relative contributions to stabilising the applied loads were quantified. After complete medial soft tissue transection, a reconstruction using a semitendinosus tendon graft was performed, and the effect on kinematic behaviour under equivocal conditions was measured. In the CC-TKA knee, the sMCL was the major medial restraint in anterior drawer, internal-external, and valgus rotation. No significant differences were found between the rotational laxities of the reconstructed knee to the pre-deficient state for the arc of motion examined. The relative contribution of the reconstruction was higher in valgus rotation at 60° than the sMCL; otherwise, the contribution of the reconstruction was similar to that of the sMCL. There is contention whether a CC-TKA can function with medial deficiency or more constraint is required. This work has shown that a CC-TKA may not provide enough stability with an absent sMCL. However, in such cases, combining the CC-TKA with a medial soft tissue reconstruction may be considered as an alternative to a hinged implant.

  18. An Improved Reconstruction of Total Marine Fisheries Catches for the New Hebrides and the Republic of Vanuatu, 1950–2014

    Directory of Open Access Journals (Sweden)

    Marc Léopold

    2017-10-01

    Full Text Available For many small island nations, fisheries provide residents with both food security and economic stability. However, in order to create effective and sustainable fisheries policies and management that will ensure a growing population can prosper, policy makers need to know what is being fished and how much is fished. Vanuatu, the smallest country in Melanesia, has a declared and claimed Exclusive Economic Zone (EEZ of over 820,000 km2 and fisheries resources play a large part in the food security and economic stability of this country. This reconstruction of the total marine fisheries catch of Vanuatu for 1950–2014 faced major data gaps. It showed that the reconstructed total catches of nearly 1.4 million tonnes (metric tons 40% higher than the 977,997 tonnes reported by the Food and Agriculture Organization (FAO on behalf of Vanuatu for the same period. However, if large-scale industrial catches are excluded, the reconstructed small-scale fisheries catches (~270,000 tonnes were over 200% higher than the 114,862 tonnes of reported catch that were assumed to represent the small-scale sector in FAO data. Subsistence catches made up almost 93% of small-scale catches, followed by artisanal and recreational catches with ~7 and <1%, respectively. By continuously improving the fisheries data of Vanuatu for both the past and the present, policy makers, stakeholders, and fishers can make better decisions that will maintain the benefits of marine fishery resources.

  19. Maxillary reconstruction with a double-barrel osteocutaneous fibular flap and arteriovenous saphenous loop after a globe-sparing total maxillectomy-A Case Report.

    Science.gov (United States)

    Chen, Szu-Han; Hung, Kuo-Shu; Lee, Yao-Chou

    2017-05-01

    Maxillary reconstruction using titanium mesh or bone grafts can invite unwanted complications, such as graft resorption, infection, and mesh exposure, especially for patients who require postoperative radiotherapy. Here, we reported a 58-year-old male patient who was diagnosed with maxillary sinus squamous cell carcinoma. The patient received cancer ablation by a globe-sparing total maxillectomy and was immediately reconstructed with a double-barrel osteocutaneous fibular flap to simultaneously restore the alveolar ridge, orbital support, and oro-sinonasal separation. The short pedicle length inherent in the double-barrel design of the fibular flap and the depletion of healthy recipient vessels in the midface after cancer ablation were overcome by creating an arteriovenous saphenous loop in the neck region. Though there was venous congestion on postoperative day 2, the postoperative recovery was uneventful after the revision of the venous anastomoses. During the 6-months follow-up, the outcome was functionally and aesthetically satisfactory. We believe that the double-barrel fibular osteocutaneous flap, which avoids using titanium mesh and bone grafts, may be a viable reconstructive option in cancer patients with globe-sparing total maxillectomy defects, especially for those who require postoperative radiotherapy. © 2015 Wiley Periodicals, Inc. Microsurgery 37:334-338, 2017. © 2015 Wiley Periodicals, Inc.

  20. Variability of the total ozone trend over Europe for the period 1950─2004 derived from reconstructed data

    Directory of Open Access Journals (Sweden)

    J. L. Borkowski

    2008-06-01

    Full Text Available The total ozone data over Europe are available for only few ground-based stations in the pre-satellite era disallowing examination of the spatial trend variability over the whole continent. A need of having gridded ozone data for a trend analysis and input to radiative transfer models stimulated a reconstruction of the daily ozone values since January 1950. Description of the reconstruction model and its validation were a subject of our previous paper. The data base used was built within the objectives of the COST action 726 "Long-term changes and climatology of UV radiation over Europe". Here we focus on trend analyses. The long-term variability of total ozone is discussed using results of a flexible trend model applied to the reconstructed total ozone data for the period 1950–2004. The trend pattern, which comprises both anthropogenic and "natural" component, is not a priori assumed but it comes from a smooth curve fit to the zonal monthly means and monthly grid values. The ozone long-term changes are calculated separately for cold (October–next year April and warm (May–September seasons. The confidence intervals for the estimated ozone changes are derived by the block bootstrapping. The statistically significant negative trends are found almost over the whole Europe only in the period 1985–1994. Negative trends up to −3% per decade appeared over small areas in earlier periods when the anthropogenic forcing on the ozone layer was weak . The statistically positive trends are found only during warm seasons 1995–2004 over Svalbard archipelago. The reduction of ozone level in 2004 relative to that before the satellite era is not dramatic, i.e., up to ~−5% and ~−3.5% in the cold and warm subperiod, respectively. Present ozone level is still depleted over many popular resorts in southern Europe and northern Africa. For high latitude regions the trend overturning could be inferred in last decade (1995–2004 as the ozone depleted

  1. 20-year experience with iatrogenic penile injury.

    Science.gov (United States)

    Amukele, Samuel A; Lee, Gene W; Stock, Jeffrey A; Hanna, Moneer K

    2003-10-01

    We review our experience with the management of iatrogenic penile injuries. Apart from circumcision, serious damage to the penis can occur following hypospadias repair, surgery for priapism or total loss of the penis following surgical repair of bladder exstrophy. A retrospective analysis of patients with iatrogenic penile amputation referred to us between 1980 and 2000 was undertaken. Causes of injury and choice of management were reviewed. Of the 13 cases treated during the 20-year period mechanism of primary injury was circumcision in 4, hypospadias repair in 6, priapism in 1, bladder exstrophy repair in 1 and penile carcinoma in 1. A variety of techniques were used for phallic reconstruction. Penile degloving, division of suspensory ligament and rotational skin flaps achieved penile augmentation and enhancement. Reasonable cosmesis and penile length were achieved in all cases. In indicated cases microsurgical phalloplasty was technically feasible. However long-term followup showed various complications including erosions from the use of a penile stiffener. The ultimate goal of reconstructive surgery is to have a penis with normal function and appearance. The management of penile injury requires a wide variety of surgical techniques that are tailored to the individual patient. Expedient penile reconstruction is successful and therapeutic delay is associated with complications.

  2. The Importance of a Conchal Bowl Element in the Fabrication of a Three-Dimensional Framework in Total Auricular Reconstruction

    Directory of Open Access Journals (Sweden)

    Young Soo Kim

    2013-05-01

    Full Text Available BackgroundTo construct a sophisticated three-dimensional framework, numerous modifications have been reported in the literature. However, most surgeons have paid little attention to the anatomical configuration of the concha and more to its deepness and hollowness, leading to unsatisfactory outcomes.MethodsFor a configuration of the concha that is definitely anatomical, the author further developed and employed the conchal bowl element, which has been used by several surgeons although the results have not been published elsewhere. The author constructed the conchal bowl element in one of three patterns according to the amount of available cartilages: one block, two-pieces, or a cymba bowl element only. A total of 20 patients underwent auricular reconstruction using a costal cartilage framework between 2009 and 2012. The 8 earliest reconstructions were performed without a conchal bowl element and the latter 12 with a conchal bowl element. The patients were followed up for more than 1 year. The aesthetic results were scored by evaluating characteristics involving the stability of the crus helicis, the conchal definition, and the smoothness of the helical curve.ResultsThe ears reconstructed early without a conchal bowl element showed a shallow and one or two incompletely separated concha with an obliterated cymba conchal space. They also did not have a realistic or smooth curve of the helix because of an unstable crus helicis. However, ears reconstructed later with the concha bowl element showed a definite crus helicis, deep cymba conchal space, and smooth helical curve.ConclusionsThe construction of the conchal bowl element is simple, not time-consuming procedure. It is suggested that the conchal bowl element must be constructed and attached to the main framework for natural configuration of the reconstructed ear.

  3. Accelerating an Ordered-Subset Low-Dose X-Ray Cone Beam Computed Tomography Image Reconstruction with a Power Factor and Total Variation Minimization.

    Science.gov (United States)

    Huang, Hsuan-Ming; Hsiao, Ing-Tsung

    2016-01-01

    In recent years, there has been increased interest in low-dose X-ray cone beam computed tomography (CBCT) in many fields, including dentistry, guided radiotherapy and small animal imaging. Despite reducing the radiation dose, low-dose CBCT has not gained widespread acceptance in routine clinical practice. In addition to performing more evaluation studies, developing a fast and high-quality reconstruction algorithm is required. In this work, we propose an iterative reconstruction method that accelerates ordered-subsets (OS) reconstruction using a power factor. Furthermore, we combine it with the total-variation (TV) minimization method. Both simulation and phantom studies were conducted to evaluate the performance of the proposed method. Results show that the proposed method can accelerate conventional OS methods, greatly increase the convergence speed in early iterations. Moreover, applying the TV minimization to the power acceleration scheme can further improve the image quality while preserving the fast convergence rate.

  4. Reconstruction of a total avulsion of the hepatic veins and the suprahepatic inferior vena cava secondary to blunt thoracoabdominal trauma.

    Science.gov (United States)

    Kaemmerer, Daniel; Daffner, Wolfgang; Niwa, Martin; Kuntze, Thomas; Hommann, Merten

    2011-02-01

    Blunt injury to the inferior vena cava is a rare but dramatic event having a high mortality up to 80%. The mortality increases after total avulsion especially in combination with secondary intra-abdominal injuries. We report on a 15-year-old boy who sustained a blunt trauma with a total, partially covered avulsion of the hepatic veins and the suprahepatic inferior vena cava. We treated the patient under internal bypassing of the retrohepatic vena cava by using the heart-lung machine and reconstructed the hepatic veins and suprahepatic vena cava with a conduit made of pericard.

  5. Noise properties of CT images reconstructed by use of constrained total-variation, data-discrepancy minimization

    DEFF Research Database (Denmark)

    Rose, Sean; Andersen, Martin S.; Sidky, Emil Y.

    2015-01-01

    Purpose: The authors develop and investigate iterative image reconstruction algorithms based on data-discrepancy minimization with a total-variation (TV) constraint. The various algorithms are derived with different data-discrepancy measures reflecting the maximum likelihood (ML) principle......: An incremental algorithm framework is developed for this purpose. The instances of the incremental algorithms are derived for solving optimization problems including a data fidelity objective function combined with a constraint on the image TV. For the data fidelity term the authors, compare application....... Simulations demonstrate the iterative algorithms and the resulting image statistical properties for low-dose CT data acquired with sparse projection view angle sampling. Of particular interest is to quantify improvement of image statistical properties by use of the ML data fidelity term. Methods...

  6. Total Maxillary Reconstruction Using a Double-Barreled and Double Skin Paddle Fibular Flap after Total Maxillectomy

    Directory of Open Access Journals (Sweden)

    Miguel de la Parra

    2013-11-01

    Full Text Available 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.

  7. Total Maxillary Reconstruction Using a Double-Barreled and Double Skin Paddle Fibular Flap after Total Maxillectomy

    Science.gov (United States)

    Sanchez, Gerardo; Lopez, Jaime; Perez, Adrian; Naal, Norberto

    2013-01-01

    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. PMID:24286054

  8. Our Clinical Experience in Lower Eyelid Reconstruction and Comparison of Reconstruction Techniques.

    Directory of Open Access Journals (Sweden)

    Erol Kesiktas

    2011-03-01

    Full Text Available Lower eyelid reconstruction after tumor resection or trauma is extremely important in order to obtain the protection of the globe and it requires extra care. The aim of this study is to evaluate the techniques that we use in lower eyelid reconstruction. Between the years of 1999-2009, a total of 23 patients who had lower eyelid defects due to tumor resection (21 patients or trauma (2 patients were reconstructed by the use of various flaps. Eleven of the patients were women and twelve of them were men. Average age was 60.7. For the reconstruction 13 Mustarde flap, 9 bipedicled Tripier flap, 1 Tenzel flap and 1 bipedicled infraorbital flaps were used. Average postoperative follow up interval was 35 months. (18-47 months. Flap necrosis, function loss in the lower lid were not experienced in any of the patients. Cosmetically satisfactory results were obtained. In lower eyelid reconstruction, the size of the defect and the amount of skin around must be carefully evaluated and should be considered while planning the reconstruction. [Cukurova Med J 2011; 36(1: 15-23

  9. Reconstruction of the esophagojejunostomy by double stapling method using EEA™ OrVil™ in laparoscopic total gastrectomy and proximal gastrectomy

    Directory of Open Access Journals (Sweden)

    Yano Seiji

    2011-05-01

    Full Text Available Abstract Here we report the method of anastomosis based on double stapling technique (hereinafter, DST using a trans-oral anvil delivery system (EEATM OrVilTM for reconstructing the esophagus and lifted jejunum following laparoscopic total gastrectomy or proximal gastric resection. As a basic technique, laparoscopic total gastrectomy employed Roux-en-Y reconstruction, laparoscopic proximal gastrectomy employed double tract reconstruction, and end-to-side anastomosis was used for the cut-off stump of the esophagus and lifted jejunum. We used EEATM OrVilTM as a device that permitted mechanical purse-string suture similarly to conventional EEA, and endo-Surgitie. After the gastric lymph node dissection, the esophagus was cut off using an automated stapler. EEATM OrVilTM was orally and slowly inserted from the valve tip, and a small hole was created at the tip of the obliquely cut-off stump with scissors to let the valve tip pass through. Yarn was cut to disconnect the anvil from a tube and the anvil head was retained in the esophagus. The end-Surgitie was inserted at the right subcostal margin, and after the looped-shaped thread was wrapped around the esophageal stump opening, assisting Maryland forceps inserted at the left subcostal and left abdomen were used to grasp the left and right esophageal stump. The surgeon inserted anvil grasping forceps into the right abdomen, and after grasping the esophagus with the forceps, tightened the end Surgitie, thereby completing the purse-string suture on the esophageal stump. The main unit of the automated stapler was inserted from the cut-off stump of the lifted jejunum, and a trocar was made to pass through. To prevent dropout of the small intestines from the automated stapler, the automated stapler and the lifted jejunum were fastened with silk thread, the abdomen was again inflated, and the lifted jejunum was led into the abdominal cavity. When it was confirmed that the automated stapler and center rod

  10. Reduction corporoplasty.

    Science.gov (United States)

    Hakky, Tariq S; Martinez, Daniel; Yang, Christopher; Carrion, Rafael E

    2015-01-01

    Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell disease and priapism. Surgical management of aneurysmal dilation of the corpora has yet to be defined in the literature. We preformed bilateral elliptical incisions over the lateral corpora as management of aneurysmal dilation of the corpora to correct phallic disfigurement. The patient tolerated the procedure well and has resolution of his corporal disfigurement. Reduction corporoplasty using bilateral lateral elliptical incisions in the management of aneurysmal dilation of the corpora is a safe an feasible operation in the management of phallic disfigurement.

  11. AMECM/DCB scaffold prompts successful total meniscus reconstruction in a rabbit total meniscectomy model.

    Science.gov (United States)

    Yuan, Zhiguo; Liu, Shuyun; Hao, Chunxiang; Guo, Weimin; Gao, Shuang; Wang, Mingjie; Chen, Mingxue; Sun, Zhen; Xu, Yichi; Wang, Yu; Peng, Jiang; Yuan, Mei; Guo, Quan-Yi

    2016-12-01

    Tissue-engineered meniscus regeneration is a very promising treatment strategy for meniscus lesions. However, generating the scaffold presents a huge challenge for meniscus engineering as this has to meet particular biomechanical and biocompatibility requirements. In this study, we utilized acellular meniscus extracellular matrix (AMECM) and demineralized cancellous bone (DCB) to construct three different types of three-dimensional porous meniscus scaffold: AMECM, DCB, and AMECM/DCB, respectively. We tested the scaffolds' physicochemical characteristics and observed their interactions with meniscus fibrochondrocytes to evaluate their cytocompatibility. We implanted the three different types of scaffold into the medial knee menisci of New Zealand rabbits that had undergone total meniscectomy; negative control rabbits received no implants. The reconstructed menisci and corresponding femoral condyle and tibial plateau cartilage were all evaluated at 3 and 6 months (n = 8). The in vitro study demonstrated that the AMECM/DCB scaffold had the most suitable biomechanical properties, as this produced the greatest compressive and tensile strength scores. The AMECM/DCB and AMECM scaffolds facilitated fibrochondrocyte proliferation and the secretion of collagen and glycosaminoglycans (GAGs) more effectively than did the DCB scaffold. The in vivo experiments demonstrated that both the AMECM/DCB and DCB groups had generated neomeniscus at both 3 and 6 months post-implantation, but there was no obvious meniscus regeneration in the AMECM or control groups, so the neomeniscus analysis could not perform on AMECM and control group. At both 3 and 6 months, histological scores were better for regenerated menisci in the AMECM/DCB than in the DCB group, and significantly better for articular cartilage in the AMECM/DCB group compared with the other three groups. Knee MRI scores (Whole-Organ Magnetic Resonance Imaging Scores (WORMS)) were better in the AMECM/DCB group than in the

  12. Methods and results of reconstruction of 131I concentration in milk from total beta-activity measurements in Belarus after Chernobyl

    International Nuclear Information System (INIS)

    Savkin, Mikhail; Shinkarev, Sergey; Titov, Alexey

    2008-01-01

    Full text: During the first few weeks following the Chernobyl accident a large scale monitoring of radioactive contamination of foodstuffs locally produced was carried out in the most contaminated areas of Belarus. Due to a lack of spectrometric instruments, radiometric devices (DP-100) were used for beta activity measurements mostly of milk and milk products. Because the intake of 131 I with milk was the main contributor of the thyroid dose for the Belarus population, it is very important to reconstruct levels of 131 I in milk for Belarus settlements. The purpose of the paper is to present the methods and results of assessing the 13I concentration in milk based on historical records of total-beta activity measurements carried out in April-June 1986 in Belarus. The results of reconstruction of the 131 I concentration in milk will be used in on-going epidemiologic studies of a cohort of Belarus children. About 20,000 total-beta activity measurements were used in the analysis; for about 50% of those, the measurement result exceeded the minimum detectable activity. Estimates of 131 I concentration in milk at the date of sampling and of time-integrated milk concentrations were reconstructed for 482 settlements in Gomel Oblast and for 100 settlements in Mogilev Oblast, the most contaminated areas in Belarus, where at least one milk measurement was available. The assessment of the 131 I concentrations in milk involved: 1) An analysis of the calibration coefficients of the detectors for radionuclides available in milk (the main radionuclides were 131 I, 132 4Cs, 137 Cs, 89 Sr, 90 Sr); and 2) An assessment of the relative activity distribution of those radionuclides in milk. Only measurements made before 21 May 1986 were considered to be reliable, as the measurements conducted late May and in June were found to be unreliable because of the decrease in 131 I concentrations and the growing influence of other radionuclides with longer half-lives. Analysis of multiple

  13. Total hip reconstruction in acetabular dysplasia.

    NARCIS (Netherlands)

    Schller, H.M.; Dalstra, M.; Huiskes, R.; Marti, R.K.

    1993-01-01

    In acetabular dysplasia, fixation of the acetabular component of a cemented total hip prosthesis may be insecure and superolateral bone grafts are often used to augment the acetabular roof. We used finite element analysis to study the mechanical importance of the lateral acetabular roof and found

  14. Autograft reconstructions for bone defects in primary total knee replacement in severe varus knees

    Directory of Open Access Journals (Sweden)

    Yatinder Kharbanda

    2014-01-01

    Full Text Available Background: Large posteromedial defects encountered in severe varus knees during primary total knee arthroplasty can be treated by cementoplasty, structural bone grafts or metallic wedges. The option is selected depending upon the size of the defect. We studied the outcome of autograft (structural and impaction bone grafting reconstruction of medial tibial bone defects encountered during primary total knee replacement in severe varus knees. Materials and Methods: Out of 675 primary varus knees operated, bone defects in proximal tibia were encountered in 54 knees. Posteromedial defects involving 25-40% of the tibial condyle cut surface and measuring more than 5 mm in depth were grafted using a structural graft obtained from cut distal femur or proximal tibia in 48 knees. For larger, peripheral uncontained vertical defects in six cases, measuring >25 mm in depth and involving >40% cut surface of proximal tibial condyle, impaction bone grafting with a mesh support was used. Results: Bone grafts incorporated in 54 knees in 6 months. There was no graft collapse or stress fractures, loosening or nonunion. The average followup period was 7.8 years (range 5-10 years. We observed an average postoperative increase in the Knee Society Score from 40 to 90 points. There was improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC scores in terms of pain, stiffness and physical function during activities of daily living. Conclusion: Bone grafting for defects in primary total knee is justified as it is biological, available then and is cost effective besides preserving bone stock for future revisions. Structural grafts should be used in defects >5 mm deep and involving 25-40% of the cut proximal tibial condyle surface. For larger peripheral vertical defects, impaction bone grafting contained in a mesh should be done.

  15. Split-Bregman-based sparse-view CT reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Vandeghinste, Bert; Vandenberghe, Stefaan [Ghent Univ. (Belgium). Medical Image and Signal Processing (MEDISIP); Goossens, Bart; Pizurica, Aleksandra; Philips, Wilfried [Ghent Univ. (Belgium). Image Processing and Interpretation Research Group (IPI); Beenhouwer, Jan de [Ghent Univ. (Belgium). Medical Image and Signal Processing (MEDISIP); Antwerp Univ., Wilrijk (Belgium). The Vision Lab; Staelens, Steven [Ghent Univ. (Belgium). Medical Image and Signal Processing (MEDISIP); Antwerp Univ., Edegem (Belgium). Molecular Imaging Centre Antwerp

    2011-07-01

    Total variation minimization has been extensively researched for image denoising and sparse view reconstruction. These methods show superior denoising performance for simple images with little texture, but result in texture information loss when applied to more complex images. It could thus be beneficial to use other regularizers within medical imaging. We propose a general regularization method, based on a split-Bregman approach. We show results for this framework combined with a total variation denoising operator, in comparison to ASD-POCS. We show that sparse-view reconstruction and noise regularization is possible. This general method will allow us to investigate other regularizers in the context of regularized CT reconstruction, and decrease the acquisition times in {mu}CT. (orig.)

  16. Reduction Corporoplasty

    Directory of Open Access Journals (Sweden)

    Tariq S. Hakky

    2015-04-01

    Full Text Available Objective Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell disease and priapism. Introduction Surgical management of aneurysmal dilation of the corpora has yet to be defined in the literature. Materials and Methods: We preformed bilateral elliptical incisions over the lateral corpora as management of aneurysmal dilation of the corpora to correct phallic disfigurement. Results The patient tolerated the procedure well and has resolution of his corporal disfigurement. Conclusions Reduction corporoplasty using bilateral lateral elliptical incisions in the management of aneurysmal dilation of the corpora is a safe an feasible operation in the management of phallic disfigurement.

  17. Comparison of reconstructed radial pin total fission rates with experimental results in full scale BWR fuel elements

    Energy Technology Data Exchange (ETDEWEB)

    Giust, Flavio [Paul Scherrer Institute, CH-5232 Villigen PSI (Switzerland); Ecole Polytechnique Federale de Lausanne, CH-1015 Lausanne (Switzerland); Nordostschweizerische Kraftwerke AG, Parkstrasse 23, CH-5401 Baden (Switzerland); Grimm, Peter; Jatuff, Fabian [Paul Scherrer Institute, CH-5232 Villigen PSI (Switzerland); Chawla, Rakesh [Paul Scherrer Institute, CH-5232 Villigen PSI (Switzerland); Ecole Polytechnique Federale de Lausanne, CH-1015 Lausanne (Switzerland)

    2008-07-01

    Total fission rate measurements have been performed on full size BWR fuel assemblies of type SVEA-96+ in the zero power reactor PROTEUS at the Paul Scherrer Institute. This work presents comparisons of reconstructed 2D pin fission rates in two configurations, I-1A and I-2A. Both configurations contain, in the central test zone, an array of 3x3 SVEA-96+ fuel elements moderated with light water at 20 deg. C. In configuration I-2A, an L-shaped hafnium control blade (half of a real cruciform blade) is inserted adjacent to the NW corner of the central fuel element. To minimize the impact of the surroundings, all measurements were done in fuel pins belonging to the central assembly. The 3x3 experimental configuration was modeled using the core monitoring and design tools that are applied at the Leibstadt Nuclear Power Plant (KKL). These are the 2D transport code HELIOS, used for the cross-section generation, and the 3D, 2-group nodal diffusion code PRESTO-2. The exterior is represented, in the axial and radial directions, by 2-group albedos calculated at the test zone boundary using a full-core 3D MCNPX model. The calculated-to-experimental (C/E) ratios of the total fission rates have a standard deviation of 1.3% in configuration I-1A (uncontrolled) and 3.2% in configuration I-2A (controlled). Sensitivity cases are analyzed to show the impact of certain parameters on the calculated fission rate distribution and reactivity. It is shown that the relative pin fission rate is only weakly dependent on these parameters. In cases without a control blade, the pin power reconstruction methodology delivers the same level of accuracy as 2D transport calculations. On the other hand, significant deviations, that are inherent to the use of reflected geometry in the lattice calculations, are observed in cases when the control blade is inserted. (authors)

  18. Urogenital function after cloacal reconstruction, two techniques evaluated

    NARCIS (Netherlands)

    Versteegh, H.P.; Sloots, C.E.J.; Wolffenbuttel, K.P.; Jong, J.R. de; Sleeboom, C.; Feitz, W.F.J.; Heurn, L.W.E. van; Zee, D.C. van der; Wijnen, R.M.H.; Blaauw, I. de

    2014-01-01

    OBJECTIVE: Current surgical techniques for cloacal reconstruction are posterior sagittal anorecto vagino urethroplasty (PSARVUP) and posterior sagittal anorectoplasty (PSARP) with total urogenital mobilization (TUM). The aim of this study was to explore the results of reconstructive cloaca surgery

  19. Urogenital function after cloacal reconstruction, two techniques evaluated

    NARCIS (Netherlands)

    Versteegh, Hendt P.; Sloots, Cornelius E. J.; Wolffenbuttel, Katja P.; de Jong, Justin R.; Sleeboom, Christien; Feitz, Wout F.; van Heurn, L. W. Ernest; van der Zee, David C.; Wijnen, Rene M. H.; de Blaauw, Ivo

    2014-01-01

    Current surgical techniques for cloacal reconstruction are posterior sagittal anorecto vagino urethroplasty (PSARVUP) and posterior sagittal anorectoplasty (PSARP) with total urogenital mobilization (TUM). The aim of this study was to explore the results of reconstructive cloaca surgery in the

  20. Adaptive-weighted total variation minimization for sparse data toward low-dose x-ray computed tomography image reconstruction.

    Science.gov (United States)

    Liu, Yan; Ma, Jianhua; Fan, Yi; Liang, Zhengrong

    2012-12-07

    Previous studies have shown that by minimizing the total variation (TV) of the to-be-estimated image with some data and other constraints, piecewise-smooth x-ray computed tomography (CT) can be reconstructed from sparse-view projection data without introducing notable artifacts. However, due to the piecewise constant assumption for the image, a conventional TV minimization algorithm often suffers from over-smoothness on the edges of the resulting image. To mitigate this drawback, we present an adaptive-weighted TV (AwTV) minimization algorithm in this paper. The presented AwTV model is derived by considering the anisotropic edge property among neighboring image voxels, where the associated weights are expressed as an exponential function and can be adaptively adjusted by the local image-intensity gradient for the purpose of preserving the edge details. Inspired by the previously reported TV-POCS (projection onto convex sets) implementation, a similar AwTV-POCS implementation was developed to minimize the AwTV subject to data and other constraints for the purpose of sparse-view low-dose CT image reconstruction. To evaluate the presented AwTV-POCS algorithm, both qualitative and quantitative studies were performed by computer simulations and phantom experiments. The results show that the presented AwTV-POCS algorithm can yield images with several notable gains, in terms of noise-resolution tradeoff plots and full-width at half-maximum values, as compared to the corresponding conventional TV-POCS algorithm.

  1. Trends in breast reconstruction: Implications for the National Health Insurance Service

    Directory of Open Access Journals (Sweden)

    Ki Yong Hong

    2018-05-01

    Full Text Available Background Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Methods Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. Results At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases in 2012 to 18.3% (76 cases in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (P<0.05. Among the IBR cases, the percentage of prosthesis-based reconstructions increased significantly (P<0.05, but this trend was not found with DBR. Total mastectomy became significantly more common after the expansion of NHIS coverage (P<0.05. Conclusions Over the last decade, there has been an increase in mastectomy and breast reconstruction, and the pace of increase accelerated after the expansion of NHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.

  2. Total endoscopic free flap harvest of a serratus anterior fascia flap for microsurgical lower leg reconstruction

    Directory of Open Access Journals (Sweden)

    Erdmann, Alfons

    2014-04-01

    Full Text Available [english] Background: A tremendous number of free flaps have been developed in the past. As the surgical result depends not only on a successful flap transfer but also on the harvest, this paper details the procedures for undertaking the first total endoscopic harvest of a serratus fascia flap for free flap transplantation to the lower leg. Patient and methods: In September 2012 we performed the first total endoscopic serratus anterior fascia free flap harvest. The incision of 2.5 cm length was made 10 cm in front of anterior muscle border of the latissimus dorsi at level with the midthorax. After insertion of a flexible laparoscopic single port system we started CO gas insufflation. We used this setting to meticulously prepare a neo cavity between atissimus dorsi and M. serratus anterior. The vessels were dissected and the thoraco-dorsal nerve was separated. With a second auxiliary incision we used a clamp to support the raising of the fascia flap from the underlying muscle. Finally we clipped the vessels to the latissimus dorsi muscle and the flap vessels at the Arteria and Vena axillaris. The flap was extracted via the 2.5 cm incision.Results: We were able to perform a total endoscopic harvest of a serratus fascia flap for free flap reconstruction of soft tissues. With this new operative technique we were able to avoid a long skin incision, which in our view lowers the morbidity at the harvest area.Conclusion: We describe a new method for the total endoscopic harvest of the serratus fascia flap for free flap transfer. The flap was harvested within reasonable time and following surgery leaves the patient with minimal donor site morbidity compared to the open technique.

  3. Reconstructed image of human heart for total artificial heart implantation, based on MR image and cast silicone model of heart

    International Nuclear Information System (INIS)

    Komoda, Takashi; Maeta, Hajime; Uyama, Chikao.

    1991-01-01

    Based on transverse (TRN) and LV long axis (LAX) MR images of two cadaver hearts, three-dimensional (3-D) computer models of the connecting interface between remaining heart and total artificial heart, i.e., mitral and tricuspid valvular annuli (MVA and TVA), ascending aorta (Ao) and pulmonary artery (PA), were reconstructed to compare the shape and the size of MVA and those of TVA, the distance between the center of MVA and TVA (D G ), the angle between the plane of MVA and that of TVA (R T ), and the angles of Ao and PA, respectively, to the plane of MVA (R A , R P ), with those obtained in cast silicone models. It was found that based on LAX rather than TRN MR image, MVA and TVA might be more precisely reconstructed. The data obtained in 3-D images of MVA, TVA, Ao and PA based on silicone models of 32 hearts were as follows: D G (cm): 4.17±0.43, R T (degrees): 22.1±11.3, R A (degrees): 54.9±15.3, R P (degrees): 30.8±17.1. (author)

  4. Trends in breast reconstruction: Implications for the National Health Insurance Service.

    Science.gov (United States)

    Hong, Ki Yong; Son, Yoosung; Chang, Hak; Jin, Ung Sik

    2018-05-01

    Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS) began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR) cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR) cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases) in 2012 to 18.3% (76 cases) in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (PNHIS coverage (PNHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.

  5. Digestive tract reconstruction using isoperistaltic jejunum-later-cut overlap method after totally laparoscopic total gastrectomy for gastric cancer: Short-term outcomes and impact on quality of life.

    Science.gov (United States)

    Huang, Ze-Ning; Huang, Chang-Ming; Zheng, Chao-Hui; Li, Ping; Xie, Jian-Wei; Wang, Jia-Bin; Lin, Jian-Xian; Lu, Jun; Chen, Qi-Yue; Cao, Long-Long; Lin, Mi; Tu, Ru-Hong; Lin, Ju-Li

    2017-10-21

    To evaluate the short-term outcomes and quality of life (QoL) in gastric cancer patients undergoing digestive tract construction using the isoperistaltic jejunum-later-cut overlap method (IJOM) after totally laparoscopic total gastrectomy (TLTG). A total of 507 patients who underwent laparoscopic gastrectomy (D2) from January 2014 to March 2016 were originally included in the study. The patients were divided into two groups to undergo digestive tract construction using either IJOM after TLTG (group T, n = 51) or Roux-en-Y anastomosis after laparoscopic-assisted total gastrectomy (LATG) (group A, n = 456). The short-term outcomes and QoL were compared between the two groups after 1:2 propensity-score matching (PSM). We used a questionnaire to assess QoL. Before matching, age, sex, tumor size, tumor location, preoperative albumin and blood loss were significantly different between the two groups ( P < 0.05). After PSM, the patients were well balanced in terms of their clinicopathological characteristics, although both blood loss and in-hospital postoperative days in group T were significantly lower than those in group A ( P < 0.05). After matching, group T reported better QoL in the domains of pain and dysphagia. Among the items evaluating pain and dysphagia, group T tended to report better QoL ("Have you felt pain" and "Have you had difficulty eating solid food") ( P < 0.05). The IJOM for digestive tract reconstruction after TLTG is associated with reduced blood loss and less pain and dysphagia, thus improving QoL after laparoscopic gastrectomy.

  6. Antibiotic impregnated total femur spacers: a technical tip

    Directory of Open Access Journals (Sweden)

    Colin D. Canham, MD

    2018-03-01

    Full Text Available Simultaneous prosthetic joint infection of ipsilateral hip and knee arthroplasties is often accompanied by significant bone loss and presents a challenging reconstructive problem. Two-stage reconstruction is favored and requires the placement of a total femur spacer, which is not a commercially available device. We describe a surgical technique, reporting on 2 cases in which a customized total femur antibiotic impregnated spacer was created by combining an articulating knee spacer and an articulating hip spacer with a reinforced cement dowel construct connecting the 2 spacers. Custom total femoral spacers are useful in the management of infected femoral megaprostheses and cases with ipsilateral injected hip and knee arthroplasties and severe femoral bone loss. Keywords: total femur spacer, revision arthroplasty, total hip arthroplasty, total knee arthroplasty, prosthetic joint infection

  7. Photoacoustic image reconstruction via deep learning

    Science.gov (United States)

    Antholzer, Stephan; Haltmeier, Markus; Nuster, Robert; Schwab, Johannes

    2018-02-01

    Applying standard algorithms to sparse data problems in photoacoustic tomography (PAT) yields low-quality images containing severe under-sampling artifacts. To some extent, these artifacts can be reduced by iterative image reconstruction algorithms which allow to include prior knowledge such as smoothness, total variation (TV) or sparsity constraints. These algorithms tend to be time consuming as the forward and adjoint problems have to be solved repeatedly. Further, iterative algorithms have additional drawbacks. For example, the reconstruction quality strongly depends on a-priori model assumptions about the objects to be recovered, which are often not strictly satisfied in practical applications. To overcome these issues, in this paper, we develop direct and efficient reconstruction algorithms based on deep learning. As opposed to iterative algorithms, we apply a convolutional neural network, whose parameters are trained before the reconstruction process based on a set of training data. For actual image reconstruction, a single evaluation of the trained network yields the desired result. Our presented numerical results (using two different network architectures) demonstrate that the proposed deep learning approach reconstructs images with a quality comparable to state of the art iterative reconstruction methods.

  8. Advanced reconstruction algorithms for electron tomography: From comparison to combination

    Energy Technology Data Exchange (ETDEWEB)

    Goris, B. [EMAT, University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerp (Belgium); Roelandts, T. [Vision Lab, University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk (Belgium); Batenburg, K.J. [Vision Lab, University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk (Belgium); Centrum Wiskunde and Informatica, Science Park 123, NL-1098XG Amsterdam (Netherlands); Heidari Mezerji, H. [EMAT, University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerp (Belgium); Bals, S., E-mail: sara.bals@ua.ac.be [EMAT, University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerp (Belgium)

    2013-04-15

    In this work, the simultaneous iterative reconstruction technique (SIRT), the total variation minimization (TVM) reconstruction technique and the discrete algebraic reconstruction technique (DART) for electron tomography are compared and the advantages and disadvantages are discussed. Furthermore, we describe how the result of a three dimensional (3D) reconstruction based on TVM can provide objective information that is needed as the input for a DART reconstruction. This approach results in a tomographic reconstruction of which the segmentation is carried out in an objective manner. - Highlights: ► A comparative study between different reconstruction algorithms for tomography is performed. ► Reconstruction algorithms that uses prior knowledge about the specimen have a superior result. ► One reconstruction algorithm can provide the prior knowledge for a second algorithm.

  9. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.

    Science.gov (United States)

    Movahed, Reza; Teschke, Marcus; Wolford, Larry M

    2013-12-01

    Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Outcome of revision total knee arthroplasty with the use of trabecular metal cone for reconstruction of severe bone loss at the proximal tibia

    DEFF Research Database (Denmark)

    Jensen, Claus L; Olsen, Nikolaj Winther; Schrøder, Henrik M

    2014-01-01

    technology (TMT) cones for the reconstruction of tibial bone loss at the time of rTKA. METHODS: Thirty-six patients had rTKA with the use of a TMT Cone. Bone loss was classified according to the AORI classification and 25% of the patients suffered from T3 AORI defects and 75% of the patients from T2 AORI...... defects. Implants used were from the NexGen series. At follow-up, radiographs were evaluated according to the Knee Society Roentgenographic Scoring System. Knee and function score was calculated using the Knee Society Clinical Rating System. Average follow-up time was 47 months (range 3-84 months......BACKGROUND: The relative effectiveness of different methods for reconstructing large bone loss at the proximal tibia in revision total knee arthroplasty (rTKA) has not been established. The aim of this study was to evaluate the clinical and radiological outcome after the use of trabecular metal...

  11. Tensor-based dictionary learning for dynamic tomographic reconstruction

    International Nuclear Information System (INIS)

    Tan, Shengqi; Wu, Zhifang; Zhang, Yanbo; Mou, Xuanqin; Wang, Ge; Cao, Guohua; Yu, Hengyong

    2015-01-01

    In dynamic computed tomography (CT) reconstruction, the data acquisition speed limits the spatio-temporal resolution. Recently, compressed sensing theory has been instrumental in improving CT reconstruction from far few-view projections. In this paper, we present an adaptive method to train a tensor-based spatio-temporal dictionary for sparse representation of an image sequence during the reconstruction process. The correlations among atoms and across phases are considered to capture the characteristics of an object. The reconstruction problem is solved by the alternating direction method of multipliers. To recover fine or sharp structures such as edges, the nonlocal total variation is incorporated into the algorithmic framework. Preclinical examples including a sheep lung perfusion study and a dynamic mouse cardiac imaging demonstrate that the proposed approach outperforms the vectorized dictionary-based CT reconstruction in the case of few-view reconstruction. (paper)

  12. Tensor-based Dictionary Learning for Dynamic Tomographic Reconstruction

    Science.gov (United States)

    Tan, Shengqi; Zhang, Yanbo; Wang, Ge; Mou, Xuanqin; Cao, Guohua; Wu, Zhifang; Yu, Hengyong

    2015-01-01

    In dynamic computed tomography (CT) reconstruction, the data acquisition speed limits the spatio-temporal resolution. Recently, compressed sensing theory has been instrumental in improving CT reconstruction from far few-view projections. In this paper, we present an adaptive method to train a tensor-based spatio-temporal dictionary for sparse representation of an image sequence during the reconstruction process. The correlations among atoms and across phases are considered to capture the characteristics of an object. The reconstruction problem is solved by the alternating direction method of multipliers. To recover fine or sharp structures such as edges, the nonlocal total variation is incorporated into the algorithmic framework. Preclinical examples including a sheep lung perfusion study and a dynamic mouse cardiac imaging demonstrate that the proposed approach outperforms the vectorized dictionary-based CT reconstruction in the case of few-view reconstruction. PMID:25779991

  13. Iterative reconstruction reduces abdominal CT dose

    International Nuclear Information System (INIS)

    Martinsen, Anne Catrine Trægde; Sæther, Hilde Kjernlie; Hol, Per Kristian; Olsen, Dag Rune; Skaane, Per

    2012-01-01

    Objective: In medical imaging, lowering radiation dose from computed tomography scanning, without reducing diagnostic performance is a desired achievement. Iterative image reconstruction may be one tool to achieve dose reduction. This study reports the diagnostic performance using a blending of 50% statistical iterative reconstruction (ASIR) and filtered back projection reconstruction (FBP) compared to standard FBP image reconstruction at different dose levels for liver phantom examinations. Methods: An anthropomorphic liver phantom was scanned at 250, 185, 155, 140, 120 and 100 mA s, on a 64-slice GE Lightspeed VCT scanner. All scans were reconstructed with ASIR and FBP. Four readers evaluated independently on a 5-point scale 21 images, each containing 32 test sectors. In total 672 areas were assessed. ROC analysis was used to evaluate the differences. Results: There was a difference in AUC between the 250 mA s FBP images and the 120 and 100 mA s FBP images. ASIR reconstruction gave a significantly higher diagnostic performance compared to standard reconstruction at 100 mA s. Conclusion: A blending of 50–90% ASIR and FBP may improve image quality of low dose CT examinations of the liver, and thus give a potential for reducing radiation dose.

  14. Low-dose CT imaging of a total hip arthroplasty phantom using model-based iterative reconstruction and orthopedic metal artifact reduction

    Energy Technology Data Exchange (ETDEWEB)

    Wellenberg, R.H.H.; Streekstra, G.J.; Maas, M. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Boomsma, M.F.; Osch, J.A.C. van [Department of Radiology, Zwolle (Netherlands); Vlassenbroek, A. [Philips Medical Systems, Brussels (Belgium); Milles, J. [Philips Medical Systems, Eindhoven (Netherlands); Edens, M.A. [Department of Innovation and Science, Zwolle (Netherlands); Slump, C.H. [University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Enschede (Netherlands)

    2017-05-15

    To compare quantitative measures of image quality, in terms of CT number accuracy, noise, signal-to-noise-ratios (SNRs), and contrast-to-noise ratios (CNRs), at different dose levels with filtered-back-projection (FBP), iterative reconstruction (IR), and model-based iterative reconstruction (MBIR) alone and in combination with orthopedic metal artifact reduction (O-MAR) in a total hip arthroplasty (THA) phantom. Scans were acquired from high- to low-dose (CTDI{sub vol}: 40.0, 32.0, 24.0, 16.0, 8.0, and 4.0 mGy) at 120- and 140- kVp. Images were reconstructed using FBP, IR (iDose{sup 4} level 2, 4, and 6) and MBIR (IMR, level 1, 2, and 3) with and without O-MAR. CT number accuracy in Hounsfield Units (HU), noise or standard deviation, SNRs, and CNRs were analyzed. The IMR technique showed lower noise levels (p < 0.01), higher SNRs (p < 0.001) and CNRs (p < 0.001) compared with FBP and iDose{sup 4} in all acquisitions from high- to low-dose with constant CT numbers. O-MAR reduced noise (p < 0.01) and improved SNRs (p < 0.01) and CNRs (p < 0.001) while improving CT number accuracy only at a low dose. At the low dose of 4.0 mGy, IMR level 1, 2, and 3 showed 83%, 89%, and 95% lower noise values, a factor 6.0, 9.2, and 17.9 higher SNRs, and 5.7, 8.8, and 18.2 higher CNRs compared with FBP respectively. Based on quantitative analysis of CT number accuracy, noise values, SNRs, and CNRs, we conclude that the combined use of IMR and O-MAR enables a reduction in radiation dose of 83% compared with FBP and iDose{sup 4} in the CT imaging of a THA phantom. (orig.)

  15. La violència de gènere, segons la psicoanàlisi

    Directory of Open Access Journals (Sweden)

    Miquel Bassols

    2010-06-01

    Full Text Available Concepts such as “gender” and “violence” must be interrogated by Lacanian psychoanalysis. Violence is not a natural drive in human beings but the product of the symbolic order and its segregation of a real object. The Lacanian concept of jouissance introduces new ethical consequences: there are different forms of jouissance; none of them is more truthful than another. For psychoanalysis the issue is not about genders, but about the sexual positions of the subject. In this sense, one should speak of the Phallic position and the Not-All position – beyond phallic logics. The so-called gender violence can be interpreted as an attempt by the Phallic position to segregate the Not-All from universal discourse. The only “therapeutics” against segregating violence is desire in so much as it is the desire of the Other.

  16. [Pelvic reconstructions after bone tumor resection].

    Science.gov (United States)

    Anract, Philippe; Biau, David; Babinet, Antoine; Tomeno, Bernard

    2014-02-01

    The three more frequent primitive malignant bone tumour which concerned the iliac bone are chondrosarcoma, following Ewing sarcoma and osteosarcoma. Wide resection remains the most important part of the treatment associated with chemotherapy for osteosarcoma and the Ewing sarcoma. Iliac wing resections and obdurate ring don't required reconstruction. However, acetabular resections and iliac wing resection with disruption of the pelvic ring required reconstruction to provide acceptable functional result. Acetabular reconstruction remains high technical demanding challenge. After isolated acetabular resection or associated to obdurate ring, our usual method of reconstruction is homolateral proximal femoral autograft and total hip prosthesis but it is possible to also used : saddle prosthesis, Mac Minn prosthesis with auto or allograft, modular prosthesis or custom made prosthesis, massive allograft with or without prosthesis and femoro-ilac arthrodesis. After resection of the iliac wing plus acetabulum, reconstruction can be performed by femoro-obturatrice and femora-sacral arthrodesis, homolateral proximal femoral autograft and prosthesis, femoral medialisation, massive allograft and massive allograft. Carcinological results are lesser than resection for distal limb tumor, local recurrence rate range 17 to 45%. Functional results after Iliac wing and obdurate ring are good. However, acetabular reconstruction provide uncertain functional results. The lesser results arrive after hemipelvic or acetabular and iliac wing resection-reconstruction, especially when gluteus muscles were also resected. The most favourable results arrive after isolated acetabular or acetabular plus obturateur ring resection-reconstruction.

  17. Nonexpansive immediate breast reconstruction using human acellular tissue matrix graft (AlloDerm).

    Science.gov (United States)

    Salzberg, C Andrew

    2006-07-01

    Immediate breast reconstruction has become a standard of care following mastectomy for cancer, largely due to improved esthetic and psychologic outcomes achieved with this technique. However, the current historical standards--transverse rectus abdominis myocutaneous flap reconstruction and expander--implant surgery-still have limitations as regards patient morbidity, short-term body-image improvements, and even cost. To address these shortcomings, we employ a novel concept of human tissue replacement to enhance breast shape and provide total coverage, enabling immediate mound reconstruction without the need for breast expansion prior to permanent implant placement. AlloDerm (human acellular tissue matrix) is a human-derived graft tissue with extensive experience in various settings of skin and soft tissue replacement surgery. This report describes the success using acellular tissue matrix to provide total coverage over the prosthesis in immediate reconstruction, with limited muscle dissection. In this population, 49 patients (76 breasts) successfully underwent the acellular tissue matrix-based immediate reconstruction, resulting in durable breast reconstruction with good symmetry. These findings may predict that acellular tissue matrix-supplemented immediate breast reconstruction will become a new technique for the immediate reconstruction of the postmastectomy breast.

  18. Prosthetic breast reconstruction: indications and update

    Science.gov (United States)

    Quinn, Tam T.; Miller, George S.; Rostek, Marie; Cabalag, Miguel S.; Rozen, Warren M.

    2016-01-01

    Background Despite 82% of patients reporting psychosocial improvement following breast reconstruction, only 33% patients choose to undergo surgery. Implant reconstruction outnumbers autologous reconstruction in many centres. Methods A systematic review of the literature was undertaken. Inclusion required: (I) Meta-analyses or review articles; (II) adult patients aged 18 years or over undergoing alloplastic breast reconstruction; (III) studies including outcome measures; (IV) case series with more than 10 patients; (V) English language; and (VI) publication after 1st January, 2000. Results After full text review, analysis and data extraction was conducted for a total of 63 articles. Definitive reconstruction with an implant can be immediate or delayed. Older patients have similar or even lower complication rates to younger patients. Complications include capsular contracture, hematoma and infection. Obesity, smoking, large breasts, diabetes and higher grade tumors are associated with increased risk of wound problems and reconstructive failure. Silicone implant patients have higher capsular contracture rates but have higher physical and psychosocial function. There were no associations made between silicone implants and cancer or systemic disease. There were no differences in outcomes or complications between round and shaped implants. Textured implants have a lower risk of capsular contracture than smooth implants. Smooth implants are more likely to be displaced as well as having higher rates of infection. Immediate breast reconstruction (IBR) gives the best aesthetic outcome if radiotherapy is not required but has a higher rate of capsular contracture and implant failure. Delayed-immediate reconstruction patients can achieve similar aesthetic results to IBR whilst preserving the breast skin if radiotherapy is required. Delayed breast reconstruction (DBR) patients have fewer complications than IBR patients. Conclusions Implant reconstruction is a safe and popular

  19. Thermal injury in TAPIA breast reconstruction

    DEFF Research Database (Denmark)

    Børsen-Koch, Mikkel; Gunnarsson, Gudjon L.; Sørensen, Jens Ahm

    2017-01-01

    be due to the relative high frequency of this type of reconstructions. Reports of thermal injury to reconstructions using the Latissimus Dorsi flap are rare. The injuries previously described are most often caused by severe heat exposure. The thoracodorsal artery perforator (TAP)-flap can be used...... as an alternative to the Latissimus Dorsi flap but it may be more susceptible to thermal insult due to the total denervation, the restricted blood supply and the limited thickness of the flap. Precautions are recommended to avoid this type of injury....

  20. Reconstruction of MODIS total suspended matter time series maps by DINEOF and validation with autonomous platform data

    Science.gov (United States)

    Nechad, Bouchra; Alvera-Azcaràte, Aida; Ruddick, Kevin; Greenwood, Naomi

    2011-08-01

    In situ measurements of total suspended matter (TSM) over the period 2003-2006, collected with two autonomous platforms from the Centre for Environment, Fisheries and Aquatic Sciences (Cefas) measuring the optical backscatter (OBS) in the southern North Sea, are used to assess the accuracy of TSM time series extracted from satellite data. Since there are gaps in the remote sensing (RS) data, due mainly to cloud cover, the Data Interpolating Empirical Orthogonal Functions (DINEOF) is used to fill in the TSM time series and build a continuous daily "recoloured" dataset. The RS datasets consist of TSM maps derived from MODIS imagery using the bio-optical model of Nechad et al. (Rem Sens Environ 114: 854-866, 2010). In this study, the DINEOF time series are compared to the in situ OBS measured in moderately to very turbid waters respectively in West Gabbard and Warp Anchorage, in the southern North Sea. The discrepancies between instantaneous RS, DINEOF-filled RS data and Cefas data are analysed in terms of TSM algorithm uncertainties, space-time variability and DINEOF reconstruction uncertainty.

  1. [Reconstructive surgery of cranio-orbital injuries].

    Science.gov (United States)

    Eolchiian, S A; Potapov, A A; Serova, N K; Kataev, M G; Sergeeva, L A; Zakharova, N E; Van Damm, P

    2011-01-01

    The aim of study was to optimize evaluation and surgery of cranioorbital injuries in different periods after trauma. Material and methods. We analyzed 374 patients with cranioorbital injuries treated in Burdenko Neurosurgery Institute in different periods after trauma from January 1998 till April 2010. 288 (77%) underwent skull and facial skeleton reconstructive surgery within 24 hours - 7 years after trauma. Clinical and CT examination data were used for preoperative planning and assessment of surgery results. Stereolithographic models (STLM) were applied for preoperative planning in 89 cases. The follow-up period ranged from 4 months up to 10 years. Results. In 254 (88%) of 288 patients reconstruction of anterior skull base, upper and/or midface with restoration of different parts of orbit was performed. Anterior skull base CSF leaks repair, calvarial vault reconstruction, maxillar and mandibular osteosynthesis were done in 34 (12%) cases. 242 (84%) of 288 patients underwent one reconstructive operation, while 46 (16%)--two and more (totally 105 operations). The patients with extended frontoorbital and midface fractures commonly needed more than one operation--in 27 (62.8%) cases. Different plastic materials were used for reconstruction in 233 (80.9%) patients, of those in 147 (51%) cases split calvarial bone grafts were preferred. Good functional and cosmetic results were achieved in 261 (90.6%) of 288 patients while acceptable were observed in 27 (9.4%). Conclusion. Active single-stage surgical management for repair of combined cranioorbital injury in acute period with primary reconstruction optimizes functional and cosmetic outcomes and prevents the problems of delayed or secondary reconstruction. Severe extended anterior skull base, upper and midface injuries when intracranial surgery is needed produced the most challenging difficulties for adequate reconstruction. Randomized trial is required to define the extent and optimal timing of reconstructive surgery

  2. Orbital floor reconstruction with free flaps after maxillectomy.

    Science.gov (United States)

    Sampathirao, Leela Mohan C S R; Thankappan, Krishnakumar; Duraisamy, Sriprakash; Hedne, Naveen; Sharma, Mohit; Mathew, Jimmy; Iyer, Subramania

    2013-06-01

    Background The purpose of this study is to evaluate the outcome of orbital floor reconstruction with free flaps after maxillectomy. Methods This was a retrospective analysis of 34 consecutive patients who underwent maxillectomy with orbital floor removal for malignancies, reconstructed with free flaps. A cross-sectional survey to assess the functional and esthetic outcome was done in 28 patients who were alive and disease-free, with a minimum of 6 months of follow-up. Results Twenty-six patients had bony reconstruction, and eight had soft tissue reconstruction. Free fibula flap was the commonest flap used (n = 14). Visual acuity was normal in 86%. Eye movements were normal in 92%. Abnormal globe position resulted in nine patients. Esthetic satisfaction was good in 19 patients (68%). Though there was no statistically significant difference in outcome of visual acuity, eye movement, and patient esthetic satisfaction between patients with bony and soft tissue reconstruction, more patients without bony reconstruction had abnormal globe position (p = 0.040). Conclusion Free tissue transfer has improved the results of orbital floor reconstruction after total maxillectomy, preserving the eye. Good functional and esthetic outcome was achieved. Though our study favors a bony orbital reconstruction, a larger study with adequate power and equal distribution of patients among the groups would be needed to determine this. Free fibula flap remains the commonest choice when a bony reconstruction is contemplated.

  3. Surface Reconstruction and Image Enhancement via $L^1$-Minimization

    KAUST Repository

    Dobrev, Veselin

    2010-01-01

    A surface reconstruction technique based on minimization of the total variation of the gradient is introduced. Convergence of the method is established, and an interior-point algorithm solving the associated linear programming problem is introduced. The reconstruction algorithm is illustrated on various test cases including natural and urban terrain data, and enhancement oflow-resolution or aliased images. Copyright © by SIAM.

  4. Position reconstruction in LUX

    Science.gov (United States)

    Akerib, D. S.; Alsum, S.; Araújo, H. M.; Bai, X.; Bailey, A. J.; Balajthy, J.; Beltrame, P.; Bernard, E. P.; Bernstein, A.; Biesiadzinski, T. P.; Boulton, E. M.; Brás, P.; Byram, D.; Cahn, S. B.; Carmona-Benitez, M. C.; Chan, C.; Currie, A.; Cutter, J. E.; Davison, T. J. R.; Dobi, A.; Druszkiewicz, E.; Edwards, B. N.; Fallon, S. R.; Fan, A.; Fiorucci, S.; Gaitskell, R. J.; Genovesi, J.; Ghag, C.; Gilchriese, M. G. D.; Hall, C. R.; Hanhardt, M.; Haselschwardt, S. J.; Hertel, S. A.; Hogan, D. P.; Horn, M.; Huang, D. Q.; Ignarra, C. M.; Jacobsen, R. G.; Ji, W.; Kamdin, K.; Kazkaz, K.; Khaitan, D.; Knoche, R.; Larsen, N. A.; Lenardo, B. G.; Lesko, K. T.; Lindote, A.; Lopes, M. I.; Manalaysay, A.; Mannino, R. L.; Marzioni, M. F.; McKinsey, D. N.; Mei, D.-M.; Mock, J.; Moongweluwan, M.; Morad, J. A.; Murphy, A. St. J.; Nehrkorn, C.; Nelson, H. N.; Neves, F.; O'Sullivan, K.; Oliver-Mallory, K. C.; Palladino, K. J.; Pease, E. K.; Rhyne, C.; Shaw, S.; Shutt, T. A.; Silva, C.; Solmaz, M.; Solovov, V. N.; Sorensen, P.; Sumner, T. J.; Szydagis, M.; Taylor, D. J.; Taylor, W. C.; Tennyson, B. P.; Terman, P. A.; Tiedt, D. R.; To, W. H.; Tripathi, M.; Tvrznikova, L.; Uvarov, S.; Velan, V.; Verbus, J. R.; Webb, R. C.; White, J. T.; Whitis, T. J.; Witherell, M. S.; Wolfs, F. L. H.; Xu, J.; Yazdani, K.; Young, S. K.; Zhang, C.

    2018-02-01

    The (x, y) position reconstruction method used in the analysis of the complete exposure of the Large Underground Xenon (LUX) experiment is presented. The algorithm is based on a statistical test that makes use of an iterative method to recover the photomultiplier tube (PMT) light response directly from the calibration data. The light response functions make use of a two dimensional functional form to account for the photons reflected on the inner walls of the detector. To increase the resolution for small pulses, a photon counting technique was employed to describe the response of the PMTs. The reconstruction was assessed with calibration data including 83mKr (releasing a total energy of 41.5 keV) and 3H (β- with Q = 18.6 keV) decays, and a deuterium-deuterium (D-D) neutron beam (2.45 MeV) . Within the detector's fiducial volume, the reconstruction has achieved an (x, y) position uncertainty of σ = 0.82 cm and σ = 0.17 cm for events of only 200 and 4,000 detected electroluminescence photons respectively. Such signals are associated with electron recoils of energies ~0.25 keV and ~10 keV, respectively. The reconstructed position of the smallest events with a single electron emitted from the liquid surface (22 detected photons) has a horizontal (x, y) uncertainty of 2.13 cm.

  5. Ray tracing reconstruction investigation for C-arm tomosynthesis

    Science.gov (United States)

    Malalla, Nuhad A. Y.; Chen, Ying

    2016-04-01

    C-arm tomosynthesis is a three dimensional imaging technique. Both x-ray source and the detector are mounted on a C-arm wheeled structure to provide wide variety of movement around the object. In this paper, C-arm tomosynthesis was introduced to provide three dimensional information over a limited view angle (less than 180o) to reduce radiation exposure and examination time. Reconstruction algorithms based on ray tracing method such as ray tracing back projection (BP), simultaneous algebraic reconstruction technique (SART) and maximum likelihood expectation maximization (MLEM) were developed for C-arm tomosynthesis. C-arm tomosynthesis projection images of simulated spherical object were simulated with a virtual geometric configuration with a total view angle of 40 degrees. This study demonstrated the sharpness of in-plane reconstructed structure and effectiveness of removing out-of-plane blur for each reconstruction algorithms. Results showed the ability of ray tracing based reconstruction algorithms to provide three dimensional information with limited angle C-arm tomosynthesis.

  6. A biomechanical modeling-guided simultaneous motion estimation and image reconstruction technique (SMEIR-Bio) for 4D-CBCT reconstruction

    Science.gov (United States)

    Huang, Xiaokun; Zhang, You; Wang, Jing

    2018-02-01

    Reconstructing four-dimensional cone-beam computed tomography (4D-CBCT) images directly from respiratory phase-sorted traditional 3D-CBCT projections can capture target motion trajectory, reduce motion artifacts, and reduce imaging dose and time. However, the limited numbers of projections in each phase after phase-sorting decreases CBCT image quality under traditional reconstruction techniques. To address this problem, we developed a simultaneous motion estimation and image reconstruction (SMEIR) algorithm, an iterative method that can reconstruct higher quality 4D-CBCT images from limited projections using an inter-phase intensity-driven motion model. However, the accuracy of the intensity-driven motion model is limited in regions with fine details whose quality is degraded due to insufficient projection number, which consequently degrades the reconstructed image quality in corresponding regions. In this study, we developed a new 4D-CBCT reconstruction algorithm by introducing biomechanical modeling into SMEIR (SMEIR-Bio) to boost the accuracy of the motion model in regions with small fine structures. The biomechanical modeling uses tetrahedral meshes to model organs of interest and solves internal organ motion using tissue elasticity parameters and mesh boundary conditions. This physics-driven approach enhances the accuracy of solved motion in the organ’s fine structures regions. This study used 11 lung patient cases to evaluate the performance of SMEIR-Bio, making both qualitative and quantitative comparisons between SMEIR-Bio, SMEIR, and the algebraic reconstruction technique with total variation regularization (ART-TV). The reconstruction results suggest that SMEIR-Bio improves the motion model’s accuracy in regions containing small fine details, which consequently enhances the accuracy and quality of the reconstructed 4D-CBCT images.

  7. Special Inspector General for Iraq Reconstruction. Quarterly Report to the United States Congress

    National Research Council Canada - National Science Library

    Bowen, Jr, Stuart W

    2007-01-01

    .... relief and reconstruction program in Iraq. Two notable developments frame this Report. First, total relief and reconstruction investment for Iraq from all sources the United States, Iraq, and other donors passed...

  8. A distributed multi-GPU system for high speed electron microscopic tomographic reconstruction.

    Science.gov (United States)

    Zheng, Shawn Q; Branlund, Eric; Kesthelyi, Bettina; Braunfeld, Michael B; Cheng, Yifan; Sedat, John W; Agard, David A

    2011-07-01

    Full resolution electron microscopic tomographic (EMT) reconstruction of large-scale tilt series requires significant computing power. The desire to perform multiple cycles of iterative reconstruction and realignment dramatically increases the pressing need to improve reconstruction performance. This has motivated us to develop a distributed multi-GPU (graphics processing unit) system to provide the required computing power for rapid constrained, iterative reconstructions of very large three-dimensional (3D) volumes. The participating GPUs reconstruct segments of the volume in parallel, and subsequently, the segments are assembled to form the complete 3D volume. Owing to its power and versatility, the CUDA (NVIDIA, USA) platform was selected for GPU implementation of the EMT reconstruction. For a system containing 10 GPUs provided by 5 GTX295 cards, 10 cycles of SIRT reconstruction for a tomogram of 4096(2) × 512 voxels from an input tilt series containing 122 projection images of 4096(2) pixels (single precision float) takes a total of 1845 s of which 1032 s are for computation with the remainder being the system overhead. The same system takes only 39 s total to reconstruct 1024(2) × 256 voxels from 122 1024(2) pixel projections. While the system overhead is non-trivial, performance analysis indicates that adding extra GPUs to the system would lead to steadily enhanced overall performance. Therefore, this system can be easily expanded to generate superior computing power for very large tomographic reconstructions and especially to empower iterative cycles of reconstruction and realignment. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. UV Reconstruction Algorithm And Diurnal Cycle Variability

    Science.gov (United States)

    Curylo, Aleksander; Litynska, Zenobia; Krzyscin, Janusz; Bogdanska, Barbara

    2009-03-01

    UV reconstruction is a method of estimation of surface UV with the use of available actinometrical and aerological measurements. UV reconstruction is necessary for the study of long-term UV change. A typical series of UV measurements is not longer than 15 years, which is too short for trend estimation. The essential problem in the reconstruction algorithm is the good parameterization of clouds. In our previous algorithm we used an empirical relation between Cloud Modification Factor (CMF) in global radiation and CMF in UV. The CMF is defined as the ratio between measured and modelled irradiances. Clear sky irradiance was calculated with a solar radiative transfer model. In the proposed algorithm, the time variability of global radiation during the diurnal cycle is used as an additional source of information. For elaborating an improved reconstruction algorithm relevant data from Legionowo [52.4 N, 21.0 E, 96 m a.s.l], Poland were collected with the following instruments: NILU-UV multi channel radiometer, Kipp&Zonen pyranometer, radiosonde profiles of ozone, humidity and temperature. The proposed algorithm has been used for reconstruction of UV at four Polish sites: Mikolajki, Kolobrzeg, Warszawa-Bielany and Zakopane since the early 1960s. Krzyscin's reconstruction of total ozone has been used in the calculations.

  10. A mixed-order nonlinear diffusion compressed sensing MR image reconstruction.

    Science.gov (United States)

    Joy, Ajin; Paul, Joseph Suresh

    2018-03-07

    Avoid formation of staircase artifacts in nonlinear diffusion-based MR image reconstruction without compromising computational speed. Whereas second-order diffusion encourages the evolution of pixel neighborhood with uniform intensities, fourth-order diffusion considers smooth region to be not necessarily a uniform intensity region but also a planar region. Therefore, a controlled application of fourth-order diffusivity function is used to encourage second-order diffusion to reconstruct the smooth regions of the image as a plane rather than a group of blocks, while not being strong enough to introduce the undesirable speckle effect. Proposed method is compared with second- and fourth-order nonlinear diffusion reconstruction, total variation (TV), total generalized variation, and higher degree TV using in vivo data sets for different undersampling levels with application to dictionary learning-based reconstruction. It is observed that the proposed technique preserves sharp boundaries in the image while preventing the formation of staircase artifacts in the regions of smoothly varying pixel intensities. It also shows reduced error measures compared with second-order nonlinear diffusion reconstruction or TV and converges faster than TV-based methods. Because nonlinear diffusion is known to be an effective alternative to TV for edge-preserving reconstruction, the crucial aspect of staircase artifact removal is addressed. Reconstruction is found to be stable for the experimentally determined range of fourth-order regularization parameter, and therefore not does not introduce a parameter search. Hence, the computational simplicity of second-order diffusion is retained. © 2018 International Society for Magnetic Resonance in Medicine.

  11. Remember the 'spring' of your youth: The vanity of male power in Qohelet 12

    OpenAIRE

    Nel, Philip

    2008-01-01

    In patriarchal and phallic cultures the loss of power to create life as well as the implicit loss of potency are symbolized in the decaying or breaking of the phallic simulacrum representing the male genital member - often at the very 'fountain' of its power exhibition. This paper is a close reading of Qoh 11:7-12:8 (a highly contested text in critical reading). What follows is an analysis of the metaphoric references whereby an argument is construed in favour of the idea that, according to Q...

  12. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement

    Directory of Open Access Journals (Sweden)

    Vasileios Sakellariou

    2014-09-01

    Full Text Available Developmental dysplasia of the hip (DDH or congenital hip dysplasia (CDH is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is hallenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

  13. Surgical outcomes and nipple projection using the modified skate flap for nipple-areolar reconstruction in a series of 422 implant reconstructions.

    Science.gov (United States)

    Zhong, Toni; Antony, Anu; Cordeiro, Peter

    2009-05-01

    Numerous techniques have been used in an attempt to achieve long-term nipple projection following nipple-areolar reconstruction (NAR). A common setback, however, is the diminution of projection over time; this phenomenon is particularly evident following implant based breast reconstruction. The purpose of this report was thus to evaluate surgical outcomes and long-term nipple projection with the use of "modified skate flap" technique in exclusively implant based postmastectomy reconstructions. A retrospective review was performed for the period between 1993 and 2007. All consecutive patients with 2-staged tissue expander/implant reconstructions followed by NAR using the modified skate flap technique performed by the senior author (P.C.) were identified in a prospectively maintained breast reconstruction database. Only patients with a minimum of 1-year follow-up were included in the study. Patients with a history of irradiation to the breast were excluded from nipple projection assessment. Clinical outcome measurements included long-term nipple projection as well as incidence of complications from the NAR procedure using the modified skate flap technique. Over the 15-year study period, 475 patients underwent 2-staged tissue expander/implant reconstruction followed by NAR using the modified skate flap technique. Of these, there was a total of 292 patients with the minimum requirement of 1-year follow-up post NAR (61% follow-up rate). The total number of reconstructed nipple areolar complexes evaluated in this series was 422 (130 bilateral and 162 unilateral NAR). Forty patients (28 unilateral and 12 bilateral NAR) who received radiation to their breasts were excluded from nipple projection assessment. At a median follow-up of 44 months (range: 12-84 months), mean nipple projection was 2.5 mm (range: 1-4 mm). Minor complications occurred in 7.2% of the patients (n = 292). Skin graft donor site dehiscence was the most common complication (3.1%) followed by partial skin

  14. Autologous breast reconstruction using the immediately lipofilled extended latissimus dorsi flap.

    Science.gov (United States)

    Johns, N; Fairbairn, N; Trail, M; Ewing, A; Yong, L; Raine, C; Dixon, J M

    2018-02-01

    The latissimus dorsi flap is a popular choice for autologous breast reconstruction. To dramatically improve volume, we report our experience of using the immediately lipofilled extended latissimus dorsi (ELD) flap and show it as a valid option for autologous breast reconstruction. Patients undergoing the procedure between December 2013 and June 2016 were included. Demographic, clinical and operative factors were analysed, together with in-hospital morbidity and duration of postoperative hospital stay. A total of 71 ELD flaps with immediate lipofilling were performed. Forty-five reconstructions were immediate and the remaining 26 delayed. Median (range) volume of autologous fat injected immediately was 171 ml (40-630 ml). Contralateral reductions were performed in 25 patients with the median reduction volume 185 g (89-683 g). Median duration of admission was 6.5 (3-18) days and patients were followed up for 12 months (1-37). Three total flap failures occurred and had to be excised (4%). One haematoma occurred requiring drainage (1%). Signs of infection requiring intravenous antibiotics occurred in five patients (7%). In 5 patients wound dehiscence occurred, and only two of these required resuturing (3%). In total, 7 patients developed a seroma requiring repeated drainage (10%). Three reconstructions experienced mild mastectomy flap necrosis with no needing reoperation (4%). Our experience represents the largest series to date and shows that in carefully selected patients the technique is safe, can avoid the requirement for implants, and has the potential to streamline the reconstructive journey. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Radiotherapy and breast reconstruction: a meta-analysis.

    LENUS (Irish Health Repository)

    Barry, M

    2011-05-01

    The optimum sequencing of breast reconstruction (BR) in patients receiving postmastectomy radiation therapy (PMRT) is controversial. A comprehensive search of published studies that examined postoperative morbidity following immediate or delayed BR with combined radiotherapy was performed. Medical (MEDLINE & EMBASE) databases were searched and cross-referenced for appropriate studies where morbidity following BR was the primary outcome measured. A total of 1,105 patients were identified from 11 appropriately selected studies. Patients undergoing PMRT and BR are more likely to suffer morbidity compared with patients not receiving PMRT (OR = 4.2; 95% CI, 2.4-7.2 [no PMRT vs. PMRT]). Reconstruction technique was also examined with outcome when PMRT was delivered after BR, and this demonstrated that autologous reconstruction is associated with less morbidity in this setting (OR = 0.21; 95% CI, 0.1-0.4 [autologous vs. implant-based]). Delaying BR until after PMRT had no significant effect on outcome (OR = 0.87; 95% CI, 0.47-1.62 [delayed vs. immediate]). PMRT has a detrimental effect on BR outcome. These results suggest that where immediate reconstruction is undertaken with the necessity of PMRT, an autologous flap results in less morbidity when compared with implant-based reconstruction.

  16. A distributed multi-GPU system for high speed electron microscopic tomographic reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Shawn Q.; Branlund, Eric; Kesthelyi, Bettina; Braunfeld, Michael B.; Cheng, Yifan; Sedat, John W. [The Howard Hughes Medical Institute and the W.M. Keck Advanced Microscopy Laboratory, Department of Biochemistry and Biophysics, University of California, San Francisco, 600, 16th Street, Room S412D, CA 94158-2517 (United States); Agard, David A., E-mail: agard@msg.ucsf.edu [The Howard Hughes Medical Institute and the W.M. Keck Advanced Microscopy Laboratory, Department of Biochemistry and Biophysics, University of California, San Francisco, 600, 16th Street, Room S412D, CA 94158-2517 (United States)

    2011-07-15

    Full resolution electron microscopic tomographic (EMT) reconstruction of large-scale tilt series requires significant computing power. The desire to perform multiple cycles of iterative reconstruction and realignment dramatically increases the pressing need to improve reconstruction performance. This has motivated us to develop a distributed multi-GPU (graphics processing unit) system to provide the required computing power for rapid constrained, iterative reconstructions of very large three-dimensional (3D) volumes. The participating GPUs reconstruct segments of the volume in parallel, and subsequently, the segments are assembled to form the complete 3D volume. Owing to its power and versatility, the CUDA (NVIDIA, USA) platform was selected for GPU implementation of the EMT reconstruction. For a system containing 10 GPUs provided by 5 GTX295 cards, 10 cycles of SIRT reconstruction for a tomogram of 4096{sup 2}x512 voxels from an input tilt series containing 122 projection images of 4096{sup 2} pixels (single precision float) takes a total of 1845 s of which 1032 s are for computation with the remainder being the system overhead. The same system takes only 39 s total to reconstruct 1024{sup 2}x256 voxels from 122 1024{sup 2} pixel projections. While the system overhead is non-trivial, performance analysis indicates that adding extra GPUs to the system would lead to steadily enhanced overall performance. Therefore, this system can be easily expanded to generate superior computing power for very large tomographic reconstructions and especially to empower iterative cycles of reconstruction and realignment. -- Highlights: {yields} A distributed multi-GPU system has been developed for electron microscopic tomography (EMT). {yields} This system allows for rapid constrained, iterative reconstruction of very large volumes. {yields} This system can be easily expanded to generate superior computing power for large-scale iterative EMT realignment.

  17. A distributed multi-GPU system for high speed electron microscopic tomographic reconstruction

    International Nuclear Information System (INIS)

    Zheng, Shawn Q.; Branlund, Eric; Kesthelyi, Bettina; Braunfeld, Michael B.; Cheng, Yifan; Sedat, John W.; Agard, David A.

    2011-01-01

    Full resolution electron microscopic tomographic (EMT) reconstruction of large-scale tilt series requires significant computing power. The desire to perform multiple cycles of iterative reconstruction and realignment dramatically increases the pressing need to improve reconstruction performance. This has motivated us to develop a distributed multi-GPU (graphics processing unit) system to provide the required computing power for rapid constrained, iterative reconstructions of very large three-dimensional (3D) volumes. The participating GPUs reconstruct segments of the volume in parallel, and subsequently, the segments are assembled to form the complete 3D volume. Owing to its power and versatility, the CUDA (NVIDIA, USA) platform was selected for GPU implementation of the EMT reconstruction. For a system containing 10 GPUs provided by 5 GTX295 cards, 10 cycles of SIRT reconstruction for a tomogram of 4096 2 x512 voxels from an input tilt series containing 122 projection images of 4096 2 pixels (single precision float) takes a total of 1845 s of which 1032 s are for computation with the remainder being the system overhead. The same system takes only 39 s total to reconstruct 1024 2 x256 voxels from 122 1024 2 pixel projections. While the system overhead is non-trivial, performance analysis indicates that adding extra GPUs to the system would lead to steadily enhanced overall performance. Therefore, this system can be easily expanded to generate superior computing power for very large tomographic reconstructions and especially to empower iterative cycles of reconstruction and realignment. -- Highlights: → A distributed multi-GPU system has been developed for electron microscopic tomography (EMT). → This system allows for rapid constrained, iterative reconstruction of very large volumes. → This system can be easily expanded to generate superior computing power for large-scale iterative EMT realignment.

  18. Few-view image reconstruction with dual dictionaries

    International Nuclear Information System (INIS)

    Lu Yang; Zhao Jun; Wang Ge

    2012-01-01

    In this paper, we formulate the problem of computed tomography (CT) under sparsity and few-view constraints, and propose a novel algorithm for image reconstruction from few-view data utilizing the simultaneous algebraic reconstruction technique (SART) coupled with dictionary learning, sparse representation and total variation (TV) minimization on two interconnected levels. The main feature of our algorithm is the use of two dictionaries: a transitional dictionary for atom matching and a global dictionary for image updating. The atoms in the global and transitional dictionaries represent the image patches from high-quality and low-quality CT images, respectively. Experiments with simulated and real projections were performed to evaluate and validate the proposed algorithm. The results reconstructed using the proposed approach are significantly better than those using either SART or SART–TV. (paper)

  19. Versatality of Nasolabial Flap in Orofacial Reconstruction

    Directory of Open Access Journals (Sweden)

    Nandesh Shetty

    2015-01-01

    Materials and Methods: A total of 10 patients were selected based on the size of surgical defect. Nasolabial flap was used to reconstruct defects of small to moderate size in the oro-facial region and post-operative follow up was done. Results: All of the patients underwent inferiorly based Transposition Island flap for reconstruction of different oro-facial defects. Few complications like bulky size of the flap, slight donor site distortion (scar formation and intra-oral hair growth were seen in six patients. Two incidences of infection in the transferred flap were seen. Conclusion: It is a safe minor procedure done under general anesthesia with good reconstructive results over small or moderately sized maxillofacial defects. Proper attention to flap design, operative technique and post - operative management are useful in reducing the incidence of complications.

  20. Mastectomy Skin Necrosis After Breast Reconstruction: A Comparative Analysis Between Autologous Reconstruction and Implant-Based Reconstruction.

    Science.gov (United States)

    Sue, Gloria R; Lee, Gordon K

    2018-05-01

    Mastectomy skin necrosis is a significant problem after breast reconstruction. We sought to perform a comparative analysis on this complication between patients undergoing autologous breast reconstruction and patients undergoing 2-stage expander implant breast reconstruction. A retrospective review was performed on consecutive patients undergoing autologous breast reconstruction or 2-stage expander implant breast reconstruction by the senior author from 2006 through 2015. Patient demographic factors including age, body mass index, history of diabetes, history of smoking, and history of radiation to the breast were collected. Our primary outcome measure was mastectomy skin necrosis. Fisher exact test was used for statistical analysis between the 2 patient cohorts. The treatment patterns of mastectomy skin necrosis were then analyzed. We identified 204 patients who underwent autologous breast reconstruction and 293 patients who underwent 2-stage expander implant breast reconstruction. Patients undergoing autologous breast reconstruction were older, heavier, more likely to have diabetes, and more likely to have had prior radiation to the breast compared with patients undergoing implant-based reconstruction. The incidence of mastectomy skin necrosis was 30.4% of patients in the autologous group compared with only 10.6% of patients in the tissue expander group (P care in the autologous group, only 3.2% were treated with local wound care in the tissue expander group (P skin necrosis is significantly more likely to occur after autologous breast reconstruction compared with 2-stage expander implant-based breast reconstruction. Patients with autologous reconstructions are more readily treated with local wound care compared with patients with tissue expanders, who tended to require operative treatment of this complication. Patients considering breast reconstruction should be counseled appropriately regarding the differences in incidence and management of mastectomy skin

  1. MODIFIED TECHNIQUE OF TOTAL LARYNGECTOMY

    Directory of Open Access Journals (Sweden)

    Predrag Spirić

    2010-12-01

    Full Text Available Surgical technique of total laryngectomy is well presented in many surgical textbooks. Essentially, it has remained the same since Gluck an Soerensen in 1922 described all its details. Generally, it stresses the U shape skin incision with releasing laryngeal structures and removing larynx from up to down. Further, pharyngeal reconstruction is performed with different kinds of sutures in two or more layers and is finished with skin suture and suction drainage. One of worst complications following this surgery is pharyngocutaneous fistula (PF. Modifications proposed in this this article suggests vertical skin incision with larynx removal from below upwards. In pharyngeal reconstruction we used the running locked suture in submucosal plan with „tobacco sac“ at the end on the tongue base instead of traditional T shaped suture. Suction drains were not used.The aim of study was to present the modified surgical technique of total laryingectomy and its impact on hospital stay duration and pharyngocutanous fistula formation. In this randomized study we analyzed 49 patients operated with modified surgical technique compared to 49 patient operated with traditional surgical technique of total laryngectomy. The modified technique of total laryngectomy was presented. Using modified technique we managed to decrease the PF percentage from previous 20,41% to acceptable 8,16% (p=0,0334. Also, the average hospital stay was shortened from 14,96 to 10,63 days (t =-2.9850; p=0.0358.The modified technique of total laryngectomy is safe, short and efficient surgical intervention which decreases the number of pharyngocutaneos fistulas and shortens the hospital stay.

  2. Optimizing aesthetic outcomes for breast reconstruction in patients with significant macromastia or ptosis

    Directory of Open Access Journals (Sweden)

    Wojciech Dec

    2018-06-01

    Full Text Available Background: Achieving excellent aesthetic outcomes in reconstruction of large or ptotic breasts is especially challenging. Incorporating a Wise pattern into the mastectomy design is effective in reducing the excess breast skin, however it increases the risk of mastectomy skin necrosis. The aim of this study is to describe surgical maneuvers which optimize aesthetic outcomes, anticipate flap volume requirements, and limit mastectomy skin necrosis in autologous reconstruction in patients with macromastia and grade III ptosis. Methods: This is a retrospective review of operative and clinical records of patients who underwent unilateral or bilateral breast reconstruction with autologous tissue between August 2015 and May 2017. Patients were divided into macromastia and ptosis groups. Key surgical maneuvers for safely achieving aesthetically optimal results were identified. Results: A total of 29 breasts were successfully reconstructed in 19 patients with a Wise pattern mastectomy skin reduction. Free flap weights were similar in both groups, mastectomy weights were greater in the macromastia group, p < 0.05. Complications were limited to three cases of wound breakdown and one case of mastectomy skin necrosis. Total number of revision stages was reduced in unilateral reconstructions when a contralateral breast reduction or mastopexy was performed during the first stage. Conclusions: A Wise pattern can safely and effectively be incorporated into a mastectomy incision design in patients who are not candidates for a nipple sparing mastectomy. Optimal aesthetics are achieved with similar volume flaps for both macromastia and ptosis patients. In cases of unilateral breast reconstruction a contralateral breast reduction or mastopexy should be performed at the time of the immediate breast reconstruction. Keywords: Breast reconstruction, Aesthetic breast reconstruction, Macromastia breast reconstruction, Ptosis breast reconstruction

  3. Challenges in the reconstruction of bilateral maxillectomy defects.

    Science.gov (United States)

    Joseph, Shawn T; Thankappan, Krishnakumar; Buggaveeti, Rahul; Sharma, Mohit; Mathew, Jimmy; Iyer, Subramania

    2015-02-01

    Bilateral maxillectomy defects, if not adequately reconstructed, can result in grave esthetic and functional problems. The purpose of this study was to investigate the outcome of reconstruction of such defects. This is a retrospective case series. The defects were analyzed for their components and the flaps used for reconstruction. Outcomes for flap loss and functional indices, including oral diet, speech, and dental rehabilitation, also were evaluated. Ten consecutive patients who underwent bilateral maxillectomy reconstruction received 14 flaps. Six patients had malignancies of the maxilla, and 4 patients had nonmalignant indications. Ten bony free flaps were used. Four soft tissue flaps were used. The fibula free flap was the most common flap used. Three patients had total flap loss. Seven patients were alive and available for functional evaluation. Of these, 4 were taking an oral diet with altered consistency and 2 were on a regular diet. Speech was intelligible in all patients. Only 2 patients opted for dental rehabilitation with removable dentures. Reconstruction after bilateral maxillectomy is essential to prevent esthetic and functional problems. Bony reconstruction is ideal. The fibula bone free flap is commonly used. The complexity of the defect makes reconstruction difficult and the initial success rate of free flaps is low. Secondary reconstructions after the initial flap failures were successful. A satisfactory functional outcome can be achieved. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Simultaneous motion estimation and image reconstruction (SMEIR) for 4D cone-beam CT

    International Nuclear Information System (INIS)

    Wang, Jing; Gu, Xuejun

    2013-01-01

    Purpose: Image reconstruction and motion model estimation in four-dimensional cone-beam CT (4D-CBCT) are conventionally handled as two sequential steps. Due to the limited number of projections at each phase, the image quality of 4D-CBCT is degraded by view aliasing artifacts, and the accuracy of subsequent motion modeling is decreased by the inferior 4D-CBCT. The objective of this work is to enhance both the image quality of 4D-CBCT and the accuracy of motion model estimation with a novel strategy enabling simultaneous motion estimation and image reconstruction (SMEIR).Methods: The proposed SMEIR algorithm consists of two alternating steps: (1) model-based iterative image reconstruction to obtain a motion-compensated primary CBCT (m-pCBCT) and (2) motion model estimation to obtain an optimal set of deformation vector fields (DVFs) between the m-pCBCT and other 4D-CBCT phases. The motion-compensated image reconstruction is based on the simultaneous algebraic reconstruction technique (SART) coupled with total variation minimization. During the forward- and backprojection of SART, measured projections from an entire set of 4D-CBCT are used for reconstruction of the m-pCBCT by utilizing the updated DVF. The DVF is estimated by matching the forward projection of the deformed m-pCBCT and measured projections of other phases of 4D-CBCT. The performance of the SMEIR algorithm is quantitatively evaluated on a 4D NCAT phantom. The quality of reconstructed 4D images and the accuracy of tumor motion trajectory are assessed by comparing with those resulting from conventional sequential 4D-CBCT reconstructions (FDK and total variation minimization) and motion estimation (demons algorithm). The performance of the SMEIR algorithm is further evaluated by reconstructing a lung cancer patient 4D-CBCT.Results: Image quality of 4D-CBCT is greatly improved by the SMEIR algorithm in both phantom and patient studies. When all projections are used to reconstruct a 3D-CBCT by FDK, motion

  5. Reconstruction of multiple-pinhole micro-SPECT data using origin ensembles.

    Science.gov (United States)

    Lyon, Morgan C; Sitek, Arkadiusz; Metzler, Scott D; Moore, Stephen C

    2016-10-01

    The authors are currently developing a dual-resolution multiple-pinhole microSPECT imaging system based on three large NaI(Tl) gamma cameras. Two multiple-pinhole tungsten collimator tubes will be used sequentially for whole-body "scout" imaging of a mouse, followed by high-resolution (hi-res) imaging of an organ of interest, such as the heart or brain. Ideally, the whole-body image will be reconstructed in real time such that data need only be acquired until the area of interest can be visualized well-enough to determine positioning for the hi-res scan. The authors investigated the utility of the origin ensemble (OE) algorithm for online and offline reconstructions of the scout data. This algorithm operates directly in image space, and can provide estimates of image uncertainty, along with reconstructed images. Techniques for accelerating the OE reconstruction were also introduced and evaluated. System matrices were calculated for our 39-pinhole scout collimator design. SPECT projections were simulated for a range of count levels using the MOBY digital mouse phantom. Simulated data were used for a comparison of OE and maximum-likelihood expectation maximization (MLEM) reconstructions. The OE algorithm convergence was evaluated by calculating the total-image entropy and by measuring the counts in a volume-of-interest (VOI) containing the heart. Total-image entropy was also calculated for simulated MOBY data reconstructed using OE with various levels of parallelization. For VOI measurements in the heart, liver, bladder, and soft-tissue, MLEM and OE reconstructed images agreed within 6%. Image entropy converged after ∼2000 iterations of OE, while the counts in the heart converged earlier at ∼200 iterations of OE. An accelerated version of OE completed 1000 iterations in <9 min for a 6.8M count data set, with some loss of image entropy performance, whereas the same dataset required ∼79 min to complete 1000 iterations of conventional OE. A combination of the two

  6. Total femur arthroplasty for revision hip failure in osteogenesis imperfecta: limits of biology

    Directory of Open Access Journals (Sweden)

    Pablo Sanz-Ruiz, PhD, MD

    2017-09-01

    Full Text Available Osteogenesis imperfecta (OI is a rare congenital disease characterized by alterations in bone quality, with susceptibility to fractures, instability, deformities, and osteoarthrosis. Prosthetic surgery in these patients is associated with an abnormally high rate of implant failures. On the other hand, abnormal bone fragility adds to the complexity of revision surgery in such individuals—thus representing a genuine challenge for the orthopaedic surgeon. We present a case of femoral reconstruction in a patient with OI and prosthetic loosening after reconstruction secondary to femoral septic pseudoarthrosis. Intramedullary total femoral reconstruction was carried out after exceeding the biological reconstruction limits. This is the first reported instance of the use of an intramedullary total femur arthroplasty as salvage technique in an OI patient. This technique should be considered when we have exceeded biological limits for femoral fixation.

  7. Reconstruction in oral malignancy: Factors affecting morbidity of various procedures

    Science.gov (United States)

    Chakrabarti, Suvadip; Chakrabarti, Preeti Rihal; Desai, Sanjay M.; Agrawal, Deepak; Mehta, Dharmendra Y.; Pancholi, Mayank

    2015-01-01

    Aims and Objective: (1) To study the age and sex distribution of patient with oral malignancies. (2) To analyze various types of surgery performed. (3) Evaluation of reconstruction and factors affecting complications and its relation to the type of reconstruction. Materials and Methods: Cases of oral malignancies, undergoing surgery for the same in Sri Aurobindo Medical College and PG Institute, Indore from the period from October 1, 2012, to March 31, 2015. Results: Out of analysis of 111 cases of oral malignancy, 31 (27.9%) cases were in the fifth decade of life with male to female ratio 1.9:1. The commonest site of cancer was buccal mucosa. Forty-seven cases (43.2%) were in stage IVa. Diabetes was the most common co-morbidity reported, accounting for 53.9% of cases with reported morbidity. Tobacco chewing was the common entity in personal habits. All the cases underwent neck dissection along with resection of the primary. Hemimandibulectomy was the most preferred form of primary resection accounting for 53.15% (59 cases), followed by wide resection of primary 27% (30 cases). Pectoralis major myocutaneous (PMMC) flap only was the most common reconstruction across the study population. PMMC alone accounted for 38.7% (43 cases). The infection rate was 16.21%. PMMC alone accounted for 5 out of 18 (27.8%) of total infection rate, and 4.5% of the total study population. PMMC + deltopectoral accounted for 5 out of 18 (27.8%) of total infection rate, and 4.5% of the total study population. Conclusion: PMMC is a major workhorse for reconstruction with better functional outcome and acceptance among operated patients. PMID:26981469

  8. Fast dictionary-based reconstruction for diffusion spectrum imaging.

    Science.gov (United States)

    Bilgic, Berkin; Chatnuntawech, Itthi; Setsompop, Kawin; Cauley, Stephen F; Yendiki, Anastasia; Wald, Lawrence L; Adalsteinsson, Elfar

    2013-11-01

    Diffusion spectrum imaging reveals detailed local diffusion properties at the expense of substantially long imaging times. It is possible to accelerate acquisition by undersampling in q-space, followed by image reconstruction that exploits prior knowledge on the diffusion probability density functions (pdfs). Previously proposed methods impose this prior in the form of sparsity under wavelet and total variation transforms, or under adaptive dictionaries that are trained on example datasets to maximize the sparsity of the representation. These compressed sensing (CS) methods require full-brain processing times on the order of hours using MATLAB running on a workstation. This work presents two dictionary-based reconstruction techniques that use analytical solutions, and are two orders of magnitude faster than the previously proposed dictionary-based CS approach. The first method generates a dictionary from the training data using principal component analysis (PCA), and performs the reconstruction in the PCA space. The second proposed method applies reconstruction using pseudoinverse with Tikhonov regularization with respect to a dictionary. This dictionary can either be obtained using the K-SVD algorithm, or it can simply be the training dataset of pdfs without any training. All of the proposed methods achieve reconstruction times on the order of seconds per imaging slice, and have reconstruction quality comparable to that of dictionary-based CS algorithm.

  9. A parametric reconstruction of the deceleration parameter

    Energy Technology Data Exchange (ETDEWEB)

    Al Mamon, Abdulla [Manipal University, Manipal Centre for Natural Sciences, Manipal (India); Visva-Bharati, Department of Physics, Santiniketan (India); Das, Sudipta [Visva-Bharati, Department of Physics, Santiniketan (India)

    2017-07-15

    The present work is based on a parametric reconstruction of the deceleration parameter q(z) in a model for the spatially flat FRW universe filled with dark energy and non-relativistic matter. In cosmology, the parametric reconstruction technique deals with an attempt to build up a model by choosing some specific evolution scenario for a cosmological parameter and then estimate the values of the parameters with the help of different observational datasets. In this paper, we have proposed a logarithmic parametrization of q(z) to probe the evolution history of the universe. Using the type Ia supernova, baryon acoustic oscillation and the cosmic microwave background datasets, the constraints on the arbitrary model parameters q{sub 0} and q{sub 1} are obtained (within 1σ and 2σ confidence limits) by χ{sup 2}-minimization technique. We have then reconstructed the deceleration parameter, the total EoS parameter ω{sub tot}, the jerk parameter and have compared the reconstructed results of q(z) with other well-known parametrizations of q(z). We have also shown that two model selection criteria (namely, the Akaike information criterion and Bayesian information criterion) provide a clear indication that our reconstructed model is well consistent with other popular models. (orig.)

  10. Reconstructed coronal views of CT and isotopic images of the pancreas

    International Nuclear Information System (INIS)

    Kasuga, Toshio; Kobayashi, Toshio; Nakanishi, Fumiko

    1980-01-01

    To compare functional images of the pancreas by scintigraphy with morphological views of the pancreas by CT, CT coronal views of the pancreas were reconstructed. As CT coronal views were reconstructed from the routine scanning, there was a problem in longitudinal spatial resolution. However, almost satisfactory total images of the pancreas were obtained by improving images adequately. In 27 patients whose diseases had been confirmed, it was easy to compare pancreatic scintigrams with pancreatic CT images by using reconstructed CT coronal views, and information which had not been obtained by original CT images could be obtained by using reconstructed CT coronal views. Especially, defects on pancreatic images and the shape of pancreas which had not been visualized clearly by scintigraphy alone could be visualized by using reconstructed CT coronal views of the pancreas. (Tsunoda, M.)

  11. Queering the cosmology of the vikings: a queer analysis of the cult of Odin and "holy white stones".

    Science.gov (United States)

    Solli, Brit

    2008-01-01

    Ideas concerning Eros, honor and death were central to the Norse perception of the world. Odin is the greatest war god, and associated with manliness. However, Odin is also the most powerful master of seid (sorcery), an activity associated with women. Seid may be interpreted as a form of shamanism. If a man performed seid he could be accused of ergi, that is, unmanliness. Therefore it could be said that Odin exercised an activity considered unmanly. How could Odin perform seid without losing his position as the god of war and warriors? This paradox is discussed from a queer theoretical perspective. On this basis a new interpretation of the so-called "holy white" phallic stones in western Norway is suggested. Most of these stones are associated with burials from the later part of the Scandinavian Early Iron Age. The temporal distribution of the white phallic stones correlates well with the increasing importance of the cult of Odin. There may be a cultic association between the cult of Odin and the burial practices involving white holy phallic stones.

  12. Septal graft in laryngeal reconstruction

    International Nuclear Information System (INIS)

    Bahannan, Abdulrahman; Slavicek, A.; Taudy, M.; Chovanec, M.

    2006-01-01

    A 62-year-old woman presented with symptoms of dyspnea. Ultrasonography and computed tomography examinations revealed mass extending from the cricoid cartilage to the left lobe of thyroid gland and thyroid cartilage. Cytology revealed possibility of cartilaginous origin, which was proven to be chondrosarcoma (Grade 1) from the biopsy specimen obtained during panendosopy. She underwent one stage radical resection and immediate reconstruction of laryngeal skeleton defect by mucocartilaginous graft from the nasal septum. Her postoperative course was optimal with preservation of the laryngeal functions. Twenty-eight months postoperatively, she had to undergo total laryngectomy as a salvage procedure for the advanced local recurrence. We report on the relatively easy technique for functional reconstruction of the large laryngeal defect with the employment cartilage graft from the nasal septum. (author)

  13. Intrathoracic Hernia after Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Yoshihiko Tashiro

    2016-05-01

    Full Text Available Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation.

  14. Aortic reconstruction with bovine pericardial grafts

    Directory of Open Access Journals (Sweden)

    Silveira Lindemberg Mota

    2003-01-01

    Full Text Available INTRODUCTION: Glutaraldehyde-treated crimped bovine pericardial grafts are currently used in aortic graft surgery. These conduits have become good options for these operations, available in different sizes and shapes and at a low cost. OBJECTIVE:To evaluate the results obtained with bovine pericardial grafts for aortic reconstruction, specially concerning late complications. METHOD: Between January 1995 and January 2002, 57 patients underwent different types of aortic reconstruction operations using bovine pericardial grafts. A total of 29 (50.8% were operated on an urgent basis (mostly acute Stanford A dissection and 28 electively. Thoracotomy was performed in three patients for descending aortic replacement (two patients and aortoplasty with a patch in one. All remaining 54 underwent sternotomy, cardiopulmonary bypass and aortic resection. Deep hypothermia and total circulatory arrest was used in acute dissections and arch operations. RESULTS: Hospital mortality was 17.5%. Follow-up was 24.09 months (18.5 to 29.8 months confidence interval and complication-free actuarial survival curve was 92.3% (standard deviation ± 10.6. Two patients lately developed thoracoabdominal aneurysms following previous DeBakey II dissection and one died from endocarditis. One "patch" aortoplasty patient developed local descending aortic pseudoaneurysm 42 months after surgery. All other patients are asymptomatic and currently clinically evaluated with echocardiography and CT scans, showing no complications. CONCLUSION: Use of bovine pericardial grafts in aortic reconstruction surgery is adequate and safe, with few complications related to the conduits.

  15. Immediate breast reconstruction with anatomical implants following mastectomy: The radiation perspective

    Energy Technology Data Exchange (ETDEWEB)

    Ben-David, Merav, E-mail: Merav.ben-david@sheba.health.gov.il [Radiation Oncology Unit, Chaim Sheba Medical Center, Ramat Gan (Israel); Sackler School of Medicine, Tel Aviv University, Tel Aviv (Israel); Granot, Hila [Radiation Oncology Unit, Chaim Sheba Medical Center, Ramat Gan (Israel); Gelernter, Ilana [Statistical Laboratory, School of Mathematics, Tel Aviv University, Tel Aviv (Israel); Scheflan, Michael [Department of Surgery, Assuta and Herzliya Medical Centers, Ramat Gan (Israel)

    2016-07-01

    Immediate implant-based breast reconstruction followed by postmastectomy radiation therapy (PMRT) is controversial because of the risk of compromised treatment plans and concerns regarding cosmetic outcomes. We evaluated the effects of immediate direct-to-implant breast reconstruction with anatomical implants on the quality of PMRT delivered by 3-dimensional conformal radiotherapy (3D-CRT). In this retrospective, single-institution study, patients who had undergone reconstruction with direct anatomic implant, performed by a single surgeon, received 3D-CRT between 2008 and 2013. For each patient, 2 plans (including or excluding internal mammary nodes [IMN]) were created and calculated. The primary end point was the dose distribution among reconstructed breasts, heart, lungs, and IMNs, and between right and left breasts. Of 29 consecutive patients, 11 received right-sided and 18 received left-sided PMRT to a total dose of 50 Gy. For plans excluding IMN coverage, mean D{sub mean} for right and left reconstructed breasts was 49.09 Gy (98.2% of the prescribed dose) and 48.51 Gy (97.0%), respectively. For plans including IMNs, mean D{sub mean} was 49.15 Gy (98.3%) for right and 48.46 Gy (96.9%) for left reconstructed breasts; the mean IMN D{sub mean} was 47.27 Gy (right) and 47.89 Gy (left). Heart D{sub mean} was below 1.56 Gy for all plans. Mean total lung volume receiving a dose of ≥ 20 Gy was 13.80% to 19.47%. PMRT can be delivered effectively and safely by 3D-CRT after direct-to-implant breast reconstruction with anatomical implants, even if patients require IMN treatment.

  16. A new method of morphological comparison for bony reconstructive surgery: maxillary reconstruction using scapular tip bone

    Science.gov (United States)

    Chan, Harley; Gilbert, Ralph W.; Pagedar, Nitin A.; Daly, Michael J.; Irish, Jonathan C.; Siewerdsen, Jeffrey H.

    2010-02-01

    esthetic appearance is one of the most important factors for reconstructive surgery. The current practice of maxillary reconstruction chooses radial forearm, fibula or iliac rest osteocutaneous to recreate three-dimensional complex structures of the palate and maxilla. However, these bone flaps lack shape similarity to the palate and result in a less satisfactory esthetic. Considering similarity factors and vasculature advantages, reconstructive surgeons recently explored the use of scapular tip myo-osseous free flaps to restore the excised site. We have developed a new method that quantitatively evaluates the morphological similarity of the scapula tip bone and palate based on a diagnostic volumetric computed tomography (CT) image. This quantitative result was further interpreted as a color map that rendered on the surface of a three-dimensional computer model. For surgical planning, this color interpretation could potentially assist the surgeon to maximize the orientation of the bone flaps for best fit of the reconstruction site. With approval from the Research Ethics Board (REB) of the University Health Network, we conducted a retrospective analysis with CT image obtained from 10 patients. Each patient had a CT scans including the maxilla and chest on the same day. Based on this image set, we simulated total, subtotal and hemi palate reconstruction. The procedure of simulation included volume segmentation, conversing the segmented volume to a stereo lithography (STL) model, manual registration, computation of minimum geometric distances and curvature between STL model. Across the 10 patients data, we found the overall root-mean-square (RMS) conformance was 3.71+/- 0.16 mm

  17. A reconstructed database of historic bluefin tuna captures in the Gibraltar Strait and Western Mediterranean

    Directory of Open Access Journals (Sweden)

    Josué M. Polanco-Martínez

    2018-02-01

    Full Text Available This data paper presents a reconstruction of a compilation of a small but consistent database of historical capture records of bluefin tuna (Thunnus thynnus; BFT hereafter from the Gibraltar Strait and Western Mediterranean (Portugal, Spain and Italy. The compilation come from diverse historical and documentary sources and span the time interval from 1525 to 1936 covering a period of 412 years. There is a total of 3074 datum, which reach up to 67.83% of the total implying a 32.17% of missing data. However, we have only reconstructed the captures for the time interval 1700–1936 and we provide these reconstructions only for this time interval and for 9 out of 11 series due to the scarcity and inhomogeneity of the two oldest capture time series. This reconstructed database provides an invaluable opportunity for fisheries and marine research as well as for multidisciplinary research in climate change. Keywords: Data reconstructions, DINEOF, Missing data, Historic Bluefin tuna captures, Gibraltar Strait and Western Mediterranean

  18. Fast Dictionary-Based Reconstruction for Diffusion Spectrum Imaging

    Science.gov (United States)

    Bilgic, Berkin; Chatnuntawech, Itthi; Setsompop, Kawin; Cauley, Stephen F.; Yendiki, Anastasia; Wald, Lawrence L.; Adalsteinsson, Elfar

    2015-01-01

    Diffusion Spectrum Imaging (DSI) reveals detailed local diffusion properties at the expense of substantially long imaging times. It is possible to accelerate acquisition by undersampling in q-space, followed by image reconstruction that exploits prior knowledge on the diffusion probability density functions (pdfs). Previously proposed methods impose this prior in the form of sparsity under wavelet and total variation (TV) transforms, or under adaptive dictionaries that are trained on example datasets to maximize the sparsity of the representation. These compressed sensing (CS) methods require full-brain processing times on the order of hours using Matlab running on a workstation. This work presents two dictionary-based reconstruction techniques that use analytical solutions, and are two orders of magnitude faster than the previously proposed dictionary-based CS approach. The first method generates a dictionary from the training data using Principal Component Analysis (PCA), and performs the reconstruction in the PCA space. The second proposed method applies reconstruction using pseudoinverse with Tikhonov regularization with respect to a dictionary. This dictionary can either be obtained using the K-SVD algorithm, or it can simply be the training dataset of pdfs without any training. All of the proposed methods achieve reconstruction times on the order of seconds per imaging slice, and have reconstruction quality comparable to that of dictionary-based CS algorithm. PMID:23846466

  19. Reconstruction of Defects After Fournier Gangrene: A Systematic Review.

    Science.gov (United States)

    Karian, Laurel S; Chung, Stella Y; Lee, Edward S

    2015-01-01

    Reconstruction of scrotal defects after Fournier gangrene is often achieved with skin grafts or flaps, but there is no general consensus on the best method of reconstruction or how to approach the exposed testicle. We systematically reviewed the literature addressing methods of reconstruction of Fournier defects after debridement. PubMed and Cochrane databases were searched from 1950 to 2013. Inclusion criteria were reconstruction for Fournier defects, patients 18 to 90 years old, and reconstructive complication rates reported as whole numbers or percentages. Exclusion criteria were studies focused on methods of debridement or other phases of care rather than reconstruction, studies with fewer than 5 male patients with Fournier defects, literature reviews, and articles not in English. The initial search yielded 982 studies, which was refined to 16 studies with a total pool of 425 patients. There were 25 (5.9%) patients with defects that healed by secondary intention, 44 (10.4%) with delayed primary closure, 36 (8.5%) with implantation of the testicle in a medial thigh pocket, 6 (1.4%) with loose wound approximation, 96 (22.6%) with skin grafts, 68 (16.0%) with scrotal advancement flaps, 128 (30.1%) with flaps, and 22 (5.2%) with flaps or skin grafts in combination with tissue adhesives. Four outcomes were evaluated: number of patients, defect size, method of reconstruction, and wound-healing complications. Most reconstructive techniques provide reliable coverage and protection of testicular function with an acceptable cosmetic result. There is no conclusive evidence to support flap coverage of exposed testes rather than skin graft. A reconstructive algorithm is proposed. Skin grafting or flap reconstruction is recommended for defects larger than 50% of the scrotum or extending beyond the scrotum, whereas scrotal advancement flap reconstruction or healing by secondary intention is best for defects confined to less than 50% of the scrotum that cannot be closed

  20. Alpha image reconstruction (AIR): A new iterative CT image reconstruction approach using voxel-wise alpha blending

    International Nuclear Information System (INIS)

    Hofmann, Christian; Sawall, Stefan; Knaup, Michael; Kachelrieß, Marc

    2014-01-01

    Purpose: Iterative image reconstruction gains more and more interest in clinical routine, as it promises to reduce image noise (and thereby patient dose), to reduce artifacts, or to improve spatial resolution. Among vendors and researchers, however, there is no consensus of how to best achieve these aims. The general approach is to incorporatea priori knowledge into iterative image reconstruction, for example, by adding additional constraints to the cost function, which penalize variations between neighboring voxels. However, this approach to regularization in general poses a resolution noise trade-off because the stronger the regularization, and thus the noise reduction, the stronger the loss of spatial resolution and thus loss of anatomical detail. The authors propose a method which tries to improve this trade-off. The proposed reconstruction algorithm is called alpha image reconstruction (AIR). One starts with generating basis images, which emphasize certain desired image properties, like high resolution or low noise. The AIR algorithm reconstructs voxel-specific weighting coefficients that are applied to combine the basis images. By combining the desired properties of each basis image, one can generate an image with lower noise and maintained high contrast resolution thus improving the resolution noise trade-off. Methods: All simulations and reconstructions are performed in native fan-beam geometry. A water phantom with resolution bar patterns and low contrast disks is simulated. A filtered backprojection (FBP) reconstruction with a Ram-Lak kernel is used as a reference reconstruction. The results of AIR are compared against the FBP results and against a penalized weighted least squares reconstruction which uses total variation as regularization. The simulations are based on the geometry of the Siemens Somatom Definition Flash scanner. To quantitatively assess image quality, the authors analyze line profiles through resolution patterns to define a contrast

  1. Computational acceleration for MR image reconstruction in partially parallel imaging.

    Science.gov (United States)

    Ye, Xiaojing; Chen, Yunmei; Huang, Feng

    2011-05-01

    In this paper, we present a fast numerical algorithm for solving total variation and l(1) (TVL1) based image reconstruction with application in partially parallel magnetic resonance imaging. Our algorithm uses variable splitting method to reduce computational cost. Moreover, the Barzilai-Borwein step size selection method is adopted in our algorithm for much faster convergence. Experimental results on clinical partially parallel imaging data demonstrate that the proposed algorithm requires much fewer iterations and/or less computational cost than recently developed operator splitting and Bregman operator splitting methods, which can deal with a general sensing matrix in reconstruction framework, to get similar or even better quality of reconstructed images.

  2. WE-EF-207-08: Improve Cone Beam CT Using a Synchronized Moving Grid, An Inter-Projection Sensor Fusion and a Probability Total Variation Reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, H; Kong, V; Jin, J [Georgia Regents University Cancer Center, Augusta, GA (Georgia); Ren, L; Zhang, Y; Giles, W [Duke University Medical Center, Durham, NC (United States)

    2015-06-15

    Purpose: To present a cone beam computed tomography (CBCT) system, which uses a synchronized moving grid (SMOG) to reduce and correct scatter, an inter-projection sensor fusion (IPSF) algorithm to estimate the missing information blocked by the grid, and a probability total variation (pTV) algorithm to reconstruct the CBCT image. Methods: A prototype SMOG-equipped CBCT system was developed, and was used to acquire gridded projections with complimentary grid patterns in two neighboring projections. Scatter was reduced by the grid, and the remaining scatter was corrected by measuring it under the grid. An IPSF algorithm was used to estimate the missing information in a projection from data in its 2 neighboring projections. Feldkamp-Davis-Kress (FDK) algorithm was used to reconstruct the initial CBCT image using projections after IPSF processing for pTV. A probability map was generated depending on the confidence of estimation in IPSF for the regions of missing data and penumbra. pTV was finally used to reconstruct the CBCT image for a Catphan, and was compared to conventional CBCT image without using SMOG, images without using IPSF (SMOG + FDK and SMOG + mask-TV), and image without using pTV (SMOG + IPSF + FDK). Results: The conventional CBCT without using SMOG shows apparent scatter-induced cup artifacts. The approaches with SMOG but without IPSF show severe (SMOG + FDK) or additional (SMOG + TV) artifacts, possibly due to using projections of missing data. The 2 approaches with SMOG + IPSF removes the cup artifacts, and the pTV approach is superior than the FDK by substantially reducing the noise. Using the SMOG also reduces half of the imaging dose. Conclusion: The proposed technique is promising in improving CBCT image quality while reducing imaging dose.

  3. WE-EF-207-08: Improve Cone Beam CT Using a Synchronized Moving Grid, An Inter-Projection Sensor Fusion and a Probability Total Variation Reconstruction

    International Nuclear Information System (INIS)

    Zhang, H; Kong, V; Jin, J; Ren, L; Zhang, Y; Giles, W

    2015-01-01

    Purpose: To present a cone beam computed tomography (CBCT) system, which uses a synchronized moving grid (SMOG) to reduce and correct scatter, an inter-projection sensor fusion (IPSF) algorithm to estimate the missing information blocked by the grid, and a probability total variation (pTV) algorithm to reconstruct the CBCT image. Methods: A prototype SMOG-equipped CBCT system was developed, and was used to acquire gridded projections with complimentary grid patterns in two neighboring projections. Scatter was reduced by the grid, and the remaining scatter was corrected by measuring it under the grid. An IPSF algorithm was used to estimate the missing information in a projection from data in its 2 neighboring projections. Feldkamp-Davis-Kress (FDK) algorithm was used to reconstruct the initial CBCT image using projections after IPSF processing for pTV. A probability map was generated depending on the confidence of estimation in IPSF for the regions of missing data and penumbra. pTV was finally used to reconstruct the CBCT image for a Catphan, and was compared to conventional CBCT image without using SMOG, images without using IPSF (SMOG + FDK and SMOG + mask-TV), and image without using pTV (SMOG + IPSF + FDK). Results: The conventional CBCT without using SMOG shows apparent scatter-induced cup artifacts. The approaches with SMOG but without IPSF show severe (SMOG + FDK) or additional (SMOG + TV) artifacts, possibly due to using projections of missing data. The 2 approaches with SMOG + IPSF removes the cup artifacts, and the pTV approach is superior than the FDK by substantially reducing the noise. Using the SMOG also reduces half of the imaging dose. Conclusion: The proposed technique is promising in improving CBCT image quality while reducing imaging dose

  4. One-Year Outcomes of Total Meniscus Reconstruction Using a Novel Fiber-Reinforced Scaffold in an Ovine Model.

    Science.gov (United States)

    Patel, Jay M; Merriam, Aaron R; Culp, Brian M; Gatt, Charles J; Dunn, Michael G

    2016-04-01

    Meniscus injuries and resulting meniscectomies lead to joint deterioration, causing pain, discomfort, and instability. Tissue-engineered devices to replace the meniscus have not shown consistent success with regard to function, mechanical integrity, or protection of cartilage. To evaluate a novel resorbable polymer fiber-reinforced meniscus reconstruction scaffold in an ovine model for 52 weeks and assess its integrity, tensile and compressive mechanics, cell phenotypes, matrix organization and content, and protection of the articular cartilage surfaces. Controlled laboratory study. Eight skeletally mature ewes were implanted with the fiber-reinforced scaffold after total meniscectomy, and 2 additional animals had untreated total meniscectomies. Animals were sacrificed at 52 weeks, and the explants and articular surfaces were analyzed macroscopically. Explants were characterized by ultimate tensile testing, confined compression creep testing, and biochemical, histological, and immunohistochemical analyses. Cartilage damage was characterized using the Mankin score on histologic slides from both the femur and tibia. One sheep was removed from the study because of a torn extensor tendon; the remaining 7 explants remained fully intact and incorporated into the bone tunnels. All explants exhibited functional tensile loads, tensile stiffnesses, and compressive moduli. Fibrocartilagenous repair with both types 1 and 2 collagen were observed, with areas of matrix organization and biochemical content similar to native tissue. Narrowing in the body region was observed in 5 of 7 explants. Mankin scores showed less cartilage damage in the explant group (femoral condyle: 3.43 ± 0.79, tibial plateau: 3.50 ± 1.63) than in the meniscectomy group (femoral condyle: 8.50 ± 3.54, tibial plateau: 6.75 ± 2.47) and were comparable with Mankin scores at the previously reported 16- and 32-week time points. A resorbable fiber-reinforced meniscus scaffold supports formation of functional

  5. Total knee reconstruction without posterior stabilization in rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Radu Prejbeanu

    2010-12-01

    Full Text Available Objectives: to present the results with posterior cruciate ligament-retaining total knee arthroplasty in rheumatoid arthritis (RA patients. Background: Total knee replacement in RA patients has many particularities. One of them is the difficulty of obtaining a proper ligamentous balance.Methods: 24 RA patients were followed for a 5-year period after posterior cruciate ligament-retaining total knee arthroplasty. Clinical assessments analyzed general health status by using Hospital for Special Surgery Knee Evaluation Form (HSSKEF and mediolateral and anteroposterior ligament stability by using varus-valgus and posterior drawer tests. Radiological assessments evaluated axial alignment, size and position of components, radiolucent lines in anteroposterior and lateral standard views, integrity of the posterior cruciate ligament on lateral view X-ray at 45 degrees of flexion.Results: the mean HSSKEF score increased from 32 to 84 points at the end of follow-up. Preoperative mean range of motion was 60 degrees; postoperative mean range of motion was of 105 degrees, with significant statistical difference (p<0.05. The mean femoral component axial deviation was 6 degrees. The tibial component had a mean axial deviation of 1 degree of varus. There were no radioluscency lines of more than 1mm. 21 patients had excellent results. None of the knees was unstable. Conclusion: posterior cruciate ligament-retaining total knee arthroplasty can be used in RA patients without excessive valgus deformity (over 15 degrees, providing thus sufficient stabilization. The outcomes re similar to those patients who followed a posterior stabilized endoprosthesis.

  6. Algebraic reconstruction techniques for spectral reconstruction in diffuse optical tomography

    International Nuclear Information System (INIS)

    Brendel, Bernhard; Ziegler, Ronny; Nielsen, Tim

    2008-01-01

    Reconstruction in diffuse optical tomography (DOT) necessitates solving the diffusion equation, which is nonlinear with respect to the parameters that have to be reconstructed. Currently applied solving methods are based on the linearization of the equation. For spectral three-dimensional reconstruction, the emerging equation system is too large for direct inversion, but the application of iterative methods is feasible. Computational effort and speed of convergence of these iterative methods are crucial since they determine the computation time of the reconstruction. In this paper, the iterative methods algebraic reconstruction technique (ART) and conjugated gradients (CGs) as well as a new modified ART method are investigated for spectral DOT reconstruction. The aim of the modified ART scheme is to speed up the convergence by considering the specific conditions of spectral reconstruction. As a result, it converges much faster to favorable results than conventional ART and CG methods

  7. Surface Reconstruction and Image Enhancement via $L^1$-Minimization

    KAUST Repository

    Dobrev, Veselin; Guermond, Jean-Luc; Popov, Bojan

    2010-01-01

    A surface reconstruction technique based on minimization of the total variation of the gradient is introduced. Convergence of the method is established, and an interior-point algorithm solving the associated linear programming problem is introduced

  8. Robot-Assisted Free Flap in Head and Neck Reconstruction

    Directory of Open Access Journals (Sweden)

    Han Gyeol Song

    2013-07-01

    Full Text Available BackgroundRobots have allowed head and neck surgeons to extirpate oropharyngeal tumors safely without the need for lip-split incision or mandibulotomy. Using robots in oropharyngeal reconstruction is new but essential for oropharyngeal defects that result from robotic tumor excision. We report our experience with robotic free-flap reconstruction of head and neck defects to exemplify the necessity for robotic reconstruction.MethodsWe investigated head and neck cancer patients who underwent ablation surgery and free-flap reconstruction by robot. Between July 1, 2011 and March 31, 2012, 5 cases were performed and patient demographics, location of tumor, pathologic stage, reconstruction methods, flap size, recipient vessel, necessary pedicle length, and operation time were investigated.ResultsAmong five free-flap reconstructions, four were radial forearm free flaps and one was an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and one flap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flap insetting and microanastomosis were achieved using a specially manufactured robotic instrument. The total operation time was 1,041.0 minutes (range, 814 to 1,132 minutes, and complications including flap necrosis, hematoma, and wound dehiscence did not occur.ConclusionsThis study demonstrates the clinically applicable use of robots in oropharyngeal reconstruction, especially using a free flap. A robot can assist the operator in insetting the flap at a deep portion of the oropharynx without the need to perform a traditional mandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methods and is accepted as the most up-to-date method.

  9. One-stage human acellular nerve allograft reconstruction for digital nerve defects

    Directory of Open Access Journals (Sweden)

    Xue-yuan Li

    2015-01-01

    Full Text Available Human acellular nerve allografts have a wide range of donor origin and can effectively avoid nerve injury in the donor area. Very little is known about one-stage reconstruction of digital nerve defects. The present study observed the feasibility and effectiveness of human acellular nerve allograft in the reconstruction of < 5-cm digital nerve defects within 6 hours after injury. A total of 15 cases of nerve injury, combined with nerve defects in 18 digits from the Department of Emergency were enrolled in this study. After debridement, digital nerves were reconstructed using human acellular nerve allografts. The patients were followed up for 6-24 months after reconstruction. Mackinnon-Dellon static two-point discrimination results showed excellent and good rates of 89%. Semmes-Weinstein monofilament test demonstrated that light touch was normal, with an obvious improvement rate of 78%. These findings confirmed that human acellular nerve allograft for one-stage reconstruction of digital nerve defect after hand injury is feasible, which provides a novel trend for peripheral nerve reconstruction.

  10. Homotopic non-local regularized reconstruction from sparse positron emission tomography measurements

    International Nuclear Information System (INIS)

    Wong, Alexander; Liu, Chenyi; Wang, Xiao Yu; Fieguth, Paul; Bie, Hongxia

    2015-01-01

    Positron emission tomography scanners collect measurements of a patient’s in vivo radiotracer distribution. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide (tracer), which is introduced into the body on a biologically active molecule, and the tomograms must be reconstructed from projections. The reconstruction of tomograms from the acquired PET data is an inverse problem that requires regularization. The use of tightly packed discrete detector rings, although improves signal-to-noise ratio, are often associated with high costs of positron emission tomography systems. Thus a sparse reconstruction, which would be capable of overcoming the noise effect while allowing for a reduced number of detectors, would have a great deal to offer. In this study, we introduce and investigate the potential of a homotopic non-local regularization reconstruction framework for effectively reconstructing positron emission tomograms from such sparse measurements. Results obtained using the proposed approach are compared with traditional filtered back-projection as well as expectation maximization reconstruction with total variation regularization. A new reconstruction method was developed for the purpose of improving the quality of positron emission tomography reconstruction from sparse measurements. We illustrate that promising reconstruction performance can be achieved for the proposed approach even at low sampling fractions, which allows for the use of significantly fewer detectors and have the potential to reduce scanner costs

  11. Cost-effectiveness of simultaneous versus sequential surgery in head and neck reconstruction.

    Science.gov (United States)

    Wong, Kevin K; Enepekides, Danny J; Higgins, Kevin M

    2011-02-01

    To determine whether simultaneous (ablation and reconstruction overlaps by two teams) head and neck reconstruction is cost effective compared to sequentially (ablation followed by reconstruction) performed surgery. Case-controlled study. Tertiary care hospital. Oncology patients undergoing free flap reconstruction of the head and neck. A match paired comparison study was performed with a retrospective chart review examining the total time of surgery for sequential and simultaneous surgery. Nine patients were selected for both the sequential and simultaneous groups. Sequential head and neck reconstruction patients were pair matched with patients who had undergone similar oncologic ablative or reconstructive procedures performed in a simultaneous fashion. A detailed cost analysis using the microcosting method was then undertaken looking at the direct costs of the surgeons, anesthesiologist, operating room, and nursing. On average, simultaneous surgery required 3 hours 15 minutes less operating time, leading to a cost savings of approximately $1200/case when compared to sequential surgery. This represents approximately a 15% reduction in the cost of the entire operation. Simultaneous head and neck reconstruction is more cost effective when compared to sequential surgery.

  12. Quantitatively assessed CT imaging measures of pulmonary interstitial pneumonia: Effects of reconstruction algorithms on histogram parameters

    International Nuclear Information System (INIS)

    Koyama, Hisanobu; Ohno, Yoshiharu; Yamazaki, Youichi; Nogami, Munenobu; Kusaka, Akiko; Murase, Kenya; Sugimura, Kazuro

    2010-01-01

    This study aimed the influences of reconstruction algorithm for quantitative assessments in interstitial pneumonia patients. A total of 25 collagen vascular disease patients (nine male patients and 16 female patients; mean age, 57.2 years; age range 32-77 years) underwent thin-section MDCT examinations, and MDCT data were reconstructed with three kinds of reconstruction algorithm (two high-frequencies [A and B] and one standard [C]). In reconstruction algorithm B, the effect of low- and middle-frequency space was suppressed compared with reconstruction algorithm A. As quantitative CT parameters, kurtosis, skewness, and mean lung density (MLD) were acquired from a frequency histogram of the whole lung parenchyma in each reconstruction algorithm. To determine the difference of quantitative CT parameters affected by reconstruction algorithms, these parameters were compared statistically. To determine the relationships with the disease severity, these parameters were correlated with PFTs. In the results, all the histogram parameters values had significant differences each other (p < 0.0001) and those of reconstruction algorithm C were the highest. All MLDs had fair or moderate correlation with all parameters of PFT (-0.64 < r < -0.45, p < 0.05). Though kurtosis and skewness in high-frequency reconstruction algorithm A had significant correlations with all parameters of PFT (-0.61 < r < -0.45, p < 0.05), there were significant correlations only with diffusing capacity of carbon monoxide (DLco) and total lung capacity (TLC) in reconstruction algorithm C and with forced expiratory volume in 1 s (FEV1), DLco and TLC in reconstruction algorithm B. In conclusion, reconstruction algorithm has influence to quantitative assessments on chest thin-section MDCT examination in interstitial pneumonia patients.

  13. Quantitatively assessed CT imaging measures of pulmonary interstitial pneumonia: Effects of reconstruction algorithms on histogram parameters

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, Hisanobu [Department of Radiology, Hyogo Kaibara Hospital, 5208-1 Kaibara, Kaibara-cho, Tanba 669-3395 (Japan)], E-mail: hisanobu19760104@yahoo.co.jp; Ohno, Yoshiharu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan)], E-mail: yosirad@kobe-u.ac.jp; Yamazaki, Youichi [Department of Medical Physics and Engineering, Faculty of Health Sciences, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita 565-0871 (Japan)], E-mail: y.yamazk@sahs.med.osaka-u.ac.jp; Nogami, Munenobu [Division of PET, Institute of Biomedical Research and Innovation, 2-2 MInamimachi, Minatojima, Chu0-ku, Kobe 650-0047 (Japan)], E-mail: aznogami@fbri.org; Kusaka, Akiko [Division of Radiology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan)], E-mail: a.kusaka@hosp.kobe-u.ac.jp; Murase, Kenya [Department of Medical Physics and Engineering, Faculty of Health Sciences, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita 565-0871 (Japan)], E-mail: murase@sahs.med.osaka-u.ac.jp; Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan)], E-mail: sugimura@med.kobe-u.ac.jp

    2010-04-15

    This study aimed the influences of reconstruction algorithm for quantitative assessments in interstitial pneumonia patients. A total of 25 collagen vascular disease patients (nine male patients and 16 female patients; mean age, 57.2 years; age range 32-77 years) underwent thin-section MDCT examinations, and MDCT data were reconstructed with three kinds of reconstruction algorithm (two high-frequencies [A and B] and one standard [C]). In reconstruction algorithm B, the effect of low- and middle-frequency space was suppressed compared with reconstruction algorithm A. As quantitative CT parameters, kurtosis, skewness, and mean lung density (MLD) were acquired from a frequency histogram of the whole lung parenchyma in each reconstruction algorithm. To determine the difference of quantitative CT parameters affected by reconstruction algorithms, these parameters were compared statistically. To determine the relationships with the disease severity, these parameters were correlated with PFTs. In the results, all the histogram parameters values had significant differences each other (p < 0.0001) and those of reconstruction algorithm C were the highest. All MLDs had fair or moderate correlation with all parameters of PFT (-0.64 < r < -0.45, p < 0.05). Though kurtosis and skewness in high-frequency reconstruction algorithm A had significant correlations with all parameters of PFT (-0.61 < r < -0.45, p < 0.05), there were significant correlations only with diffusing capacity of carbon monoxide (DLco) and total lung capacity (TLC) in reconstruction algorithm C and with forced expiratory volume in 1 s (FEV1), DLco and TLC in reconstruction algorithm B. In conclusion, reconstruction algorithm has influence to quantitative assessments on chest thin-section MDCT examination in interstitial pneumonia patients.

  14. Reconstruction of massive full-thickness abdominal wall defect

    DEFF Research Database (Denmark)

    Aydin, Dogu; Paulsen, Ida Felbo; Bentzen, Vibeke Egerup

    2016-01-01

    We demonstrate that it is possible to use a nonabsorbable mesh for abdominal wall reconstruction after total wound rupture and successfully split-skin graft directly on the mesh. Sufficient granulation tissue formation prior to skin grafting was obtained with long-term use of negative pressure...

  15. Blind spectrum reconstruction algorithm with L0-sparse representation

    International Nuclear Information System (INIS)

    Liu, Hai; Zhang, Zhaoli; Liu, Sanyan; Shu, Jiangbo; Liu, Tingting; Zhang, Tianxu

    2015-01-01

    Raman spectrum often suffers from band overlap and Poisson noise. This paper presents a new blind Poissonian Raman spectrum reconstruction method, which incorporates the L 0 -sparse prior together with the total variation constraint into the maximum a posteriori framework. Furthermore, the greedy analysis pursuit algorithm is adopted to solve the L 0 -based minimization problem. Simulated and real spectrum experimental results show that the proposed method can effectively preserve spectral structure and suppress noise. The reconstructed Raman spectra are easily used for interpreting unknown chemical mixtures. (paper)

  16. Total energy calculations and bonding at interfaces

    International Nuclear Information System (INIS)

    Louie, S.G.

    1984-08-01

    Some of the concepts and theoretical techniques employed in recent ab initio studies of the electronic and structural properties of surfaces and interfaces are discussed. Results of total energy calculations for the 2 x 1 reconstructed diamond (111) surface and for stacking faults in Si are reviewed. 30 refs., 8 figs

  17. Reconstruction of March-June precipitation from tree rings in central Liaoning, China

    Science.gov (United States)

    Wang, Yanchao; Liu, Yu

    2017-11-01

    A dendrochronological profile was generated from Chinese pines ( Pinus tabulaeformis Carr.) in the Qianshan Mountains in northeastern China. Based on correlation analyses, the pattern of precipitation from March to June ( P 36 ) was reconstructed using a simple linear model, which explained 42.7% of the total variance in observed precipitation from 1951 to 2012. The reconstructed P 36 series revealed a consistently increasing trend in precipitation during the twentieth century in the Qianshan Mountains. The reconstructed data showed trends that were similar to those in the variation in trends for March-June precipitation observed at the Shenyang station, the reconstructed January-May precipitation trends in Shenyang City, and the reconstructed average June-September relative humidity for Yiwulü Mountain. The reconstructed data also showed good agreement with the droughts reported in historical documents and recorded by meteorological stations in Liaoning. Spatial correlation analyses show that the reconstructed data reflect the variability in precipitation that occurs over much of northeastern China. In addition, our reconstruction showed a significant periodicity. The significant correlations between the reconstructed P 36 and the El Niño-Southern Oscillation (ENSO), Pacific Decadal Oscillation (PDO) and sunspot numbers indicate that precipitation variability in the Qianshan Mountain region is probably driven by extensive atmosphere-sea interactions and solar activities.

  18. Joint reconstruction via coupled Bregman iterations with applications to PET-MR imaging

    Science.gov (United States)

    Rasch, Julian; Brinkmann, Eva-Maria; Burger, Martin

    2018-01-01

    Joint reconstruction has recently attracted a lot of attention, especially in the field of medical multi-modality imaging such as PET-MRI. Most of the developed methods rely on the comparison of image gradients, or more precisely their location, direction and magnitude, to make use of structural similarities between the images. A challenge and still an open issue for most of the methods is to handle images in entirely different scales, i.e. different magnitudes of gradients that cannot be dealt with by a global scaling of the data. We propose the use of generalized Bregman distances and infimal convolutions thereof with regard to the well-known total variation functional. The use of a total variation subgradient respectively the involved vector field rather than an image gradient naturally excludes the magnitudes of gradients, which in particular solves the scaling behavior. Additionally, the presented method features a weighting that allows to control the amount of interaction between channels. We give insights into the general behavior of the method, before we further tailor it to a particular application, namely PET-MRI joint reconstruction. To do so, we compute joint reconstruction results from blurry Poisson data for PET and undersampled Fourier data from MRI and show that we can gain a mutual benefit for both modalities. In particular, the results are superior to the respective separate reconstructions and other joint reconstruction methods.

  19. Revision total knee arthroplasty with the use of trabecular metal cones

    DEFF Research Database (Denmark)

    Jensen, Claus L; Petersen, Michael Mygind; Schrøder, Henrik

    2012-01-01

    "Trabecular Metal Cone" (TM Cone) (Zimmer, Inc, Warsaw, Ind) for reconstruction of bone loss in the proximal tibia during revision total knee arthroplasty is now optional. Forty patients were randomized to receive revision total knee arthroplasty with or without TM Cone (No TM Cone). The Anderson...

  20. Cost minimisation analysis of using acellular dermal matrix (Strattice™) for breast reconstruction compared with standard techniques.

    Science.gov (United States)

    Johnson, R K; Wright, C K; Gandhi, A; Charny, M C; Barr, L

    2013-03-01

    We performed a cost analysis (using UK 2011/12 NHS tariffs as a proxy for cost) comparing immediate breast reconstruction using the new one-stage technique of acellular dermal matrix (Strattice™) with implant versus the standard alternative techniques of tissue expander (TE)/implant as a two-stage procedure and latissimus dorsi (LD) flap reconstruction. Clinical report data were collected for operative time, length of stay, outpatient procedures, and number of elective and emergency admissions in our first consecutive 24 patients undergoing one-stage Strattice reconstruction. Total cost to the NHS based on tariff, assuming top-up payments to cover Strattice acquisition costs, was assessed and compared to the two historical control groups matched on key variables. Eleven patients having unilateral Strattice reconstruction were compared to 10 having TE/implant reconstruction and 10 having LD flap and implant reconstruction. Thirteen patients having bilateral Strattice reconstruction were compared to 12 having bilateral TE/implant reconstruction. Total costs were: unilateral Strattice, £3685; unilateral TE, £4985; unilateral LD and implant, £6321; bilateral TE, £5478; and bilateral Strattice, £6771. The cost analysis shows a financial advantage of using acellular dermal matrix (Strattice) in unilateral breast reconstruction versus alternative procedures. The reimbursement system in England (Payment by Results) is based on disease-related groups similar to that of many countries across Europe and tariffs are based on reported hospital costs, making this analysis of relevance in other countries. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. A fast iterative soft-thresholding algorithm for few-view CT reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Junfeng; Mou, Xuanqin; Zhang, Yanbo [Jiaotong Univ., Xi' an (China). Inst. of Image Processing and Pattern Recognition

    2011-07-01

    Iterative soft-thresholding algorithms with total variation regularization can produce high-quality reconstructions from few views and even in the presence of noise. However, these algorithms are known to converge quite slowly, with a proven theoretically global convergence rate O(1/k), where k is iteration number. In this paper, we present a fast iterative soft-thresholding algorithm for few-view fan beam CT reconstruction with a global convergence rate O(1/k{sup 2}), which is significantly faster than the iterative soft-thresholding algorithm. Simulation results demonstrate the superior performance of the proposed algorithm in terms of convergence speed and reconstruction quality. (orig.)

  2. Aggregate Measures of Watershed Health from Reconstructed ...

    Science.gov (United States)

    Risk-based indices such as reliability, resilience, and vulnerability (R-R-V), have the potential to serve as watershed health assessment tools. Recent research has demonstrated the applicability of such indices for water quality (WQ) constituents such as total suspended solids and nutrients on an individual basis. However, the calculations can become tedious when time-series data for several WQ constituents have to be evaluated individually. Also, comparisons between locations with different sets of constituent data can prove difficult. In this study, data reconstruction using relevance vector machine algorithm was combined with dimensionality reduction via variational Bayesian noisy principal component analysis to reconstruct and condense sparse multidimensional WQ data sets into a single time series. The methodology allows incorporation of uncertainty in both the reconstruction and dimensionality-reduction steps. The R-R-V values were calculated using the aggregate time series at multiple locations within two Indiana watersheds. Results showed that uncertainty present in the reconstructed WQ data set propagates to the aggregate time series and subsequently to the aggregate R-R-V values as well. serving as motivating examples. Locations with different WQ constituents and different standards for impairment were successfully combined to provide aggregate measures of R-R-V values. Comparisons with individual constituent R-R-V values showed that v

  3. Adaptive wavelet tight frame construction for accelerating MRI reconstruction

    Directory of Open Access Journals (Sweden)

    Genjiao Zhou

    2017-09-01

    Full Text Available The sparsity regularization approach, which assumes that the image of interest is likely to have sparse representation in some transform domain, has been an active research area in image processing and medical image reconstruction. Although various sparsifying transforms have been used in medical image reconstruction such as wavelet, contourlet, and total variation (TV etc., the efficiency of these transforms typically rely on the special structure of the underlying image. A better way to address this issue is to develop an overcomplete dictionary from the input data in order to get a better sparsifying transform for the underlying image. However, the general overcomplete dictionaries do not satisfy the so-called perfect reconstruction property which ensures that the given signal can be perfectly represented by its canonical coefficients in a manner similar to orthonormal bases, resulting in time consuming in the iterative image reconstruction. This work is to develop an adaptive wavelet tight frame method for magnetic resonance image reconstruction. The proposed scheme incorporates the adaptive wavelet tight frame approach into the magnetic resonance image reconstruction by solving a l0-regularized minimization problem. Numerical results show that the proposed approach provides significant time savings as compared to the over-complete dictionary based methods with comparable performance in terms of both peak signal-to-noise ratio and subjective visual quality.

  4. Comprehensive approach to functional palatomaxillary reconstruction using regional and free tissue transfer: Report of reconstructive and prosthodontic outcomes of 140 patients.

    Science.gov (United States)

    Urken, Mark L; Roche, Ansley M; Kiplagat, Kimberly J; Dewey, Eliza H; Lazarus, Cathy; Likhterov, Ilya; Buchbinder, Daniel; Okay, Devin J

    2018-03-14

    Palatomaxillary defects were historically restored with a prosthetic obturator; however, advances in local and free tissue transfer has provided a viable alternative for appropriately selected patients with palatomaxillary defects. A retrospective chart review of patients who underwent palatomaxillary reconstruction by the lead author between 1998 and 2016 was conducted. Patients who were restored with a palatal obturator were excluded. One hundred forty patients were reconstructed with a total of 159 local, regional, and free flaps with a 96.7% success rate. Seventy-four patients (52.8%) underwent prosthodontic rehabilitation, with 183 implants placed and an 86% success rate. Palatomaxillary reconstruction applying a systematic approach, using a multitude of techniques, is a safe and effective way to restore patients without compromising the ability to maintain surveillance. Prosthodontic rehabilitation can be achieved in a high percentage of patients using dental implants, leading to optimal aesthetic and functional results. © 2018 Wiley Periodicals, Inc.

  5. Parallel MR image reconstruction using augmented Lagrangian methods.

    Science.gov (United States)

    Ramani, Sathish; Fessler, Jeffrey A

    2011-03-01

    Magnetic resonance image (MRI) reconstruction using SENSitivity Encoding (SENSE) requires regularization to suppress noise and aliasing effects. Edge-preserving and sparsity-based regularization criteria can improve image quality, but they demand computation-intensive nonlinear optimization. In this paper, we present novel methods for regularized MRI reconstruction from undersampled sensitivity encoded data--SENSE-reconstruction--using the augmented Lagrangian (AL) framework for solving large-scale constrained optimization problems. We first formulate regularized SENSE-reconstruction as an unconstrained optimization task and then convert it to a set of (equivalent) constrained problems using variable splitting. We then attack these constrained versions in an AL framework using an alternating minimization method, leading to algorithms that can be implemented easily. The proposed methods are applicable to a general class of regularizers that includes popular edge-preserving (e.g., total-variation) and sparsity-promoting (e.g., l(1)-norm of wavelet coefficients) criteria and combinations thereof. Numerical experiments with synthetic and in vivo human data illustrate that the proposed AL algorithms converge faster than both general-purpose optimization algorithms such as nonlinear conjugate gradient (NCG) and state-of-the-art MFISTA.

  6. Comparison of four surgical methods for eyebrow reconstruction

    Directory of Open Access Journals (Sweden)

    Omranifard Mahmood

    2007-01-01

    Full Text Available Background: The eyebrow plays an important role in facial harmony and eye protection. Eyebrows can be injured by burn, trauma, tumour, tattooing and alopecia. Eyebrow reconstructions have been done via several techniques. Here, our experience with a fairly new method for eyebrow reconstruction is presented. Materials and Methods: This is a descriptive-analytical study which was done on 76 patients at the Al-Zahra and Imam Mousa Kazem hospitals at Isfahan University of Medical University, Isfahan, Iran, from 1994 to 2004. Totally 86 eyebrows were reconstructed. All patients were examined before and after the operation. Methods which are commonly applied in eyebrow reconstruction are as follows: 1. Superficial Temporal Artery Flap (Island, 2. Interpolitation Scalp Flap, 3. Graft. Our method which is named Forehead Facial Island Flap with inferior pedicle provides an easier approach for the surgeon and more ideal hair growth direction for the patient. Results: Significantly lower rates of complication along with greater patient satisfaction were obtained with Forehead Facial Island Flap. Conclusions: According to the acquired results, this method seems to be more technically practical and aesthetically favourable when compared to others.

  7. Breast reconstruction after mastectomy

    Directory of Open Access Journals (Sweden)

    Daniel eSchmauss

    2016-01-01

    Full Text Available Breast cancer is the leading cause of cancer death in women worldwide. Its surgical approach has become less and less mutilating in the last decades. However, the overall number of breast reconstructions has significantly increased lately. Nowadays breast reconstruction should be individualized at its best, first of all taking into consideration oncological aspects of the tumor, neo-/adjuvant treatment and genetic predisposition, but also its timing (immediate versus delayed breast reconstruction, as well as the patient’s condition and wish. This article gives an overview over the various possibilities of breast reconstruction, including implant- and expander-based reconstruction, flap-based reconstruction (vascularized autologous tissue, the combination of implant and flap, reconstruction using non-vascularized autologous fat, as well as refinement surgery after breast reconstruction.

  8. Breast reconstruction - implants

    Science.gov (United States)

    Breast implants surgery; Mastectomy - breast reconstruction with implants; Breast cancer - breast reconstruction with implants ... harder to find a tumor if your breast cancer comes back. Getting breast implants does not take as long as breast reconstruction ...

  9. Influence of Adaptive Statistical Iterative Reconstruction on coronary plaque analysis in coronary computed tomography angiography

    DEFF Research Database (Denmark)

    Precht, Helle; Kitslaar, Pieter H; Broersen, Alexander

    2016-01-01

    performed. Images were reconstructed using FBP, 30% and 60% adaptive statistical IR (ASIR). Coronary plaque analysis was performed as per patient and per vessel (LM, LAD, CX and RCA) measurements. Lumen and vessel volumes and plaque burden measurements were based on automatic detected contours in each...... reconstruction. Lumen and plaque intensity measurements and HU based plaque characterization were based on corrected contours copied to each reconstruction. RESULTS: No significant changes between FBP and 30% ASIR were found except for lumen- (-2.53 HU) and plaque intensities (-1.28 HU). Between FBP and 60% ASIR...... the change in total volume showed an increase of 0.94%, 4.36% and 2.01% for lumen, plaque and vessel, respectively. The change in total plaque burden between FBP and 60% ASIR was 0.76%. Lumen and plaque intensities decreased between FBP and 60% ASIR with -9.90 HU and -1.97 HU, respectively. The total plaque...

  10. The reconstruction of thyroid dose following Chernobyl

    International Nuclear Information System (INIS)

    Stepanenko, V.; Kondrashov, A.; Yaskova, E.; Petin, D.; Skvortsov, V.; Parshkov, E.; Gavrilin, Yu.; Khrousch, V.; Shinkarev, S.; Makarenkova, I.; Volkov, V.; Zvonova, I.; Bratilova, A.; Kaidanovsky, J.; Minenko, V.; Drozdovich, V.; Ulanovsky, A.; Korneev, S.; Heinemann, K.; Pomplun, E.; Hille, R.; Bailiff, A.

    1996-01-01

    The report presents the overview of several approaches in working out the methods of thyroid internal dose reconstruction following Chernobyl. One of these approaches was developed (IBPh, Moscow; MRRC, Obninsk; IRM, Minsk) using the correlations between the mean dose calculation based on I 131 thyroid content measurements and Cs 137 contamination of territories. The available data on I 131 soil contamination were taken into account. The lack of data on I 131 soil contamination was supposed to be compensated by I 129 measurements in soil samples from contaminated territories. The semiempiric model was developed for dose reconstruction. The comparison of the results obtained by semiempiric model and empirical values are presented. The estimated values of average dose according semiempiric model were used for individual dose reconstruction. The IRH (St.-Petersburg) has developed the following method for individual dose reconstruction: correlation between the total I 131 radioiodine incorporation in thyroid and whole body Cs 137 content during first months after accident. The individual dose reconstruction is also mentioned to be performed using the data on individual milk consumption during first weeks after accident. For evaluation of average doses it is suggested to use the linear correlation: thyroid dose values based on radioiodine thyroid measurements vs Cs 137 contamination, air kerma rate, mean I 131 concentration in the milk. The method for retrospective reconstruction of thyroid dose caused by short-living iodine nuclides released after the Chernobyl accident has been developed by Research Centre, Juelich, Germany. It is based on the constant ratio that these nuclides have with the long-living I 129 . The contamination of soil samples by this nuclide can be used to assess thyroid doses. First results of I 129 contamination values and derived thyroid doses are to be presented

  11. Adaptive algebraic reconstruction technique

    International Nuclear Information System (INIS)

    Lu Wenkai; Yin Fangfang

    2004-01-01

    Algebraic reconstruction techniques (ART) are iterative procedures for reconstructing objects from their projections. It is proven that ART can be computationally efficient by carefully arranging the order in which the collected data are accessed during the reconstruction procedure and adaptively adjusting the relaxation parameters. In this paper, an adaptive algebraic reconstruction technique (AART), which adopts the same projection access scheme in multilevel scheme algebraic reconstruction technique (MLS-ART), is proposed. By introducing adaptive adjustment of the relaxation parameters during the reconstruction procedure, one-iteration AART can produce reconstructions with better quality, in comparison with one-iteration MLS-ART. Furthermore, AART outperforms MLS-ART with improved computational efficiency

  12. Total hip arthroplasty for giant cell tumour.

    Directory of Open Access Journals (Sweden)

    Kulkarni S

    1996-07-01

    Full Text Available A 32 month follow up of an uncommon case of a Giant Cell Tumour affecting the proximal end of femur is presented. Following a wide excision, the hip was reconstructed using Charnley type of low friction total hip arthroplasty. At a 32 month review, there was no recurrence and the function was good.

  13. Comparing 3-dimensional virtual methods for reconstruction in craniomaxillofacial surgery.

    Science.gov (United States)

    Benazzi, Stefano; Senck, Sascha

    2011-04-01

    In the present project, the virtual reconstruction of digital osteomized zygomatic bones was simulated using different methods. A total of 15 skulls were scanned using computed tomography, and a virtual osteotomy of the left zygomatic bone was performed. Next, virtual reconstructions of the missing part using mirror imaging (with and without best fit registration) and thin plate spline interpolation functions were compared with the original left zygomatic bone. In general, reconstructions using thin plate spline warping showed better results than the mirroring approaches. Nevertheless, when dealing with skulls characterized by a low degree of asymmetry, mirror imaging and subsequent registration can be considered a valid and easy solution for zygomatic bone reconstruction. The mirroring tool is one of the possible alternatives in reconstruction, but it might not always be the optimal solution (ie, when the hemifaces are asymmetrical). In the present pilot study, we have verified that best fit registration of the mirrored unaffected hemiface and thin plate spline warping achieved better results in terms of fitting accuracy, overcoming the evident limits of the mirroring approach. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Trends in Revision Elbow Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers.

    Science.gov (United States)

    Wilson, Alexander T; Pidgeon, Tyler S; Morrell, Nathan T; DaSilva, Manuel F

    2015-11-01

    To determine the frequency of revision elbow ulnar collateral ligament (UCL) reconstruction in professional baseball pitchers. Data were collected on 271 professional baseball pitchers who underwent primary UCL reconstruction. Each player was evaluated retrospectively for occurrence of revision UCL reconstructive surgery to treat failed primary reconstruction. Data on players who underwent revision UCL reconstruction were compiled to determine total surgical revision incidence and revision rate by year. The incidence of early revision was analyzed for trends. Average career length after primary UCL reconstruction was calculated and compared with that of players who underwent revision surgery. Logistic regression analysis was performed to assess risk factors for revision including handedness, pitching role, and age at the time of primary reconstruction. Between 1974 and 2014, the annual incidence of primary UCL reconstructions among professional pitchers increased, while the proportion of cases being revised per year decreased. Of the 271 pitchers included in the study, 40 (15%) required at least 1 revision procedure during their playing career. Three cases required a second UCL revision reconstruction. The average time from primary surgery to revision was 5.2 ± 3.2 years (range, 1-13 years). The average length of career following primary reconstruction for all players was 4.9 ± 4.3 years (range, 0-22 years). The average length of career following revision UCL reconstruction was 2.5 ± 2.4 years (range, 0-8 years). No risk factors for needing revision UCL reconstruction were identified. The incidence of primary UCL reconstructions among professional pitchers is increasing; however, the rate of primary reconstructions requiring revision is decreasing. Explanations for the decreased revision rate may include improved surgical technique and improved rehabilitation protocols. Therapeutic IV. Copyright © 2015 American Society for Surgery of the Hand. Published by

  15. TECHNIQUES FOR RECONSTRUCTION OF THE PRESERVED HOUSING STOCK

    Directory of Open Access Journals (Sweden)

    Kustikova Yuliya Olegovna

    2017-10-01

    Full Text Available Nowadays in Russian cities a significant part of the housing stock in areas of existing buildings has a high level of physical and moral deterioration, indicators of infrastructure elements do not meet the current and future requirements. Reconstruction of residential buildings is one of the important directions in solving the housing problem. This will allow us to not only extend the life cycle but also significantly improve the quality of housing, eliminate a communal settlement, provide the houses with modern engineering equipment, improve architectural expressiveness of buildings and increase their energy efficiency. For buildings of different construction periods an individual approach is required in the development of methods and technologies of reconstruction. At the same time, the process should take place not in a separate building but in a group of buildings, neighborhood or district. This makes it possible to undertake a comprehensive assessment of the urban development situation and make the most rational decisions to meet modern conditions, and provide logical connection between various architectural trends. At the same time, there are possibilities for compaction and decompaction of buildings, the rational use of inter-district, underground space and communication systems. Moscow region is a large region, which occupies an area of 46 thousand square kilometers. The region includes more than 38 municipalities (municipal districts, urban and rural settlements. The region’s population is more than 7 million people. Moscow oblast has a central location in the Russian Federation and a close relationship with the capital. This relationship with Moscow is manifested through common social, scientific, industrial, transport links, environmental protection problems, labor resources. In 2016 the total area of the housing stock in Moscow region was about 220 million sq. m. The total area of dilapidated and emergency housing stock is just

  16. Reconstruction CT imaging of the hypopharynx and the larynx

    International Nuclear Information System (INIS)

    Okuno, Tetsuji; Fujimura, Akiko; Murakami, Yasushi; Shiga, Hayao

    1986-01-01

    The multiplanar reconstruction CT imaging of the hypopharynx and the larynx was performed on a total of 20 cases: 8 with laryngeal carcinomas, 6 with hypopharyngeal carcinomas, 4 with vocal cord paralyses due to various causes, 1 with laryngeal amyloidosis, 1 with inflammatory granuloma of the hypopharynx. Coronal, segittal, and parasagittal reconstruction images were obtained from either 1 or 2 mm overlapping axial scans with 4 or 5 mm slice thickness (3 cases) using 5 sec scan times during queit breathing. In 15 cases with coronal reconstruction imaging, the anatomical derangements of the laryngopharyngeal structures especially along the undersurface of the true vocal cord to the false cord level, the lateral wall of the pyriform sinus, and the paraglottic space were demonstrated more clearly than the axial CT imaging. In 5 cases with sagittal reconstruction imaging, the vertical extension of the lesions through the anterior commisure was more clearly depicted than the axial CT imaging. In 8 cases with parasagittal reconstruction imaging, which is along the vocal fold or across the aryepiglottic fold, pathological changes along the aryepiglottic fold, the arytenoid-corniculate cartilage complex, and the tip of the pyriform sinus were more clearly demonstrated than the axial CT imaging. In determining the feasibility of conservation surgery of the larynx and the hypopharynx, reconstruction CT imaging is recommended as the diagnostic procedure of a choice, which would supplement the findings of the routine axial CT imaging. (author)

  17. Expandable Total Humeral Replacement in a Child with Osteosarcoma

    Directory of Open Access Journals (Sweden)

    Eric R. Henderson

    2015-01-01

    Full Text Available Case. A right-handed 8-year-old female patient presented with a conventional, high-grade osteosarcoma involving her right humerus; through-shoulder amputation was recommended. After consultation, total humerus resection with expandable, total humeral endoprosthesis reconstruction was performed with a sleeve to encourage soft-tissue ingrowth. At three-year follow-up she has received one lengthening procedure and her functional scores are excellent. Conclusion. Total humeral resection and replacement in the pediatric population are rare and although early reports of expandable total humeral endoprosthesis outcomes demonstrate high failure rates, this patient’s success indicates that expandable total humeral replacement is a viable option.

  18. Total hip reconstruction in acetabular dysplasia : a finite element study

    NARCIS (Netherlands)

    Schüller, H.M.; Dalstra, M.; Huiskes, H.W.J.; Marti, R.K.

    1993-01-01

    In acetabular dysplasia, fixation of the acetabular component of a cemented total hip prosthesis may be insecure and superolateral bone grafts are often used to augment the acetabular roof. We used finite element analysis to study the mechanical importance of the lateral acetabular roof and found

  19. Diagnostic value of 3 D CT surface reconstruction in spinal fractures

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, S. [Department of Radiology, Univ. of Leipzig (Germany); Dietrich, K. [Department of Radiology, Univ. of Leipzig (Germany); Steinecke, R. [Department of Radiology, Univ. of Leipzig (Germany); Kloeppel, R. [Department of Radiology, Univ. of Leipzig (Germany); Schulz, H.G. [Department of Radiology, Univ. of Leipzig (Germany)

    1997-02-01

    Our purpose was to evaluate the diagnostic value of three-dimensional (3 D) CT surface reconstruction in spinal fractures in comparison with axial and reformatted images. A total of 50 patients with different CT-proven spinal fractures were analysed retrospectively. Based on axial scans and reformatted images, the spinal fractures were classified according to several classifications as Magerl for the thoraco-lumbar and lower cervical spine by one radiologist. Another radiologist performed 3 D CT surface reconstructions with the aim of characterizing the different types of spinal fractures. A third radiologist classified the 3 D CT surface reconstruction according to the Magerl classification. The results of the blinded reading process were compared. It was checked to see in which type and subgroup 3 D surface reconstructions were helpful. Readers one and two obtained the same results in the classification. The 3 D surface reconstruction did not yield any additional diagnostic information concerning type A and B injuries. Indeed, the full extent of the fracture could be easier recognized with axial and reformatted images in all cases. In 10 cases of C injuries, the dislocation of parts of vertebrae could be better recognized with the help of 3 D reconstructions. A 3 D CT surface reconstruction is only useful in rotational and shear vertebral injuries (Magerl type C injury). (orig.). With 4 figs., 1 tab.

  20. Complete Lower Lip Reconstruction with a Large Lip Switch Flap and a Composite Modiolus Advancement Flap

    DEFF Research Database (Denmark)

    Gunnarsson, Gudjon L.; Demmissie, Meheret Beferkadu; Havemann, Ingemar

    2017-01-01

    Total loss of the lower lip is debilitating and poses a reconstructive challenge. Aiming to restore oral continence and function and also cosmetic appearance, a successful reconstruction has a huge impact on the quality of life for the individual patient. Early sources of local tissue rearrangement...

  1. Different techniques of vessel reconstruction during kidney transplantation

    Directory of Open Access Journals (Sweden)

    Tomić Aleksandar

    2015-01-01

    Full Text Available Background/Aim. Multiple renal arteries (MRAs represent a surgical challenge by the difficulty in performing anastomoses, bleeding and stenosis. MRAs should be preserved and special attention should be paid to accessory polar arteries. All renal arteries (RAs must be reconstructed and prepared for safe anastomosis. The paper decribed the different techniques of vessel reconstruction during kidney transplantation including important steps within recovery of organs, preparation and implantation. Methods. In a 16-year period (1996-2012 of kidney transplantation in the Military Medical Academy, Belgrade, a total of 310 living donors and 44 human cadaver kidney transplantations were performed, of which 28 (8% kidneys had two or more RAs. Results. All the transplanted kidneys had immediate function. We repaired 20 cases of donor kidneys with 2 arteries, 4 cases with three RAs, one case with 4 RAs, one case with 4 RAs and renal vein reconstruction, one case with 3 arteries and additional polytetrafluoroethylene (PTFE graft reconstruction, one case with transected renal artery and reconstruction with 5 cm long deceased donor external iliac artery. There were no major complications and graft failure. At a minimum of 1-year follow-up, all the patients showed normal renal function. Conclusion. Donor kidney transplantation on a contralateral side and “end-to-end” anastomosis of the renal artery to the internal iliac artery (IIA is our standard procedure with satisfactory results. Renal artery reconstruction and anastomosis with IIA is a safe and highly efficient procedure and kidneys with MRAs are not contraindicated for transplantation. A surgical team should be fully competent to remove cadaveric abdominal organs to avoid accidental injuries of organs vessels.

  2. Plastic surgery in chest wall reconstruction: relevant aspects - case series

    Directory of Open Access Journals (Sweden)

    Diogo Franco

    Full Text Available Objective: to discuss the participation of Plastic Surgery in the reconstruction of the chest wall, highlighting relevant aspects of interdisciplinaryness. Methods: we analyzed charts from 20 patients who underwent extensive resection of the thoracic integument, between 2000 and 2014, recording the indication of resection, the extent and depth of the raw areas, types of reconstructions performed and complications. Results: among the 20 patients, averaging 55 years old, five were males and 15 females. They resections were: one squamous cell carcinoma, two basal cell carcinomas, five chondrosarcomas and 12 breast tumors. The extent of the bloody areas ranged from 4x9 cm to 25x40 cm. In 12 patients the resection included the muscular plane. In the remaining eight, the tumor removal achieved a total wall thickness. For reconstruction we used: one muscular flap associated with skin grafting, nine flaps and ten regional fasciocutaneous flaps. Two patients undergoing reconstruction with fasciocutaneous flaps had partially suffering of the flap, solved with employment of a myocutaneous flap. The other patients displayed no complications with the techniques used, requiring only one surgery. Conclusion: the proper assessment of local tissues and flaps available for reconstruction, in addition to the successful integration of Plastic Surgery with the specialties involved in the treatment, enable extensive resections of the chest wall and reconstructions that provide patient recovery.

  3. [Qilin Pills for obstructive azoospermia after ejaculatory duct reconstruction].

    Science.gov (United States)

    Zhang, Lei; Gao, Ping; Ren, Fei-Qiang; Chang, De-Gui; Yu, Xu-Jun; Zhang, Pei-Hai

    2016-09-01

    To observe the clinical effect of Qilin Pills in the treatment of severe oligozoospermia after microsurgical ejaculatory duct reconstruction for obstructive azoospermia. We retrospectively analyzed 75 cases of obstructive azoospermia treated by ejaculatory duct reconstruction followed by administration of Qilin Pills. The patients were divided into a Qilin group (n=42) and a control group (n=33) postoperatively, treated with Qilin Pills and placebo, respectively. After 3 months of medication, we compared the sperm quality between the two groups of patients. After 3 months' treatment, all the patients experienced remarkable improvement in sperm quality (P0.05). The total effectiveness rate was higher in the Qilin group than in the controls (88.1% vs 72.7%), but with no significant difference between the two groups (P>0.05). Qilin Pills are fairly effective in improving the quantity of sperm in obstructive azoospermia patients after ejaculatory duct reconstruction.

  4. The Reliability of Pectorals Major Myocutaneous Flap in Head and Neck Reconstruction

    International Nuclear Information System (INIS)

    El-Marakby, H.H.

    2006-01-01

    Background: The pectorals major myocutaneous pedicle flap (PMMPF) has been considered to be the workhorse of pedicled flaps in head and neck reconstruction. Several series of PMMPF procedures in head and neck reconstruction have been reported in the literature. Even with the worldwide use of free flaps, the flap is still considered the mainstay head and neck reconstructive procedures in many centers. However, the flap is usually associated with a high incidence of complications in addition 10 its large bulk compared with the free fasciocutaneous flaps. Also the final functional and the aesthetic results are not comparable to free flaps head and neck reconstruction. Aim of the Study: The aim of the study is to evaluate the reliability of such flap in selected cases of head and neck reconstruction. The indications, technique, complications and the functional as well as the aesthetic results of the flap utilization were evaluated. Patients and Methods: Between May 2002 and May 2005 a 26 consecutive head and neck reconstruction procedures using the PMMPF were carried out on 25 patients at the Department of Surgery, National Cancer Institute, Cairo University. The indications for the flap use were defects due to resection of stage II-IV cancer in the head and neck region. The site, stage of the disease and the presence or absence of distant metastasis were assessed. Also preoperative assessment included the fitness of patients for such an extensive procedure. The total operative time, the need for blood transfusion, the postoperative complications, were all documented. The length of hospital stay, the follow-up of patients as well as the incidence of local recurrence underneath the flap were all evaluated. Results: Pectorals major myocutaneous pedicled flap reconstructions were used to reconstruct defects in the following sites: oral cavity (LO patients); oropharynx/hypopharynx, (5 patients); and neck or face (10 patients). Of the 26 PMMPF reconstructions. 22 flaps were

  5. Breast sensation after breast reconstruction: a systematic review.

    Science.gov (United States)

    Shridharani, Sachin M; Magarakis, Michael; Stapleton, Sahael M; Basdag, Basak; Seal, Stella M; Rosson, Gedge D

    2010-07-01

    Studies show some return of breast sensation after breast reconstruction; however, recovery is variable and unpredictable. Efforts are being made to restore innervation by reattaching nerves (neurotization). We sought to systematically review the literature addressing breast sensation after reconstruction. The following databases were searched: EMBASE, Cochrane, and PubMed. Additionally, the PLASTIC AND RECONSTRUCTIVE SURGERY journal was hand searched from 1960 to 2009. Inclusion criteria included breast reconstruction for cancer, return of sensation with objective results, and patients aged 18 to 90 years. Studies with purely cosmetic procedures, case reports, studies with less than 10 patients, and studies involving male patients were excluded. The initial search yielded 109 studies, which was refined to 20 studies with a total pool of 638 patients. Innervated flaps have a greater magnitude of recovery, which occurs at an earlier stage compared with the noninnervated flaps. Overall, sensation to deep inferior epigastric artery perforator flaps may recover better sensation than transverse rectus abdominis myocutaneous flaps, followed by latissimus dorsi flaps, and finally implants. Women's needs and expectations for sensation have led plastic surgeons to investigate ways to facilitate its return. Studies, however, depict conflicting data. Larger series are needed to define the role of neurotization as a modality for improving sensory restoration. Thieme Medical Publishers.

  6. Reconstruction of soft tissue after complicated calcaneal fractures.

    Science.gov (United States)

    Koski, E Antti; Kuokkanen, Hannu O M; Koskinen, Seppo K; Tukiainen, Erkki J

    2004-01-01

    A total of 35 flap reconstructions were done to cover exposed calcaneal bones in 31 patients. All patients had calcaneal fractures, 19 of which were primarily open. Soft tissue reconstruction for the closed fractures was indicated by a postoperative wound complication. A microvascular flap was used for reconstruction in 21 operations (gracilis, n = 11; anterolateral thigh, n = 5; rectus abdominis, n = 3; and latissimus dorsi, n = 2). A suralis neurocutaneous flap was used in eight, local muscle flaps in three, and local skin flaps in three cases. The mean follow-up time was 14 months (range 3 months-4 years). One suralis flap failed and was replaced by a latissimus dorsi flap. Necrosis of the edges that required revision affected three flaps. Deep infection developed in two patients and delayed wound healing in another four. During the follow-up the soft tissues healed in all patients and there were no signs of calcaneal osteitis. Flaps were considered too bulky in five patients. Soft tissues heal most rapidly with microvascular flaps. In the long term, gracilis muscle covered with free skin grafts gives a good contour to the foot. The suralis flap is reliable and gives a good final aesthetic outcome. Local muscles can be transposed for reconstruction in small defects.

  7. Computed Tomography Image Quality Evaluation of a New Iterative Reconstruction Algorithm in the Abdomen (Adaptive Statistical Iterative Reconstruction-V) a Comparison With Model-Based Iterative Reconstruction, Adaptive Statistical Iterative Reconstruction, and Filtered Back Projection Reconstructions.

    Science.gov (United States)

    Goodenberger, Martin H; Wagner-Bartak, Nicolaus A; Gupta, Shiva; Liu, Xinming; Yap, Ramon Q; Sun, Jia; Tamm, Eric P; Jensen, Corey T

    The purpose of this study was to compare abdominopelvic computed tomography images reconstructed with adaptive statistical iterative reconstruction-V (ASIR-V) with model-based iterative reconstruction (Veo 3.0), ASIR, and filtered back projection (FBP). Abdominopelvic computed tomography scans for 36 patients (26 males and 10 females) were reconstructed using FBP, ASIR (80%), Veo 3.0, and ASIR-V (30%, 60%, 90%). Mean ± SD patient age was 32 ± 10 years with mean ± SD body mass index of 26.9 ± 4.4 kg/m. Images were reviewed by 2 independent readers in a blinded, randomized fashion. Hounsfield unit, noise, and contrast-to-noise ratio (CNR) values were calculated for each reconstruction algorithm for further comparison. Phantom evaluation of low-contrast detectability (LCD) and high-contrast resolution was performed. Adaptive statistical iterative reconstruction-V 30%, ASIR-V 60%, and ASIR 80% were generally superior qualitatively compared with ASIR-V 90%, Veo 3.0, and FBP (P ASIR-V 60% with respective CNR values of 5.54 ± 2.39, 8.78 ± 3.15, and 3.49 ± 1.77 (P ASIR 80% had the best and worst spatial resolution, respectively. Adaptive statistical iterative reconstruction-V 30% and ASIR-V 60% provided the best combination of qualitative and quantitative performance. Adaptive statistical iterative reconstruction 80% was equivalent qualitatively, but demonstrated inferior spatial resolution and LCD.

  8. Ipsilateral femoral autograft reconstruction after resection of a pelvic tumor.

    Science.gov (United States)

    Biau, David J; Thévenin, Fabrice; Dumaine, Valérie; Babinet, Antoine; Tomeno, Bernard; Anract, Philippe

    2009-01-01

    Reconstruction of bone after the resection of a pelvic tumor is challenging. The purpose of the present study was to evaluate the use of the ipsilateral femur as the graft material for reconstruction. We performed a retrospective review of thirteen patients with a malignant pelvic lesion who underwent resection followed by reconstruction with an ipsilateral femoral autograft and insertion of a total hip replacement. The study group included nine men and four women with a median age of fifty-one years at the time of the reconstruction. The diagnosis was chondrosarcoma in eight patients, metastasis in three, and myeloma and radiation-induced malignant disease in one each. The surviving patients were assessed functionally and radiographically; the cumulative probability of revision was estimated while taking into account competing risks. The median duration of follow-up was forty-nine months. At the time of the latest follow-up, seven patients were alive and disease-free and six had died from metastatic disease. Four patients had had revision of the reconstruction, two for the treatment of mechanical complications and two for the treatment of infection. Three other patients had mechanical complications but had not had a revision. The cumulative probability of revision of the reconstruction for mechanical failure was 8% (95% confidence interval, 0% to 23%), 8% (95% confidence interval, 0% to 23%), and 16% (95% confidence interval, 0% to 39%) at one, two, and four years, respectively. Although it has attendant complications consistent with pelvic tumor surgery, an ipsilateral femoral autograft reconstruction may be an option for reconstruction of pelvic discontinuity in a subgroup of patients following tumor resection. This innovative procedure requires longer-term follow-up studies.

  9. Esophagogastrostomy plus gastrojejunostomy: a novel reconstruction procedure after curative resection for proximal gastric cancer.

    Science.gov (United States)

    Chen, Shicai; Li, Jianchang; Liu, Haiying; Zeng, Jun; Yang, Guohua; Wang, Jin; Lu, Weiqun; Yu, Nanrong; Huang, Zhiliang; Xu, Houwei; Zeng, Xiang

    2014-03-01

    The choice of surgical strategy for patients with proximal gastric cancer remains controversial. In this study, we recommend that a new reconstruction procedure be performed following proximal gastrectomy. We conducted a retrospective study involving 71 patients who underwent gastrectomy for proximal gastric cancer. Clinicopathological features, postoperative complications, nutritional status, and overall survival (OS) rate were compared among three different reconstruction approaches. There were 34 cases of proximal gastrectomy followed by esophagogastrostomy reconstruction (EG), 16 cases of total gastrectomy and Roux-en Y reconstruction (RY) and 21 cases of proximal gastrectomy followed by esophagogastrostomy plus gastrojejunostomy reconstruction (EGJ). Though the clinicopathological features, the nutritional status and OS rate were similar among the three groups of patients, the incidence of reflux esophagitis was significantly higher in the EG group (35.3%) than the RY (6.2%) and EGJ (9.6%) groups(P < 0.05). Few EGJ patients suffered from either reflux esophagitis or anastomotic stenosis. The EGJ reconstruction method helps to resolve the syndrome of reflux esophagitis. Our data indicates that it is a simple, safe, and effective reconstruction procedure for PGC.

  10. Does breast reconstruction impact the decision of patients to pursue cosmetic surgery?

    Science.gov (United States)

    Hsu, Vivian M; Tahiri, Youssef; Wes, Ari M; Yan, Chen; Selber, Jesse C; Nelson, Jonas A; Kovach, Stephen J; Serletti, Joseph M; Wu, Liza C

    2014-12-01

    Breast reconstruction is an integral component of breast cancer treatment, often aiding in restoring a patient's sense of femininity. However, many patients choose to have subsequent cosmetic surgery. The purpose of this study is to investigate the reasons that motivate patients to have cosmetic surgery after breast reconstruction. The authors performed a retrospective study examining patients who had breast reconstruction and subsequent cosmetic surgery at the University of Pennsylvania Health System between January 2005 and June 2012. This cohort received a questionnaire assessing the influences and impact of their reconstructive and cosmetic procedures. A total of 1,214 patients had breast reconstruction, with 113 patients (9.3%) undergoing cosmetic surgery after reconstruction. Of 42 survey respondents, 35 had autologous breast reconstruction (83.3%). Fifty-two cosmetic procedures were performed in survey respondents, including liposuction (26.9%) and facelift (15.4%). The most common reason for pursuing cosmetic surgery was the desire to improve self-image (n = 26, 61.9%), with 29 (69.0%) patients feeling more self-conscious of appearance after reconstruction. Body image satisfaction was significantly higher after cosmetic surgery (P = 0.0081). Interestingly, a multivariate analysis revealed that patients who experienced an improvement in body image after breast reconstruction were more likely to experience a further improvement after a cosmetic procedure (P = 0.031, OR = 17.83). Patients who were interested in cosmetic surgery prior to reconstruction were also more likely to experience an improvement in body image after cosmetic surgery (P = 0.012, OR = 22.63). Cosmetic surgery may improve body image satisfaction of breast reconstruction patients and help to further meet their expectations.

  11. Cardiac C-arm computed tomography using a 3D + time ROI reconstruction method with spatial and temporal regularization

    Energy Technology Data Exchange (ETDEWEB)

    Mory, Cyril, E-mail: cyril.mory@philips.com [Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, F-69621 Villeurbanne Cedex (France); Philips Research Medisys, 33 rue de Verdun, 92156 Suresnes (France); Auvray, Vincent; Zhang, Bo [Philips Research Medisys, 33 rue de Verdun, 92156 Suresnes (France); Grass, Michael; Schäfer, Dirk [Philips Research, Röntgenstrasse 24–26, D-22335 Hamburg (Germany); Chen, S. James; Carroll, John D. [Department of Medicine, Division of Cardiology, University of Colorado Denver, 12605 East 16th Avenue, Aurora, Colorado 80045 (United States); Rit, Simon [Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1 (France); Centre Léon Bérard, 28 rue Laënnec, F-69373 Lyon (France); Peyrin, Françoise [Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, F-69621 Villeurbanne Cedex (France); X-ray Imaging Group, European Synchrotron, Radiation Facility, BP 220, F-38043 Grenoble Cedex (France); Douek, Philippe; Boussel, Loïc [Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1 (France); Hospices Civils de Lyon, 28 Avenue du Doyen Jean Lépine, 69500 Bron (France)

    2014-02-15

    Purpose: Reconstruction of the beating heart in 3D + time in the catheter laboratory using only the available C-arm system would improve diagnosis, guidance, device sizing, and outcome control for intracardiac interventions, e.g., electrophysiology, valvular disease treatment, structural or congenital heart disease. To obtain such a reconstruction, the patient's electrocardiogram (ECG) must be recorded during the acquisition and used in the reconstruction. In this paper, the authors present a 4D reconstruction method aiming to reconstruct the heart from a single sweep 10 s acquisition. Methods: The authors introduce the 4D RecOnstructiOn using Spatial and TEmporal Regularization (short 4D ROOSTER) method, which reconstructs all cardiac phases at once, as a 3D + time volume. The algorithm alternates between a reconstruction step based on conjugate gradient and four regularization steps: enforcing positivity, averaging along time outside a motion mask that contains the heart and vessels, 3D spatial total variation minimization, and 1D temporal total variation minimization. Results: 4D ROOSTER recovers the different temporal representations of a moving Shepp and Logan phantom, and outperforms both ECG-gated simultaneous algebraic reconstruction technique and prior image constrained compressed sensing on a clinical case. It generates 3D + time reconstructions with sharp edges which can be used, for example, to estimate the patient's left ventricular ejection fraction. Conclusions: 4D ROOSTER can be applied for human cardiac C-arm CT, and potentially in other dynamic tomography areas. It can easily be adapted to other problems as regularization is decoupled from projection and back projection.

  12. Cardiac C-arm computed tomography using a 3D + time ROI reconstruction method with spatial and temporal regularization

    International Nuclear Information System (INIS)

    Mory, Cyril; Auvray, Vincent; Zhang, Bo; Grass, Michael; Schäfer, Dirk; Chen, S. James; Carroll, John D.; Rit, Simon; Peyrin, Françoise; Douek, Philippe; Boussel, Loïc

    2014-01-01

    Purpose: Reconstruction of the beating heart in 3D + time in the catheter laboratory using only the available C-arm system would improve diagnosis, guidance, device sizing, and outcome control for intracardiac interventions, e.g., electrophysiology, valvular disease treatment, structural or congenital heart disease. To obtain such a reconstruction, the patient's electrocardiogram (ECG) must be recorded during the acquisition and used in the reconstruction. In this paper, the authors present a 4D reconstruction method aiming to reconstruct the heart from a single sweep 10 s acquisition. Methods: The authors introduce the 4D RecOnstructiOn using Spatial and TEmporal Regularization (short 4D ROOSTER) method, which reconstructs all cardiac phases at once, as a 3D + time volume. The algorithm alternates between a reconstruction step based on conjugate gradient and four regularization steps: enforcing positivity, averaging along time outside a motion mask that contains the heart and vessels, 3D spatial total variation minimization, and 1D temporal total variation minimization. Results: 4D ROOSTER recovers the different temporal representations of a moving Shepp and Logan phantom, and outperforms both ECG-gated simultaneous algebraic reconstruction technique and prior image constrained compressed sensing on a clinical case. It generates 3D + time reconstructions with sharp edges which can be used, for example, to estimate the patient's left ventricular ejection fraction. Conclusions: 4D ROOSTER can be applied for human cardiac C-arm CT, and potentially in other dynamic tomography areas. It can easily be adapted to other problems as regularization is decoupled from projection and back projection

  13. Robot-Assisted Free Flap in Head and Neck Reconstruction

    Directory of Open Access Journals (Sweden)

    Han Gyeol Song

    2013-07-01

    Full Text Available Background  Robots have allowed head and neck surgeons to extirpate oropharyngealtumors safely without the need for lip-split incision or mandibulotomy. Using robots inoropharyngealreconstruction is newbut essentialfor oropharyngeal defectsthatresultfromrobotic tumor excision. We report our experience with robotic free-flap reconstruction ofhead and neck defectsto exemplify the necessity forrobotic reconstruction.Methods  We investigated head and neck cancer patients who underwent ablation surgeryand free-flap reconstruction by robot. Between July 1, 2011 andMarch 31, 2012, 5 caseswereperformed and patient demographics, location of tumor, pathologic stage, reconstructionmethods, flap size, recipient vessel, necessary pedicle length, and operation time wereinvestigated.Results  Among five free-flap reconstructions, four were radial forearm free flaps and onewas an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and oneflap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flapinsetting and microanastomosis were achieved using a specially manufactured roboticinstrument. The total operation timewas 1,041.0 minutes(range, 814 to 1,132 minutes, andcomplicationsincluding flap necrosis, hematoma, andwound dehiscence did not occur.Conclusions  Thisstudy demonstratesthe clinically applicable use ofrobotsin oropharyngealreconstruction, especially using a free flap. A robot can assist the operator in insettingthe flap at a deep portion of the oropharynx without the need to perform a traditionalmandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methodsand is accepted asthemost up-to-datemethod.

  14. Fat injection to correct contour deformities of the reconstructed breast: a single surgeon experience

    Directory of Open Access Journals (Sweden)

    Youssef Tahiri

    2015-06-01

    Full Text Available Aim: Autologous fat grafting has gained acceptance as a technique to improve aesthetic outcomes in breast reconstruction. The purpose of this study was to share our clinical experience using autologous fat injection to correct contour deformities during breast reconstruction. Methods: A single surgeon, prospectively maintained database of patients who underwent autologous fat injection during breast reconstruction from January 2008 to November 2013 at McGill University Health Center was reviewed. Patient characteristics, breast history, type of breast reconstruction, volume of fat injected, and complications were analyzed. Results: One hundred and twenty-four patients benefited from autologous fat injection from January 2008 to November 2013, for a total of 187 treated breasts. The patients were on average 49.3 years old (΁ 8.9 years. Fat was harvested from the medial thighs (20.5%, flanks (39.1%, medial thighs and flanks (2.9%, trochanters (13.3%, medial knees (2.7%, and abdomen (21.9%. An average of 49.25 mL of fat was injected into each reconstructed breast. A total of 187 breasts in 124 patients were lipo-infiltrated during the second stage of breast reconstruction. Thirteen breasts (in 12 separate patients were injected several years after having undergone lumpectomy and radiotherapy. Of the 187 treated breasts, 118 were reconstructed with expanders to implants, 45 with deep inferior epigastric perforator flaps, 9 with latissimus dorsi flaps with implants, 4 with transverse rectus abdominis myocutaneous flaps, and 13 had previously undergone lumpectomy and radiotherapy. Six complications were noted in the entire series, for a rate of 3.2%. All were in previously radiated breasts. Average follow-up time was 12 months (range: 2-36 months. Conclusion: Fat injection continues to grow in popularity as an adjunct to breast reconstruction. Our experience demonstrates a low complication rate as compared to most surgical interventions of the breast

  15. Image Reconstruction. Chapter 13

    Energy Technology Data Exchange (ETDEWEB)

    Nuyts, J. [Department of Nuclear Medicine and Medical Imaging Research Center, Katholieke Universiteit Leuven, Leuven (Belgium); Matej, S. [Medical Image Processing Group, Department of Radiology, University of Pennsylvania, Philadelphia, PA (United States)

    2014-12-15

    This chapter discusses how 2‑D or 3‑D images of tracer distribution can be reconstructed from a series of so-called projection images acquired with a gamma camera or a positron emission tomography (PET) system [13.1]. This is often called an ‘inverse problem’. The reconstruction is the inverse of the acquisition. The reconstruction is called an inverse problem because making software to compute the true tracer distribution from the acquired data turns out to be more difficult than the ‘forward’ direction, i.e. making software to simulate the acquisition. There are basically two approaches to image reconstruction: analytical reconstruction and iterative reconstruction. The analytical approach is based on mathematical inversion, yielding efficient, non-iterative reconstruction algorithms. In the iterative approach, the reconstruction problem is reduced to computing a finite number of image values from a finite number of measurements. That simplification enables the use of iterative instead of mathematical inversion. Iterative inversion tends to require more computer power, but it can cope with more complex (and hopefully more accurate) models of the acquisition process.

  16. Tomographic ventricular reconstruction using multiple view first-pass radionuclide angiography

    International Nuclear Information System (INIS)

    Lacy, J.L.; Ball, M.E.; Verani, M.S.; Wiles, H.; Roberts, R.

    1985-01-01

    In first-pass radionuclide angiography (FPRA) images of both left and right ventricles are uncontaminated by adjacent structures. Thus, the problem of tomographic reconstruction is vastly simplified compared to equilibrium blood pool imaging in which all structures are imaged simultaneously. Tomographic reconstruction from a limited number of views may thus be possible. A simple filtered interpolative back-projection reconstruction technique was employed. In this technique interpolation was used between sectional distributions at successive angles. Interpolations yielding 9 and 13 back projection angles of 22.5 0 and 15 0 were evaluated. Ventricular borders were obtained in each back-projected tomographic slice by location of the intensity level which provided correct total ventricular volume. Cast cross sections were quantitatively well represented by these borders. This ventricular border definition algorithm forms the basis for applications of the technique in animals and humans

  17. On free jejunal and colon transfer for pharyngo-esophageal reconstruction

    International Nuclear Information System (INIS)

    Fukui, Kiyoko; Annraku, Kuniaki; Ikenoya, Shintaro; Makino, Sachio; Ito, Kazuyuki; Takubo, Kenji; Kaji, Shogo

    2013-01-01

    Free jejunal transfer is a common procedure for hypopharyngo-esophageal reconstruction. We reviewed our experience with patients who underwent free jejunal and colon transfer surgery for hypopharyngo-esophageal reconstruction in the last 20 years in our institute. A retrospective review was conducted for 31 cases of reconstruction with free jejunal and colon transfer performed at Japanese Red Cross Matsue Hospital during the period of 20 years from January 1992 to December 2011. The mean age of the patients was 66 years. There were 30 patients with hypopharynx cancer and one patient with larynx cancer. Thirty patients had received preoperative radiotherapy and chemotherapy. The average time of surgery for free jejunal transfer reconstruction was 8.8 hours, including extraction of the hypopharynx, pharynx and cervical esophagus, debridment of pars hemi-cervicalis, and grafting procedure of free jejunum. The most common recipient vessels were the transverse cervical artery and external jugular vein, but recently, vessels of free flaps are often chosen to be anastomosed with the superior thyroid artery and internal jugular vein. The free jejunal and colon grafts for reconstruction took successfully in all patients. The complication rate was 52% (16/31 cases). Complications often occurred in cases of total esophagectomy, recurrence after full-dose chemoradiotherapy, and radiation therapy administered postoperatively. (author)

  18. A compressed sensing based approach on Discrete Algebraic Reconstruction Technique.

    Science.gov (United States)

    Demircan-Tureyen, Ezgi; Kamasak, Mustafa E

    2015-01-01

    Discrete tomography (DT) techniques are capable of computing better results, even using less number of projections than the continuous tomography techniques. Discrete Algebraic Reconstruction Technique (DART) is an iterative reconstruction method proposed to achieve this goal by exploiting a prior knowledge on the gray levels and assuming that the scanned object is composed from a few different densities. In this paper, DART method is combined with an initial total variation minimization (TvMin) phase to ensure a better initial guess and extended with a segmentation procedure in which the threshold values are estimated from a finite set of candidates to minimize both the projection error and the total variation (TV) simultaneously. The accuracy and the robustness of the algorithm is compared with the original DART by the simulation experiments which are done under (1) limited number of projections, (2) limited view problem and (3) noisy projections conditions.

  19. Coordinate reconstruction using box reconstruction and projection of X-ray photo

    International Nuclear Information System (INIS)

    Achmad Suntoro

    2011-01-01

    Some mathematical formula have been derived for a process of reconstruction to define the coordinate of any point relative to a pre set coordinate system. The process of reconstruction uses a reconstruction box in which each edge's length of the box is known, each top-bottom face and left-right face of the box having a cross marker, and the top face and the right face of the box as plane projections by X-ray source in perspective projection -system. Using the data of the two X-ray projection images, any point inside the reconstruction box, as long as its projection is recorded in the two photos, will be determined its coordinate relative to the midpoint of the reconstruction box as the central point coordinates. (author)

  20. Segmentation-DrivenTomographic Reconstruction

    DEFF Research Database (Denmark)

    Kongskov, Rasmus Dalgas

    such that the segmentation subsequently can be carried out by use of a simple segmentation method, for instance just a thresholding method. We tested the advantages of going from a two-stage reconstruction method to a one stage segmentation-driven reconstruction method for the phase contrast tomography reconstruction......The tomographic reconstruction problem is concerned with creating a model of the interior of an object from some measured data, typically projections of the object. After reconstructing an object it is often desired to segment it, either automatically or manually. For computed tomography (CT...

  1. Track reconstruction for the P2 experiment

    Energy Technology Data Exchange (ETDEWEB)

    Tyukin, Alexey [JGU, Mainz (Germany); Collaboration: P2-Collaboration

    2016-07-01

    The P2 experiment at the future MESA accelerator in Mainz will measure elastically scattered electrons from a hydrogen or lead target in order to determine the parity violating asymmetry for different beam polarisations, which is created due to the weak charge of the target. The asymmetry can provide access to the Weinberg angle and the neutron skin of heavy nuclei. These quantities depend heavily on the momentum transfer Q{sup 2}, thus a reconstruction of single electron tracks in an inhomogeneous magnetic field is necessary. For this, the P2 detector will have four tracking planes of thin high voltage monolithic active pixel sensors (HV-MAPS). The scattered electrons propagate through a magnetic field and hit all four planes. In order to fit the hit positions the General Broken Lines method is used. As a fast propagator, a variation of the Runge-Kutta algorithm is applied, which solves the equation of motion in an inhomogeneous magnetic field numerically, such that the final state momentum and scattering angle can be reconstructed. The initial momentum and incident angle can vary strongly due to the thickness of the target, limiting the reconstruction quality. The average single track Q{sup 2} value of 0.006 GeV{sup 2}/c{sup 2} can be reconstructed with about 4 % uncertainty in a first analysis of the Geant4 simulation, leading to a high total precision due to large electron numbers in the experiment.

  2. Fast, automatic, and accurate catheter reconstruction in HDR brachytherapy using an electromagnetic 3D tracking system

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, Eric; Racine, Emmanuel; Beaulieu, Luc, E-mail: Luc.Beaulieu@phy.ulaval.ca [Département de physique, de génie physique et d’optique et Centre de recherche sur le cancer de l’Université Laval, Université Laval, Québec, Québec G1V 0A6, Canada and Département de radio-oncologie et Axe Oncologie du Centre de recherche du CHU de Québec, CHU de Québec, 11 Côte du Palais, Québec, Québec G1R 2J6 (Canada); Binnekamp, Dirk [Integrated Clinical Solutions and Marketing, Philips Healthcare, Veenpluis 4-6, Best 5680 DA (Netherlands)

    2015-03-15

    Purpose: In high dose rate brachytherapy (HDR-B), current catheter reconstruction protocols are relatively slow and error prone. The purpose of this technical note is to evaluate the accuracy and the robustness of an electromagnetic (EM) tracking system for automated and real-time catheter reconstruction. Methods: For this preclinical study, a total of ten catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a 18G biopsy needle, used as an EM stylet and equipped with a miniaturized sensor, and the second generation Aurora{sup ®} Planar Field Generator from Northern Digital Inc. The Aurora EM system provides position and orientation value with precisions of 0.7 mm and 0.2°, respectively. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical computed tomography (CT) system with a spatial resolution of 89 μm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, five catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 s, leading to a total reconstruction time inferior to 3 min for a typical 17-catheter implant. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.66 ± 0.33 mm and 1.08 ± 0.72 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be more accurate. A maximum difference of less than 0.6 mm was found between successive EM reconstructions. Conclusions: The EM reconstruction was found to be more accurate and precise than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators.

  3. Fast, automatic, and accurate catheter reconstruction in HDR brachytherapy using an electromagnetic 3D tracking system

    International Nuclear Information System (INIS)

    Poulin, Eric; Racine, Emmanuel; Beaulieu, Luc; Binnekamp, Dirk

    2015-01-01

    Purpose: In high dose rate brachytherapy (HDR-B), current catheter reconstruction protocols are relatively slow and error prone. The purpose of this technical note is to evaluate the accuracy and the robustness of an electromagnetic (EM) tracking system for automated and real-time catheter reconstruction. Methods: For this preclinical study, a total of ten catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a 18G biopsy needle, used as an EM stylet and equipped with a miniaturized sensor, and the second generation Aurora ® Planar Field Generator from Northern Digital Inc. The Aurora EM system provides position and orientation value with precisions of 0.7 mm and 0.2°, respectively. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical computed tomography (CT) system with a spatial resolution of 89 μm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, five catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 s, leading to a total reconstruction time inferior to 3 min for a typical 17-catheter implant. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.66 ± 0.33 mm and 1.08 ± 0.72 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be more accurate. A maximum difference of less than 0.6 mm was found between successive EM reconstructions. Conclusions: The EM reconstruction was found to be more accurate and precise than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators

  4. GPU-accelerated few-view CT reconstruction using the OSC and TV techniques

    Energy Technology Data Exchange (ETDEWEB)

    Matenine, Dmitri [Montreal Univ., QC (Canada). Dept. de Physique; Hissoiny, Sami [Ecole Polytechnique de Montreal, QC (Canada). Dept. de Genie Informatique et Genie Logiciel; Despres, Philippe [Centre Hospitalier Univ. de Quebec, QC (Canada). Dept. de Radio-Oncologie

    2011-07-01

    The present work proposes a promising iterative reconstruction technique designed specifically for X-ray transmission computed tomography (CT). The main objective is to reduce diagnostic radiation dose through the reduction of the number of CT projections, while preserving image quality. The second objective is to provide a fast implementation compatible with clinical activities. The proposed tomographic reconstruction technique is a combination of the Ordered Subsets Convex (OSC) algorithm and the Total Variation minimization (TV) regularization technique. The results in terms of image quality and computational speed are discussed. Using this technique, it was possible to obtain reconstructed slices of relatively good quality with as few as 100 projections, leading to potential dose reduction factors of up to an order of magnitude depending on the application. The algorithm was implemented on a Graphical Processing Unit (GPU) and yielded reconstruction times of approximately 185 ms per slice. (orig.)

  5. Solving the uncalibrated photometric stereo problem using total variation

    DEFF Research Database (Denmark)

    Quéau, Yvain; Lauze, Francois Bernard; Durou, Jean-Denis

    2013-01-01

    In this paper we propose a new method to solve the problem of uncalibrated photometric stereo, making very weak assumptions on the properties of the scene to be reconstructed. Our goal is to solve the generalized bas-relief ambiguity (GBR) by performing a total variation regularization of both...

  6. Low-dose dual-energy cone-beam CT using a total-variation minimization algorithm

    International Nuclear Information System (INIS)

    Min, Jong Hwan

    2011-02-01

    Dual-energy cone-beam CT is an important imaging modality in diagnostic applications, and may also find its use in other application such as therapeutic image guidance. Despite of its clinical values, relatively high radiation dose of dual-energy scan may pose a challenge to its wide use. In this work, we investigated a low-dose, pre-reconstruction type of dual-energy cone-beam CT (CBCT) using a total-variation minimization algorithm for image reconstruction. An empirical dual-energy calibration method was used to prepare material-specific projection data. Raw data at high and low tube voltages are converted into a set of basis functions which can be linearly combined to produce material-specific data using the coefficients obtained through the calibration process. From much fewer views than are conventionally used, material specific images are reconstructed by use of the total-variation minimization algorithm. An experimental study was performed to demonstrate the feasibility of the proposed method using a micro-CT system. We have reconstructed images of the phantoms from only 90 projections acquired at tube voltages of 40 kVp and 90 kVp each. Aluminum-only and acryl-only images were successfully decomposed. We evaluated the quality of the reconstructed images by use of contrast-to-noise ratio and detectability. A low-dose dual-energy CBCT can be realized via the proposed method by greatly reducing the number of projections

  7. Total Variation Based Parameter-Free Model for Impulse Noise Removal

    DEFF Research Database (Denmark)

    Sciacchitano, Federica; Dong, Yiqiu; Andersen, Martin Skovgaard

    2017-01-01

    We propose a new two-phase method for reconstruction of blurred images corrupted by impulse noise. In the first phase, we use a noise detector to identify the pixels that are contaminated by noise, and then, in the second phase, we reconstruct the noisy pixels by solving an equality constrained...... total variation minimization problem that preserves the exact values of the noise-free pixels. For images that are only corrupted by impulse noise (i. e., not blurred) we apply the semismooth Newton's method to a reduced problem, and if the images are also blurred, we solve the equality constrained...... reconstruction problem using a first-order primal-dual algorithm. The proposed model improves the computational efficiency (in the denoising case) and has the advantage of being regularization parameter-free. Our numerical results suggest that the method is competitive in terms of its restoration capabilities...

  8. Vaginal reconstruction

    International Nuclear Information System (INIS)

    Lesavoy, M.A.

    1985-01-01

    Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients

  9. Dose fractionation theorem in 3-D reconstruction (tomography)

    Energy Technology Data Exchange (ETDEWEB)

    Glaeser, R.M. [Lawrence Berkeley National Lab., CA (United States)

    1997-02-01

    It is commonly assumed that the large number of projections for single-axis tomography precludes its application to most beam-labile specimens. However, Hegerl and Hoppe have pointed out that the total dose required to achieve statistical significance for each voxel of a computed 3-D reconstruction is the same as that required to obtain a single 2-D image of that isolated voxel, at the same level of statistical significance. Thus a statistically significant 3-D image can be computed from statistically insignificant projections, as along as the total dosage that is distributed among these projections is high enough that it would have resulted in a statistically significant projection, if applied to only one image. We have tested this critical theorem by simulating the tomographic reconstruction of a realistic 3-D model created from an electron micrograph. The simulations verify the basic conclusions of high absorption, signal-dependent noise, varying specimen contrast and missing angular range. Furthermore, the simulations demonstrate that individual projections in the series of fractionated-dose images can be aligned by cross-correlation because they contain significant information derived from the summation of features from different depths in the structure. This latter information is generally not useful for structural interpretation prior to 3-D reconstruction, owing to the complexity of most specimens investigated by single-axis tomography. These results, in combination with dose estimates for imaging single voxels and measurements of radiation damage in the electron microscope, demonstrate that it is feasible to use single-axis tomography with soft X-ray microscopy of frozen-hydrated specimens.

  10. Dose fractionation theorem in 3-D reconstruction (tomography)

    International Nuclear Information System (INIS)

    Glaeser, R.M.

    1997-01-01

    It is commonly assumed that the large number of projections for single-axis tomography precludes its application to most beam-labile specimens. However, Hegerl and Hoppe have pointed out that the total dose required to achieve statistical significance for each voxel of a computed 3-D reconstruction is the same as that required to obtain a single 2-D image of that isolated voxel, at the same level of statistical significance. Thus a statistically significant 3-D image can be computed from statistically insignificant projections, as along as the total dosage that is distributed among these projections is high enough that it would have resulted in a statistically significant projection, if applied to only one image. We have tested this critical theorem by simulating the tomographic reconstruction of a realistic 3-D model created from an electron micrograph. The simulations verify the basic conclusions of high absorption, signal-dependent noise, varying specimen contrast and missing angular range. Furthermore, the simulations demonstrate that individual projections in the series of fractionated-dose images can be aligned by cross-correlation because they contain significant information derived from the summation of features from different depths in the structure. This latter information is generally not useful for structural interpretation prior to 3-D reconstruction, owing to the complexity of most specimens investigated by single-axis tomography. These results, in combination with dose estimates for imaging single voxels and measurements of radiation damage in the electron microscope, demonstrate that it is feasible to use single-axis tomography with soft X-ray microscopy of frozen-hydrated specimens

  11. Breast Reconstruction After Mastectomy

    Science.gov (United States)

    ... Cancer Prevention Genetics of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Reconstruction After Mastectomy On This Page What is breast reconstruction? How do surgeons use implants to reconstruct a woman’s breast? How do surgeons ...

  12. Modern principles of reconstructive surgery for advanced head and neck tumors

    Science.gov (United States)

    Kulbakin, D. E.; Choinzonov, E. L.; Mukhamedov, M. R.; Garbukov, E. U.; Shtin, V. I.; Havkin, N. M.; Vasilev, R. V.

    2017-09-01

    Background: Surgery remains the mainstay of treatment for head and neck cancer. Reconstruction after cancer surgery can help to restore both the appearance and function of the affected areas. Materials and methods: From 2008 to 2016, a total of 120 reconstructive surgeries were performed at the Department of Head and Neck Tumors of Tomsk Cancer Research Institute. The majority of patients had locally advanced cancer (T3 stage in 49 patients and T4 stage in 41 patients). The localizations of the defects requiring reconstruction were as follows: oral cavity—26 cases; tongue—24 cases; skin (including defects of lower lip)—12 cases; maxilla—14 cases; larynx and hypopharynx—12 cases; lips—6 cases, cheek—11 cases, and mandibulla—5 cases. Various free flaps (83%) and pedicle flaps (17%) were used for the reconstruction of the large defects following extirpation of head and neck malignant tumors. In 15 cases (13%), the implants from titanium and titanium nickelide (TiNi) were used to restore the supporting and skeletal functions of the reconstructed region. We used 3D model of the patient's skull for a more precise planning of the reconstruction of maxillofacial bone defects. Results: Good functional results were achieved in most cases. Full flap necrosis was observed in 12 cases (10%). Fibular flap necroses were noted in 8 cases (7%). Conclusions: Single-stage reconstructions of the lost structures after tumor resection significantly improve survival of head and neck cancer patients without causing significant functional and aesthetic damage, as well as contribute to quick rehabilitation of these patients and improvement of their social status. To reduce postoperative complications after reconstructive surgery, it is necessary to carefully select the appropriate reconstructive implant materials.

  13. Single center outcomes after reconstructive surgical correction of adult acquired buried penis: measurements of erectile function, depression, and quality of life.

    Science.gov (United States)

    Rybak, James; Larsen, Stephen; Yu, Michelle; Levine, Laurence A

    2014-04-01

    Management of adult acquired buried penis is a troublesome situation for both patient and surgeon. The buried penis has been associated with significant erectile and voiding dysfunction, depression, and overall poor quality of life (QOL). To identify outcomes following reconstructive surgery with release of buried penis, escutcheonectomy, and circumcision with or without skin grafting. We retrospectively identified 11 patients treated by a single surgeon between 2007 and 2011, patient ages were 44-69; complete data review was available on all 11. Validated European Organisation for Research and Treatment of Cancer 15 QOL, Center for Epidemiologic Studies Depression Scale (CES-D), and International Index of Erectile Function (IIEF) surveys assessed patient QOL, depression, and erectile function pre- and postoperatively. Mean body mass index (BMI) was 48.8 (42.4-64.6). Mean operative time was 191 minutes (139-272). Mean length of stay was 2.1 days. Ten of 11 patients required phallic skin grafting. There was one perioperative complication resulting in respiratory failure and overnight stay in the intensive care unit. Wound complications were seen in 2/11 patients, and 1 needed surgical debridement for superficial wound infection. Skin graft take was seen in 100% of the patients. Ninety-one percent of patients noted significant improvement in voiding postoperatively. Ninety-one percent of patients reported significant erectile dysfunction preoperatively. Subsequently, IIEF scores improved post surgery by an average of 7.7 points. Clinical depression was noted to be present in 7/11 patients preoperatively and 2/11 postoperatively based on CES-D surveys. QOL improved significantly in 10/11 compared with preoperative baseline; however, many patients noted significant difficulties based on their weight and other comorbidities. Management of adult acquired buried penis is a challenging, yet correctable problem. In our series it appears that by using established surgical

  14. AuTom: a novel automatic platform for electron tomography reconstruction

    KAUST Repository

    Han, Renmin

    2017-07-26

    We have developed a software package towards automatic electron tomography (ET): Automatic Tomography (AuTom). The presented package has the following characteristics: accurate alignment modules for marker-free datasets containing substantial biological structures; fully automatic alignment modules for datasets with fiducial markers; wide coverage of reconstruction methods including a new iterative method based on the compressed-sensing theory that suppresses the “missing wedge” effect; and multi-platform acceleration solutions that support faster iterative algebraic reconstruction. AuTom aims to achieve fully automatic alignment and reconstruction for electron tomography and has already been successful for a variety of datasets. AuTom also offers user-friendly interface and auxiliary designs for file management and workflow management, in which fiducial marker-based datasets and marker-free datasets are addressed with totally different subprocesses. With all of these features, AuTom can serve as a convenient and effective tool for processing in electron tomography.

  15. Evidence-Based ACL Reconstruction

    Directory of Open Access Journals (Sweden)

    E. Carlos RODRIGUEZ-MERCHAN

    2015-01-01

    Full Text Available There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACLreconstruction. The purpose of this article is to answer the following questions: 1 Bone patellar tendon bone (BPTB reconstruction or hamstring reconstruction (HR; 2 Double bundle or single bundle; 3 Allograft or authograft; 4 Early or late reconstruction; 5 Rate of return to sports after ACL reconstruction; 6 Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analysesfocused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years.

  16. Reconstructive dosimetry for cutaneous radiation syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lima, C.M.A.; Lima, A.R.; Degenhardt, Ä.L.; Da Silva, F.C.A., E-mail: dasilva@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Valverde, N.J. [Fundacao Eletronuclear de Assistencia Medica, Rio de Janeiro, RJ (Brazil)

    2015-10-15

    According to the International Atomic Energy Agency (IAEA), a relatively significant number of radiological accidents have occurred in recent years mainly because of the practices referred to as potentially high-risk activities, such as radiotherapy, large irradiators and industrial radiography, especially in gammagraphy assays. In some instances, severe injuries have occurred in exposed persons due to high radiation doses. In industrial radiography, 80 cases involving a total of 120 radiation workers, 110 members of the public including 12 deaths have been recorded up to 2014. Radiological accidents in industrial practices in Brazil have mainly resulted in development of cutaneous radiation syndrome (CRS) in hands and fingers. Brazilian data include 5 serious cases related to industrial gammagraphy, affecting 7 radiation workers and 19 members of the public; however, none of them were fatal. Some methods of reconstructive dosimetry have been used to estimate the radiation dose to assist in prescribing medical treatment. The type and development of cutaneous manifestations in the exposed areas of a person is the first achievable gross dose estimation. This review article presents the state-of-the-art reconstructive dosimetry methods enabling estimation of local radiation doses and provides guidelines for medical handling of the exposed individuals. The review also presents the Chilean and Brazilian radiological accident cases to highlight the importance of reconstructive dosimetry. (author)

  17. MAP-MRF-Based Super-Resolution Reconstruction Approach for Coded Aperture Compressive Temporal Imaging

    Directory of Open Access Journals (Sweden)

    Tinghua Zhang

    2018-02-01

    Full Text Available Coded Aperture Compressive Temporal Imaging (CACTI can afford low-cost temporal super-resolution (SR, but limits are imposed by noise and compression ratio on reconstruction quality. To utilize inter-frame redundant information from multiple observations and sparsity in multi-transform domains, a robust reconstruction approach based on maximum a posteriori probability and Markov random field (MAP-MRF model for CACTI is proposed. The proposed approach adopts a weighted 3D neighbor system (WNS and the coordinate descent method to perform joint estimation of model parameters, to achieve the robust super-resolution reconstruction. The proposed multi-reconstruction algorithm considers both total variation (TV and ℓ 2 , 1 norm in wavelet domain to address the minimization problem for compressive sensing, and solves it using an accelerated generalized alternating projection algorithm. The weighting coefficient for different regularizations and frames is resolved by the motion characteristics of pixels. The proposed approach can provide high visual quality in the foreground and background of a scene simultaneously and enhance the fidelity of the reconstruction results. Simulation results have verified the efficacy of our new optimization framework and the proposed reconstruction approach.

  18. Evaluation of the OSC-TV iterative reconstruction algorithm for cone-beam optical CT.

    Science.gov (United States)

    Matenine, Dmitri; Mascolo-Fortin, Julia; Goussard, Yves; Després, Philippe

    2015-11-01

    The present work evaluates an iterative reconstruction approach, namely, the ordered subsets convex (OSC) algorithm with regularization via total variation (TV) minimization in the field of cone-beam optical computed tomography (optical CT). One of the uses of optical CT is gel-based 3D dosimetry for radiation therapy, where it is employed to map dose distributions in radiosensitive gels. Model-based iterative reconstruction may improve optical CT image quality and contribute to a wider use of optical CT in clinical gel dosimetry. This algorithm was evaluated using experimental data acquired by a cone-beam optical CT system, as well as complementary numerical simulations. A fast GPU implementation of OSC-TV was used to achieve reconstruction times comparable to those of conventional filtered backprojection. Images obtained via OSC-TV were compared with the corresponding filtered backprojections. Spatial resolution and uniformity phantoms were scanned and respective reconstructions were subject to evaluation of the modulation transfer function, image uniformity, and accuracy. The artifacts due to refraction and total signal loss from opaque objects were also studied. The cone-beam optical CT data reconstructions showed that OSC-TV outperforms filtered backprojection in terms of image quality, thanks to a model-based simulation of the photon attenuation process. It was shown to significantly improve the image spatial resolution and reduce image noise. The accuracy of the estimation of linear attenuation coefficients remained similar to that obtained via filtered backprojection. Certain image artifacts due to opaque objects were reduced. Nevertheless, the common artifact due to the gel container walls could not be eliminated. The use of iterative reconstruction improves cone-beam optical CT image quality in many ways. The comparisons between OSC-TV and filtered backprojection presented in this paper demonstrate that OSC-TV can potentially improve the rendering of

  19. A fast 4D cone beam CT reconstruction method based on the OSC-TV algorithm.

    Science.gov (United States)

    Mascolo-Fortin, Julia; Matenine, Dmitri; Archambault, Louis; Després, Philippe

    2018-01-01

    Four-dimensional cone beam computed tomography allows for temporally resolved imaging with useful applications in radiotherapy, but raises particular challenges in terms of image quality and computation time. The purpose of this work is to develop a fast and accurate 4D algorithm by adapting a GPU-accelerated ordered subsets convex algorithm (OSC), combined with the total variation minimization regularization technique (TV). Different initialization schemes were studied to adapt the OSC-TV algorithm to 4D reconstruction: each respiratory phase was initialized either with a 3D reconstruction or a blank image. Reconstruction algorithms were tested on a dynamic numerical phantom and on a clinical dataset. 4D iterations were implemented for a cluster of 8 GPUs. All developed methods allowed for an adequate visualization of the respiratory movement and compared favorably to the McKinnon-Bates and adaptive steepest descent projection onto convex sets algorithms, while the 4D reconstructions initialized from a prior 3D reconstruction led to better overall image quality. The most suitable adaptation of OSC-TV to 4D CBCT was found to be a combination of a prior FDK reconstruction and a 4D OSC-TV reconstruction with a reconstruction time of 4.5 minutes. This relatively short reconstruction time could facilitate a clinical use.

  20. The Impact of Combining a Low-Tube Voltage Acquisition with Iterative Reconstruction on Total Iodine Dose in Coronary CT Angiography

    Directory of Open Access Journals (Sweden)

    Toon Van Cauteren

    2017-01-01

    Full Text Available Objectives. To assess the impact of combining low-tube voltage acquisition with iterative reconstruction (IR techniques on the iodine dose in coronary CTA. Methods. Three minipigs underwent CCTA to compare a standard of care protocol with two alternative study protocols combining low-tube voltage and low iodine dose with IR. Image quality was evaluated objectively by the CT value, signal-to-noise ratio (SNR, and contrast-to-noise ratio (CNR in the main coronary arteries and aorta and subjectively by expert reading. Statistics were performed by Mann–Whitney U test and Chi-square analysis. Results. Despite reduced iodine dose, both study protocols maintained CT values, SNR, and CNR compared to the standard of care protocol. Expert readings confirmed these findings; all scans were perceived to be of at least diagnostically acceptable quality on all evaluated parameters allowing image interpretation. No statistical differences were observed (all p values > 0.11, except for streak artifacts (p=0.02 which were considered to be more severe, although acceptable, with the 80 kVp protocol. Conclusions. Reduced tube voltage in combination with IR allows a total iodine dose reduction between 37 and 50%, by using contrast media with low iodine concentrations of 200 and 160 mg I/mL, while maintaining image quality.

  1. Joint image reconstruction method with correlative multi-channel prior for x-ray spectral computed tomography

    Science.gov (United States)

    Kazantsev, Daniil; Jørgensen, Jakob S.; Andersen, Martin S.; Lionheart, William R. B.; Lee, Peter D.; Withers, Philip J.

    2018-06-01

    Rapid developments in photon-counting and energy-discriminating detectors have the potential to provide an additional spectral dimension to conventional x-ray grayscale imaging. Reconstructed spectroscopic tomographic data can be used to distinguish individual materials by characteristic absorption peaks. The acquired energy-binned data, however, suffer from low signal-to-noise ratio, acquisition artifacts, and frequently angular undersampled conditions. New regularized iterative reconstruction methods have the potential to produce higher quality images and since energy channels are mutually correlated it can be advantageous to exploit this additional knowledge. In this paper, we propose a novel method which jointly reconstructs all energy channels while imposing a strong structural correlation. The core of the proposed algorithm is to employ a variational framework of parallel level sets to encourage joint smoothing directions. In particular, the method selects reference channels from which to propagate structure in an adaptive and stochastic way while preferring channels with a high data signal-to-noise ratio. The method is compared with current state-of-the-art multi-channel reconstruction techniques including channel-wise total variation and correlative total nuclear variation regularization. Realistic simulation experiments demonstrate the performance improvements achievable by using correlative regularization methods.

  2. Iterative reconstruction with boundary detection for carbon ion computed tomography

    Science.gov (United States)

    Shrestha, Deepak; Qin, Nan; Zhang, You; Kalantari, Faraz; Niu, Shanzhou; Jia, Xun; Pompos, Arnold; Jiang, Steve; Wang, Jing

    2018-03-01

    In heavy ion radiation therapy, improving the accuracy in range prediction of the ions inside the patient’s body has become essential. Accurate localization of the Bragg peak provides greater conformity of the tumor while sparing healthy tissues. We investigated the use of carbon ions directly for computed tomography (carbon CT) to create the relative stopping power map of a patient’s body. The Geant4 toolkit was used to perform a Monte Carlo simulation of the carbon ion trajectories, to study their lateral and angular deflections and the most likely paths, using a water phantom. Geant4 was used to create carbonCT projections of a contrast and spatial resolution phantom, with a cone beam of 430 MeV/u carbon ions. The contrast phantom consisted of cranial bone, lung material, and PMMA inserts while the spatial resolution phantom contained bone and lung material inserts with line pair (lp) densities ranging from 1.67 lp cm-1 through 5 lp cm-1. First, the positions of each carbon ion on the rear and front trackers were used for an approximate reconstruction of the phantom. The phantom boundary was extracted from this approximate reconstruction, by using the position as well as angle information from the four tracking detectors, resulting in the entry and exit locations of the individual ions on the phantom surface. Subsequent reconstruction was performed by the iterative algebraic reconstruction technique coupled with total variation minimization (ART-TV) assuming straight line trajectories for the ions inside the phantom. The influence of number of projections was studied with reconstruction from five different sets of projections: 15, 30, 45, 60 and 90. Additionally, the effect of number of ions on the image quality was investigated by reducing the number of ions/projection while keeping the total number of projections at 60. An estimation of carbon ion range using the carbonCT image resulted in improved range prediction compared to the range calculated using a

  3. [Reconstructive methods after Fournier gangrene].

    Science.gov (United States)

    Wallner, C; Behr, B; Ring, A; Mikhail, B D; Lehnhardt, M; Daigeler, A

    2016-04-01

    Fournier's gangrene is a variant of the necrotizing fasciitis restricted to the perineal and genital region. It presents as an acute life-threatening disease and demands rapid surgical debridement, resulting in large soft tissue defects. Various reconstructive methods have to be applied to reconstitute functionality and aesthetics. The objective of this work is to identify different reconstructive methods in the literature and compare them to our current concepts for reconstructing defects caused by Fournier gangrene. Analysis of the current literature and our reconstructive methods on Fournier gangrene. The Fournier gangrene is an emergency requiring rapid, calculated antibiotic treatment and radical surgical debridement. After the acute phase of the disease, appropriate reconstructive methods are indicated. The planning of the reconstruction of the defect depends on many factors, especially functional and aesthetic demands. Scrotal reconstruction requires a higher aesthetic and functional reconstructive degree than perineal cutaneous wounds. In general, thorough wound hygiene, proper pre-operative planning, and careful consideration of the patient's demands are essential for successful reconstruction. In the literature, various methods for reconstruction after Fournier gangrene are described. Reconstruction with a flap is required for a good functional result in complex regions as the scrotum and penis, while cutaneous wounds can be managed through skin grafting. Patient compliance and tissue demand are crucial factors in the decision-making process.

  4. Application of dual volume reconstruction technique in embolization of intracranial aneurysms

    Directory of Open Access Journals (Sweden)

    Xiang-hai ZHANG

    2014-03-01

    Full Text Available Objective To explore the value of dual volume reconstruction technique in Guglielmi detachable coil (GDC embolization of intracranial aneurysms. Methods Three-dimensional imaging data of 20 patients received GDC embolization of intracranial aneurysms from Jun. 2012 to Apr. 2013 were analyzed for dual volume reconstruction. The value of application of dual volume reconstruction was evaluated by the detection rate of coils bolus, degree of aneurysm occlusion, the length of aneurysm sac and aneurysm neck before and after embolization, and the characteristics and clinical value of the reconstructed images. Results  A total of 20 coil boluses were detected by dual volume reconstruction images, and the detection rate was 100%. Among all of 20 patients, no visualization of contrast medium in the aneurysm was found in 13 patients, while contrast agent was found in the aneurysm sac in 3 patients and in the aneurysm neck in 4 patients. The length of aneurysm neck and sac was somewhat changed before and after embolization with no statistically significant difference (P>0.05. The dual volume reconstruction could reveal coil bolus, vessels, cranium and fusion images, and the aneurysms could be shown by different imaging modes according to the clinical requirement. Conclusion Dual volume reconstruction technique can display the location of coil bolus, degree of occlusion and aneurysm size, and evaluate the embolization effect by multifarious imaging modes, providing a great deal of information for the evaluation of GDC embolization of intracranial aneurysm. DOI: 10.11855/j.issn.0577-7402.2014.02.13

  5. Reconstruction of solar spectral surface UV irradiances using radiative transfer simulations.

    Science.gov (United States)

    Lindfors, Anders; Heikkilä, Anu; Kaurola, Jussi; Koskela, Tapani; Lakkala, Kaisa

    2009-01-01

    UV radiation exerts several effects concerning life on Earth, and spectral information on the prevailing UV radiation conditions is needed in order to study each of these effects. In this paper, we present a method for reconstruction of solar spectral UV irradiances at the Earth's surface. The method, which is a further development of an earlier published method for reconstruction of erythemally weighted UV, relies on radiative transfer simulations, and takes as input (1) the effective cloud optical depth as inferred from pyranometer measurements of global radiation (300-3000 nm); (2) the total ozone column; (3) the surface albedo as estimated from measurements of snow depth; (4) the total water vapor column; and (5) the altitude of the location. Reconstructed daily cumulative spectral irradiances at Jokioinen and Sodankylä in Finland are, in general, in good agreement with measurements. The mean percentage difference, for instance, is mostly within +/-8%, and the root mean square of the percentage difference is around 10% or below for wavelengths over 310 nm and daily minimum solar zenith angles (SZA) less than 70 degrees . In this study, we used pseudospherical radiative transfer simulations, which were shown to improve the performance of our method under large SZA (low Sun).

  6. Firm Elevation of Reconstructed Auricle Using Polydactyly Digit in Microtia.

    Science.gov (United States)

    Jang, Suk Yoon; Kim, Woo Seob; Kim, Han Koo; Bae, Tae Hui

    2018-03-01

    Total ear reconstruction for microtia is usually accomplished in 2 stages which is known as Nagata technique. After framework fabrication and implantation, the elevation procedure is required as a second step surgery. The authors are introducing a novel material for augmenting projection of rib cartilage framework in microtia treatment.

  7. Shaping the breast in secondary microsurgical breast reconstruction: single- vs. two-esthetic unit reconstruction.

    Science.gov (United States)

    Gravvanis, Andreas; Smith, Roger W

    2010-10-01

    The esthetic outcome is dictated essentially not only by the position, size, and shape of the reconstructed breast, but also by the extra scaring involved. In the present study, we conducted a visual analog scale survey to compare the esthetic outcome in delayed autologous breast reconstruction following two different abdominal flaps inset. Twenty-five patients had their reconstruction using the Single-esthetic Unit principle and were compared with 25 patients that their breast was reconstructed using the Two-Esthetic Unit principle. Photographic images were formulated to a PowerPoint presentation and cosmetic outcomes were assessed from 30 physicians, by means of a Questionnaire and a visual analog scale. Our data showed that the single-esthetic unit breast reconstruction presents significant advantages over the traditional two-esthetic units, due to inconspicuous flap reconstruction, better position of the inframammary fold, and more natural transition from native and reconstructed tissues. Moreover, patient self-evaluation of esthetic outcome and quality of life showed that single-esthetic unit reconstruction is associated with higher patient satisfaction, therefore should be considered the method of choice. © 2010 Wiley-Liss, Inc.

  8. Head and neck reconstruction with pedicled flaps in the free flap era.

    Science.gov (United States)

    Mahieu, R; Colletti, G; Bonomo, P; Parrinello, G; Iavarone, A; Dolivet, G; Livi, L; Deganello, A

    2016-12-01

    Nowadays, the transposition of microvascular free flaps is the most popular method for management of head and neck defects. However, not all patients are suitable candidates for free flap reconstruction. In addition, not every defect requires a free flap transfer to achieve good functional results. The aim of this study was to assess whether pedicled flap reconstruction of head and neck defects is inferior to microvascular free flap reconstruction in terms of complications, functionality and prognosis. The records of consecutive patients who underwent free flap or pedicled flap reconstruction after head and neck cancer ablation from 2006 to 2015, from a single surgeon, in the AOUC Hospital, Florence Italy were analysed. A total of 93 patients, the majority with oral cancer (n = 59), were included, of which 64 were pedicled flap reconstructions (69%). The results showed no significant differences in terms of functional outcome, flap necrosis and complications in each type of reconstruction. Multivariate regression analysis of flap necrosis and functional impairments showed no associated factors. Multivariate regression analysis of complicated flap healing showed that only comorbidities remained an explaining factor (p = 0.019). Survival analysis and proportional hazard regression analysis regarding cancer relapse or distant metastasis, showed no significant differences in prognosis of patients concerning both types of reconstruction. In this retrospective, non-randomised study cohort, pedicled flaps were not significantly inferior to free flaps for reconstruction of head and neck defects, considering functionality, complications and prognosis. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  9. Validity of proxy data obtained by different psychological autopsy information reconstruction techniques.

    Science.gov (United States)

    Fang, L; Zhang, J

    2010-01-01

    Two informants were interviewed for each of 416 living controls (individuals sampled from the normal population) interviewed in a Chinese case-control psychological autopsy study. The validity of proxy data, obtained using seven psychological autopsy information reconstruction techniques (types 1, 2 and A - E), was evaluated, with living controls' self reports used as the gold-standard. Proxy data for reconstruction technique types 1, 2 and D on the Impulsivity Inventory Scale (total impulsivity score) were no different from the living controls' self report gold standard, whereas data for types A and E were smaller than data from living controls. On the 'acceptance or resignation' sub-scale of the avoidance coping dimension of the Moos Coping Response Inventory, information obtained by reconstruction technique types 1 and D was not significantly different from the living controls' self reports, whereas proxy data from types 2, A and E were smaller than those from the living controls. No statistically significant differences were identified for other proxy data obtained by reconstruction technique types 1, 2, A, D and E. These results indicate that using a second informant does not significantly enhance information reconstruction for the target.

  10. Attenuation correction for the HRRT PET-scanner using transmission scatter correction and total variation regularization.

    Science.gov (United States)

    Keller, Sune H; Svarer, Claus; Sibomana, Merence

    2013-09-01

    In the standard software for the Siemens high-resolution research tomograph (HRRT) positron emission tomography (PET) scanner the most commonly used segmentation in the μ -map reconstruction for human brain scans is maximum a posteriori for transmission (MAP-TR). Bias in the lower cerebellum and pons in HRRT brain images have been reported. The two main sources of the problem with MAP-TR are poor bone/soft tissue segmentation below the brain and overestimation of bone mass in the skull. We developed the new transmission processing with total variation (TXTV) method that introduces scatter correction in the μ-map reconstruction and total variation filtering to the transmission processing. Comparing MAP-TR and the new TXTV with gold standard CT-based attenuation correction, we found that TXTV has less bias as compared to MAP-TR. We also compared images acquired at the HRRT scanner using TXTV to the GE Advance scanner images and found high quantitative correspondence. TXTV has been used to reconstruct more than 4000 HRRT scans at seven different sites with no reports of biases. TXTV-based reconstruction is recommended for human brain scans on the HRRT.

  11. Breast Reconstruction Following Cancer Treatment.

    Science.gov (United States)

    Gerber, Bernd; Marx, Mario; Untch, Michael; Faridi, Andree

    2015-08-31

    About 8000 breast reconstructions after mastectomy are per - formed in Germany each year. It has become more difficult to advise patients because of the wide variety of heterologous and autologous techniques that are now available and because of changes in the recommendations about radiotherapy. This article is based on a review of pertinent articles (2005-2014) that were retrieved by a selective search employing the search terms "mastectomy" and "breast reconstruction." The goal of reconstruction is to achieve an oncologically safe and aestically satisfactory result for the patient over the long term. Heterologous, i.e., implant-based, breast reconstruction (IBR) and autologous breast reconstruction (ABR) are complementary techniques. Immediate reconstruction preserves the skin of the breast and its natural form and prevents the psychological trauma associated with mastectomy. If post-mastectomy radiotherapy (PMRT) is not indicated, implant-based reconstruction with or without a net/acellular dermal matrix (ADM) is a common option. Complications such as seroma formation, infection, and explantation are significantly more common when an ADM is used (15.3% vs. 5.4% ). If PMRT is performed, then the complication rate of implant-based breast reconstruction is 1 to 48% ; in particular, Baker grade III/IV capsular fibrosis occurs in 7 to 22% of patients, and the prosthesis must be explanted in 9 to 41% . Primary or, preferably, secondary autologous reconstruction is an alternative. The results of ABR are more stable over the long term, but the operation is markedly more complex. Autologous breast reconstruction after PMRT does not increase the risk of serious complications (20.5% vs. 17.9% without radiotherapy). No randomized controlled trials have yet been conducted to compare the reconstructive techniques with each other. If radiotherapy will not be performed, immediate reconstruction with an implant is recommended. On the other hand, if post-mastectomy radiotherapy

  12. Dual-volume excitation and parallel reconstruction for J-difference-edited MR spectroscopy

    DEFF Research Database (Denmark)

    Oeltzschner, Georg; Puts, Nicolaas A J; Chan, Kimberly L

    2017-01-01

    successfully reconstructed with a mean in vivo g-factor of 1.025 (typical voxel-center separation: 7-8 cm). MEGA-PRIAM experiments showed higher signal-to-noise ratio than sequential single-voxel experiments of the same total duration (mean improvement 1.38 ± 0.24). CONCLUSIONS: Simultaneous acquisition of J......PURPOSE: To develop J-difference editing with parallel reconstruction in accelerated multivoxel (PRIAM) for simultaneous measurement in two separate brain regions of γ-aminobutyric acid (GABA) or glutathione. METHODS: PRIAM separates signals from two simultaneously excited voxels using receiver...

  13. Interior region-of-interest reconstruction using a small, nearly piecewise constant subregion

    International Nuclear Information System (INIS)

    Taguchi, Katsuyuki; Xu Jingyan; Srivastava, Somesh; Tsui, Benjamin M. W.; Cammin, Jochen; Tang Qiulin

    2011-01-01

    Purpose: To develop a method to reconstruct an interior region-of-interest (ROI) image with sufficient accuracy that uses differentiated backprojection (DBP) projection onto convex sets (POCS) [H. Kudo et al., ''Tiny a priori knowledge solves the interior problem in computed tomography'', Phys. Med. Biol. 53, 2207-2231 (2008)] and a tiny knowledge that there exists a nearly piecewise constant subregion. Methods: The proposed method first employs filtered backprojection to reconstruct an image on which a tiny region P with a small variation in the pixel values is identified inside the ROI. Total variation minimization [H. Yu and G. Wang, ''Compressed sensing based interior tomography'', Phys. Med. Biol. 54, 2791-2805 (2009); W. Han et al., ''A general total variation minimization theorem for compressed sensing based interior tomography'', Int. J. Biomed. Imaging 2009, Article 125871 (2009)] is then employed to obtain pixel values in the subregion P, which serve as a priori knowledge in the next step. Finally, DBP-POCS is performed to reconstruct f(x,y) inside the ROI. Clinical data and the reconstructed image obtained by an x-ray computed tomography system (SOMATOM Definition; Siemens Healthcare) were used to validate the proposed method. The detector covers an object with a diameter of ∼500 mm. The projection data were truncated either moderately to limit the detector coverage to diameter 350 mm of the object or severely to cover diameter 199 mm. Images were reconstructed using the proposed method. Results: The proposed method provided ROI images with correct pixel values in all areas except near the edge of the ROI. The coefficient of variation, i.e., the root mean square error divided by the mean pixel values, was less than 2.0% or 4.5% with the moderate or severe truncation cases, respectively, except near the boundary of the ROI. Conclusions: The proposed method allows for reconstructing interior ROI images with sufficient accuracy with a tiny knowledge that

  14. Generation of Optimal Basis Functions for Reconstruction of Power Distribution

    Energy Technology Data Exchange (ETDEWEB)

    Park, Moonghu [Sejong Univ., Seoul (Korea, Republic of)

    2014-05-15

    This study proposes GMDH to find not only the best functional form but also the optimal parameters those describe the power distribution most accurately. A total of 1,060 cases of axially 1-dimensional core power distributions of 20-nodes are generated by 3-dimensional core analysis code covering BOL to EOL core burnup histories to validate the method. Axially five-point box powers at in-core detectors are considered as measurements. The reconstructed axial power shapes using GMDH method are compared to the reference power shapes. The results show that the proposed method is very robust and accurate compared with spline fitting method. It is shown that the GMDH analysis can give optimal basis functions for core power shape reconstruction. The in-core measurements are the 5 detector snapshots and the 20-node power distribution is successfully reconstructed. The effectiveness of the method is demonstrated by comparing the results of spline fitting for BOL, saddle and top-skewed power shapes.

  15. Universal Spatial Correlation Functions for Describing and Reconstructing Soil Microstructure

    Science.gov (United States)

    Skvortsova, Elena B.; Mallants, Dirk

    2015-01-01

    Structural features of porous materials such as soil define the majority of its physical properties, including water infiltration and redistribution, multi-phase flow (e.g. simultaneous water/air flow, or gas exchange between biologically active soil root zone and atmosphere) and solute transport. To characterize soil microstructure, conventional soil science uses such metrics as pore size and pore-size distributions and thin section-derived morphological indicators. However, these descriptors provide only limited amount of information about the complex arrangement of soil structure and have limited capability to reconstruct structural features or predict physical properties. We introduce three different spatial correlation functions as a comprehensive tool to characterize soil microstructure: 1) two-point probability functions, 2) linear functions, and 3) two-point cluster functions. This novel approach was tested on thin-sections (2.21×2.21 cm2) representing eight soils with different pore space configurations. The two-point probability and linear correlation functions were subsequently used as a part of simulated annealing optimization procedures to reconstruct soil structure. Comparison of original and reconstructed images was based on morphological characteristics, cluster correlation functions, total number of pores and pore-size distribution. Results showed excellent agreement for soils with isolated pores, but relatively poor correspondence for soils exhibiting dual-porosity features (i.e. superposition of pores and micro-cracks). Insufficient information content in the correlation function sets used for reconstruction may have contributed to the observed discrepancies. Improved reconstructions may be obtained by adding cluster and other correlation functions into reconstruction sets. Correlation functions and the associated stochastic reconstruction algorithms introduced here are universally applicable in soil science, such as for soil classification

  16. An international comparison of reimbursement for DIEAP flap breast reconstruction.

    Science.gov (United States)

    Reid, A W N; Szpalski, C; Sheppard, N N; Morrison, C M; Blondeel, P N

    2015-11-01

    The deep inferior epigastric artery perforator (DIEAP) flap is currently considered the gold standard for autologous breast reconstruction. With the current economic climate and health cutbacks, we decided to survey reimbursement for DIEAP flaps performed at the main international centres in order to assess whether they are funded consistently. Data were collected confidentially from the main international centres by an anonymous questionnaire. Our results illustrate the wide disparity in international DIEAP flap breast reconstruction reimbursement: a unilateral DIEAP flap performed in New York, USA, attracts €20,759, whereas the same operation in Madrid, Spain, will only be reimbursed for €300. Only 35.7% of the surgeons can set up their own fee. Moreover, 85.7% of the participants estimated that the current fees are insufficient, and most of them feel that we are evolving towards an even lower reimbursement rate. In 55.8% of the countries represented, there is no DIEAP-specific coding; in comparison, 74.4% of the represented countries have a specific coding for transverse rectus abdominis (TRAM) flaps. Finally, despite the fact that DIEAP flaps have become the gold standard for breast reconstruction, they comprise only a small percentage of all the total number of breast reconstruction procedures performed (7-15%), with the only exception being Belgium (40%). Our results demonstrate that DIEAP flap breast reconstruction is inconsistently funded. Unfortunately though, it appears that the current reimbursement offered by many countries may dissuade institutions and surgeons from offering this procedure. However, substantial evidence exists supporting the cost-effectiveness of perforator flaps for breast reconstruction, and, in our opinion, the long-term clinical benefits for our patients are so important that this investment of time and money is absolutely essential. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons

  17. Possibilities of reconstruction and implant-prosthetic rehabilitation following mandible resection

    Directory of Open Access Journals (Sweden)

    Konstantinović Vitomir S.

    2013-01-01

    Full Text Available Introduction. Mandible reconstruction is still very challenging for surgeons. Mandible defects could be the consequence of ablative surgery for malignancies, huge jaw cysts, infection and trauma. Segmental resection of the mandible may compromise orofacial function and often lead to patients psychological disorders. Despite very frequent use of microvascular flaps, autogenous bone grafts are still very reliable technique for mandible reconstruction. Comprehensive therapy means not only mandible reconstruction, but prosthodontic rehabilitation supported by dental implants, which can significantly improve patients quality of life. The aim of this paper was to evaluate possible techniques of mandible reconstruction and to present a patient who had been submitted to mandible resection and reconstruction with autogenous iliac bone graft and prosthodontic rehabilitation with fixed denture anchoraged by disc-shaped implants in early loading protocol. Case report. Mandible reconstruction was performed simultaneously with resection. Autogenous iliac bone graft was taken, reshaped and placed in two parts, to the required optimal contour of the mandible. After graft consolidation, decision was made for prosthodontics rehabilitation with fixed dentures supported by implants. In addition to the standard preoperative procedures, planning was done based on a biomodel gained by rapid prototyping after CT scan. It offered a real 3D planning to obtain a proper shape, dimension and the position of implants. Conclusion. If bone dimensions of a reconstructed mandible are insufficient, like in the presented case, the use of basal osseointegrated implants may be a method of choice. Avoiding bone augmentation procedures, as well as early loading protocol for this type of implants, shorten the total rehabilitation time, which is very convenient for patients. Fixed denture supported by dental implants is the best solution for comprehensive rehabilitation after mandible

  18. The Versatile Extended Thoracodorsal Artery Perforator Flap for Breast Reconstruction

    DEFF Research Database (Denmark)

    Jacobs, Jordan; Børsen-Koch, Mikkel; Gunnarsson, Gudjon L.

    2016-01-01

    complications occurred in 10 of 106 (10%) cases and included hematoma (1/108), venous congestion (2/108), and partial flap necrosis (7/108). The reconstructive goal was achieved in 103 of 106 (97%) flaps. CONCLUSIONS: The TAP flap is a pedicled, fasciocutaneous flap that can be used for total breast...

  19. Permutationally invariant state reconstruction

    DEFF Research Database (Denmark)

    Moroder, Tobias; Hyllus, Philipp; Tóth, Géza

    2012-01-01

    Feasible tomography schemes for large particle numbers must possess, besides an appropriate data acquisition protocol, an efficient way to reconstruct the density operator from the observed finite data set. Since state reconstruction typically requires the solution of a nonlinear large-scale opti...... optimization, which has clear advantages regarding speed, control and accuracy in comparison to commonly employed numerical routines. First prototype implementations easily allow reconstruction of a state of 20 qubits in a few minutes on a standard computer.......-scale optimization problem, this is a major challenge in the design of scalable tomography schemes. Here we present an efficient state reconstruction scheme for permutationally invariant quantum state tomography. It works for all common state-of-the-art reconstruction principles, including, in particular, maximum...

  20. 3D Maize Plant Reconstruction Based on Georeferenced Overlapping LiDAR Point Clouds

    Directory of Open Access Journals (Sweden)

    Miguel Garrido

    2015-12-01

    Full Text Available 3D crop reconstruction with a high temporal resolution and by the use of non-destructive measuring technologies can support the automation of plant phenotyping processes. Thereby, the availability of such 3D data can give valuable information about the plant development and the interaction of the plant genotype with the environment. This article presents a new methodology for georeferenced 3D reconstruction of maize plant structure. For this purpose a total station, an IMU, and several 2D LiDARs with different orientations were mounted on an autonomous vehicle. By the multistep methodology presented, based on the application of the ICP algorithm for point cloud fusion, it was possible to perform the georeferenced point clouds overlapping. The overlapping point cloud algorithm showed that the aerial points (corresponding mainly to plant parts were reduced to 1.5%–9% of the total registered data. The remaining were redundant or ground points. Through the inclusion of different LiDAR point of views of the scene, a more realistic representation of the surrounding is obtained by the incorporation of new useful information but also of noise. The use of georeferenced 3D maize plant reconstruction at different growth stages, combined with the total station accuracy could be highly useful when performing precision agriculture at the crop plant level.

  1. Immediate reconstruction of maxillectomy defects using anterolateral thigh free flap in patients from a low resource region.

    Science.gov (United States)

    Liu, Wei Wei; Peng, Han Wei; Guo, Zhu Ming; Zhang, Quan; Yang, An Kui

    2012-11-01

    To report the reliability and reconstructive outcome of using anterolateral thigh (ALT) flap with or without titanium mesh to repair maxillectomy defects in a patient from a low resource region (LRR). Retrospective review. Clinical data of patients with oral-maxillofacial cancers who underwent maxillectomy and reconstruction using ALT flap in two tertiary cancer centers in southern China were retrospectively reviewed. Reconstructive techniques, flap survival, postoperative oral functions, and surgical complications were reported. Apart from one total flap loss, 18 of the 19 free ALT flaps survived. Titanium mesh was used in two patients with total maxillectomy defects. Eighteen of the 19 patients resumed a normal oral diet. Fourteen patients had good speech, except one patient with poor pronunciation, and four patients had average speech. One patient presented with postoperative palatal fistula. No other complications were observed. The application of ALT flaps with or without titanium mesh to repair maxillectomy defects is straightforward and reliable and has an acceptable reconstructive outcome. It might be a suitable procedure for patients from an LRR. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  2. Parallel statistical image reconstruction for cone-beam x-ray CT on a shared memory computation platform

    International Nuclear Information System (INIS)

    Kole, J S; Beekman, F J

    2005-01-01

    Statistical reconstruction methods offer possibilities of improving image quality as compared to analytical methods, but current reconstruction times prohibit routine clinical applications. To reduce reconstruction times we have parallelized a statistical reconstruction algorithm for cone-beam x-ray CT, the ordered subset convex algorithm (OSC), and evaluated it on a shared memory computer. Two different parallelization strategies were developed: one that employs parallelism by computing the work for all projections within a subset in parallel, and one that divides the total volume into parts and processes the work for each sub-volume in parallel. Both methods are used to reconstruct a three-dimensional mathematical phantom on two different grid densities. The reconstructed images are binary identical to the result of the serial (non-parallelized) algorithm. The speed-up factor equals approximately 30 when using 32 to 40 processors, and scales almost linearly with the number of cpus for both methods. The huge reduction in computation time allows us to apply statistical reconstruction to clinically relevant studies for the first time

  3. Fast implementations of reconstruction-based scatter compensation in fully 3D SPECT image reconstruction

    International Nuclear Information System (INIS)

    Kadrmas, Dan J.; Karimi, Seemeen S.; Frey, Eric C.; Tsui, Benjamin M.W.

    1998-01-01

    Accurate scatter compensation in SPECT can be performed by modelling the scatter response function during the reconstruction process. This method is called reconstruction-based scatter compensation (RBSC). It has been shown that RBSC has a number of advantages over other methods of compensating for scatter, but using RBSC for fully 3D compensation has resulted in prohibitively long reconstruction times. In this work we propose two new methods that can be used in conjunction with existing methods to achieve marked reductions in RBSC reconstruction times. The first method, coarse-grid scatter modelling, significantly accelerates the scatter model by exploiting the fact that scatter is dominated by low-frequency information. The second method, intermittent RBSC, further accelerates the reconstruction process by limiting the number of iterations during which scatter is modelled. The fast implementations were evaluated using a Monte Carlo simulated experiment of the 3D MCAT phantom with 99m Tc tracer, and also using experimentally acquired data with 201 Tl tracer. Results indicated that these fast methods can reconstruct, with fully 3D compensation, images very similar to those obtained using standard RBSC methods, and in reconstruction times that are an order of magnitude shorter. Using these methods, fully 3D iterative reconstruction with RBSC can be performed well within the realm of clinically realistic times (under 10 minutes for 64x64x24 image reconstruction). (author)

  4. Update on orbital reconstruction.

    Science.gov (United States)

    Chen, Chien-Tzung; Chen, Yu-Ray

    2010-08-01

    Orbital trauma is common and frequently complicated by ocular injuries. The recent literature on orbital fracture is analyzed with emphasis on epidemiological data assessment, surgical timing, method of approach and reconstruction materials. Computed tomographic (CT) scan has become a routine evaluation tool for orbital trauma, and mobile CT can be applied intraoperatively if necessary. Concomitant serious ocular injury should be carefully evaluated preoperatively. Patients presenting with nonresolving oculocardiac reflex, 'white-eyed' blowout fracture, or diplopia with a positive forced duction test and CT evidence of orbital tissue entrapment require early surgical repair. Otherwise, enophthalmos can be corrected by late surgery with a similar outcome to early surgery. The use of an endoscope-assisted approach for orbital reconstruction continues to grow, offering an alternative method. Advances in alloplastic materials have improved surgical outcome and shortened operating time. In this review of modern orbital reconstruction, several controversial issues such as surgical indication, surgical timing, method of approach and choice of reconstruction material are discussed. Preoperative fine-cut CT image and thorough ophthalmologic examination are key elements to determine surgical indications. The choice of surgical approach and reconstruction materials much depends on the surgeon's experience and the reconstruction area. Prefabricated alloplastic implants together with image software and stereolithographic models are significant advances that help to more accurately reconstruct the traumatized orbit. The recent evolution of orbit reconstruction improves functional and aesthetic results and minimizes surgical complications.

  5. Brachytherapy reconstruction using orthogonal scout views from the CT

    International Nuclear Information System (INIS)

    Perez, J.; Lliso, F.; Carmona, V.; Bea, J.; Tormo, A.; Petschen, I.

    1996-01-01

    Introduction: CT assisted brachytherapy planning is demonstrating to have great advantages as external RT planning does. One of the problems we have found in this approach with the conventional gynecological Fletcher applicators is the high amount of artefacts (ovoids with rectal and vessical protections) in the CT slice. We have introduced a reconstruction method based on scout views in order to avoid this problem, allowing us to perform brachytherapy reconstruction completely CT assisted. We use a virtual simulation chain by General Electric Medical Systems. Method and discussion: Two orthogonal scout views (0 and 90 tube positions) are performed. The reconstruction method takes into account the virtual position of the focus and the fact that there is only divergence in the transverse plane. Algorithms developed for sources as well as for reference points localisation (A, B, lymphatic Fletcher trapezoid, pelvic wall, etc.) are presented. This method has the following practical advantages: the porte-cassette is not necessary, the image quality can be improved (it is very helpful in pelvic lateral views that are critical in conventional radiographs), the total time to get the data is smaller than for conventional radiographs (reduction of patient motion effects) and problems that appear in CT-slice based reconstruction in the case of strongly curved intrauterine applicators are avoided. Even though the resolution is smaller than in conventional radiographs it is good enough for brachytherapy. Regarding the CT planning this method presents the interesting feature that the co-ordinate system is the same for the reconstruction process that for the CT-slices set. As the application can be reconstructed from scout views and the doses can be evaluated on CT slices it is easier to correlate the dose values obtained for the traditional points with those provided by the CT information

  6. Relative individual workload changes may be a risk factor for rerupture of ulnar collateral ligament reconstruction.

    Science.gov (United States)

    Keller, Robert A; Mehran, Nima; Khalil, Lafi S; Ahmad, Christopher S; ElAttrache, Neal

    2017-03-01

    With an increasing number of Major League Baseball (MLB) players undergoing ulnar collateral ligament (UCL) reconstruction, there remains limited literature on appropriate post-reconstruction workload management to limit the risk of reinjury. A total of 28 MLB pitchers who underwent primary UCL reconstruction surgery and subsequently required revision reconstruction were identified and compared with 137 MLB pitchers who underwent primary reconstruction but did not later require revision surgery. Games pitched, pitch counts, and innings pitched were evaluated and compared 3 years before and after primary reconstruction. Results were then compared between groups. Pitchers who later required revision increased their games pitched by 14.1% after reconstruction whereas the no-revision group pitched 13.6% fewer games than before reconstruction (P < .01). Inning workload was reduced by 9.8% after surgery (89.8 innings after vs 99.6 innings before) for the revision group compared with the no-revision group, which threw 26% fewer innings after surgery (86.3 innings after vs 116.7 innings before) (P = .05). In addition, the revision group pitched 6.6% more pitches after reconstruction, 1138.9 pitches, compared with before reconstruction, 1068.6 pitches. Pitchers who did not require revision, in contrast, pitched 19.6% fewer pitches after reconstruction than before reconstruction (P = .08). This study's findings suggest that MLB pitchers who require revision UCL reconstruction after returning to play following primary UCL reconstruction pitch at or above their pre-primary UCL reconstruction workload whereas control pitchers who do not require revision pitch significantly less, below their pre-primary UCL reconstruction workload. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  7. MO-DE-207A-07: Filtered Iterative Reconstruction (FIR) Via Proximal Forward-Backward Splitting: A Synergy of Analytical and Iterative Reconstruction Method for CT

    International Nuclear Information System (INIS)

    Gao, H

    2016-01-01

    Purpose: This work is to develop a general framework, namely filtered iterative reconstruction (FIR) method, to incorporate analytical reconstruction (AR) method into iterative reconstruction (IR) method, for enhanced CT image quality. Methods: FIR is formulated as a combination of filtered data fidelity and sparsity regularization, and then solved by proximal forward-backward splitting (PFBS) algorithm. As a result, the image reconstruction decouples data fidelity and image regularization with a two-step iterative scheme, during which an AR-projection step updates the filtered data fidelity term, while a denoising solver updates the sparsity regularization term. During the AR-projection step, the image is projected to the data domain to form the data residual, and then reconstructed by certain AR to a residual image which is in turn weighted together with previous image iterate to form next image iterate. Since the eigenvalues of AR-projection operator are close to the unity, PFBS based FIR has a fast convergence. Results: The proposed FIR method is validated in the setting of circular cone-beam CT with AR being FDK and total-variation sparsity regularization, and has improved image quality from both AR and IR. For example, AIR has improved visual assessment and quantitative measurement in terms of both contrast and resolution, and reduced axial and half-fan artifacts. Conclusion: FIR is proposed to incorporate AR into IR, with an efficient image reconstruction algorithm based on PFBS. The CBCT results suggest that FIR synergizes AR and IR with improved image quality and reduced axial and half-fan artifacts. The authors was partially supported by the NSFC (#11405105), the 973 Program (#2015CB856000), and the Shanghai Pujiang Talent Program (#14PJ1404500).

  8. Lessons Learned from Delayed Versus Immediate Microsurgical Reconstruction of Complex Maxillectomy and Midfacial Defects: Experience in a Tertiary Center in Mexico.

    Science.gov (United States)

    Santamaria, Eric; de la Concha, Erika

    2016-10-01

    Microsurgical reconstruction of complex midfacial and maxillectomy defects is among the most challenging procedures in plastic surgery, and it often requires composite flaps to improve functional and aesthetic results. Various factors have been identified as having influence in the outcome of microsurgical reconstruction. In this article, the authors present their experience with immediate and delayed reconstruction of complex maxillectomy defects in a tertiary center in Mexico. The authors present a total of 37 patients with microsurgical reconstruction of a complex maxillectomy defect; 13 patients had immediate and 24 had delayed reconstructions. The authors recommend doing immediate reconstruction when feasible. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Sparsity-promoting orthogonal dictionary updating for image reconstruction from highly undersampled magnetic resonance data

    International Nuclear Information System (INIS)

    Huang, Jinhong; Guo, Li; Feng, Qianjin; Chen, Wufan; Feng, Yanqiu

    2015-01-01

    Image reconstruction from undersampled k-space data accelerates magnetic resonance imaging (MRI) by exploiting image sparseness in certain transform domains. Employing image patch representation over a learned dictionary has the advantage of being adaptive to local image structures and thus can better sparsify images than using fixed transforms (e.g. wavelets and total variations). Dictionary learning methods have recently been introduced to MRI reconstruction, and these methods demonstrate significantly reduced reconstruction errors compared to sparse MRI reconstruction using fixed transforms. However, the synthesis sparse coding problem in dictionary learning is NP-hard and computationally expensive. In this paper, we present a novel sparsity-promoting orthogonal dictionary updating method for efficient image reconstruction from highly undersampled MRI data. The orthogonality imposed on the learned dictionary enables the minimization problem in the reconstruction to be solved by an efficient optimization algorithm which alternately updates representation coefficients, orthogonal dictionary, and missing k-space data. Moreover, both sparsity level and sparse representation contribution using updated dictionaries gradually increase during iterations to recover more details, assuming the progressively improved quality of the dictionary. Simulation and real data experimental results both demonstrate that the proposed method is approximately 10 to 100 times faster than the K-SVD-based dictionary learning MRI method and simultaneously improves reconstruction accuracy. (paper)

  10. Sparsity-promoting orthogonal dictionary updating for image reconstruction from highly undersampled magnetic resonance data.

    Science.gov (United States)

    Huang, Jinhong; Guo, Li; Feng, Qianjin; Chen, Wufan; Feng, Yanqiu

    2015-07-21

    Image reconstruction from undersampled k-space data accelerates magnetic resonance imaging (MRI) by exploiting image sparseness in certain transform domains. Employing image patch representation over a learned dictionary has the advantage of being adaptive to local image structures and thus can better sparsify images than using fixed transforms (e.g. wavelets and total variations). Dictionary learning methods have recently been introduced to MRI reconstruction, and these methods demonstrate significantly reduced reconstruction errors compared to sparse MRI reconstruction using fixed transforms. However, the synthesis sparse coding problem in dictionary learning is NP-hard and computationally expensive. In this paper, we present a novel sparsity-promoting orthogonal dictionary updating method for efficient image reconstruction from highly undersampled MRI data. The orthogonality imposed on the learned dictionary enables the minimization problem in the reconstruction to be solved by an efficient optimization algorithm which alternately updates representation coefficients, orthogonal dictionary, and missing k-space data. Moreover, both sparsity level and sparse representation contribution using updated dictionaries gradually increase during iterations to recover more details, assuming the progressively improved quality of the dictionary. Simulation and real data experimental results both demonstrate that the proposed method is approximately 10 to 100 times faster than the K-SVD-based dictionary learning MRI method and simultaneously improves reconstruction accuracy.

  11. Conservative mastectomies and immediate reconstruction with the use of ADMs.

    Science.gov (United States)

    Govshievich, Alexander; Somogyi, Ron B; Brown, Mitchell H

    2015-12-01

    In recent years, a novel approach to immediate breast reconstruction has been introduced with the advent of acellular dermal matrix (ADM). In the setting of conservative mastectomies where the native skin envelope is preserved, placement of ADM at the lower pole in continuity with the pectoralis major muscle (PMM) provides additional support, allowing direct-to-implant breast reconstruction. The following manuscript presents the senior author's experience with ADM-assisted reconstruction and provides a detailed description of surgical technique along with a comprehensive discussion of patient selection and potential complications. A retrospective chart review of patients undergoing direct-to-implant breast reconstruction following skin sparing or nipple sparing mastectomy with the use of ADM (AlloDerm; LifeCell Corp., Branchburg, USA) was conducted at Women's College Hospital in Toronto over a 5-year period [2008-2013]. Demographic data, previous radiation therapy and post-operative complications were recorded. A total of 72 patients representing 119 breasts were identified. Average follow-up was 16 months (range, 3-51 months). Twenty-seven complications were recorded for a complication rate of 22.7% (27/119). Complications included six cases of capsular contracture (Baker III/IV), five cases of red skin syndrome, four cases of rippling, three cases of dehiscence and two cases of seroma. Overall, direct-to-implant reconstruction was successfully completed in 97.5% of breasts (116/119). One case of infection was treated with explantation and conversion to autogenous reconstruction. Two breasts with tissue necrosis or dehiscence had the implants removed and replaced with tissue expanders. Overall reoperation rate was 9.7% (7/72 patients). ADM assisted direct-to-implant breast reconstruction has been shown to be a safe option for women who are candidates for skin sparing or nipple sparing mastectomies. Judicious patient selection, effective collaboration between the

  12. Water, gravity and trees: Relationship of tree-ring widths and total water storage dynamics

    Science.gov (United States)

    Creutzfeldt, B.; Heinrich, I.; Merz, B.; Blume, T.; Güntner, A.

    2012-04-01

    Water stored in the subsurface as groundwater or soil moisture is the main fresh water source not only for drinking water and food production but also for the natural vegetation. In a changing environment water availability becomes a critical issue in many different regions. Long-term observations of the past are needed to improve the understanding of the hydrological system and the prediction of future developments. Tree ring data have repeatedly proved to be valuable sources for reconstructing long-term climate dynamics, e.g. temperature, precipitation and different hydrological variables. In water-limited environments, tree growth is primarily influenced by total water stored in the subsurface and hence, tree-ring records usually contain information about subsurface water storage. The challenge is to retrieve the information on total water storage from tree rings, because a training dataset of water stored in the sub-surface is required for calibration against the tree-ring series. However, measuring water stored in the subsurface is notoriously difficult. We here present high-precision temporal gravimeter measurements which allow for the depth-integrated quantification of total water storage dynamics at the field scale. In this study, we evaluate the relationship of total water storage change and tree ring growth also in the context of the complex interactions of other meteorological forcing factors. A tree-ring chronology was derived from a Norway spruce stand in the Bavarian Forest, Germany. Total water storage dynamics were measured directly by the superconducting gravimeter of the Geodetic Observatory Wettzell for a 9-years period. Time series were extended to 63-years period by a hydrological model using gravity data as the only calibration constrain. Finally, water storage changes were reconstructed based on the relationship between the hydrological model and the tree-ring chronology. Measurement results indicate that tree-ring growth is primarily

  13. Major League pitching workload after primary ulnar collateral ligament reconstruction and risk for revision surgery.

    Science.gov (United States)

    Keller, Robert A; Mehran, Nima; Marshall, Nathan E; Okoroha, Kelechi R; Khalil, Lafi; Tibone, James E; Moutzouros, Vasilios

    2017-02-01

    Literature has attempted to correlate pitching workload with risk of ulnar collateral ligament (UCL) injury; however, limited data are available in evaluating workload and its relationship with the need for revision reconstruction in Major League Baseball (MLB) pitchers. We identified 29 MLB pitchers who underwent primary UCL reconstruction surgery and subsequently required revision reconstruction and compared them with 121 MLB pitchers who underwent primary reconstruction but did not later require revision surgery. Games pitched, pitch counts, and innings pitched were evaluated and compared for the seasons after returning from primary reconstruction and for the last season pitched before undergoing revision surgery. The difference in workload between pitchers who did and did not require revision reconstruction was not statistically significant in games pitched, innings pitched, and MLB-only pitch counts. The one significant difference in workload was in total pitch counts (combined MLB and minor league), with the pitchers who required revision surgery pitching less than those who did not (primary: 1413.6 pitches vs. revision: 959.0 pitches, P = .04). In addition, pitchers who required revision surgery underwent primary reconstruction at an early age (22.9 years vs. 27.3 years, P risk for injury after primary UCL reconstruction. However, correlations of risk may be younger age and less MLB experience at the time of the primary reconstruction. Copyright © 2017. Published by Elsevier Inc.

  14. How Are We Measuring Patient Satisfaction After Anterior Cruciate Ligament Reconstruction?

    Science.gov (United States)

    Kahlenberg, Cynthia A; Nwachukwu, Benedict U; Ferraro, Richard A; Schairer, William W; Steinhaus, Michael E; Allen, Answorth A

    2016-12-01

    Reconstruction of the anterior cruciate ligament (ACL) is one of the most common orthopaedic operations in the United States. The long-term impact of ACL reconstruction is controversial, however, as longer term data have failed to demonstrate that ACL reconstruction helps alter the natural history of early onset osteoarthritis that occurs after ACL injury. There is significant interest in evaluating the value of ACL reconstruction surgeries. To examine the quality of patient satisfaction reporting after ACL reconstruction surgery. Systematic review; Level of evidence, 4. A systematic review of the MEDLINE database was performed using the PubMed interface. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines as well as the PRISMA checklist were employed. The initial search yielded 267 studies. The inclusion criteria were: English language, US patient population, clinical outcome study of ACL reconstruction surgery, and reporting of patient satisfaction included in the study. Study quality was assessed using the Newcastle-Ottawa scale. A total of 22 studies met the inclusion criteria. These studies comprised a total of 1984 patients with a mean age of 31.9 years at the time of surgery and a mean follow-up period of 59.3 months. The majority of studies were evidence level 4 (n = 18; 81.8%), had a mean Newcastle-Ottawa scale score of 5.5, and were published before 2006 (n = 17; 77.3%); 5 studies (22.7%) failed to clearly describe their method for determining patient satisfaction. The most commonly used method for assessing satisfaction was a 0 to 10 satisfaction scale (n = 11; 50.0%). Among studies using a 0 to 10 scale, mean satisfaction ranged from 7.4 to 10.0. Patient-reported outcome and objective functional measures for ACL stability and knee function were positively correlated with patient satisfaction. Degenerative knee change was negatively correlated with satisfaction. The level of evidence for studies reporting patient

  15. Optimized image acquisition for breast tomosynthesis in projection and reconstruction space

    International Nuclear Information System (INIS)

    Chawla, Amarpreet S.; Lo, Joseph Y.; Baker, Jay A.; Samei, Ehsan

    2009-01-01

    Breast tomosynthesis has been an exciting new development in the field of breast imaging. While the diagnostic improvement via tomosynthesis is notable, the full potential of tomosynthesis has not yet been realized. This may be attributed to the dependency of the diagnostic quality of tomosynthesis on multiple variables, each of which needs to be optimized. Those include dose, number of angular projections, and the total angular span of those projections. In this study, the authors investigated the effects of these acquisition parameters on the overall diagnostic image quality of breast tomosynthesis in both the projection and reconstruction space. Five mastectomy specimens were imaged using a prototype tomosynthesis system. 25 angular projections of each specimen were acquired at 6.2 times typical single-view clinical dose level. Images at lower dose levels were then simulated using a noise modification routine. Each projection image was supplemented with 84 simulated 3 mm 3D lesions embedded at the center of 84 nonoverlapping ROIs. The projection images were then reconstructed using a filtered backprojection algorithm at different combinations of acquisition parameters to investigate which of the many possible combinations maximizes the performance. Performance was evaluated in terms of a Laguerre-Gauss channelized Hotelling observer model-based measure of lesion detectability. The analysis was also performed without reconstruction by combining the model results from projection images using Bayesian decision fusion algorithm. The effect of acquisition parameters on projection images and reconstructed slices were then compared to derive an optimization rule for tomosynthesis. The results indicated that projection images yield comparable but higher performance than reconstructed images. Both modes, however, offered similar trends: Performance improved with an increase in the total acquisition dose level and the angular span. Using a constant dose level and angular

  16. Spectrotemporal CT data acquisition and reconstruction at low dose

    International Nuclear Information System (INIS)

    Clark, Darin P.; Badea, Cristian T.; Lee, Chang-Lung; Kirsch, David G.

    2015-01-01

    problem using the split Bregman method and GPU-based implementations of backprojection, reprojection, and kernel regression. Using a preclinical mouse model, the authors apply the proposed algorithm to study myocardial injury following radiation treatment of breast cancer. Results: Quantitative 5D simulations are performed using the MOBY mouse phantom. Twenty data sets (ten cardiac phases, two energies) are reconstructed with 88 μm, isotropic voxels from 450 total projections acquired over a single 360° rotation. In vivo 5D myocardial injury data sets acquired in two mice injected with gold and iodine nanoparticles are also reconstructed with 20 data sets per mouse using the same acquisition parameters (dose: ∼60 mGy). For both the simulations and the in vivo data, the reconstruction quality is sufficient to perform material decomposition into gold and iodine maps to localize the extent of myocardial injury (gold accumulation) and to measure cardiac functional metrics (vascular iodine). Their 5D CT imaging protocol represents a 95% reduction in radiation dose per cardiac phase and energy and a 40-fold decrease in projection sampling time relative to their standard imaging protocol. Conclusions: Their 5D CT data acquisition and reconstruction protocol efficiently exploits the rank-sparse nature of spectral and temporal CT data to provide high-fidelity reconstruction results without increased radiation dose or sampling time

  17. Region-of-interest reconstruction for a cone-beam dental CT with a circular trajectory

    International Nuclear Information System (INIS)

    Hu, Zhanli; Zou, Jing; Gui, Jianbao; Zheng, Hairong; Xia, Dan

    2013-01-01

    Dental CT is the most appropriate and accurate device for preoperative evaluation of dental implantation. It can demonstrate the quantity of bone in three dimensions (3D), the location of important adjacent anatomic structures and the quality of available bone with minimal geometric distortion. Nevertheless, with the rapid increase of dental CT examinations, we are facing the problem of dose reduction without loss of image quality. In this work, backprojection-filtration (BPF) and Feldkamp–Davis–Kress (FDK) algorithm was applied to reconstruct the 3D full image and region-of-interest (ROI) image from complete and truncated circular cone-beam data respectively by computer-simulation. In addition, the BPF algorithm was evaluated based on the 3D ROI-image reconstruction from real data, which was acquired from our developed circular cone-beam prototype dental CT system. The results demonstrated that the ROI-image quality reconstructed from truncated data using the BPF algorithm was comparable to that reconstructed from complete data. The FDK algorithm, however, created artifacts while reconstructing ROI-image. Thus it can be seen, for circular cone-beam dental CT, reducing scanning angular range of the BPF algorithm used for ROI-image reconstruction are helpful for reducing the radiation dose and scanning time. Finally, an analytical method was developed for estimation of the ROI projection area on the detector before CT scanning, which would help doctors to roughly estimate the total radiation dose before the CT examination. -- Highlights: ► BPF algorithm was applied by using dental CT for the first time. ► A method was developed for estimation of projection region before CT scanning. ► Roughly predict the total radiation dose before CT scans. ► Potential reduce imaging radiation dose, scatter, and scanning time

  18. Quality of life factors and survival after total or extended maxillectomy for sinonasal malignancies.

    Science.gov (United States)

    Murphy, James; Isaiah, Amal; Wolf, Jeffrey S; Lubek, Joshua E

    2015-04-01

    Total and extended maxillectomy results in significant morbidity that can have an effect on quality of life factors. Modern reconstructive techniques have ameliorated this effect, but they have not been quantified. The purpose of the present study was to evaluate the quality of life factors and survival of patients undergoing total or extended maxillectomy for malignant disease. A retrospective study was performed of all patients who had undergone total or extended maxillectomy at a tertiary care cancer center from January 2008 to May 2013. The minimum follow-up period was 6 months. The quality of life factors analyzed included swallowing function and diet consistency, pain control, and postoperative complications. A total of 25 patients (13 women and 12 men) met the inclusion criteria. Using the American Joint Committee on Cancer staging system, 76% of the patients had stage IV disease. Of the 25 patients, 13 received a free tissue transfer, 11 an obturator flap, and 1 a regional flap. None of the patients with a free tissue transfer experienced failure. The tumor size had no systemic influence on the reconstructive method chosen (P = .32 to P = .98). The median follow-up period was 41 weeks (range 24 to 252). One death was recorded, and 10 patients were lost to follow-up. Eleven patients progressed to a regular diet. Fifteen patients required a tracheostomy, and all were decannulated at a mean of 14 days postoperatively. One patient had dental implants placed. The type of reconstruction did not influence swallowing function (P = .49) or long-term pain (P = .38). The mean pain score was 4.9 ± 2.7. Pain management proved difficult in 7 patients. Also, 6 patients developed a surgical site infection, 3 of whom required a return to the operating room. Seven patients were readmitted to the hospital for complications; however, the reconstructive method did not influence the incidence of complications (P = .64). The inevitable morbidity, with respect to quality

  19. Rubble Women: The Long-Term Effects of Postwar Reconstruction on Female Labor Market Outcomes

    OpenAIRE

    Akbulut-Yuksel, Mevlude; Khamis, Melanie; Yuksel, Mutlu

    2011-01-01

    During World War II, more than one-half million tons of bombs were dropped in aerial raids on German cities, destroying about forty percent of the total housing stock nationwide. With a large fraction of the male population gone, the reconstruction process had mainly fallen on women in postwar Germany. This paper provides causal evidence on long-term legacies of postwar reconstruction and mandatory employment on women's labor market outcomes. We combine a unique dataset on city-level destruct...

  20. O FALO COMO SEXUALIDADE E JOCOSIDADE NAS REPRESENTAÇÕES DE SILENO NO DRAMA SATÍRICO CICLOPE NA CERÂMICA DOS SÉCULOS VI e V a.c. (Dossiê: O Mundo Antigo: Literatura e Historiografia

    Directory of Open Access Journals (Sweden)

    Leandro Mendonça Barbosa

    2015-09-01

    Full Text Available Resumo: O que se pretende com este artigo é perceber como a representação fálica – uma constante em diversos aspectos da arte grega – foi inserida nos contextos de Sileno, divindade participante do cortejo dionisíaco e que possuía, dentre outras características, uma sexualidade latente. Desde o período arcaico esta criatura já é representada itifálica, possuindo um aspecto ao mesmo tempo jocoso e altamente sexualizado. Neste artigo abordaremos a relação da sexualidade fálica de Sileno com o poder sexual masculino, inerente a sociedades patriarcais como a de Atenas. Entender a representação fálica como elemento deste patriarcado, e como este se insere na questão de Sileno, é primordial. Para nossas análises lançaremos mão do drama satírico Ciclope, escrito no século V a.C. por Eurípides, e de imagens em cerâmica produzidas entre os séculos VI e V a.C.Palavras-Chave: Sileno, falo, sexualidade, jocosidadeAbstract: The aim of this work is to understand how the phallic representation - a constant in many aspects of Greek art - was inserted in the contexts of Sileno, participant divinity of the Dionysian procession, who had, among other features, a latent sexuality. Since the archaic period this creature has already a phallic representation, looking like, at the same time, highly sexualized facetious. In this article we discuss the relationship of phallic sexuality of Sileno, with male sexual power inherent in patriarchal societies such as Athens. Understanding the phallic representation as part of the patriarchy, and how this fits into the question of Sileno, is paramount. To our analysis we will use the satirical drama Ciclope, written in the V BC by Eurípides, and images produced in Attica between the VI and V BC.Keywords: Silenus, phallus, sexuality, Attica.Recebido em: 07/07/2015  – Aceito em 28/08/2015

  1. Incomplete projection reconstruction of computed tomography based on the modified discrete algebraic reconstruction technique

    Science.gov (United States)

    Yang, Fuqiang; Zhang, Dinghua; Huang, Kuidong; Gao, Zongzhao; Yang, YaFei

    2018-02-01

    Based on the discrete algebraic reconstruction technique (DART), this study aims to address and test a new improved algorithm applied to incomplete projection data to generate a high quality reconstruction image by reducing the artifacts and noise in computed tomography. For the incomplete projections, an augmented Lagrangian based on compressed sensing is first used in the initial reconstruction for segmentation of the DART to get higher contrast graphics for boundary and non-boundary pixels. Then, the block matching 3D filtering operator was used to suppress the noise and to improve the gray distribution of the reconstructed image. Finally, simulation studies on the polychromatic spectrum were performed to test the performance of the new algorithm. Study results show a significant improvement in the signal-to-noise ratios (SNRs) and average gradients (AGs) of the images reconstructed from incomplete data. The SNRs and AGs of the new images reconstructed by DART-ALBM were on average 30%-40% and 10% higher than the images reconstructed by DART algorithms. Since the improved DART-ALBM algorithm has a better robustness to limited-view reconstruction, which not only makes the edge of the image clear but also makes the gray distribution of non-boundary pixels better, it has the potential to improve image quality from incomplete projections or sparse projections.

  2. The Importance of a Conchal Bowl Element in the Fabrication of a Three-Dimensional Framework in Total Auricular Reconstruction

    Directory of Open Access Journals (Sweden)

    Young Soo Kim

    2013-05-01

    Full Text Available Background  To construct a sophisticated three-dimensionalframework, numerousmodifications have been reported in the literature. However, mostsurgeons have paid little attentionto the anatomical configuration of the concha and more to its deepness and hollowness,leading to unsatisfactory outcomes.Methods  For a configuration ofthe concha thatis definitely anatomical,the authorfurtherdeveloped and employed the conchal bowl element,which has been used by severalsurgeonsalthough the results have not been published elsewhere. The author constructed the conchalbowl element in one of three patterns according to the amount of available cartilages: oneblock,two-pieces, or a cymba bowl element only. A total of 20 patients underwent auricularreconstruction using a costal cartilage framework between 2009 and 2012. The 8 earliestreconstructionswere performedwithout a conchal bowl element and the latter 12with a conchalbowl element. The patientswere followed up for more than 1 year. The aesthetic resultswerescored by evaluating characteristicsinvolving the stability ofthe crus helicis,the conchal definition, and the smoothness ofthe helical curve.Results  The earsreconstructed earlywithout a conchal bowl elementshowed a shallowandone or two incompletely separated concha with an obliterated cymba conchal space. Theyalso did not have a realistic orsmooth curve ofthe helix because of an unstable crus helicis.However, earsreconstructed laterwith the concha bowl elementshowed a definite crus helicis,deep cymba conchalspace, and smooth helical curve.Conclusions  The construction of the conchal bowl element is simple, not time-consumingprocedure. It is suggested that the conchal bowl element must be constructed and attachedto themain framework for natural configuration ofthe reconstructed ear.

  3. Implementation and Analysis of a Lean Six Sigma Program in Microsurgery to Improve Operative Throughput in Perforator Flap Breast Reconstruction.

    Science.gov (United States)

    Hultman, Charles Scott; Kim, Sendia; Lee, Clara N; Wu, Cindy; Dodge, Becky; Hultman, Chloe Elizabeth; Roach, S Tanner; Halvorson, Eric G

    2016-06-01

    Perforator flaps have become a preferred method of breast reconstruction but can consume considerable resources. We examined the impact of a Six Sigma program on microsurgical breast reconstruction at an academic medical center. Using methods developed by Motorola and General Electric, we applied critical pathway planning, workflow analysis, lean manufacturing, continuous quality improvement, and defect reduction to microsurgical breast reconstruction. Primary goals were to decrease preoperative-to-cut time and total operative time, through reduced variability and improved efficiency. Secondary goals were to reduce length of stay, complications, and reoperation. The project was divided into 3 phases: (1) Pre-Six Sigma (24 months), (2) Six Sigma (10 months), (3) and Post-Six Sigma (24 months). These periods (baseline, intervention, control) were compared by Student t test and χ analysis. Over a 5-year period, 112 patients underwent 168 perforator flaps for breast reconstructions, by experienced microsurgeons. Total operative time decreased from 714 to 607 minutes (P Six Sigma program in microsurgical breast reconstruction was associated with better operational and financial outcomes. These incremental gains were maintained over the course of the study, suggesting that these benefits were due, in part, to process improvements. However, continued reductions in total operative time and length of stay, well after the intervention period, support the possibility that "learning curve" phenomenon may have contributed to the improvement in these outcomes.

  4. BES-II fast data reconstruction

    International Nuclear Information System (INIS)

    Rong Gang; Zhang Jiawen; Guo Yiqing; Zhang Shaoqiang; Zhao Dixin

    2002-01-01

    The BES-II fast data reconstruction is reported. Based on PC FARM and/or a 'Distributed Clustered Linux PC System', BES-II fast data reconstruction system is set up. With this system the BES-II data can be fully reconstructed in about 20 minutes after data collection. It takes only 12 minutes to fully reconstruct 30000 events, collected with BES-II detector at BEPC Collider, with a P III-800 PC. The detector performance can be examined based on fully reconstructed data in about 20 minutes after data taking in the BES-II experiment

  5. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    International Nuclear Information System (INIS)

    Akiyama, Haruhiko; Takemoto, Mitsuru; Morishima, Takkan

    2011-01-01

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  6. Practices of Built Heritage Post-Disaster Reconstruction for Resilient Cities

    Directory of Open Access Journals (Sweden)

    Tomasz Jeleński

    2018-03-01

    Full Text Available The concept of resilience has become increasingly important to our understanding of sustainable planning. Post-disaster urban and architectural reconstruction might be treated as a strategy for resilient cities, helping them to reinvent themselves after possible destruction. The purpose of this study is to analyse several cases of nearly total reconstruction of historical urban complexes. Specifically, it explores how urban heritage conservation and recreation could contribute to the resilience agenda, giving traumatised societies a sense of continuity and localness. It analyses the changes in the conservation doctrine, highlighting the growing acceptance of architectural reconstructions. Drawing on historical examples, mainly derived from the Polish School of Conservation practice, this paper argues that the methods and processes attempted to regain identity for the thoroughly rebuilt structures proved effective in recreating the identity of such cities as Kalisz, Warsaw, Gdańsk, and Wrocław. The article argues that while processes at the governmental level emphasised the strengthening of national identity, the experiences of the reconstructed townscapes eventually involved forms of more diverse municipal identities. The article highlights that the strategy of recreating traditional images of cities after their mutilation in disastrous events might be a key to becoming a more resilient city and the formation of the post-disaster citizenry.

  7. Simultaneous anatomic reconstruction of the acromioclavicular and coracoclavicular ligaments using a single tendon graft.

    Science.gov (United States)

    Shin, Sang-Jin; Campbell, Sean; Scott, Jonathan; McGarry, Michelle H; Lee, Thay Q

    2014-09-01

    The purpose of this study was to introduce a novel surgical technique for simultaneous anatomic reconstruction of the acromioclavicular and coracoclavicular ligaments using a single tendon graft and to compare its biomechanical characteristics to those of a coracoid cerclage reconstruction of the coracoclavicular ligaments. Six matched pairs of human acromioclavicular joints with an average age of 54.8 ± 7.8 years were used. One shoulder from each pair received the single tendon acromioclavicular-coracoclavicular reconstruction; the contralateral shoulder received the coracoid cerclage reconstruction. Bovine extensor tendon was used for both techniques. The single tendon acromioclavicular-coracoclavicular reconstruction technique provided anatomic restoration of the two coracoclavicular ligaments and the superior and inferior acromioclavicular ligaments simultaneously using one coracoid hole, one acromion hole, and two clavicular holes with interference screws. Anterior-posterior and superior-inferior translations were quantified for all specimens before and after reconstruction, followed by load to failure testing. Following coracoid cerclage reconstruction, total anterior-posterior translation was significantly greater than intact (10.0 ± 5.7 mm; p = 0.008). Following single tendon acromioclavicular-coracoclavicular reconstruction, there was no significant difference in anterior-posterior translation compared to intact (-1.6 ± 2.2 mm; n.s.). The coracoid cerclage technique demonstrated significantly greater anterior-posterior translation than the single tendon acromioclavicular-coracoclavicular technique (p = 0.007). Both techniques restored superior-inferior translation to the intact condition (n.s.). Ultimate load, deformation at ultimate load, and energy absorbed at ultimate load were significantly greater after acromioclavicular-coracoclavicular reconstruction than after coracoid cerclage reconstruction (p

  8. The Masculine Vaginal: Working With Queer Men's Embodiment at the Transgender Edge.

    Science.gov (United States)

    Hansbury, Griffin

    2017-12-01

    Turning away from the conspicuous phenomena of transgender experience, with an eye toward locating and illuminating the transgender edge in cisgender, this paper explores the relationship between men and the Vaginal, both material and fantasized. Positing the Vaginal as a counterpart to the Phallic allows a delinkage of vaginal psychic and embodied states from the strictly female so that, like the Phallic, they can be accessed by people of all genders and sexes. This concept goes beyond the conceptual to the fleshy, embodied experience of many transgender men, who live in whole, partial, and/or temporary "female" bodies. It can also be applied to the physio-psychic reality of many cisgender men. Included is a discussion of a case in which a gay cisgender male patient experiences and fantasizes his anus as a vagina.

  9. Statistical Reconstruction of Gas Oil Cuts Reconstruction statistique de coupes gazoles

    Directory of Open Access Journals (Sweden)

    Hudebine D.

    2009-11-01

    Full Text Available Gas oil cuts are extremely complex mixtures of several thousands of different chemical species. Consequently, conventional petroleum analyses do not allow to obtain the molecular detail that is required for the development of robust and predictive kinetic models. Recently, two-dimensional Gas Chromatographic techniques (GC2D have greatly improved the knowledge in the field of characterization of gas oils. However, they remain R&D tools and are hardly utilized in the refining industry. Hence, the goal of the statistical reconstruction of gas oils is to provide a surrogate for this GC2D analysis. To this aim, the gas oil cuts are characterized by means of matrices of molar fractions of pseudo-compounds, which are classified by chemical family and by carbon atom number. The input analyses are the Fitzgerald mass spectrometry, the sulfur speciation (one-dimensional gas chromatography coupled to a specific sulfur chemiluminescence detector and the total nitrogen and basic nitrogen contents, and allow to quantify the proportions of all the chemical families present in the matrix. The simulated distillation is also used in order to introduce information on the volatility of the gas oil cut. The reconstruction method proposed in this paper is mainly based on a reference statistical distribution of the number of carbon atoms for the side chains connected to the naphtheno-aromatic cores. For each chemical family, the knowledge of the number of potential side chains and the estimation of the maximum length of these alkyl chains allow to determine the carbon number distribution by adjusting of the reference distribution. After reconstruction, the properties of the resulting molar fractions matrix are very close to the analyses used for the reconstruction. Moreover, the method allows to predict, with a high precision, complementary analyses such as the hydrogen content, the aromatic carbon content and the density at 15 ˚C. Finally, the matrix can be

  10. Evaluation of imaging protocol for ECT based on CS image reconstruction algorithm

    International Nuclear Information System (INIS)

    Zhou Xiaolin; Yun Mingkai; Cao Xuexiang; Liu Shuangquan; Wang Lu; Huang Xianchao; Wei Long

    2014-01-01

    Single-photon emission computerized tomography and positron emission tomography are essential medical imaging tools, for which the sampling angle number and scan time should be carefully chosen to give a good compromise between image quality and radiopharmaceutical dose. In this study, the image quality of different acquisition protocols was evaluated via varied angle number and count number per angle with Monte Carlo simulation data. It was shown that, when similar imaging counts were used, the factor of acquisition counts was more important than that of the sampling number in emission computerized tomography. To further reduce the activity requirement and the scan duration, an iterative image reconstruction algorithm for limited-view and low-dose tomography based on compressed sensing theory has been developed. The total variation regulation was added to the reconstruction process to improve the signal to noise Ratio and reduce artifacts caused by the limited angle sampling. Maximization of the maximum likelihood of the estimated image and the measured data and minimization of the total variation of the image are alternatively implemented. By using this advanced algorithm, the reconstruction process is able to achieve image quality matching or exceed that of normal scans with only half of the injection radiopharmaceutical dose. (authors)

  11. Predictors of contralateral prophylactic mastectomy and the impact on breast reconstruction.

    Science.gov (United States)

    Pinell-White, Ximena A; Kolegraff, Keli; Carlson, Grant W

    2014-01-01

    Contralateral prophylactic mastectomy (CPM) is being performed with increased frequency. Predictors of CPM and their impact on breast reconstruction are examined. A retrospective review of a dually trained oncologic and plastic surgeon's experience with patients undergoing total mastectomy from 2002 to 2012 was performed. Patients who underwent bilateral therapeutic mastectomies or who had previous contralateral mastectomy were excluded from this series. Four hundred forty-six patients were treated with total mastectomy and 174 (39%) underwent CPM. The incidence of CPM nearly tripled over the period studied. Compared to women treated with unilateral mastectomy, women who elected for CPM were younger (mean age, 50.4 vs 56.8 years, P mastectomy. Incidental contralateral cancers were discovered in 4% of women who underwent CPM (n = 7), lobular carcinoma in situ in 2.3% (n = 4), and atypical lesions in an additional 11.6% (n = 20). Women who underwent CPM favored reconstruction with breast implants (60.9% vs 17.3%), whereas the transverse rectus abdominis musculocutaneous flap predominated among their unilateral counterparts (38.6% vs 15.5%). Among women who underwent immediate breast reconstruction, the addition of a contralateral procedure expectedly increased breast complication rates (50.3% vs 35.0%, P = 0.007), especially the more severe complications that required hospitalization or reoperation (18.6% vs 5.0%, P procedure is significant.

  12. Detection and three-dimensional reconstruction of a vascular network from serial sections

    Energy Technology Data Exchange (ETDEWEB)

    Ip, H H.S.

    1983-07-01

    The process of three-dimensional reconstruction from serial sections includes aligning adjacent sections, segmenting the desired objects and constructing a computer internal model of the reconstructed object. Computational methodologies taking advantage of the parallel processing facilities of CLIP4 are presented for automating these tasks. The author is interested in the detailed structure of the carotid body which is a highly vascularized organ with the largest blood flow rate of any tissue in the body (Biscoe (1971), Seidl (1975), Lubbers et al. (1977), Clarke and Daly (1982)). It plays an important role in monitoring the chemical composition of arterial blood (p(o/sub 2/), p(co/sub 2/), ph). The aim of the investigation in the paper is to reconstruct the total vasculature of the organ and to make an analytical study of the geometrical configuration of its vessels. 15 references.

  13. Predictive factors for natural pregnancy after microsurgical reconstruction in patients with primary epididymal obstructive azoospermia.

    Science.gov (United States)

    Harza, Mihai; Voinea, Sebastian; Ismail, Gener; Gagiu, Cristian; Baston, Catalin; Preda, Adrian; Manea, Ioan; Priporeanu, Tiberiu; Sinescu, Ioanel

    2014-01-01

    Primary epididymal obstructive azoospermia (OA) is the most prevalent form of OA in nonvasectomized patients and has been less studied. We aim to assess the results with microsurgical vasoepididymostomy used in the treatment of men diagnosed with primary epididymal obstructive azoospermia and to identify the factors associated with natural pregnancy occurring after microsurgical reconstruction. This prospective study included consecutive patients with epididymal OA who underwent microsurgical reconstruction in our center. Clinical and biological data were obtained every three months during follow-up. Occurrence of natural pregnancy was the primary study outcome. In total, 36 patients underwent microsurgical reconstruction. The mean age was 34 ± 4.5 years (range 24-46 years). Median follow-up time was 15 [IQR 12-21] months. The total patency rate was 77.7% (n = 28). During follow-up, 8 (22.2%) natural pregnancies occurred. The overall live birth rate was 100%. Low FSH levels (HR: 0.22; 95% CI: 0.052-0.88; P = 0.032) and higher total motile sperm count (TMSC) (HR: 1.001; 95% CI 1-1.001; P = 0.012) were associated with a higher rate of natural pregnancy. Our data suggest that microsurgical vasoepididymostomy is an effective therapy of primary epididymal OA. Baseline lower FSH and higher TMSC were independent predictors for natural pregnancy occurrence.

  14. Total variation-based neutron computed tomography

    Science.gov (United States)

    Barnard, Richard C.; Bilheux, Hassina; Toops, Todd; Nafziger, Eric; Finney, Charles; Splitter, Derek; Archibald, Rick

    2018-05-01

    We perform the neutron computed tomography reconstruction problem via an inverse problem formulation with a total variation penalty. In the case of highly under-resolved angular measurements, the total variation penalty suppresses high-frequency artifacts which appear in filtered back projections. In order to efficiently compute solutions for this problem, we implement a variation of the split Bregman algorithm; due to the error-forgetting nature of the algorithm, the computational cost of updating can be significantly reduced via very inexact approximate linear solvers. We present the effectiveness of the algorithm in the significantly low-angular sampling case using synthetic test problems as well as data obtained from a high flux neutron source. The algorithm removes artifacts and can even roughly capture small features when an extremely low number of angles are used.

  15. [Use and versatility of titanium for the reconstruction of the thoracic wall].

    Science.gov (United States)

    Córcoles Padilla, Juan Manuel; Bolufer Nadal, Sergio; Kurowski, Krzysztof; Gálvez Muñoz, Carlos; Rodriguez Paniagua, José Manuel

    2014-02-01

    Chest wall deformities/defects and chest wall resections, as well as complex rib fractures require reconstruction with various prosthetic materials to ensure the basic functions of the chest wall. Titanium provides many features that make it an ideal material for this surgery. The aim is to present our initial results with this material in several diseases. From 2008 to 2012, 14 patients were operated on and titanium was used for reconstruction of the chest wall. A total of 7 patients had chest wall tumors, 2 with sternal resection, 4 patients with chest wall deformities/defects and 3 patients with severe rib injury due to traffic accident. The reconstruction was successful in all cases, with early extubation without detecting problems in the functionality of the chest wall at a respiratory level. Patients with chest wall tumors including sternal resections were extubated in the operating room as well as the chest wall deformities. Chest trauma cases were extubated within 24h from internal rib fixation. There were no complications related to the material used and the method of implementation. Titanium is an ideal material for reconstruction of the chest wall in several clinical situations allowing for great versatility and adaptability in different chest wall reconstructions. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  16. Maar net nog ’n butch? ’n Feministiese lesing van die Halewijnlied

    Directory of Open Access Journals (Sweden)

    D. J. Jordaan

    1995-04-01

    In this article the authors argue that a form of covert feminism is present in the Halewijnlied (Song of Halewijn, an important Middle Dutch text. Utilizing the poststructuralist notion of écriture rather than lecture, the latent content of the text is explored, enabling the authors to (re-construct the ‘meaning' of the text within the context of Kristeva's notion that the Virgin cult constitutes "a triumph of the unconscious in monotheism This "triumph of the unconscious "amounts to a form of female power which is the “underhand double of explicit phallic power" and sets up a temporary "commonality of the sexes" within the patriarchal system. By means of the personage of the Princess, Freudian displacement in terms of social sex roles occurs, negating some of the binary oppositions characterising the man:woman dichotomy. This process results in an 'androgenic’ space in which both sexes are temporarily set free from the sexual roles forced upon them by a patriarchal system.

  17. Systematic Review: Aesthetic Assessment of Breast Reconstruction Outcomes by Healthcare Professionals.

    Science.gov (United States)

    Maass, Saskia W M C; Bagher, Shaghayegh; Hofer, Stefan O P; Baxter, Nancy N; Zhong, Toni

    2015-12-01

    Achieving an aesthetic outcome following postmastectomy breast reconstruction is both an important goal for the patient and plastic surgeon. However, there is currently an absence of a widely accepted, standardized, and validated professional aesthetic assessment scale following postmastectomy breast reconstruction. A systematic review was performed to identify all articles that provided professional assessment of the aesthetic outcome following postmastectomy, implant- or autologous tissue-based breast reconstruction. A modified version of the Scientific Advisory Committee's Medical Outcomes Trust (MOT) criteria was used to evaluate all professional aesthetic assessment scales identified by our systematic review. The criteria included conceptual framework formation, reliability, validity, responsiveness, interpretability, burden, and correlation with patient-reported outcomes. A total of 120 articles were identified: 52 described autologous breast reconstruction, 37 implant-based reconstruction, and 29 both. Of the 12 different professional aesthetic assessment scales that exist in the literature, the most commonly used scale was the four-point professional aesthetic assessment scale. The highest score on the modified MOT criteria was assigned to the ten-point professional aesthetic assessment scale. However, this scale has limited clinical usefulness due to its poor responsiveness to change, lack of interpretability, and wide range of intra- and inter-rater agreements (Veiga et al. in Ann Plast Surg 48(5):515-520, 2002). A "gold standard" professional aesthetic assessment scale needs to be developed to enhance the comparability of breast reconstruction results across techniques, surgeons, and studies to aid with the selection of procedures that produce the best aesthetic results from both the perspectives of the surgeon and patients.

  18. Reconstruction of daily erythemal UV radiation values for the last century - The benefit of modelled ozone

    Science.gov (United States)

    Junk, J.; Feister, U.; Rozanov, E.; Krzyścin, J. W.

    2013-05-01

    Solar erythemal UV radiation (UVER) is highly relevant for numerous biological processes that affect plants, animals, and human health. Nevertheless, long-term UVER records are scarce. As significant declines in the column ozone concentration were observed in the past and a recovery of the stratospheric ozone layer is anticipated by the middle of the 21st century, there is a strong interest in the temporal variation of UVER time series. Therefore, we combined groundbased measurements of different meteorological variables with modeled ozone data sets to reconstruct time series of daily totals of UVER at the Meteorological Observatory Potsdam, Germany. Artificial neural networks were trained with measured UVER, sunshine duration, the day of year, measured and modeled total column ozone, as well as the minimum solar zenith angle. This allows for the reconstruction of daily totals of UVER for the period from 1901 to 1999. Additionally, analyses of the long-term variations from 1901 until 1999 of the reconstructed, new UVER data set are presented. The time series of monthly and annual totals of UVER provide a long-term meteorological basis for epidemiological investigations in human health and occupational medicine for the region of Potsdam and Berlin. A strong benefit of our ANN-approach is the fact that it can be easily adapted to different geographical locations, as successfully tested in the framework of the COSTAction 726.

  19. Hybrid spectral CT reconstruction.

    Directory of Open Access Journals (Sweden)

    Darin P Clark

    Full Text Available Current photon counting x-ray detector (PCD technology faces limitations associated with spectral fidelity and photon starvation. One strategy for addressing these limitations is to supplement PCD data with high-resolution, low-noise data acquired with an energy-integrating detector (EID. In this work, we propose an iterative, hybrid reconstruction technique which combines the spectral properties of PCD data with the resolution and signal-to-noise characteristics of EID data. Our hybrid reconstruction technique is based on an algebraic model of data fidelity which substitutes the EID data into the data fidelity term associated with the PCD reconstruction, resulting in a joint reconstruction problem. Within the split Bregman framework, these data fidelity constraints are minimized subject to additional constraints on spectral rank and on joint intensity-gradient sparsity measured between the reconstructions of the EID and PCD data. Following a derivation of the proposed technique, we apply it to the reconstruction of a digital phantom which contains realistic concentrations of iodine, barium, and calcium encountered in small-animal micro-CT. The results of this experiment suggest reliable separation and detection of iodine at concentrations ≥ 5 mg/ml and barium at concentrations ≥ 10 mg/ml in 2-mm features for EID and PCD data reconstructed with inherent spatial resolutions of 176 μm and 254 μm, respectively (point spread function, FWHM. Furthermore, hybrid reconstruction is demonstrated to enhance spatial resolution within material decomposition results and to improve low-contrast detectability by as much as 2.6 times relative to reconstruction with PCD data only. The parameters of the simulation experiment are based on an in vivo micro-CT experiment conducted in a mouse model of soft-tissue sarcoma. Material decomposition results produced from this in vivo data demonstrate the feasibility of distinguishing two K-edge contrast agents with

  20. Hybrid spectral CT reconstruction

    Science.gov (United States)

    Clark, Darin P.

    2017-01-01

    Current photon counting x-ray detector (PCD) technology faces limitations associated with spectral fidelity and photon starvation. One strategy for addressing these limitations is to supplement PCD data with high-resolution, low-noise data acquired with an energy-integrating detector (EID). In this work, we propose an iterative, hybrid reconstruction technique which combines the spectral properties of PCD data with the resolution and signal-to-noise characteristics of EID data. Our hybrid reconstruction technique is based on an algebraic model of data fidelity which substitutes the EID data into the data fidelity term associated with the PCD reconstruction, resulting in a joint reconstruction problem. Within the split Bregman framework, these data fidelity constraints are minimized subject to additional constraints on spectral rank and on joint intensity-gradient sparsity measured between the reconstructions of the EID and PCD data. Following a derivation of the proposed technique, we apply it to the reconstruction of a digital phantom which contains realistic concentrations of iodine, barium, and calcium encountered in small-animal micro-CT. The results of this experiment suggest reliable separation and detection of iodine at concentrations ≥ 5 mg/ml and barium at concentrations ≥ 10 mg/ml in 2-mm features for EID and PCD data reconstructed with inherent spatial resolutions of 176 μm and 254 μm, respectively (point spread function, FWHM). Furthermore, hybrid reconstruction is demonstrated to enhance spatial resolution within material decomposition results and to improve low-contrast detectability by as much as 2.6 times relative to reconstruction with PCD data only. The parameters of the simulation experiment are based on an in vivo micro-CT experiment conducted in a mouse model of soft-tissue sarcoma. Material decomposition results produced from this in vivo data demonstrate the feasibility of distinguishing two K-edge contrast agents with a spectral

  1. Enhanced reconstruction of weighted networks from strengths and degrees

    International Nuclear Information System (INIS)

    Mastrandrea, Rossana; Fagiolo, Giorgio; Squartini, Tiziano; Garlaschelli, Diego

    2014-01-01

    Network topology plays a key role in many phenomena, from the spreading of diseases to that of financial crises. Whenever the whole structure of a network is unknown, one must resort to reconstruction methods that identify the least biased ensemble of networks consistent with the partial information available. A challenging case, frequently encountered due to privacy issues in the analysis of interbank flows and Big Data, is when there is only local (node-specific) aggregate information available. For binary networks, the relevant ensemble is one where the degree (number of links) of each node is constrained to its observed value. However, for weighted networks the problem is much more complicated. While the naïve approach prescribes to constrain the strengths (total link weights) of all nodes, recent counter-intuitive results suggest that in weighted networks the degrees are often more informative than the strengths. This implies that the reconstruction of weighted networks would be significantly enhanced by the specification of both strengths and degrees, a computationally hard and bias-prone procedure. Here we solve this problem by introducing an analytical and unbiased maximum-entropy method that works in the shortest possible time and does not require the explicit generation of reconstructed samples. We consider several real-world examples and show that, while the strengths alone give poor results, the additional knowledge of the degrees yields accurately reconstructed networks. Information-theoretic criteria rigorously confirm that the degree sequence, as soon as it is non-trivial, is irreducible to the strength sequence. Our results have strong implications for the analysis of motifs and communities and whenever the reconstructed ensemble is required as a null model to detect higher-order patterns

  2. Low-dose X-ray CT reconstruction via dictionary learning.

    Science.gov (United States)

    Xu, Qiong; Yu, Hengyong; Mou, Xuanqin; Zhang, Lei; Hsieh, Jiang; Wang, Ge

    2012-09-01

    Although diagnostic medical imaging provides enormous benefits in the early detection and accuracy diagnosis of various diseases, there are growing concerns on the potential side effect of radiation induced genetic, cancerous and other diseases. How to reduce radiation dose while maintaining the diagnostic performance is a major challenge in the computed tomography (CT) field. Inspired by the compressive sensing theory, the sparse constraint in terms of total variation (TV) minimization has already led to promising results for low-dose CT reconstruction. Compared to the discrete gradient transform used in the TV method, dictionary learning is proven to be an effective way for sparse representation. On the other hand, it is important to consider the statistical property of projection data in the low-dose CT case. Recently, we have developed a dictionary learning based approach for low-dose X-ray CT. In this paper, we present this method in detail and evaluate it in experiments. In our method, the sparse constraint in terms of a redundant dictionary is incorporated into an objective function in a statistical iterative reconstruction framework. The dictionary can be either predetermined before an image reconstruction task or adaptively defined during the reconstruction process. An alternating minimization scheme is developed to minimize the objective function. Our approach is evaluated with low-dose X-ray projections collected in animal and human CT studies, and the improvement associated with dictionary learning is quantified relative to filtered backprojection and TV-based reconstructions. The results show that the proposed approach might produce better images with lower noise and more detailed structural features in our selected cases. However, there is no proof that this is true for all kinds of structures.

  3. Coronary artery plaques: Cardiac CT with model-based and adaptive-statistical iterative reconstruction technique

    International Nuclear Information System (INIS)

    Scheffel, Hans; Stolzmann, Paul; Schlett, Christopher L.; Engel, Leif-Christopher; Major, Gyöngi Petra; Károlyi, Mihály; Do, Synho; Maurovich-Horvat, Pál; Hoffmann, Udo

    2012-01-01

    Objectives: To compare image quality of coronary artery plaque visualization at CT angiography with images reconstructed with filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model based iterative reconstruction (MBIR) techniques. Methods: The coronary arteries of three ex vivo human hearts were imaged by CT and reconstructed with FBP, ASIR and MBIR. Coronary cross-sectional images were co-registered between the different reconstruction techniques and assessed for qualitative and quantitative image quality parameters. Readers were blinded to the reconstruction algorithm. Results: A total of 375 triplets of coronary cross-sectional images were co-registered. Using MBIR, 26% of the images were rated as having excellent overall image quality, which was significantly better as compared to ASIR and FBP (4% and 13%, respectively, all p < 0.001). Qualitative assessment of image noise demonstrated a noise reduction by using ASIR as compared to FBP (p < 0.01) and further noise reduction by using MBIR (p < 0.001). The contrast-to-noise-ratio (CNR) using MBIR was better as compared to ASIR and FBP (44 ± 19, 29 ± 15, 26 ± 9, respectively; all p < 0.001). Conclusions: Using MBIR improved image quality, reduced image noise and increased CNR as compared to the other available reconstruction techniques. This may further improve the visualization of coronary artery plaque and allow radiation reduction.

  4. Combining Acceleration Techniques for Low-Dose X-Ray Cone Beam Computed Tomography Image Reconstruction.

    Science.gov (United States)

    Huang, Hsuan-Ming; Hsiao, Ing-Tsung

    2017-01-01

    Over the past decade, image quality in low-dose computed tomography has been greatly improved by various compressive sensing- (CS-) based reconstruction methods. However, these methods have some disadvantages including high computational cost and slow convergence rate. Many different speed-up techniques for CS-based reconstruction algorithms have been developed. The purpose of this paper is to propose a fast reconstruction framework that combines a CS-based reconstruction algorithm with several speed-up techniques. First, total difference minimization (TDM) was implemented using the soft-threshold filtering (STF). Second, we combined TDM-STF with the ordered subsets transmission (OSTR) algorithm for accelerating the convergence. To further speed up the convergence of the proposed method, we applied the power factor and the fast iterative shrinkage thresholding algorithm to OSTR and TDM-STF, respectively. Results obtained from simulation and phantom studies showed that many speed-up techniques could be combined to greatly improve the convergence speed of a CS-based reconstruction algorithm. More importantly, the increased computation time (≤10%) was minor as compared to the acceleration provided by the proposed method. In this paper, we have presented a CS-based reconstruction framework that combines several acceleration techniques. Both simulation and phantom studies provide evidence that the proposed method has the potential to satisfy the requirement of fast image reconstruction in practical CT.

  5. Nipple-sparing mastectomy with immediate implant reconstruction: cosmetic outcomes and technical refinements.

    Science.gov (United States)

    Salgarello, Marzia; Visconti, Giuseppe; Barone-Adesi, Liliana

    2010-11-01

    Nipple-sparing mastectomy is gaining widespread popularity, as it could allow improved aesthetic outcome without increasing oncologic risk. To investigate the reconstructive issues experienced with immediate implant reconstruction, the authors reviewed the cosmetic outcomes of their series. The authors retrospectively analyzed the data on 33 cases of nipple-sparing mastectomy for both cancer and prophylaxis with immediate implant reconstruction using the submusculo-subfascial pocket. Cosmetic evaluation methods were clinical and photography-based assessments and a patient-satisfaction survey. The average follow-up period was 26.8 months. No nipple-areola complex cancer involvement was registered. The reconstructive outcomes ranged from good to excellent in 83 percent of the cases. Patients' satisfaction was high to very high, except in one patient who experienced total nipple-areola complex loss (one breast, 2.4 percent). Overall, early minor complications were registered in four breasts (9.5 percent) and late minor complications in five cases (12 percent). The authors' series suggest that nipple-sparing mastectomy is an option for carefully selected and screened patients. Larger studies with longer follow-up are needed, however. On the whole, the immediate one-stage implant reconstruction with hyperprojected anatomical gel implants represents a valid option. The skin incision algorithm proposed, which is based on the breast size, shape, and previous scars, might aid in the decision-making process to achieve satisfying results using this procedure. The radial approaches represent a good compromise between the oncologic and reconstructive procedures.

  6. Evaluating climate field reconstruction techniques using improved emulations of real-world conditions

    Science.gov (United States)

    Wang, J.; Emile-Geay, J.; Guillot, D.; Smerdon, J. E.; Rajaratnam, B.

    2014-01-01

    Pseudoproxy experiments (PPEs) have become an important framework for evaluating paleoclimate reconstruction methods. Most existing PPE studies assume constant proxy availability through time and uniform proxy quality across the pseudoproxy network. Real multiproxy networks are, however, marked by pronounced disparities in proxy quality, and a steep decline in proxy availability back in time, either of which may have large effects on reconstruction skill. A suite of PPEs constructed from a millennium-length general circulation model (GCM) simulation is thus designed to mimic these various real-world characteristics. The new pseudoproxy network is used to evaluate four climate field reconstruction (CFR) techniques: truncated total least squares embedded within the regularized EM (expectation-maximization) algorithm (RegEM-TTLS), the Mann et al. (2009) implementation of RegEM-TTLS (M09), canonical correlation analysis (CCA), and Gaussian graphical models embedded within RegEM (GraphEM). Each method's risk properties are also assessed via a 100-member noise ensemble. Contrary to expectation, it is found that reconstruction skill does not vary monotonically with proxy availability, but also is a function of the type and amplitude of climate variability (forced events vs. internal variability). The use of realistic spatiotemporal pseudoproxy characteristics also exposes large inter-method differences. Despite the comparable fidelity in reconstructing the global mean temperature, spatial skill varies considerably between CFR techniques. Both GraphEM and CCA efficiently exploit teleconnections, and produce consistent reconstructions across the ensemble. RegEM-TTLS and M09 appear advantageous for reconstructions on highly noisy data, but are subject to larger stochastic variations across different realizations of pseudoproxy noise. Results collectively highlight the importance of designing realistic pseudoproxy networks and implementing multiple noise realizations of PPEs

  7. Tomographic reconstruction by using FPSIRT (Fast Particle System Iterative Reconstruction Technique)

    Energy Technology Data Exchange (ETDEWEB)

    Moreira, Icaro Valgueiro M.; Melo, Silvio de Barros; Dantas, Carlos; Lima, Emerson Alexandre; Silva, Ricardo Martins; Cardoso, Halisson Alberdan C., E-mail: ivmm@cin.ufpe.br, E-mail: sbm@cin.ufpe.br, E-mail: rmas@cin.ufpe.br, E-mail: hacc@cin.ufpe.br, E-mail: ccd@ufpe.br, E-mail: eal@cin.ufpe.br [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil)

    2015-07-01

    The PSIRT (Particle System Iterative Reconstruction Technique) is a method of tomographic image reconstruction primarily designed to work with configurations suitable for industrial applications. A particle system is an optimization technique inspired in real physical systems that associates to the reconstructing material a set of particles with certain physical features, subject to a force eld, which can produce movement. The system constantly updates the set of particles by repositioning them in such a way as to approach the equilibrium. The elastic potential along a trajectory is a function of the difference between the attenuation coefficient in the current configuration and the corresponding input data. PSIRT has been successfully used to reconstruct simulated and real objects subject to sets of parallel and fanbeam lines in different angles, representing typical gamma-ray tomographic arrangements. One of PSIRT's limitation was its performance, too slow for real time scenarios. In this work, it is presented a reformulation in PSIRT's computational model, which is able to grant the new algorithm, the FPSIRT - Fast System Iterative Reconstruction Technique, a performance up to 200-time faster than PSIRT's. In this work a comparison of their application to real and simulated data from the HSGT, High Speed Gamma Tomograph, is presented. (author)

  8. Tomographic reconstruction by using FPSIRT (Fast Particle System Iterative Reconstruction Technique)

    International Nuclear Information System (INIS)

    Moreira, Icaro Valgueiro M.; Melo, Silvio de Barros; Dantas, Carlos; Lima, Emerson Alexandre; Silva, Ricardo Martins; Cardoso, Halisson Alberdan C.

    2015-01-01

    The PSIRT (Particle System Iterative Reconstruction Technique) is a method of tomographic image reconstruction primarily designed to work with configurations suitable for industrial applications. A particle system is an optimization technique inspired in real physical systems that associates to the reconstructing material a set of particles with certain physical features, subject to a force eld, which can produce movement. The system constantly updates the set of particles by repositioning them in such a way as to approach the equilibrium. The elastic potential along a trajectory is a function of the difference between the attenuation coefficient in the current configuration and the corresponding input data. PSIRT has been successfully used to reconstruct simulated and real objects subject to sets of parallel and fanbeam lines in different angles, representing typical gamma-ray tomographic arrangements. One of PSIRT's limitation was its performance, too slow for real time scenarios. In this work, it is presented a reformulation in PSIRT's computational model, which is able to grant the new algorithm, the FPSIRT - Fast System Iterative Reconstruction Technique, a performance up to 200-time faster than PSIRT's. In this work a comparison of their application to real and simulated data from the HSGT, High Speed Gamma Tomograph, is presented. (author)

  9. Reconstruction of tissue dynamics in the compressed breast using multiplexed measurements and temporal basis functions

    Science.gov (United States)

    Boverman, Gregory; Miller, Eric L.; Brooks, Dana H.; Fang, Qianqian; Carp, S. A.; Selb, J. J.; Boas, David A.

    2007-02-01

    In the course of our experiments imaging the compressed breast in conjunction with digital tomosynthesis, we have noted that significant changes in tissue optical properties, on the order of 5%, occur during our imaging protocol. These changes seem to consistent with changes both in total Hemoglobin concentration as well as in oxygen saturation, as was the case for our standalone breast compression study, which made use of reflectance measurements. Simulation experiments show the importance of taking into account the temporal dynamics in the image reconstruction, and demonstrate the possibility of imaging the spatio-temporal dynamics of oxygen saturation and total Hemoglobin in the breast. In the image reconstruction, we make use of spatio-temporal basis functions, specifically a voxel basis for spatial imaging, and a cubic spline basis in time, and we reconstruct the spatio-temporal images using the entire data set simultaneously, making use of both absolute and relative measurements in the cost function. We have modified the sequence of sources used in our imaging acquisition protocol to improve our temporal resolution, and preliminary results are shown for normal subjects.

  10. Multi-proxy reconstructions of May–September precipitation field in China over the past 500 years

    Directory of Open Access Journals (Sweden)

    F. Shi

    2017-12-01

    Full Text Available The dominant modes of variability of precipitation for the whole of China over the past millennium and the mechanism governing their spatial structure remain unclear. This is mainly due to insufficient high-resolution proxy records of precipitation in western China. Numerous tree-ring chronologies have recently been archived in publicly available databases through PAGES2k activities, and these provide an opportunity to refine precipitation field reconstructions for China. Based on 479 proxy records, including 371 tree-ring width chronologies, a tree-ring isotope chronology, and 107 drought/flood indices, we reconstruct the precipitation field for China for the past half millennium using the optimal information extraction method. A total of 3631 of 4189 grid points in the reconstruction field passed the cross-validation process, accounting for 86.68 % of the total number of grid points. The first leading mode of variability of the reconstruction shows coherent variations over most of China. The second mode is a north–south dipole in eastern China characterized by variations of the same sign in western China and northern China (except for Xinjiang province. It is likely controlled by the El Niño–Southern Oscillation (ENSO variability. The third mode is a sandwich triple mode in eastern China including variations of the same sign in western China and central China. The last two modes are reproduced by most of the six coupled climate models' last millennium simulations performed in the framework of the Paleoclimate Modelling Intercomparison Project Phase III (PMIP3. In particular, the link of the second mode with ENSO is confirmed by the models. However, there is a mismatch between models and proxy reconstructions in the time development of different modes. This mismatch suggests the important role of internal variability in the reconstructed precipitation mode variations of the past 500 years.

  11. Multi-proxy reconstructions of May-September precipitation field in China over the past 500 years

    Science.gov (United States)

    Shi, Feng; Zhao, Sen; Guo, Zhengtang; Goosse, Hugues; Yin, Qiuzhen

    2017-12-01

    The dominant modes of variability of precipitation for the whole of China over the past millennium and the mechanism governing their spatial structure remain unclear. This is mainly due to insufficient high-resolution proxy records of precipitation in western China. Numerous tree-ring chronologies have recently been archived in publicly available databases through PAGES2k activities, and these provide an opportunity to refine precipitation field reconstructions for China. Based on 479 proxy records, including 371 tree-ring width chronologies, a tree-ring isotope chronology, and 107 drought/flood indices, we reconstruct the precipitation field for China for the past half millennium using the optimal information extraction method. A total of 3631 of 4189 grid points in the reconstruction field passed the cross-validation process, accounting for 86.68 % of the total number of grid points. The first leading mode of variability of the reconstruction shows coherent variations over most of China. The second mode is a north-south dipole in eastern China characterized by variations of the same sign in western China and northern China (except for Xinjiang province). It is likely controlled by the El Niño-Southern Oscillation (ENSO) variability. The third mode is a sandwich triple mode in eastern China including variations of the same sign in western China and central China. The last two modes are reproduced by most of the six coupled climate models' last millennium simulations performed in the framework of the Paleoclimate Modelling Intercomparison Project Phase III (PMIP3). In particular, the link of the second mode with ENSO is confirmed by the models. However, there is a mismatch between models and proxy reconstructions in the time development of different modes. This mismatch suggests the important role of internal variability in the reconstructed precipitation mode variations of the past 500 years.

  12. Reconstruction of pressure sores with perforator-based propeller flaps.

    Science.gov (United States)

    Jakubietz, Rafael G; Jakubietz, Danni F; Zahn, Robert; Schmidt, Karsten; Meffert, Rainer H; Jakubietz, Michael G

    2011-03-01

    Perforator flaps have been successfully used for reconstruction of pressure sores. Although V-Y advancement flaps approximate debrided wound edges, perforator-based propeller flaps allow rotation of healthy tissue into the defect. Perforator-based propeller flaps were planned in 13 patients. Seven pressure sores were over the sacrum, five over the ischial tuberosity, and one on the tip of the scapula. Three patients were paraplegic, six were bedridden, and five were ambulatory. In three patients, no perforators were found. In 10 patients, propeller flaps were transferred. In two patients, total flap necrosis occurred, which was reconstructed with local advancement flaps. In two cases, a wound dehiscence occurred and had to be revised. One hematoma required evacuation. No further complications were noted. No recurrence at the flap site occurred. Local perforator flaps allow closure of pressure sores without harvesting muscle. The propeller version has the added benefit of transferring tissue from a distant site, avoiding reapproximation of original wound edges. Twisting of the pedicle may cause torsion and venous obstruction. This can be avoided by dissecting a pedicle of at least 3 cm. Propeller flaps are a safe option for soft tissue reconstruction of pressure sores. © Thieme Medical Publishers.

  13. The evolving breast reconstruction

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Gunnarsson, Gudjon Leifur

    2014-01-01

    The aim of this editorial is to give an update on the use of the propeller thoracodorsal artery perforator flap (TAP/TDAP-flap) within the field of breast reconstruction. The TAP-flap can be dissected by a combined use of a monopolar cautery and a scalpel. Microsurgical instruments are generally...... not needed. The propeller TAP-flap can be designed in different ways, three of these have been published: (I) an oblique upwards design; (II) a horizontal design; (III) an oblique downward design. The latissimus dorsi-flap is a good and reliable option for breast reconstruction, but has been criticized...... for oncoplastic and reconstructive breast surgery and will certainly become an invaluable addition to breast reconstructive methods....

  14. Reconstructing see-saw models

    International Nuclear Information System (INIS)

    Ibarra, Alejandro

    2007-01-01

    In this talk we discuss the prospects to reconstruct the high-energy see-saw Lagrangian from low energy experiments in supersymmetric scenarios. We show that the model with three right-handed neutrinos could be reconstructed in theory, but not in practice. Then, we discuss the prospects to reconstruct the model with two right-handed neutrinos, which is the minimal see-saw model able to accommodate neutrino observations. We identify the relevant processes to achieve this goal, and comment on the sensitivity of future experiments to them. We find the prospects much more promising and we emphasize in particular the importance of the observation of rare leptonic decays for the reconstruction of the right-handed neutrino masses

  15. An Evaluation of Surgical Functional Reconstruction of the Foot Using Kinetic and Kinematic Systems: A Case Report.

    Science.gov (United States)

    Jordán-Palomar, Elena Irene; Javierre, Etelvina; Rey-Vasalo, José; Alfaro-Santafé, Víctor; Gómez-Benito, María José

    Most pedobarographic studies of microsurgical foot reconstruction have been retrospective. In the present study, we report the results from a prospective pedobarographic study of a patient after microsurgical reconstruction of her foot with a latissimus dorsi flap and a cutaneous paddle, with a 42-month follow-up period. We describe the foot reconstruction plan and the pedobarographic measurements and analyzed its functional outcome. The goal of the present study was to demonstrate that pedobarography could have a role in the treatment of foot reconstruction from a quantitative perspective. The pedobarographic measurements were recorded after the initial coverage surgery and 2 subsequent foot remodeling procedures. A total of 4 pedobarographic measurements and 2 gait analyses were recorded and compared for both the noninvolved foot and the injured foot. Furthermore, the progress of the reconstructed foot was critically evaluated using this method. Both static and dynamic patterns were compared at subsequent follow-up visits after the foot reconstruction. The values and progression of the foot shape, peak foot pressure (kPa), average foot pressure (kPa), total contact surface (cm 2 ), loading time (%), and step time (ms) were recorded. Initially, the pressure distribution of the reconstructed foot showed higher peak values at nonanatomic locations, revealing a greater ulceration risk. Over time, we found an improvement in the shape and values of these factors in the involved foot. To homogenize the pressure distribution and correct the imbalance between the 2 feet, patient-specific insoles were designed and fabricated. In our patient, pedobarography provided an objective, repeatable, and recordable method for the evaluation of the reconstructed foot. Pedobarography can therefore provide valuable insights into the prevention of pressure ulcers and optimization of rehabilitation. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc

  16. Pre-operative planning for mandibular reconstruction - A full digital planning workflow resulting in a patient specific reconstruction

    Science.gov (United States)

    2011-01-01

    Objectives Reconstruction of large mandiblular defects following ablative oncologic surgery could be done by using vascularized bone transfer or, more often, primarily with simultaneous or delayed bone grafting, using load bearing reconstruction plates. Bending of these reconstruction plates is typically directed along the outer contour of the original mandible. Simultaneously or in a second operation vascularized or non-vascularized bone is fixed to the reconstruction plate. However, the prosthodontic-driven backward planning to ease bony reconstruction of the mandible in terms of dental rehabilitation using implant-retained overdentures might be an eligible solution. The purpose of this work was to develop, establish and clinically evaluate a novel 3D planning procedure for mandibular reconstruction. Materials and methods Three patients with tumors involving the mandible, which included squamous cell carcinoma in the floor of the mouth and keratocystic odontogenic tumor, were treated surgically by hemimandibulectomy. Results In primary alloplastic mandible reconstruction, shape and size of the reconstruction plate could be predefined and prebent prior to surgery. Clinical relevance This study provides modern treatment strategies for mandibular reconstruction. PMID:21968330

  17. Reconstruction of emission coefficients for a non-axisymmetric coupling arc by algebraic reconstruction technique

    International Nuclear Information System (INIS)

    Zhang Guangjun; Xiong Jun; Gao Hongming; Wu Lin

    2011-01-01

    A preliminary investigation of tomographic reconstruction of an asymmetric arc plasma has been carried out. The objective of this work aims at reconstructing emission coefficients of a non-axisymmetric coupling arc from measured intensities by means of an algebraic reconstruction technique (ART). In order to define the optimal experimental scheme for good quality with limited views, the dependence of the reconstruction quality on three configurations (four, eight, ten projection angles) are presented and discussed via a displaced Gaussian model. Then, the emission coefficients of a free burning arc are reconstructed by the ART with the ten-view configuration and an Abel inversion, respectively, and good agreement is obtained. Finally, the emission coefficient profiles of the coupling arc are successfully achieved with the ten-view configuration. The results show that the distribution of emission coefficient for the coupling arc is different from centrosymmetric shape. The ART is perfectly suitable for reconstructing emission coefficients of the coupling arc with the ten-view configuration, proving the feasibility and utility of the ART to characterize an asymmetric arc.

  18. Block matching sparsity regularization-based image reconstruction for incomplete projection data in computed tomography

    Science.gov (United States)

    Cai, Ailong; Li, Lei; Zheng, Zhizhong; Zhang, Hanming; Wang, Linyuan; Hu, Guoen; Yan, Bin

    2018-02-01

    In medical imaging many conventional regularization methods, such as total variation or total generalized variation, impose strong prior assumptions which can only account for very limited classes of images. A more reasonable sparse representation frame for images is still badly needed. Visually understandable images contain meaningful patterns, and combinations or collections of these patterns can be utilized to form some sparse and redundant representations which promise to facilitate image reconstructions. In this work, we propose and study block matching sparsity regularization (BMSR) and devise an optimization program using BMSR for computed tomography (CT) image reconstruction for an incomplete projection set. The program is built as a constrained optimization, minimizing the L1-norm of the coefficients of the image in the transformed domain subject to data observation and positivity of the image itself. To solve the program efficiently, a practical method based on the proximal point algorithm is developed and analyzed. In order to accelerate the convergence rate, a practical strategy for tuning the BMSR parameter is proposed and applied. The experimental results for various settings, including real CT scanning, have verified the proposed reconstruction method showing promising capabilities over conventional regularization.

  19. Influence of Adaptive Statistical Iterative Reconstruction on coronary plaque analysis in coronary computed tomography angiography.

    Science.gov (United States)

    Precht, Helle; Kitslaar, Pieter H; Broersen, Alexander; Dijkstra, Jouke; Gerke, Oke; Thygesen, Jesper; Egstrup, Kenneth; Lambrechtsen, Jess

    The purpose of this study was to study the effect of iterative reconstruction (IR) software on quantitative plaque measurements in coronary computed tomography angiography (CCTA). Thirty patients with a three clinical risk factors for coronary artery disease (CAD) had one CCTA performed. Images were reconstructed using FBP, 30% and 60% adaptive statistical IR (ASIR). Coronary plaque analysis was performed as per patient and per vessel (LM, LAD, CX and RCA) measurements. Lumen and vessel volumes and plaque burden measurements were based on automatic detected contours in each reconstruction. Lumen and plaque intensity measurements and HU based plaque characterization were based on corrected contours copied to each reconstruction. No significant changes between FBP and 30% ASIR were found except for lumen- (-2.53 HU) and plaque intensities (-1.28 HU). Between FBP and 60% ASIR the change in total volume showed an increase of 0.94%, 4.36% and 2.01% for lumen, plaque and vessel, respectively. The change in total plaque burden between FBP and 60% ASIR was 0.76%. Lumen and plaque intensities decreased between FBP and 60% ASIR with -9.90 HU and -1.97 HU, respectively. The total plaque component volume changes were all small with a maximum change of -1.13% of necrotic core between FBP and 60% ASIR. Quantitative plaque measurements only showed modest differences between FBP and the 60% ASIR level. Differences were increased lumen-, vessel- and plaque volumes, decreased lumen- and plaque intensities and a small percentage change in the individual plaque component volumes. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  20. Four-Dimensional Patient Dose Reconstruction for Scanned Ion Beam Therapy of Moving Liver Tumors

    International Nuclear Information System (INIS)

    Richter, Daniel; Saito, Nami; Chaudhri, Naved; Härtig, Martin; Ellerbrock, Malte; Jäkel, Oliver; Combs, Stephanie E.; Habermehl, Daniel; Herfarth, Klaus; Durante, Marco; Bert, Christoph

    2014-01-01

    Purpose: Estimation of the actual delivered 4-dimensional (4D) dose in treatments of patients with mobile hepatocellular cancer with scanned carbon ion beam therapy. Methods and Materials: Six patients were treated with 4 fractions to a total relative biological effectiveness (RBE)–weighted dose of 40 Gy (RBE) using a single field. Respiratory motion was addressed by dedicated margins and abdominal compression (5 patients) or gating (1 patient). 4D treatment dose reconstructions based on the treatment records and the measured motion monitoring data were performed for the single-fraction dose and a total of 17 fractions. To assess the impact of uncertainties in the temporal correlation between motion trajectory and beam delivery sequence, 3 dose distributions for varying temporal correlation were calculated per fraction. For 3 patients, the total treatment dose was formed from the fractional distributions using all possible combinations. Clinical target volume (CTV) coverage was analyzed using the volumes receiving at least 95% (V 95 ) and 107% (V 107 ) of the planned doses. Results: 4D dose reconstruction based on daily measured data is possible in a clinical setting. V 95 and V 107 values for the single fractions ranged between 72% and 100%, and 0% and 32%, respectively. The estimated total treatment dose to the CTV exhibited improved and more robust dose coverage (mean V 95 > 87%, SD < 3%) and overdose (mean V 107 < 4%, SD < 3%) with respect to the single-fraction dose for all analyzed patients. Conclusions: A considerable impact of interplay effects on the single-fraction CTV dose was found for most of the analyzed patients. However, due to the fractionated treatment, dose heterogeneities were substantially reduced for the total treatment dose. 4D treatment dose reconstruction for scanned ion beam therapy is technically feasible and may evolve into a valuable tool for dose assessment

  1. Improved total variation-based CT image reconstruction applied to clinical data

    Energy Technology Data Exchange (ETDEWEB)

    Ritschl, Ludwig; Bergner, Frank; Kachelriess, Marc [Institute of Medical Physics (IMP), University of Erlangen-Nuernberg, Henkestr. 91, 91052 Erlangen (Germany); Fleischmann, Christof, E-mail: ludwig.ritschl@imp.uni-erlangen.de [Ziehm Imaging GmbH, Donaustrasse 31, 90451 Nuernberg (Germany)

    2011-03-21

    In computed tomography there are different situations where reconstruction has to be performed with limited raw data. In the past few years it has been shown that algorithms which are based on compressed sensing theory are able to handle incomplete datasets quite well. As a cost function these algorithms use the l{sub 1}-norm of the image after it has been transformed by a sparsifying transformation. This yields to an inequality-constrained convex optimization problem. Due to the large size of the optimization problem some heuristic optimization algorithms have been proposed in the past few years. The most popular way is optimizing the raw data and sparsity cost functions separately in an alternating manner. In this paper we will follow this strategy and present a new method to adapt these optimization steps. Compared to existing methods which perform similarly, the proposed method needs no a priori knowledge about the raw data consistency. It is ensured that the algorithm converges to the lowest possible value of the raw data cost function, while holding the sparsity constraint at a low value. This is achieved by transferring the step-size determination of both optimization procedures into the raw data domain, where they are adapted to each other. To evaluate the algorithm, we process measured clinical datasets. To cover a wide field of possible applications, we focus on the problems of angular undersampling, data lost due to metal implants, limited view angle tomography and interior tomography. In all cases the presented method reaches convergence within less than 25 iteration steps, while using a constant set of algorithm control parameters. The image artifacts caused by incomplete raw data are mostly removed without introducing new effects like staircasing. All scenarios are compared to an existing implementation of the ASD-POCS algorithm, which realizes the step-size adaption in a different way. Additional prior information as proposed by the PICCS algorithm

  2. Fibrotic changes after postmastectomy radiotherapy and reconstructive surgery in breast cancer. A retrospective analysis in 109 patients

    International Nuclear Information System (INIS)

    Classen, Johannes; St. Vincentius-Kliniken, Karlsruhe; Nitzsche, Sibille; Wallwiener, Diethelm; Brucker, Sara; Kristen, Peter; Souchon, Rainer; Bamberg, Michael

    2010-01-01

    The purpose of this study was to analyze the probability and time course of fibrotic changes in breast reconstruction before or after postmastectomy radiotherapy (PMRT). Between 1995 and 2004, 109 patients were treated with PMRT at Tuebingen University and underwent heterologous (HL) or autologous (AL) breast reconstruction prior or subsequent to radiation therapy. Fibrosis of the reconstructed breast after radiotherapy was assessed using the Baker score for HL reconstructions and the Common Terminology Criteria for Adverse Events (CTCAE) for all patients. Actuarial rates of fibrosis were calculated for the maximum degree acquired during follow- up and at the last follow-up visit documented. Median time to follow-up was 34 months (3-227 months). Radiotherapy was applied with a median total dose of 50.4 Gy. A total of 44 patients (40.4%) received a boost treatment with a median dose of 10 Gy. Breast reconstruction was performed with AL, HL, or combined techniques in 20, 82, and 7 patients, respectively. The 3-year incidence of ≥ grade III maximum fibrosis was 20% and 43% for Baker and CTCAE scores, respectively. The corresponding figures for fibrosis at last follow-up visit were 18% and 2%. The 3-year rate of surgical correction of the contralateral breast was 30%. Initially unplanned surgery of the reconstructed breast was performed in 39 patients (35.8%). Boost treatment and type of cosmetic surgery (HL vs. AL) were not significantly associated with the incidence of fibrosis. We found severe fibrosis to be a frequent complication after PMRT radiotherapy and breast reconstruction. However, surgical intervention can ameliorate the majority of high grade fibrotic events leading to acceptable long-term results. No treatment parameters associated with the rate of fibrosis could be identified. (orig.)

  3. Technical basis for dose reconstruction

    International Nuclear Information System (INIS)

    Anspaugh, L.R.

    1996-01-01

    The purpose of this paper is to consider two general topics: Technical considerations of why dose-reconstruction studies should or should not be performed and methods of dose reconstruction. The first topic is of general and growing interest as the number of dose-reconstruction studies increases, and one asks the question whether it is necessary to perform a dose reconstruction for virtually every site at which, for example, the Department of Energy (DOE) has operated a nuclear-related facility. And there is the broader question of how one might logically draw the line at performing or not performing dose-reconstruction (radiological and chemical) studies for virtually every industrial complex in the entire country. The second question is also of general interest. There is no single correct way to perform a dose-reconstruction study, and it is important not to follow blindly a single method to the point that cheaper, faster, more accurate, and more transparent methods might not be developed and applied. 90 refs., 4 tabs

  4. Technical basis for dose reconstruction

    International Nuclear Information System (INIS)

    Anspaugh, L.R.

    1996-01-01

    The purpose of this paper is to consider two general topics: technical considerations of why dose-reconstruction studies should or should not be performed and methods of dose reconstruction. The first topic is of general and growing interest as the number of dose-reconstruction studies increases, and one asks the question whether it is necessary to perform a dose reconstruction for virtually every site at which, for example, the Department of Energy (DOE) has operated a nuclear-related facility. And there is the broader question of how one might logically draw the line at performing or not performing dose-reconstruction (radiological and chemical) studies for virtually every industrial complex in the entire country. The second question is also of general interest. There is no single correct way to perform a dose-reconstruction study, and it is important not to follow blindly a single method to the point that cheaper, faster, more accurate, and more transparent methods might not be developed and applied

  5. Three-dimensional ICT reconstruction

    International Nuclear Information System (INIS)

    Zhang Aidong; Li Ju; Chen Fa; Sun Lingxia

    2005-01-01

    The three-dimensional ICT reconstruction method is the hot topic of recent ICT technology research. In the context, qualified visual three-dimensional ICT pictures are achieved through multi-piece two-dimensional images accumulation by, combining with thresholding method and linear interpolation. Different direction and different position images of the reconstructed pictures are got by rotation and interception respectively. The convenient and quick method is significantly instructive to more complicated three-dimensional reconstruction of ICT images. (authors)

  6. Three-dimensional ICT reconstruction

    International Nuclear Information System (INIS)

    Zhang Aidong; Li Ju; Chen Fa; Sun Lingxia

    2004-01-01

    The three-dimensional ICT reconstruction method is the hot topic of recent ICT technology research. In the context qualified visual three-dimensional ICT pictures are achieved through multi-piece two-dimensional images accumulation by order, combining with thresholding method and linear interpolation. Different direction and different position images of the reconstructed pictures are got by rotation and interception respectively. The convenient and quick method is significantly instructive to more complicated three-dimensional reconstruction of ICT images. (authors)

  7. SU-D-206-01: Employing a Novel Consensus Optimization Strategy to Achieve Iterative Cone Beam CT Reconstruction On a Multi-GPU Platform

    International Nuclear Information System (INIS)

    Li, B; Tian, Z; Jiang, S; Jia, X; Zhou, L

    2016-01-01

    Purpose: While compressed sensing-based cone-beam CT (CBCT) iterative reconstruction techniques have demonstrated tremendous capability of reconstructing high-quality images from undersampled noisy data, its long computation time still hinders wide application in routine clinic. The purpose of this study is to develop a reconstruction framework that employs modern consensus optimization techniques to achieve CBCT reconstruction on a multi-GPU platform for improved computational efficiency. Methods: Total projection data were evenly distributed to multiple GPUs. Each GPU performed reconstruction using its own projection data with a conventional total variation regularization approach to ensure image quality. In addition, the solutions from GPUs were subject to a consistency constraint that they should be identical. We solved the optimization problem with all the constraints considered rigorously using an alternating direction method of multipliers (ADMM) algorithm. The reconstruction framework was implemented using OpenCL on a platform with two Nvidia GTX590 GPU cards, each with two GPUs. We studied the performance of our method and demonstrated its advantages through a simulation case with a NCAT phantom and an experimental case with a Catphan phantom. Result: Compared with the CBCT images reconstructed using conventional FDK method with full projection datasets, our proposed method achieved comparable image quality with about one third projection numbers. The computation time on the multi-GPU platform was ∼55 s and ∼ 35 s in the two cases respectively, achieving a speedup factor of ∼ 3.0 compared with single GPU reconstruction. Conclusion: We have developed a consensus ADMM-based CBCT reconstruction method which enabled performing reconstruction on a multi-GPU platform. The achieved efficiency made this method clinically attractive.

  8. SU-D-206-01: Employing a Novel Consensus Optimization Strategy to Achieve Iterative Cone Beam CT Reconstruction On a Multi-GPU Platform

    Energy Technology Data Exchange (ETDEWEB)

    Li, B [University of Texas Southwestern Medical Center, Dallas, TX (United States); Southern Medical University, Guangzhou, Guangdong (China); Tian, Z; Jiang, S; Jia, X [University of Texas Southwestern Medical Center, Dallas, TX (United States); Zhou, L [Southern Medical University, Guangzhou, Guangdong (China)

    2016-06-15

    Purpose: While compressed sensing-based cone-beam CT (CBCT) iterative reconstruction techniques have demonstrated tremendous capability of reconstructing high-quality images from undersampled noisy data, its long computation time still hinders wide application in routine clinic. The purpose of this study is to develop a reconstruction framework that employs modern consensus optimization techniques to achieve CBCT reconstruction on a multi-GPU platform for improved computational efficiency. Methods: Total projection data were evenly distributed to multiple GPUs. Each GPU performed reconstruction using its own projection data with a conventional total variation regularization approach to ensure image quality. In addition, the solutions from GPUs were subject to a consistency constraint that they should be identical. We solved the optimization problem with all the constraints considered rigorously using an alternating direction method of multipliers (ADMM) algorithm. The reconstruction framework was implemented using OpenCL on a platform with two Nvidia GTX590 GPU cards, each with two GPUs. We studied the performance of our method and demonstrated its advantages through a simulation case with a NCAT phantom and an experimental case with a Catphan phantom. Result: Compared with the CBCT images reconstructed using conventional FDK method with full projection datasets, our proposed method achieved comparable image quality with about one third projection numbers. The computation time on the multi-GPU platform was ∼55 s and ∼ 35 s in the two cases respectively, achieving a speedup factor of ∼ 3.0 compared with single GPU reconstruction. Conclusion: We have developed a consensus ADMM-based CBCT reconstruction method which enabled performing reconstruction on a multi-GPU platform. The achieved efficiency made this method clinically attractive.

  9. Enhanced imaging of microcalcifications in digital breast tomosynthesis through improved image-reconstruction algorithms

    International Nuclear Information System (INIS)

    Sidky, Emil Y.; Pan Xiaochuan; Reiser, Ingrid S.; Nishikawa, Robert M.; Moore, Richard H.; Kopans, Daniel B.

    2009-01-01

    Purpose: The authors develop a practical, iterative algorithm for image-reconstruction in undersampled tomographic systems, such as digital breast tomosynthesis (DBT). Methods: The algorithm controls image regularity by minimizing the image total p variation (TpV), a function that reduces to the total variation when p=1.0 or the image roughness when p=2.0. Constraints on the image, such as image positivity and estimated projection-data tolerance, are enforced by projection onto convex sets. The fact that the tomographic system is undersampled translates to the mathematical property that many widely varied resultant volumes may correspond to a given data tolerance. Thus the application of image regularity serves two purposes: (1) Reduction in the number of resultant volumes out of those allowed by fixing the data tolerance, finding the minimum image TpV for fixed data tolerance, and (2) traditional regularization, sacrificing data fidelity for higher image regularity. The present algorithm allows for this dual role of image regularity in undersampled tomography. Results: The proposed image-reconstruction algorithm is applied to three clinical DBT data sets. The DBT cases include one with microcalcifications and two with masses. Conclusions: Results indicate that there may be a substantial advantage in using the present image-reconstruction algorithm for microcalcification imaging.

  10. The benefit of modeled ozone data for the reconstruction of a 99-year UV radiation time series

    Science.gov (United States)

    Junk, J.; Feister, U.; Helbig, A.; GöRgen, K.; Rozanov, E.; KrzyśCin, J. W.; Hoffmann, L.

    2012-08-01

    Solar erythemal UV radiation (UVER) is highly relevant for numerous biological processes that affect plants, animals, and human health. Nevertheless, long-term UVER records are scarce. As significant declines in the column ozone concentration were observed in the past and a recovery of the stratospheric ozone layer is anticipated by the middle of the 21st century, there is a strong interest in the temporal variation of UVERtime series. Therefore, we combined ground-based measurements of different meteorological variables with modeled ozone data sets to reconstruct time series of daily totals of UVER at the Meteorological Observatory, Potsdam, Germany. Artificial neural networks were trained with measured UVER, sunshine duration, the day of year, measured and modeled total column ozone, as well as the minimum solar zenith angle. This allows for the reconstruction of daily totals of UVERfor the period from 1901 to 1999. Additionally, analyses of the long-term variations from 1901 until 1999 of the reconstructed, new UVER data set are presented. The time series of monthly and annual totals of UVERprovide a long-term meteorological basis for epidemiological investigations in human health and occupational medicine for the region of Potsdam and Berlin. A strong benefit of our ANN-approach is the fact that it can be easily adapted to different geographical locations, as successfully tested in the framework of the COSTAction 726.

  11. Reconstruction of sparse-view X-ray computed tomography using adaptive iterative algorithms.

    Science.gov (United States)

    Liu, Li; Lin, Weikai; Jin, Mingwu

    2015-01-01

    In this paper, we propose two reconstruction algorithms for sparse-view X-ray computed tomography (CT). Treating the reconstruction problems as data fidelity constrained total variation (TV) minimization, both algorithms adapt the alternate two-stage strategy: projection onto convex sets (POCS) for data fidelity and non-negativity constraints and steepest descent for TV minimization. The novelty of this work is to determine iterative parameters automatically from data, thus avoiding tedious manual parameter tuning. In TV minimization, the step sizes of steepest descent are adaptively adjusted according to the difference from POCS update in either the projection domain or the image domain, while the step size of algebraic reconstruction technique (ART) in POCS is determined based on the data noise level. In addition, projection errors are used to compare with the error bound to decide whether to perform ART so as to reduce computational costs. The performance of the proposed methods is studied and evaluated using both simulated and physical phantom data. Our methods with automatic parameter tuning achieve similar, if not better, reconstruction performance compared to a representative two-stage algorithm. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Dual-source CT coronary imaging in heart transplant recipients: image quality and optimal reconstruction interval

    International Nuclear Information System (INIS)

    Bastarrika, Gorka; Arraiza, Maria; Pueyo, Jesus C.; Cecco, Carlo N. de; Ubilla, Matias; Mastrobuoni, Stefano; Rabago, Gregorio

    2008-01-01

    The image quality and optimal reconstruction interval for coronary arteries in heart transplant recipients undergoing non-invasive dual-source computed tomography (DSCT) coronary angiography was evaluated. Twenty consecutive heart transplant recipients who underwent DSCT coronary angiography were included (19 male, one female; mean age 63.1±10.7 years). Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent observers assessed the image quality of each coronary segments using a five-point scale (from 0 = not evaluative to 4=excellent quality). A total of 289 coronary segments in 20 heart transplant recipients were evaluated. Mean heart rate during the scan was 89.1±10.4 bpm. At the best reconstruction interval, diagnostic image quality (score ≥2) was obtained in 93.4% of the coronary segments (270/289) with a mean image quality score of 3.04± 0.63. Systolic reconstruction intervals provided better image quality scores than diastolic reconstruction intervals (overall mean quality scores obtained with the systolic and diastolic reconstructions 3.03±1.06 and 2.73±1.11, respectively; P<0.001). Different systolic reconstruction intervals (35%, 40%, 45% of RR interval) did not yield to significant differences in image quality scores for the coronary segments (P=0.74). Reconstructions obtained at the systolic phase of the cardiac cycle allowed excellent diagnostic image quality coronary angiograms in heart transplant recipients undergoing DSCT coronary angiography. (orig.)

  13. Investigation of various reconstruction parameters for algebraic reconstruction technique in a newly developed chest digital tomosynthesis

    International Nuclear Information System (INIS)

    Lee, H.; Choi, S.; Kim, Y.-S.; Park, H.-S.; Seo, C.-W.; Kim, H.-J.; Lee, D.; Lee, Y.

    2017-01-01

    Chest digital tomosynthesis (CDT) is a promising new modality that provides 3D information by reconstructing limited projection views. CDT systems have been developed to improve the limitations of conventional radiography such as image degradation and low sensitivity. However, the development of reconstruction methods is challenging because of the limited projection views within various angular ranges. Optimization of reconstruction parameters for various reconsturction methods in CDT system also is needed. The purpose of this study was to investigate the feasibility of algebraic reconstruction technique (ART) method, and to evaluate the effect of the reconstruction parameters for our newly developed CDT system. We designed ART method with 41 projection views over an angular range of ±20°. To investigate the effect of reconstruction parameters, we measured the contrast-to-noise ratio (CNR), artifact spread function (ASF), and quality factor (QF) using LUNGMAN phantom included tumors. We found that the proper choice of reconstruction parameters such as relaxation parameter, initial guess, and number of iterations improved the quality of reconstructed images from the same projection views. Optimal values of ART relaxation parameter with uniform (UI) and back-projection (BP) initial guesses were 0.4 and 0.6, respectively. BP initial guess improved image quality in comparison with UI initial guess, in terms of providing a higher CNR and QF values with a faster speed. CNR and QF values improved with increasing number of iteration. Particularly, ART method with BP initial guess (when β = 0.6) after 3-terations provide satisfactory reconstructed image. In conclusion, the use of ART method with proper reconstruction parameters provided better image quality than FBP method as well as conventional radiography. These results indicated that the ART method with optimal reconstruction parameters could improve image quality for nodule detection using the CDT system.

  14. Investigation of various reconstruction parameters for algebraic reconstruction technique in a newly developed chest digital tomosynthesis

    Science.gov (United States)

    Lee, H.; Choi, S.; Lee, D.; Kim, Y.-s.; Park, H.-S.; Lee, Y.; Seo, C.-W.; Kim, H.-J.

    2017-08-01

    Chest digital tomosynthesis (CDT) is a promising new modality that provides 3D information by reconstructing limited projection views. CDT systems have been developed to improve the limitations of conventional radiography such as image degradation and low sensitivity. However, the development of reconstruction methods is challenging because of the limited projection views within various angular ranges. Optimization of reconstruction parameters for various reconsturction methods in CDT system also is needed. The purpose of this study was to investigate the feasibility of algebraic reconstruction technique (ART) method, and to evaluate the effect of the reconstruction parameters for our newly developed CDT system. We designed ART method with 41 projection views over an angular range of ±20°. To investigate the effect of reconstruction parameters, we measured the contrast-to-noise ratio (CNR), artifact spread function (ASF), and quality factor (QF) using LUNGMAN phantom included tumors. We found that the proper choice of reconstruction parameters such as relaxation parameter, initial guess, and number of iterations improved the quality of reconstructed images from the same projection views. Optimal values of ART relaxation parameter with uniform (UI) and back-projection (BP) initial guesses were 0.4 and 0.6, respectively. BP initial guess improved image quality in comparison with UI initial guess, in terms of providing a higher CNR and QF values with a faster speed. CNR and QF values improved with increasing number of iteration. Particularly, ART method with BP initial guess (when β = 0.6) after 3-terations provide satisfactory reconstructed image. In conclusion, the use of ART method with proper reconstruction parameters provided better image quality than FBP method as well as conventional radiography. These results indicated that the ART method with optimal reconstruction parameters could improve image quality for nodule detection using the CDT system.

  15. Radiological dose reconstruction for birds reconciles outcomes of Fukushima with knowledge of dose-effect relationships

    International Nuclear Information System (INIS)

    Garnier-Laplace, Jacqueline; Beaugelin-Seiller, Karine; Della-Vedova, Claire; Metivier, Jean-Michel; Ritz, Christian; Mousseau, Timothy A.; Pape Moeller, Anders

    2015-01-01

    We reconstructed the radiological dose for birds observed at 300 census sites in the 50-km northwest area affected by the accident at the Fukushima Daiichi nuclear power plant over 2011-2014. Substituting the ambient dose rate measured at the census points (from 0.16 to 31 μGy h -1 ) with the dose rate reconstructed for adult birds of each species (from 0.3 to 97 μGy h -1 ), we confirmed that the overall bird abundance at Fukushima decreased with increasing total doses. This relationship was directly consistent with exposure levels found in the literature to induce physiological disturbances in birds. Among the 57 species constituting the observed bird community, we found that 90% were likely chronically exposed at a dose rate that could potentially affect their reproductive success. We quantified a loss of 22.6% of the total number of individuals per increment of one unit log10-transformed total dose (in Gy), over the four-year post-accident period in the explored area. We estimated that a total dose of 0.55 Gy reduced by 50% the total number of birds in the study area over 2011-2014. The data also suggest a significant positive relationship between total dose and species diversity. (authors)

  16. Low-Dose X-ray CT Reconstruction via Dictionary Learning

    Science.gov (United States)

    Xu, Qiong; Zhang, Lei; Hsieh, Jiang; Wang, Ge

    2013-01-01

    Although diagnostic medical imaging provides enormous benefits in the early detection and accuracy diagnosis of various diseases, there are growing concerns on the potential side effect of radiation induced genetic, cancerous and other diseases. How to reduce radiation dose while maintaining the diagnostic performance is a major challenge in the computed tomography (CT) field. Inspired by the compressive sensing theory, the sparse constraint in terms of total variation (TV) minimization has already led to promising results for low-dose CT reconstruction. Compared to the discrete gradient transform used in the TV method, dictionary learning is proven to be an effective way for sparse representation. On the other hand, it is important to consider the statistical property of projection data in the low-dose CT case. Recently, we have developed a dictionary learning based approach for low-dose X-ray CT. In this paper, we present this method in detail and evaluate it in experiments. In our method, the sparse constraint in terms of a redundant dictionary is incorporated into an objective function in a statistical iterative reconstruction framework. The dictionary can be either predetermined before an image reconstruction task or adaptively defined during the reconstruction process. An alternating minimization scheme is developed to minimize the objective function. Our approach is evaluated with low-dose X-ray projections collected in animal and human CT studies, and the improvement associated with dictionary learning is quantified relative to filtered backprojection and TV-based reconstructions. The results show that the proposed approach might produce better images with lower noise and more detailed structural features in our selected cases. However, there is no proof that this is true for all kinds of structures. PMID:22542666

  17. Novel posterior reconstruction technique during robot-assisted laparoscopic prostatectomy: description and comparative outcomes.

    Science.gov (United States)

    Jeong, Chang Wook; Oh, Jong Jin; Jeong, Seong Jin; Hong, Sung Kyu; Byun, Seok-Soo; Choe, Gheeyoung; Lee, Sang Eun

    2012-07-01

    The aim of the present study was to assess the impact of a novel posterior reconstruction technique during robot-assisted laparoscopic prostatectomy on continence recovery. A total of 116 consecutive patients who received the novel posterior reconstruction (case group) were retrospectively compared with a cohort of 126 patients who did not receive posterior reconstruction (control group). The primary end-point was the duration of continence recovery (no pad use) after robot-assisted laparoscopic prostatectomy. The posterior reconstruction was obtained by opposing the median dorsal fibrous raphe to the posterior counterpart of the detrusor apron, rather than the Denonvilliers' fascia. The case group showed higher continence rates at all points of evaluation, which were 2 weeks (30.1% vs 19.8%), 1 month (58.4% vs 45.7%), 3 months (82.7% vs 70.5%) and 6 months postoperatively (95.3% vs 86.4%) (P = 0.007). Application of the novel posterior reconstruction technique, age and length of membranous urethra were significant variables for the complete recovery of continence on multivariable analysis. This study shows that the application of this novel PR technique significantly improves the recovery of continence in patients undergoing robot-assisted laparoscopic prostatectomy. © 2012 The Japanese Urological Association.

  18. Functional Outcome Following Arthroscopic ACL Reconstruction with Rigid Fix: A Retrospective Observational Study

    Directory of Open Access Journals (Sweden)

    Satish Shervegar

    2015-10-01

    Full Text Available Background: No uniform consensus exists to decide type of fixation for arthroscopic anterior cruciate ligament reconstruction. Hypothsis: There is similar functional outcome after rigid fix compared to other methods of fixation which has been published. Study design: Retrospective observational study. Methods: A total of 50 patients underwent arthroscopic anterior cruciate ligament reconstruction with hamstring tendons using femoral Rigid fix cross-pin and interference screw tibial fixation. The evaluation methods were clinical examination, IKDC scores, Lysholm and pre injury and post reconstruction Tegner score. Patients were followed up from minimum of 6 months to 4 year seven months. Results: C In our study of sample size 50 we found that mean age of patients was 30.8 Years with male preponderance. Mean post operative IKDC and Lysholm score has been 75.6 and 84.4 respectively.Mean Tegner pre-injury score and post reconstruction score has been 5.4 and 4.26 .Box plot comparison of pre injury and post operativeTegner score reveals a statistically significant difference with respect to paired t test P Conclusions: Arthroscopic anterior cruciate ligament reconstruction with femoral rigid fix cross pins and tibial interference screws results in comparable short term to midterm functional results compared to other types of fixation

  19. Functional Outcome Following Arthroscopic ACL Reconstruction with Rigid Fix: A Retrospective Observational Study

    Directory of Open Access Journals (Sweden)

    Satish Shervegar

    2015-09-01

    Full Text Available Background: No uniform consensus exists to decide type of fixation for arthroscopic anterior cruciate ligament reconstruction. Hypothsis: There is similar functional outcome after rigid fix compared to other methods of fixation which has been published. Study design: Retrospective observational study. Methods: A total of 50 patients underwent arthroscopic anterior cruciate ligament reconstruction with hamstring tendons using femoral Rigid fix cross-pin and interference screw tibial fixation. The evaluation methods were clinical examination, IKDC scores, Lysholm and pre injury and post reconstruction Tegner score. Patients were followed up from minimum of 6 months to 4 year seven months. Results: C In our study of sample size 50 we found that mean age of patients was 30.8 Years with male preponderance. Mean post operative IKDC and Lysholm score has been 75.6 and 84.4 respectively.Mean Tegner pre-injury score and post reconstruction score has been 5.4 and 4.26 .Box plot comparison of pre injury and post operativeTegner score reveals a statistically significant difference with respect to paired t test P Conclusions: Arthroscopic anterior cruciate ligament reconstruction with femoral rigid fix cross pins and tibial interference screws results in comparable short term to midterm functional results compared to other types of fixation

  20. Predictive Factors for Natural Pregnancy after Microsurgical Reconstruction in Patients with Primary Epididymal Obstructive Azoospermia

    Directory of Open Access Journals (Sweden)

    Mihai Harza

    2014-01-01

    Full Text Available Primary epididymal obstructive azoospermia (OA is the most prevalent form of OA in nonvasectomized patients and has been less studied. We aim to assess the results with microsurgical vasoepididymostomy used in the treatment of men diagnosed with primary epididymal obstructive azoospermia and to identify the factors associated with natural pregnancy occurring after microsurgical reconstruction. This prospective study included consecutive patients with epididymal OA who underwent microsurgical reconstruction in our center. Clinical and biological data were obtained every three months during follow-up. Occurrence of natural pregnancy was the primary study outcome. In total, 36 patients underwent microsurgical reconstruction. The mean age was 34±4.5 years (range 24–46 years. Median follow-up time was 15 [IQR 12–21] months. The total patency rate was 77.7% (n=28. During follow-up, 8 (22.2% natural pregnancies occurred. The overall live birth rate was 100%. Low FSH levels (HR: 0.22; 95% CI: 0.052–0.88; P=0.032 and higher total motile sperm count (TMSC (HR: 1.001; 95% CI 1–1.001; P=0.012 were associated with a higher rate of natural pregnancy. Our data suggest that microsurgical vasoepididymostomy is an effective therapy of primary epididymal OA. Baseline lower FSH and higher TMSC were independent predictors for natural pregnancy occurrence.

  1. Random unitary maps for quantum state reconstruction

    International Nuclear Information System (INIS)

    Merkel, Seth T.; Riofrio, Carlos A.; Deutsch, Ivan H.; Flammia, Steven T.

    2010-01-01

    We study the possibility of performing quantum state reconstruction from a measurement record that is obtained as a sequence of expectation values of a Hermitian operator evolving under repeated application of a single random unitary map, U 0 . We show that while this single-parameter orbit in operator space is not informationally complete, it can be used to yield surprisingly high-fidelity reconstruction. For a d-dimensional Hilbert space with the initial observable in su(d), the measurement record lacks information about a matrix subspace of dimension ≥d-2 out of the total dimension d 2 -1. We determine the conditions on U 0 such that the bound is saturated, and show they are achieved by almost all pseudorandom unitary matrices. When we further impose the constraint that the physical density matrix must be positive, we obtain even higher fidelity than that predicted from the missing subspace. With prior knowledge that the state is pure, the reconstruction will be perfect (in the limit of vanishing noise) and for arbitrary mixed states, the fidelity is over 0.96, even for small d, and reaching F>0.99 for d>9. We also study the implementation of this protocol based on the relationship between random matrices and quantum chaos. We show that the Floquet operator of the quantum kicked top provides a means of generating the required type of measurement record, with implications on the relationship between quantum chaos and information gain.

  2. Functional reconstruction of ischemic contracture in the

    Directory of Open Access Journals (Sweden)

    TANG Hao

    2011-04-01

    Full Text Available 【Abstract】Objective: To discuss the method of functional reconstruction of ischemic contracture in the lower limb and propose a classification protocol for ischemic contracture in the lower limb based on its severity and prognosis. Methods: A total of 42 patients with ischemic contracture in the lower limb were included in this study. According to different types of disturbance and degrees of severity, surgical reconstructions consisting of nerve decompression, tendon lengthening or transfer, intrinsic foot muscle release and sural-tibial nerve anastomosis were performed in every patient. Results: Postoperatively, all patients were able to walk on flat ground. Drop foot was corrected in 10 patients, and 5 patients still felt some difficulty during stair activity. Split Achilles tendon transfer to flexor hallucis longus tendon was performed in 12 patients, and their walking stability was improved. Seven patients accepted ipsilateral suraltibial nerve anastomosis, and sensitivity recovery reached to S2 in 2 patients and S3 in 5 patients. Conclusions: Ischemic contracture in the lower limb is a devastating complication after lower limb trauma. The prevention of contracture is much more important than the treatment of an established contracture. Split Achilles tendon transfer to flexor hallucis longus tendon and sural-tibial nerve anastomosis, which was initially implemented by us, could improve the functional recovery of ischemic contracture in lower limbs, and thus provides a new alternative for functional reconstruction of ischemic contracture in the lower limb. Key words: Ischemic contracture; Classification; Recovery of function

  3. Hamstrings tendon graft preparation for anterior cruciate ligament reconstruction using the WhipKnotTM soft tissue cinch technique.

    Directory of Open Access Journals (Sweden)

    Amin Masoumiganjgah

    2012-04-01

    Full Text Available BackgroundAppropriate graft tension and secure graft incorporation inbone tunnels are essential for successful anterior cruciateligament (ACL reconstruction using hamstrings tendonautografts. The WhipKnot™ soft tissue cinch, introduced bySmith and Nephew in 2004, is an alternative option to thecommonly used whipstitch technique during preparation ofthe hamstring autograft in ACL reconstruction.AimsTo investigate the effectiveness of the WhipKnot™ softtissue cinch and technique during the preparation of thetendon graft for ACL reconstruction.MethodA total of 33 ACL reconstruction operations performedbetween February 2011 and December 2011 were includedin this study. These were performed by a single seniorsurgeon who used the Whipknot™ technique for thepreparation of each graft. Four were used for eachoperation; two for each end of the harvested hamstringstendons, including semitendinosus and gracilis tendonsrespectively.ResultsIn total, 132 WhipKnots were used during the kneeoperations. Use of the WhipKnot™ technique resulted insuccessful graft preparations, tensioning and effective graftplacement in the tibial and femoral tunnels in almost allinstances. Only one case of WhipKnot™ failure (slippagewas recorded.ConclusionThese results indicate that the Whipknot™ technique is asafe, reliable and practical option for the preparation of thehamstrings autografts.

  4. "Transversus Abdominis Plane Blocks in Microsurgical Breast Reconstruction: Analysis of Pain, Narcotic Consumption, Length of Stay and Cost."

    Science.gov (United States)

    Salibian, Ara A; Frey, Jordan D; Thanik, Vishal D; Karp, Nolan S; Choi, Mihye

    2018-06-02

    Transversus abdominis plane (TAP) blocks are increasingly being utilized in microvascular breast reconstruction. The implications of TAP blocks on specific reconstructive, patient and institutional outcomes remain to be fully elucidated. Patients undergoing abdominally-based microvascular breast reconstruction from 2015-2017 were reviewed. Length of stay, complications, narcotic consumption, donor-site pain and hospital expenses were compared between patients that did and those that did not receive TAP blocks with liposomal bupivacaine. Outcomes were subsequently compared in patients with elevated body mass index (BMI). Fifty patients (43.9%) received TAP blocks (27 [54.0%] under ultrasound guidance) and 64 patients (56.1%) did not. Patients with TAP blocks had significantly decreased oral and total narcotic consumption (p=0.0001 and pconsumption and postoperative pain compared to patients without TAP blocks. Patients with BMIconsumption or length of stay between the TAP versus no TAP block groups. TAP blocks with liposomal bupivacaine significantly reduce oral and total postoperative narcotic consumption as well as donor-site pain in all patients after abdominally-based microvascular breast reconstruction without increasing hospital expenses. TAP blocks additionally significantly decrease length of stay in patients with BMI≥25.

  5. The effects of iodine attenuation on pulmonary nodule volumetry using novel dual-layer computed tomography reconstructions

    Energy Technology Data Exchange (ETDEWEB)

    Harder, A.M. den; Hamersvelt, R.W. van; Leiner, T.; Schilham, A.M.R.; Willemink, M.J.; Jong, P.A. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Bangert, F. [Sint Antonius Ziekenhuis, Department of Radiology, Nieuwegein (Netherlands); Milles, Julien [Philips Healthcare, Best (Netherlands)

    2017-12-15

    To assess the effect of iodine attenuation on pulmonary nodule volumetry using virtual non-contrast (VNC) and mono-energetic reconstructions. A consecutive series of patients who underwent a contrast-enhanced chest CT scan were included. Images were acquired on a novel dual-layer spectral CT system. Conventional reconstructions as well as VNC and mono-energetic images at different keV levels were used for nodule volumetry. Twenty-four patients with a total of 63 nodules were included. Conventional reconstructions showed a median (interquartile range) volume and diameter of 174 (87 - 253) mm{sup 3} and 6.9 (5.4 - 9.9) mm, respectively. VNC reconstructions resulted in a significant volume reduction of 5.5% (2.6 - 11.2%; p<0.001). Mono-energetic reconstructions showed a correlation between nodule attenuation and nodule volume (Spearman correlation 0.77, (0.49 - 0.94)). Lowering the keV resulted in increased volumes while higher keV levels resulted in decreased pulmonary nodule volumes compared to conventional CT. Novel dual-layer spectral CT offers the possibility to reconstruct VNC and mono-energetic images. Those reconstructions show that higher pulmonary nodule attenuation results in larger nodule volumes. This may explain the reported underestimation in nodule volume on non-contrast enhanced compared to contrast-enhanced acquisitions. (orig.)

  6. The effects of iodine attenuation on pulmonary nodule volumetry using novel dual-layer computed tomography reconstructions

    International Nuclear Information System (INIS)

    Harder, A.M. den; Hamersvelt, R.W. van; Leiner, T.; Schilham, A.M.R.; Willemink, M.J.; Jong, P.A. de; Bangert, F.; Milles, Julien

    2017-01-01

    To assess the effect of iodine attenuation on pulmonary nodule volumetry using virtual non-contrast (VNC) and mono-energetic reconstructions. A consecutive series of patients who underwent a contrast-enhanced chest CT scan were included. Images were acquired on a novel dual-layer spectral CT system. Conventional reconstructions as well as VNC and mono-energetic images at different keV levels were used for nodule volumetry. Twenty-four patients with a total of 63 nodules were included. Conventional reconstructions showed a median (interquartile range) volume and diameter of 174 (87 - 253) mm 3 and 6.9 (5.4 - 9.9) mm, respectively. VNC reconstructions resulted in a significant volume reduction of 5.5% (2.6 - 11.2%; p<0.001). Mono-energetic reconstructions showed a correlation between nodule attenuation and nodule volume (Spearman correlation 0.77, (0.49 - 0.94)). Lowering the keV resulted in increased volumes while higher keV levels resulted in decreased pulmonary nodule volumes compared to conventional CT. Novel dual-layer spectral CT offers the possibility to reconstruct VNC and mono-energetic images. Those reconstructions show that higher pulmonary nodule attenuation results in larger nodule volumes. This may explain the reported underestimation in nodule volume on non-contrast enhanced compared to contrast-enhanced acquisitions. (orig.)

  7. Entropy and transverse section reconstruction

    International Nuclear Information System (INIS)

    Gullberg, G.T.

    1976-01-01

    A new approach to the reconstruction of a transverse section using projection data from multiple views incorporates the concept of maximum entropy. The principle of maximizing information entropy embodies the assurance of minimizing bias or prejudice in the reconstruction. Using maximum entropy is a necessary condition for the reconstructed image. This entropy criterion is most appropriate for 3-D reconstruction of objects from projections where the system is underdetermined or the data are limited statistically. This is the case in nuclear medicine time limitations in patient studies do not yield sufficient projections

  8. Pancreas preserving total duodenectomy for complex duodenal injury.

    Science.gov (United States)

    Wig, Jai Dev; Kudari, Ashwinikumar; Yadav, Thakur Deen; Doley, Rudra Prasad; Bharathy, Kishore Gurumoorthy Subramanya; Kalra, Naveen

    2009-07-06

    To assess the feasibility and safety of a pancreas-preserving total duodenectomy in the management of severe duodenal injury caused by abdominal trauma. Two patients with both extensive injury of the duodenum and diffuse peritonitis underwent pancreas preserving total duodenectomy at our tertiary care centre. These two young male patients (age 20 and 22 years) presented 2 days and 6 hours respectively following blunt abdominal trauma. The duodenum was almost completely separated from the pancreas. Ampulla was seen as a button on the pancreas. Following total duodenectomy, reconstruction was performed by suturing the jejunum to the head of the pancreas anteriorly and posteriorly away from the ampulla (invagination of the pancreas into the jejunum). There were no complications attributable to the procedure. Both patients are well on follow up. A Pancreas-preserving total duodenectomy offers a safe alternative to the Whipple procedure in managing complex duodenal injury. This procedure avoids unnecessary resection of the adjacent pancreas and anastomosis to undilated hepatic and pancreatic ducts.

  9. Breast reconstruction - natural tissue

    Science.gov (United States)

    ... flap; TRAM; Latissimus muscle flap with a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; Transverse upper gracilis flap; TUG; Mastectomy - breast reconstruction with natural tissue; Breast cancer - breast reconstruction with natural tissue

  10. From bonito to anchovy: a reconstruction of Turkey’s marine fisheries catches (1950-2010

    Directory of Open Access Journals (Sweden)

    A. ULMAN

    2013-06-01

    Full Text Available Turkey’s marine fisheries catches were estimated for the 1950-2010 time period using a reconstruction approach, which estimated all fisheries removals, including unreported landings, recreational landings and discards.  We added these estimates to the ‘official’ data, as reported in TURKSTAT, which are also available from the United Nation’s Food and Agriculture Organization (FAO.  The total reconstructed catch for the 1950-2010 time period (inclusive of the reported data is approximately 32 million t, or 74% more than the 18.4 million t of reported data. This added approximately 13.6 million t to the reported data, consisting of 6.9 million t of unreported landings, 2.6 million t of discards, 2.4 million t of recreational catches, and 1.7 million t of subsistence catches.  In 2010, total reported marine landings for Turkey were 445,680 t and the total reconstructed catch was 763,760 t, or 73% more than the reported data.   The main unreported taxon by tonnage was European anchovy (Engraulis encrasicolus due to its sheer high proportion of catch.  The major reasons for underreporting include a general distrust fishers have towards the taxing system combined with inefficient fisheries monitoring and surveillance capabilities.  Accounting for all fisheries components is crucial in understanding the development of fisheries resources, improving management, and reducing threats to the domestic food security of Turkey.

  11. Jini service to reconstruct tomographic data

    Science.gov (United States)

    Knoll, Peter; Mirzaei, S.; Koriska, K.; Koehn, H.

    2002-06-01

    A number of imaging systems rely on the reconstruction of a 3- dimensional model from its projections through the process of computed tomography (CT). In medical imaging, for example magnetic resonance imaging (MRI), positron emission tomography (PET), and Single Computer Tomography (SPECT) acquire two-dimensional projections of a three dimensional projections of a three dimensional object. In order to calculate the 3-dimensional representation of the object, i.e. its voxel distribution, several reconstruction algorithms have been developed. Currently, mainly two reconstruct use: the filtered back projection(FBP) and iterative methods. Although the quality of iterative reconstructed SPECT slices is better than that of FBP slices, such iterative algorithms are rarely used for clinical routine studies because of their low availability and increased reconstruction time. We used Jini and a self-developed iterative reconstructions algorithm to design and implement a Jini reconstruction service. With this service, the physician selects the patient study from a database and a Jini client automatically discovers the registered Jini reconstruction services in the department's Intranet. After downloading the proxy object the this Jini service, the SPECT acquisition data are reconstructed. The resulting transaxial slices are visualized using a Jini slice viewer, which can be used for various imaging modalities.

  12. Morbidity and Functional Outcomes following Free Jejunal Flap Reconstruction for Head and Neck Cancer.

    Science.gov (United States)

    Ni, Song; Zhu, Yiming; Qu, Dong; Wang, Jian; Li, Dezhi; Zhang, Bin; Xu, Zhengang; Liu, Shaoyan

    2017-01-01

    To evaluate the morbidity and fundamental functional outcomes (swallow and speech) after free jejunal flap (FJF) reconstruction following total pharyngolaryngo-esophagectomy (PLE) in China. 18 patients with FJF reconstruction after total PLE were retrospectively reviewed. Scheduled barium swallow test was performed 7-10 days postoperatively. Rehabilitation of swallowing and speech for patients was assessed by the Performance Status Scale for Head and Neck Cancer Patients. 8 patients died of tumor recurrence and 2 patients died of other reasons (cerebrovascular disease and respiratory disease, respectively). The 1-year, 2-year, and 3-year survival rates were 70.5, 49.4, and 33.8%, respectively. 83.3% of all patients could tolerate soft chewable foods, such as cooked vegetables, fish, hamburger, and small pieces of meat. 2 patients with early stenosis at upper anastomotic sites were with good swallowing function; while 2 patients with early stenosis at lower anastomotic sites were found to have difficulty in oral diet. 2 (11.1%) patients with larynx-preserving pharyngo-esophagectomy showed no compromise in speech. Only 2 (11.1%) patients underwent primary tracheoesophageal puncture for inserting an indwelling voice prosthesis for speech, and both patients achieved functional tracheoesophageal speech. The remaining 14 (77.8%) patients with total PLE did not resume functional speech. Postoperative barium swallow examination is helpful to predict long-term anastomotic stenosis. Good functional swallow rehabilitation is achieved following FJF reconstruction after total PLE or a larynx-preserving procedure. However, the speech outcomes are not satisfactory. It raises the demand of enhancement of functional recovery so that quality of life can be improved for these patients in China. © 2017 S. Karger AG, Basel.

  13. BREAST RECONSTRUCTIONS AFTER BREAST CANCER TREATING

    Directory of Open Access Journals (Sweden)

    Erik Vrabič

    2018-02-01

    Full Text Available Background. Breasts are an important symbol of physical beauty, feminity, mothering and sexual desire through the entire history of mankind. Lost of the whole or part of the breast is functional and aesthetic disturbance for woman. It is understandable, that the woman, who is concerned over breast loss, is as appropriate as another person´s concern over the loss of a limb or other body part. Before the 1960, breast reconstruction was considered as a dangerous procedure and it was almost prohibited. Considering the psychological importance of the breast in modern society, the possibility of breast reconstruction for the woman about to undergo a mastectomy is a comforting alternative. We can perform breast reconstruction with autologous tissue (autologous reconstruction, with breast implants and combination of both methods. For autologous reconstruction we can use local tissue (local flaps, or tissue from distant parts of the body (free vascular tissue transfer. Tissue expansion must be performed first, in many cases of breast reconstructions with breast implants. Conclusions. Possibility of breast reconstruction made a big progress last 3 decades. Today we are able to reconstruct almost every defect of the breast and the entire breast. Breast reconstruction rise the quality of life for breast cancer patients. Breast reconstruction is a team work of experts from many medicine specialites. In Slovenia we can offer breast reconstruction for breast cancer patients in Ljubljana, where plastic surgeons from Clinical Department for Plastic Surgery and Burns cooperate with oncologic surgeons. Ten years ago a similar cooperation between plastic surgeons and surgeons of the Centre for Breast Diseases was established in Maribor.

  14. Reconstruction of a ring applicator using CT imaging: impact of the reconstruction method and applicator orientation

    International Nuclear Information System (INIS)

    Hellebust, Taran Paulsen; Tanderup, Kari; Bergstrand, Eva Stabell; Knutsen, Bjoern Helge; Roeislien, Jo; Olsen, Dag Rune

    2007-01-01

    The purpose of this study is to investigate whether the method of applicator reconstruction and/or the applicator orientation influence the dose calculation to points around the applicator for brachytherapy of cervical cancer with CT-based treatment planning. A phantom, containing a fixed ring applicator set and six lead pellets representing dose points, was used. The phantom was CT scanned with the ring applicator at four different angles related to the image plane. In each scan the applicator was reconstructed by three methods: (1) direct reconstruction in each image (DR) (2) reconstruction in multiplanar reconstructed images (MPR) and (3) library plans, using pre-defined applicator geometry (LIB). The doses to the lead pellets were calculated. The relative standard deviation (SD) for all reconstruction methods was less than 3.7% in the dose points. The relative SD for the LIB method was significantly lower (p < 0.05) than for the DR and MPR methods for all but two points. All applicator orientations had similar dose calculation reproducibility. Using library plans for applicator reconstruction gives the most reproducible dose calculation. However, with restrictive guidelines for applicator reconstruction the uncertainties for all methods are low compared to other factors influencing the accuracy of brachytherapy

  15. Reconstructing flaw image using dataset of full matrix capture technique

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tae Hun; Kim, Yong Sik; Lee, Jeong Seok [KHNP Central Research Institute, Daejeon (Korea, Republic of)

    2017-02-15

    A conventional phased array ultrasonic system offers the ability to steer an ultrasonic beam by applying independent time delays of individual elements in the array and produce an ultrasonic image. In contrast, full matrix capture (FMC) is a data acquisition process that collects a complete matrix of A-scans from every possible independent transmit-receive combination in a phased array transducer and makes it possible to reconstruct various images that cannot be produced by conventional phased array with the post processing as well as images equivalent to a conventional phased array image. In this paper, a basic algorithm based on the LLL mode total focusing method (TFM) that can image crack type flaws is described. And this technique was applied to reconstruct flaw images from the FMC dataset obtained from the experiments and ultrasonic simulation.

  16. Delayed vaginal reconstruction in the fibrotic pelvis following radiation or previous reconstruction

    International Nuclear Information System (INIS)

    Berek, J.S.; Hacker, N.F.; Lagasse, L.D.; Smith, M.L.

    1983-01-01

    Vaginal reconstruction was performed in 14 patients who had developed vaginal stenosis secondary to extensive pelvic fibrosis after pelvic radiation therapy (12 patients) or prior vaginal reconstruction (2 patients). Sixteen procedures were performed using a split-thickness skin graft. All patients had satisfactory vaginal restoration, and 12 patients reported good vaginal function. No fistula developed as a result of the operative procedure, but one patient later developed a rectovaginal fistula resulting from tumor recurrence. Successful vaginal reconstruction can be achieved even years after initial therapy in patients who develop an obliterated vagina from previous radiation or surgery

  17. Oral rehabilitation of a patient with sub - total maxillectomy

    OpenAIRE

    Romesh Soni; Shitu Jindal; B P Singh; Neelam Mittal; T P Chaturvedi; D R Prithviraj

    2011-01-01

    This clinical report describes oral rehabilitation of a patient with sub-total maxillectomy with palatine process of maxilla and horizontal plate of palatine bone intact to retain the maxillary obturator. Clinical examination has been performed to know the amount of favorable undercuts to be used for retention of the obturator for better functional efficiency. Successful prosthetic reconstruction of hemimaxillectomy defect is a challenging procedure that requires multidisciplinary expertise t...

  18. The cyclops lesion after bicruciate-retaining total knee replacement

    OpenAIRE

    Klaassen, Mark A.; Aikins, Jerry L.

    2017-01-01

    The cyclops lesion is a localized anterior arthrofibrosis most commonly seen following anterior cruciate ligament reconstruction. The lesion forms at the anterior cruciate ligament insertion creating a painful extension block between femoral intercondylar notch and tibial plateau. We present 2 cases (3 knees) in which cyclops lesions appeared atypically following bicruciate-retaining total knee replacement. Two lesions occurred in a single patient following bilateral knee replacement. One les...

  19. Multicenter evaluation of quality of life and patient satisfaction after breast reconstruction, a long-term retrospective study.

    Science.gov (United States)

    Ménez, T; Michot, A; Tamburino, S; Weigert, R; Pinsolle, V

    2018-04-01

    Breast reconstruction techniques are multiple and they should be chosen in order to improve women's satisfaction and well-being, thus obtaining a personalized treatment. This report's major purpose was to study, through the Breast-Q questionnaire, how the functional and aesthetic outcomes, as well as the complications, of the main autologous breast reconstruction techniques, can affect patients quality of life and well-being at long-term. The secondary purpose was to analyse, thus to identify, the independent factors characterizing the different reconstructive techniques, which may affect patients' satisfaction. Women who underwent autologous breast reconstruction through deep inferior epigastric artery perforator or Latissimus dorsi muscle flap from May 2006 to May 2013 were included. The assessment was based on the Breast-Q reconstruction questionnaire. All times of post-mastectomy reconstruction were concerned: immediate, delayed, after previous procedure failure or conversion to another reconstructive technique due to the patient's dissatisfaction. A total of 98 patients were included. Concerning patients satisfaction, the breast-Q score is highest in patients who underwent immediate breast reconstruction, while scores after delayed breast reconstruction, previous surgery failure or conversion to another technique are generally equivalent. Higher scores have been observed in patients who underwent reconstruction through autologous Latissimus dorsi compared to Latissimus dorsi with prosthetic implant reconstruction. The authors identified factors of higher patients' satisfaction, like absence of major complication and advanced patient's age, in order to personalize the surgical planning according to the patient's priorities. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Breast reconstruction following mastectomy: current status in Australia.

    Science.gov (United States)

    Sandelin, Kerstin; King, Elizabeth; Redman, Sally

    2003-09-01

    Although breast reconstruction provides some advantages for women following mastectomy, few Australian breast cancer patients currently receive reconstruction. In Australia, the routine provision of breast reconstruction will require the development of specific health service delivery models. The present paper reports an analysis of the provision of breast reconstruction in eight sites in Australia. A semi-structured telephone interview was conducted with 10 surgeons offering breast reconstruction as part of their practice, including nine breast or general surgeons and one plastic surgeon. Surgeons reported offering breast reconstruction to all women facing mastectomy; the proportion of women deciding to have breast reconstruction varied between sites with up to 50% of women having a reconstruction at some sites. Most sites offered three types of reconstruction. Two pathways emerged: either the breast surgeon performed the breast surgery in a team with the plastic surgeon who undertook the breast reconstruction or the breast surgeon provided both the breast surgery and the reconstruction. Considerable waiting times for breast reconstruction were reported in the public sector particularly for delayed reconstruction. Surgeons reported receiving training in breast reconstruction from plastic surgeons or from a breast surgery team that performed reconstructions; a number had been trained overseas. No audits of breast reconstruction were being undertaken. Breast reconstruction can be offered on a routine basis in Australia in both the private and public sectors. Women may be more readily able to access breast reconstruction when it is provided by a breast surgeon alone, but the range of reconstruction options may be more limited. If access to breast reconstruction is to be increased, there will be a need to: (i) develop effective models for the rural sector taking account of the lack of plastic surgeons; (ii) address waiting times for reconstruction surgery in the

  1. ℓ0 Gradient Minimization Based Image Reconstruction for Limited-Angle Computed Tomography.

    Directory of Open Access Journals (Sweden)

    Wei Yu

    Full Text Available In medical and industrial applications of computed tomography (CT imaging, limited by the scanning environment and the risk of excessive X-ray radiation exposure imposed to the patients, reconstructing high quality CT images from limited projection data has become a hot topic. X-ray imaging in limited scanning angular range is an effective imaging modality to reduce the radiation dose to the patients. As the projection data available in this modality are incomplete, limited-angle CT image reconstruction is actually an ill-posed inverse problem. To solve the problem, image reconstructed by conventional filtered back projection (FBP algorithm frequently results in conspicuous streak artifacts and gradual changed artifacts nearby edges. Image reconstruction based on total variation minimization (TVM can significantly reduce streak artifacts in few-view CT, but it suffers from the gradual changed artifacts nearby edges in limited-angle CT. To suppress this kind of artifacts, we develop an image reconstruction algorithm based on ℓ0 gradient minimization for limited-angle CT in this paper. The ℓ0-norm of the image gradient is taken as the regularization function in the framework of developed reconstruction model. We transformed the optimization problem into a few optimization sub-problems and then, solved these sub-problems in the manner of alternating iteration. Numerical experiments are performed to validate the efficiency and the feasibility of the developed algorithm. From the statistical analysis results of the performance evaluations peak signal-to-noise ratio (PSNR and normalized root mean square distance (NRMSD, it shows that there are significant statistical differences between different algorithms from different scanning angular ranges (p<0.0001. From the experimental results, it also indicates that the developed algorithm outperforms classical reconstruction algorithms in suppressing the streak artifacts and the gradual changed

  2. Petz recovery versus matrix reconstruction

    Science.gov (United States)

    Holzäpfel, Milan; Cramer, Marcus; Datta, Nilanjana; Plenio, Martin B.

    2018-04-01

    The reconstruction of the state of a multipartite quantum mechanical system represents a fundamental task in quantum information science. At its most basic, it concerns a state of a bipartite quantum system whose subsystems are subjected to local operations. We compare two different methods for obtaining the original state from the state resulting from the action of these operations. The first method involves quantum operations called Petz recovery maps, acting locally on the two subsystems. The second method is called matrix (or state) reconstruction and involves local, linear maps that are not necessarily completely positive. Moreover, we compare the quantities on which the maps employed in the two methods depend. We show that any state that admits Petz recovery also admits state reconstruction. However, the latter is successful for a strictly larger set of states. We also compare these methods in the context of a finite spin chain. Here, the state of a finite spin chain is reconstructed from the reduced states of a few neighbouring spins. In this setting, state reconstruction is the same as the matrix product operator reconstruction proposed by Baumgratz et al. [Phys. Rev. Lett. 111, 020401 (2013)]. Finally, we generalize both these methods so that they employ long-range measurements instead of relying solely on short-range correlations embodied in such local reduced states. Long-range measurements enable the reconstruction of states which cannot be reconstructed from measurements of local few-body observables alone and hereby we improve existing methods for quantum state tomography of quantum many-body systems.

  3. Stepladder Reconstructive Options in Post-Ablative Complex Surgical Defects in the Head and Neck

    International Nuclear Information System (INIS)

    EL MARAKBY, H.H.; NAGUIB, Sh.F.; EL-SAWY, A.F.; AMIN, A.A.

    2008-01-01

    Background: Reconstruction of head and neck defects can pose many challenges to the reconstructive head and neck surgeon. Achieving the best cosmetic and functional results without compromising the safety of oncologic surgery are the primary reconstructive goals. Speech and articulation are particularly important in oral reconstructive procedures. In addition, preservation of the integrity and function of the donor sites should always be considered in all reconstructive procedures. Aim of the Study: The aim of the study is to evaluate different reconstructive options in complex defects of the head and neck region after resection of malignant tumours. The feasibility of the reconstructive ladder starting from simple techniques such as local flaps and skin grafts up to free flaps will be assessed. Patients and Methods: In this study we evaluated different reconstructive procedures used in 50 patients with complex head and neck defects undertaken at the department of surgery at the National Cancer Institute between July 2003 and December 2007. Results: The average age of patients was 52 years and the range was 26-67 years. Most of the tumours were either squamous cell carcinoma (74%) or Basal cell carcinoma (20%). Tumour sites included the nose (6%), lip (10%), cheek (12%) scalp (6%) as well as mucosal defects of the oral cavity (40%) and the hypopharynx (20%). We used local flaps and skin grafts in reconstruction in 36% of cases and pedicled flaps in 32% while free flaps were used in 32% of cases. Complications occurred in 32% of patients of which total flaps loss constituted 6% and partial flap loss 4%. Minor complications such as oro-cutaneous fistulae, wound infection, seroma and haematoma were noticed in 22% and all of them were treated conservatively. The final functional and aesthetic results were satisfactory in 60% of cases while poor results were encountered in patients who suffered some degree of flap loss.

  4. Reconstruction of lip defects with the karapandzic technique

    International Nuclear Information System (INIS)

    Rashid, M.; Illahi, I.; Aslam, R.; Hameed, S.; Masood, T.; Hanif, M. S.

    2003-01-01

    Objective: To study the use and effects of Karapandzic technique of lip reconstruction by long-term assessment. Results: A total of 37 patients were included in the study. Thirteen (35%) patients were outdoor cases while 24 (65%) were in-patients. Average time of reconstruction was 40 minutes, which was done under general anesthesia in 21(57%) patients and under local anesthesia in 16 (43%) cases. Mean hospital stay of the indoor cases was 26 hours. There was no flap loss except for marginal necrosis in 04 (11%) patients. Wound infection and wound dehiscence was observed in 03 (08%) patients. Sensations were completely intact in 29 (78%) patients and aesthetically 28 (76%) patients gave normal look at the end of two years (2Y). Twenty-seven (74%) patients had no change in speech and only one (3%) patient had unsatisfactory speech after 2 years. Varying degree of microstomia was observed in all the cases at immediate postoperative stage of one month but 35 (95%) patients showed gradual improvement with active mouth opening and stretching by prosthetic splints over 2 years. Conclusion: The Karapandzic technique of lip reconstruction is strongly recommended over the other techniques as it is a single stage, quick and safe procedure which gives cosmetically and functionally excellent results. Microstomia, occurring in early postoperative stage, shows gradual improvement on long-term follow-up. (author)

  5. Quantitative analysis of emphysema and airway measurements according to iterative reconstruction algorithms: comparison of filtered back projection, adaptive statistical iterative reconstruction and model-based iterative reconstruction

    International Nuclear Information System (INIS)

    Choo, Ji Yung; Goo, Jin Mo; Park, Chang Min; Park, Sang Joon; Lee, Chang Hyun; Shim, Mi-Suk

    2014-01-01

    To evaluate filtered back projection (FBP) and two iterative reconstruction (IR) algorithms and their effects on the quantitative analysis of lung parenchyma and airway measurements on computed tomography (CT) images. Low-dose chest CT obtained in 281 adult patients were reconstructed using three algorithms: FBP, adaptive statistical IR (ASIR) and model-based IR (MBIR). Measurements of each dataset were compared: total lung volume, emphysema index (EI), airway measurements of the lumen and wall area as well as average wall thickness. Accuracy of airway measurements of each algorithm was also evaluated using an airway phantom. EI using a threshold of -950 HU was significantly different among the three algorithms in decreasing order of FBP (2.30 %), ASIR (1.49 %) and MBIR (1.20 %) (P < 0.01). Wall thickness was also significantly different among the three algorithms with FBP (2.09 mm) demonstrating thicker walls than ASIR (2.00 mm) and MBIR (1.88 mm) (P < 0.01). Airway phantom analysis revealed that MBIR showed the most accurate value for airway measurements. The three algorithms presented different EIs and wall thicknesses, decreasing in the order of FBP, ASIR and MBIR. Thus, care should be taken in selecting the appropriate IR algorithm on quantitative analysis of the lung. (orig.)

  6. Quantitative analysis of emphysema and airway measurements according to iterative reconstruction algorithms: comparison of filtered back projection, adaptive statistical iterative reconstruction and model-based iterative reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Choo, Ji Yung [Seoul National University Medical Research Center, Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul (Korea, Republic of); Korea University Ansan Hospital, Ansan-si, Department of Radiology, Gyeonggi-do (Korea, Republic of); Goo, Jin Mo; Park, Chang Min; Park, Sang Joon [Seoul National University Medical Research Center, Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University, Cancer Research Institute, Seoul (Korea, Republic of); Lee, Chang Hyun; Shim, Mi-Suk [Seoul National University Medical Research Center, Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul (Korea, Republic of)

    2014-04-15

    To evaluate filtered back projection (FBP) and two iterative reconstruction (IR) algorithms and their effects on the quantitative analysis of lung parenchyma and airway measurements on computed tomography (CT) images. Low-dose chest CT obtained in 281 adult patients were reconstructed using three algorithms: FBP, adaptive statistical IR (ASIR) and model-based IR (MBIR). Measurements of each dataset were compared: total lung volume, emphysema index (EI), airway measurements of the lumen and wall area as well as average wall thickness. Accuracy of airway measurements of each algorithm was also evaluated using an airway phantom. EI using a threshold of -950 HU was significantly different among the three algorithms in decreasing order of FBP (2.30 %), ASIR (1.49 %) and MBIR (1.20 %) (P < 0.01). Wall thickness was also significantly different among the three algorithms with FBP (2.09 mm) demonstrating thicker walls than ASIR (2.00 mm) and MBIR (1.88 mm) (P < 0.01). Airway phantom analysis revealed that MBIR showed the most accurate value for airway measurements. The three algorithms presented different EIs and wall thicknesses, decreasing in the order of FBP, ASIR and MBIR. Thus, care should be taken in selecting the appropriate IR algorithm on quantitative analysis of the lung. (orig.)

  7. Mating of a PROSTALAC spacer with an intramedullary nail for reconstruction of an infected interprosthetic femoral shaft fracture: a case report.

    Science.gov (United States)

    Kamath, Atul F; Austin, Daniel; Lee, Gwo-Chin

    2012-08-01

    Reconstruction for concurrent infection of an ipsilateral total hip arthroplasty (THA) and total knee arthroplasty (TKA) is a challenge. We report a 2-stage reconstruction of a THA for chronic infection of both the THA and TKA with severe femoral bone loss secondary to interprosthetic fractures. The reconstruction involved using a custom-made, temporary, antibiotic-impregnated PROSTALAC spacer mated with an intramedullary nail. The acetabulum was then exposed and the necrotic cartilage was removed and curetted. The acetabulum was reamed to accept a PROSTALAC acetabular shell. The shell was cemented into the acetabulum with antibiotic cement. The custom-made spacer was then inserted distally first into the tibia. The distal end of the intramedullary nail was interlocked with a bicortical bolt to minimise nail rotation. Antibiotic-impregnated cement was moulded around the nail and spacer. The proximal end of the spacer was then reduced into the acetabular socket, and the joint was irrigated and the wound closed. A customised abduction brace was fitted, and partial weight bearing was allowed. Sufficient leg length, soft-tissue tension, and range of hip motion were restored, and a total femur and constrained liner was re-implanted 4 months later. Mating of an intramedullary nail with a PROSTALAC spacer is a viable reconstructive option.

  8. Reconstruction and durability study of the old living hut built in 1969 at Syowa Station, Antarctica

    Directory of Open Access Journals (Sweden)

    Toshio Hannuki

    2002-09-01

    Full Text Available The living hut was built by the 10th Japanese Antarctic Research Expedition (JARE-10 at Syowa Station in 1969. The living hut, which had been used over 29 years at Syowa Station, was demolished and the prefabricated building elements of the hut were brought back to Japan in 1998. The building elements were reconstructed for the durability test and the present conditions of the reconstructed living hut were investigated. The reconstruction work of the hut was finished within 5 days and with a total of 22 workers. The elements and devices were usable on the whole. The building can be reused if damaged parts are restored and external facing and interior finish are renewed.

  9. MREIT experiments with 200 µA injected currents: a feasibility study using two reconstruction algorithms, SMM and harmonic BZ

    International Nuclear Information System (INIS)

    Arpinar, V E; Muftuler, L T; Hamamura, M J; Degirmenci, E

    2012-01-01

    Magnetic resonance electrical impedance tomography (MREIT) is a technique that produces images of conductivity in tissues and phantoms. In this technique, electrical currents are applied to an object and the resulting magnetic flux density is measured using magnetic resonance imaging (MRI) and the conductivity distribution is reconstructed using these MRI data. Currently, the technique is used in research environments, primarily studying phantoms and animals. In order to translate MREIT to clinical applications, strict safety standards need to be established, especially for safe current limits. However, there are currently no standards for safe current limits specific to MREIT. Until such standards are established, human MREIT applications need to conform to existing electrical safety standards in medical instrumentation, such as IEC601. This protocol limits patient auxiliary currents to 100 µA for low frequencies. However, published MREIT studies have utilized currents 10–400 times larger than this limit, bringing into question whether the clinical applications of MREIT are attainable under current standards. In this study, we investigated the feasibility of MREIT to accurately reconstruct the relative conductivity of a simple agarose phantom using 200 µA total injected current and tested the performance of two MREIT reconstruction algorithms. These reconstruction algorithms used are the iterative sensitivity matrix method (SMM) by Ider and Birgul (1998 Elektrik 6 215–25) with Tikhonov regularization and the harmonic B Z proposed by Oh et al (2003 Magn. Reason. Med. 50 875–8). The reconstruction techniques were tested at both 200 µA and 5 mA injected currents to investigate their noise sensitivity at low and high current conditions. It should be noted that 200 µA total injected current into a cylindrical phantom generates only 14.7 µA current in imaging slice. Similarly, 5 mA total injected current results in 367 µA in imaging slice. Total acquisition

  10. The cyclops lesion after bicruciate-retaining total knee replacement

    Directory of Open Access Journals (Sweden)

    Mark A. Klaassen, MD, FACS

    2017-12-01

    Full Text Available The cyclops lesion is a localized anterior arthrofibrosis most commonly seen following anterior cruciate ligament reconstruction. The lesion forms at the anterior cruciate ligament insertion creating a painful extension block between femoral intercondylar notch and tibial plateau. We present 2 cases (3 knees in which cyclops lesions appeared atypically following bicruciate-retaining total knee replacement. Two lesions occurred in a single patient following bilateral knee replacement. One lesion occurred in an active sportswoman. All 3 resolved following arthroscopic debridement. We describe the presentation of this unusual complication and suggest keys to its diagnosis, treatment, and prevention. Keywords: Cyclops lesion, Bicruciate-retaining, Total knee arthroplasty, Extension deficit

  11. Breast Reconstruction After Solid Organ Transplant.

    Science.gov (United States)

    Koonce, Stephanie L; Giles, Brian; McLaughlin, Sarah A; Perdikis, Galen; Waldorf, James; Lemaine, Valerie; TerKonda, Sarvam

    2015-09-01

    Solid organ transplant patients frequently develop posttransplant malignancies including breast cancer. They may desire breast reconstruction after mastectomy, which could potentially be complicated by their transplant status, immunosuppressive regimen, and previous operations. We review our experience with patients who have undergone solid organ transplant and subsequent breast reconstruction after mastectomy After institutional review board approval, we queried our prospective breast reconstruction and solid organ transplant databases for corresponding patients. Inclusion criteria comprised breast reconstruction after solid organ transplant. A chart review was conducted of identified patients. Seventeen patients were identified: 1 pulmonary transplant, 4 cardiac transplants, 2 liver transplants, 1 pancreas transplant, 2 combined kidney/pancreas transplants, and 7 kidney transplants. Indications for mastectomy included posttransplant malignancy and prophylaxis. Median time from transplant to completion of reconstruction was 186 months (range, 11-336 months). Median age at transplant was 34.5 years (range, 21-65 years) with the median age of the patients at reconstructive surgery 51.5 years (range, 34-71 years). Median body mass index was 25.3 (range, 21.3-46.5). No significant complications were noted after reconstructive surgery. All patients were on full immunosuppression at time of reconstruction. Breast reconstruction is a viable option for transplant patients after mastectomy and should not be refused based on their transplant status. Close coordination with the transplant team and careful preoperative planning is essential for optimal outcomes.

  12. Promising Technique for Facial Nerve Reconstruction in Extended Parotidectomy

    Directory of Open Access Journals (Sweden)

    Ithzel Maria Villarreal

    2015-11-01

    Full Text Available Introduction: Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons.   Case Report: A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve infiltration requiring a second intervention for nerve and defect reconstruction. A free ALT flap with vascularized nerve grafts was the surgical choice. A 6 month follow-up showed partial facial movement recovery and the facial defect mended.   Conclusion:  It is of critical importance to restore function to patients with facial nerve injury.  Vascularized nerve grafts, in many clinical and experimental studies, have shown to result in better nerve regeneration than conventional non-vascularized nerve grafts. Nevertheless, there are factors that may affect the degree, speed and regeneration rate regarding the free fasciocutaneous flap. In complex head and neck defects following a total parotidectomy, the extended free fasciocutaneous ALT (anterior-lateral thigh flap with a vascularized nerve graft is ideally suited for the reconstruction of the injured site.  Donor–site morbidity is low and additional surgical time is minimal

  13. Promising Technique for Facial Nerve Reconstruction in Extended Parotidectomy.

    Science.gov (United States)

    Villarreal, Ithzel Maria; Rodríguez-Valiente, Antonio; Castelló, Jose Ramon; Górriz, Carmen; Montero, Oscar Alvarez; García-Berrocal, Jose Ramon

    2015-11-01

    Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons. A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve infiltration requiring a second intervention for nerve and defect reconstruction. A free ALT flap with vascularized nerve grafts was the surgical choice. A 6 month follow-up showed partial facial movement recovery and the facial defect mended. It is of critical importance to restore function to patients with facial nerve injury. Vascularized nerve grafts, in many clinical and experimental studies, have shown to result in better nerve regeneration than conventional non-vascularized nerve grafts. Nevertheless, there are factors that may affect the degree, speed and regeneration rate regarding the free fasciocutaneous flap. In complex head and neck defects following a total parotidectomy, the extended free fasciocutaneous ALT (anterior-lateral thigh) flap with a vascularized nerve graft is ideally suited for the reconstruction of the injured site. Donor-site morbidity is low and additional surgical time is minimal compared with the time of a single ALT flap transfer.

  14. 99mTc-HSA lymphoscintigraphy and leg edema after arterial reconstruction

    International Nuclear Information System (INIS)

    O-hara, Masaki; Seyama, Atsushi; Akimoto, Fumikazu; Nakamura, Takashi; Wakamatsu, Takahumi; Zempo, Nobuya; Esato, Kensuke

    1992-01-01

    To investigate the etiology of lower limb edema after arterial reconstruction, 12 patients (16 limbs) who underwent arterial reconstruction due to atherosclerosis obliterans were observed. There was no relationship between the severity of limb edema and serum factors (serum total proteins, albumin, BUN, and creatinine), ankle/brachial arterial pressure ratio, peripheral venous pressure or RI lymphoscintigraphy in the supine position. The lymphatic flow in RI lymphoscintigraphy at 3∼4 weeks after operation increased with statistically significant difference compared to the preoperative flow whether the patient was in the supine or upright position. Though there was no significant relationship between the severity of leg edema and postoperative lymphatic flow in the supine position, postoperative lymphatic flow in the upright position decreased as the severity of leg edema increased. Increased lymphatic flow in the follow-up period was associated with increased severity of leg edema in the upright position. It is concluded that postoperative leg edema is due to the damage to the lymphatic vessels during operation, and then the lymphatic channels cannot adapt to the increased lymphatic flow after the arterial reconstruction. (author)

  15. WE-A-17A-10: Fast, Automatic and Accurate Catheter Reconstruction in HDR Brachytherapy Using An Electromagnetic 3D Tracking System

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, E; Racine, E; Beaulieu, L [CHU de Quebec - Universite Laval, Quebec, Quebec (Canada); Binnekamp, D [Integrated Clinical Solutions and Marketing, Philips Healthcare, Best, DA (Netherlands)

    2014-06-15

    Purpose: In high dose rate brachytherapy (HDR-B), actual catheter reconstruction protocols are slow and errors prompt. The purpose of this study was to evaluate the accuracy and robustness of an electromagnetic (EM) tracking system for improved catheter reconstruction in HDR-B protocols. Methods: For this proof-of-principle, a total of 10 catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a Philips-design 18G biopsy needle (used as an EM stylet) and the second generation Aurora Planar Field Generator from Northern Digital Inc. The Aurora EM system exploits alternating current technology and generates 3D points at 40 Hz. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical CT system with a resolution of 0.089 mm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, 5 catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 seconds or less. This would imply that for a typical clinical implant of 17 catheters, the total reconstruction time would be less than 3 minutes. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.92 ± 0.37 mm and 1.74 ± 1.39 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be significantly more accurate (unpaired t-test, p < 0.05). A mean difference of less than 0.5 mm was found between successive EM reconstructions. Conclusion: The EM reconstruction was found to be faster, more accurate and more robust than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators. We would like to disclose that the equipments, used in this study, is coming from a collaboration with Philips Medical.

  16. WE-A-17A-10: Fast, Automatic and Accurate Catheter Reconstruction in HDR Brachytherapy Using An Electromagnetic 3D Tracking System

    International Nuclear Information System (INIS)

    Poulin, E; Racine, E; Beaulieu, L; Binnekamp, D

    2014-01-01

    Purpose: In high dose rate brachytherapy (HDR-B), actual catheter reconstruction protocols are slow and errors prompt. The purpose of this study was to evaluate the accuracy and robustness of an electromagnetic (EM) tracking system for improved catheter reconstruction in HDR-B protocols. Methods: For this proof-of-principle, a total of 10 catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a Philips-design 18G biopsy needle (used as an EM stylet) and the second generation Aurora Planar Field Generator from Northern Digital Inc. The Aurora EM system exploits alternating current technology and generates 3D points at 40 Hz. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical CT system with a resolution of 0.089 mm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, 5 catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 seconds or less. This would imply that for a typical clinical implant of 17 catheters, the total reconstruction time would be less than 3 minutes. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.92 ± 0.37 mm and 1.74 ± 1.39 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be significantly more accurate (unpaired t-test, p < 0.05). A mean difference of less than 0.5 mm was found between successive EM reconstructions. Conclusion: The EM reconstruction was found to be faster, more accurate and more robust than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators. We would like to disclose that the equipments, used in this study, is coming from a collaboration with Philips Medical

  17. Association of anterior cruciate ligament injury with knee osteoarthritis and total knee replacement: A retrospective cohort study from the Taiwan National Health Insurance Database.

    Directory of Open Access Journals (Sweden)

    Sheng-Hsiung Lin

    Full Text Available This study aimed to support the potential protective role of anterior cruciate ligament (ACL reconstruction against the development of osteoarthritis (OA.In this retrospective cohort study, the long-term results of ACL reconstruction in Taiwan were evaluated based on data from the National Health Insurance Research Database (NHIRD. In total, 8,769 eligible cases were included from 11,921 ACL-injured patients. The cumulative incidence rates of OA and total knee replacement (TKR were analyzed using the Kaplan-Meier estimator. Cox proportional hazards models were applied to estimate the hazard ratios (HRs and 95% confidence intervals (CIs of OA.There was a lower cumulative incidence of OA among ACL-reconstructed patients (271, 33.1% than among non-reconstructed patients (1,874, 40.3%; p < 0.001. Patients who underwent ACL reconstruction had a lower cumulative incidence of TKR during the follow-up period (0.6% than the non-reconstructed patients (4.6%, p < 0.001. After adjusting for covariates, ACL-injured patients who underwent reconstruction within one month after ACL injury showed a significantly lower risk of OA than those who never underwent reconstruction (adjusted HR = 0.83, 95% CI = 0.69-0.99.These results indicate that ACL reconstruction might not provide complete protection from OA development after traumatic knee injury but does yield a lower cumulative incidence of OA development and TKR. Moreover, based on the present study, ACL-injured patients should undergo reconstruction as early as possible (within one month to lower the risk of OA.

  18. Right adrenal vein: comparison between adaptive statistical iterative reconstruction and model-based iterative reconstruction.

    Science.gov (United States)

    Noda, Y; Goshima, S; Nagata, S; Miyoshi, T; Kawada, H; Kawai, N; Tanahashi, Y; Matsuo, M

    2018-06-01

    To compare right adrenal vein (RAV) visualisation and contrast enhancement degree on adrenal venous phase images reconstructed using adaptive statistical iterative reconstruction (ASiR) and model-based iterative reconstruction (MBIR) techniques. This prospective study was approved by the institutional review board, and written informed consent was waived. Fifty-seven consecutive patients who underwent adrenal venous phase imaging were enrolled. The same raw data were reconstructed using ASiR 40% and MBIR. The expert and beginner independently reviewed computed tomography (CT) images. RAV visualisation rates, background noise, and CT attenuation of the RAV, right adrenal gland, inferior vena cava (IVC), hepatic vein, and bilateral renal veins were compared between the two reconstruction techniques. RAV visualisation rates were higher with MBIR than with ASiR (95% versus 88%, p=0.13 in expert and 93% versus 75%, p=0.002 in beginner, respectively). RAV visualisation confidence ratings with MBIR were significantly greater than with ASiR (pASiR (pASiR (p=0.0013 and 0.02). Reconstruction of adrenal venous phase images using MBIR significantly reduces background noise, leading to an improvement in the RAV visualisation compared with ASiR. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  19. Craniofacial reconstruction using patient-specific implants polyether ether ketone with computer-assisted planning.

    Science.gov (United States)

    Manrique, Oscar J; Lalezarzadeh, Frank; Dayan, Erez; Shin, Joseph; Buchbinder, Daniel; Smith, Mark

    2015-05-01

    Reconstruction of bony craniofacial defects requires precise understanding of the anatomic relationships. The ideal reconstructive technique should be fast as well as economical, with minimal donor-site morbidity, and provide a lasting and aesthetically pleasing result. There are some circumstances in which a patient's own tissue is not sufficient to reconstruct defects. The development of sophisticated software has facilitated the manufacturing of patient-specific implants (PSIs). The aim of this study was to analyze the utility of polyether ether ketone (PEEK) PSIs for craniofacial reconstruction. We performed a retrospective chart review from July 2009 to July 2013 in patients who underwent craniofacial reconstruction using PEEK-PSIs using a virtual process based on computer-aided design and computer-aided manufacturing. A total of 6 patients were identified. The mean age was 46 years (16-68 y). Operative indications included cancer (n = 4), congenital deformities (n = 1), and infection (n = 1). The mean surgical time was 3.7 hours and the mean hospital stay was 1.5 days. The mean surface area of the defect was 93.4 ± 43.26 cm(2), the mean implant cost was $8493 ± $837.95, and the mean time required to manufacture the implants was 2 weeks. No major or minor complications were seen during the 4-year follow-up. We found PEEK implants to be useful in the reconstruction of complex calvarial defects, demonstrating a low complication rate, good outcomes, and high patient satisfaction in this small series of patients. Polyether ether ketone implants show promising potential and warrant further study to better establish the role of this technology in cranial reconstruction.

  20. Maxillary reconstruction

    Directory of Open Access Journals (Sweden)

    Brown James

    2007-12-01

    Full Text Available This article aims to discuss the various defects that occur with maxillectomy with a full review of the literature and discussion of the advantages and disadvantages of the various techniques described. Reconstruction of the maxilla can be relatively simple for the standard low maxillectomy that does not involve the orbital floor (Class 2. In this situation the structure of the face is less damaged and the there are multiple reconstructive options for the restoration of the maxilla and dental alveolus. If the maxillectomy includes the orbit (Class 4 then problems involving the eye (enopthalmos, orbital dystopia, ectropion and diplopia are avoided which simplifies the reconstruction. Most controversy is associated with the maxillectomy that involves the orbital floor and dental alveolus (Class 3. A case is made for the use of the iliac crest with internal oblique as an ideal option but there are other methods, which may provide a similar result. A multidisciplinary approach to these patients is emphasised which should include a prosthodontist with a special expertise for these defects.

  1. GPS tomography. Validation of reconstructed 3-D humidity fields with radiosonde profiles

    Energy Technology Data Exchange (ETDEWEB)

    Shangguan, M.; Bender, M.; Ramatschi, M.; Dick, G.; Wickert, J. [Helmholtz Centre Potsdam, German Research Centre for Geosciences (GFZ), Potsdam (Germany); Raabe, A. [Leipzig Institute for Meteorology (LIM), Leipzig (Germany); Galas, R. [Technische Univ. Berlin (Germany). Dept. for Geodesy and Geoinformation Sciences

    2013-11-01

    Water vapor plays an important role in meteorological applications; GeoForschungsZentrum (GFZ) therefore developed a tomographic system to derive 3-D distributions of the tropospheric water vapor above Germany using GPS data from about 300 ground stations. Input data for the tomographic reconstructions are generated by the Earth Parameter and Orbit determination System (EPOS) software of the GFZ, which provides zenith total delay (ZTD), integrated water vapor (IWV) and slant total delay (STD) data operationally with a temporal resolution of 2.5 min (STD) and 15 min (ZTD, IWV). The water vapor distribution in the atmosphere is derived by tomographic reconstruction techniques. The quality of the solution is dependent on many factors such as the spatial coverage of the atmosphere with slant paths, the spatial distribution of their intersections and the accuracy of the input observations. Independent observations are required to validate the tomographic reconstructions and to get precise information on the accuracy of the derived 3-D water vapor fields. To determine the quality of the GPS tomography, more than 8000 vertical water vapor profiles at 13 German radiosonde stations were used for the comparison. The radiosondes were launched twice a day (at 00:00 UTC and 12:00 UTC) in 2007. In this paper, parameters of the entire profiles such as the wet refractivity, and the zenith wet delay have been compared. Before the validation the temporal and spatial distribution of the slant paths, serving as a basis for tomographic reconstruction, as well as their angular distribution were studied. The mean wet refractivity differences between tomography and radiosonde data for all points vary from -1.3 to 0.3, and the root mean square is within the range of 6.5-9. About 32% of 6803 profiles match well, 23% match badly and 45% are difficult to classify as they match only in parts.

  2. Fast MR image reconstruction for partially parallel imaging with arbitrary k-space trajectories.

    Science.gov (United States)

    Ye, Xiaojing; Chen, Yunmei; Lin, Wei; Huang, Feng

    2011-03-01

    Both acquisition and reconstruction speed are crucial for magnetic resonance (MR) imaging in clinical applications. In this paper, we present a fast reconstruction algorithm for SENSE in partially parallel MR imaging with arbitrary k-space trajectories. The proposed method is a combination of variable splitting, the classical penalty technique and the optimal gradient method. Variable splitting and the penalty technique reformulate the SENSE model with sparsity regularization as an unconstrained minimization problem, which can be solved by alternating two simple minimizations: One is the total variation and wavelet based denoising that can be quickly solved by several recent numerical methods, whereas the other one involves a linear inversion which is solved by the optimal first order gradient method in our algorithm to significantly improve the performance. Comparisons with several recent parallel imaging algorithms indicate that the proposed method significantly improves the computation efficiency and achieves state-of-the-art reconstruction quality.

  3. The difficulties encountered in conversion from classic pancreaticoduodenectomy to total laparoscopic pancreaticoduodenectomy

    Directory of Open Access Journals (Sweden)

    Muharrem Battal

    2016-01-01

    Full Text Available Background: Recently, total laparoscopic pancreatectomy has been performed at many centres as an alternative to open surgery. In this study, we aimed to present the difficulties that we have encountered in converting from classic open pancreaticoduodenectomy to total laparoscopic pancreatectomy. Materials and Methods: Between December 2012 and January 2014, we had 100 open pancreaticoduodenectomies. Subsequently, we tried to perform total laparoscopic pancreaticoduodenectomy (TLPD in 22 patients. In 17 of these 22 patients, we carried out the total laparoscopic procedure. We analysed the difficulties that we encountered converting to TLPD in three parts: Preoperative, operative and postoperative. Preoperative difficulties involved patient selection, preparation of operative instruments, and planning the operation. Operative difficulties involved the position of the trocars, dissection, and reconstruction problems. The postoperative difficulty involved follow-up of the patient. Results: According to our experiences, the most important problem is the proper selection of patients. Contrary to our previous thoughts, older patients who were in better condition were comparatively more appropriate candidates than younger patients. This is because the younger patients have generally soft pancreatic texture, which complicates the reconstruction. The main operative problems are trocar positions and maintaining the appropriate position of the camera, which requires continuous changes in its angles during the operation. However, postoperative follow-up is not very different from the classic procedure. Conclusion: TLPD is a suitable procedure under appropriate conditions.

  4. PET image reconstruction using multi-parametric anato-functional priors

    Science.gov (United States)

    Mehranian, Abolfazl; Belzunce, Martin A.; Niccolini, Flavia; Politis, Marios; Prieto, Claudia; Turkheimer, Federico; Hammers, Alexander; Reader, Andrew J.

    2017-08-01

    In this study, we investigate the application of multi-parametric anato-functional (MR-PET) priors for the maximum a posteriori (MAP) reconstruction of brain PET data in order to address the limitations of the conventional anatomical priors in the presence of PET-MR mismatches. In addition to partial volume correction benefits, the suitability of these priors for reconstruction of low-count PET data is also introduced and demonstrated, comparing to standard maximum-likelihood (ML) reconstruction of high-count data. The conventional local Tikhonov and total variation (TV) priors and current state-of-the-art anatomical priors including the Kaipio, non-local Tikhonov prior with Bowsher and Gaussian similarity kernels are investigated and presented in a unified framework. The Gaussian kernels are calculated using both voxel- and patch-based feature vectors. To cope with PET and MR mismatches, the Bowsher and Gaussian priors are extended to multi-parametric priors. In addition, we propose a modified joint Burg entropy prior that by definition exploits all parametric information in the MAP reconstruction of PET data. The performance of the priors was extensively evaluated using 3D simulations and two clinical brain datasets of [18F]florbetaben and [18F]FDG radiotracers. For simulations, several anato-functional mismatches were intentionally introduced between the PET and MR images, and furthermore, for the FDG clinical dataset, two PET-unique active tumours were embedded in the PET data. Our simulation results showed that the joint Burg entropy prior far outperformed the conventional anatomical priors in terms of preserving PET unique lesions, while still reconstructing functional boundaries with corresponding MR boundaries. In addition, the multi-parametric extension of the Gaussian and Bowsher priors led to enhanced preservation of edge and PET unique features and also an improved bias-variance performance. In agreement with the simulation results, the clinical results

  5. Phase reconstruction from velocity-encoded MRI measurements – A survey of sparsity-promoting variational approaches

    KAUST Repository

    Benning, Martin

    2014-01-01

    In recent years there has been significant developments in the reconstruction of magnetic resonance velocity images from sub-sampled k-space data. While showing a strong improvement in reconstruction quality compared to classical approaches, the vast number of different methods, and the challenges in setting them up, often leaves the user with the difficult task of choosing the correct approach, or more importantly, not selecting a poor approach. In this paper, we survey variational approaches for the reconstruction of phase-encoded magnetic resonance velocity images from sub-sampled k-space data. We are particularly interested in regularisers that correctly treat both smooth and geometric features of the image. These features are common to velocity imaging, where the flow field will be smooth but interfaces between the fluid and surrounding material will be sharp, but are challenging to represent sparsely. As an example we demonstrate the variational approaches on velocity imaging of water flowing through a packed bed of solid particles. We evaluate Wavelet regularisation against Total Variation and the relatively recent second order Total Generalised Variation regularisation. We combine these regularisation schemes with a contrast enhancement approach called Bregman iteration. We verify for a variety of sampling patterns that Morozov\\'s discrepancy principle provides a good criterion for stopping the iterations. Therefore, given only the noise level, we present a robust guideline for setting up a variational reconstruction scheme for MR velocity imaging. © 2013 Elsevier Inc. All rights reserved.

  6. Graft infections after surgical aortic reconstructions

    OpenAIRE

    Berger, P.

    2015-01-01

    Prosthetic vascular grafts are frequently used to reconstruct (part) of the aorta. Every surgical procedure caries a certain risk for infection and when a prosthetic aortic graft is implanted, this may lead to an aortic graft infection (AGI). Endovascular techniques have gradually replaced open surgical reconstructions as first line of treatment for aorto-iliac diseases. Nowadays, open reconstructions are primarily reserved for patients unsuitable for endovascular reconstructions or for redo ...

  7. REGEN: Ancestral Genome Reconstruction for Bacteria

    OpenAIRE

    Yang, Kuan; Heath, Lenwood S.; Setubal, João C.

    2012-01-01

    Ancestral genome reconstruction can be understood as a phylogenetic study with more details than a traditional phylogenetic tree reconstruction. We present a new computational system called REGEN for ancestral bacterial genome reconstruction at both the gene and replicon levels. REGEN reconstructs gene content, contiguous gene runs, and replicon structure for each ancestral genome. Along each branch of the phylogenetic tree, REGEN infers evolutionary events, including gene creation and deleti...

  8. Craniofacial Reconstruction Evaluation by Geodesic Network

    OpenAIRE

    Zhao, Junli; Liu, Cuiting; Wu, Zhongke; Duan, Fuqing; Wang, Kang; Jia, Taorui; Liu, Quansheng

    2014-01-01

    Craniofacial reconstruction is to estimate an individual’s face model from its skull. It has a widespread application in forensic medicine, archeology, medical cosmetic surgery, and so forth. However, little attention is paid to the evaluation of craniofacial reconstruction. This paper proposes an objective method to evaluate globally and locally the reconstructed craniofacial faces based on the geodesic network. Firstly, the geodesic networks of the reconstructed craniofacial face and the or...

  9. The Effects of Iodine Attenuation on Pulmonary Nodule Volumetry using Novel Dual-Layer Computed Tomography Reconstructions.

    Science.gov (United States)

    den Harder, A M; Bangert, F; van Hamersvelt, R W; Leiner, T; Milles, Julien; Schilham, A M R; Willemink, M J; de Jong, P A

    2017-12-01

    To assess the effect of iodine attenuation on pulmonary nodule volumetry using virtual non-contrast (VNC) and mono-energetic reconstructions. A consecutive series of patients who underwent a contrast-enhanced chest CT scan were included. Images were acquired on a novel dual-layer spectral CT system. Conventional reconstructions as well as VNC and mono-energetic images at different keV levels were used for nodule volumetry. Twenty-four patients with a total of 63 nodules were included. Conventional reconstructions showed a median (interquartile range) volume and diameter of 174 (87 - 253) mm 3 and 6.9 (5.4 - 9.9) mm, respectively. VNC reconstructions resulted in a significant volume reduction of 5.5% (2.6 - 11.2%; p<0.001). Mono-energetic reconstructions showed a correlation between nodule attenuation and nodule volume (Spearman correlation 0.77, (0.49 - 0.94)). Lowering the keV resulted in increased volumes while higher keV levels resulted in decreased pulmonary nodule volumes compared to conventional CT. Novel dual-layer spectral CT offers the possibility to reconstruct VNC and mono-energetic images. Those reconstructions show that higher pulmonary nodule attenuation results in larger nodule volumes. This may explain the reported underestimation in nodule volume on non-contrast enhanced compared to contrast-enhanced acquisitions. • Pulmonary nodule volumes were measured on virtual non-contrast and mono-energetic reconstructions • Mono-energetic reconstructions showed that higher attenuation results in larger volumes • This may explain the reported nodule volume underestimation on non-contrast enhanced CT • Mostly metastatic pulmonary nodules were evaluated, results might differ for benign nodules.

  10. Multiscale reconstruction for MR fingerprinting.

    Science.gov (United States)

    Pierre, Eric Y; Ma, Dan; Chen, Yong; Badve, Chaitra; Griswold, Mark A

    2016-06-01

    To reduce the acquisition time needed to obtain reliable parametric maps with Magnetic Resonance Fingerprinting. An iterative-denoising algorithm is initialized by reconstructing the MRF image series at low image resolution. For subsequent iterations, the method enforces pixel-wise fidelity to the best-matching dictionary template then enforces fidelity to the acquired data at slightly higher spatial resolution. After convergence, parametric maps with desirable spatial resolution are obtained through template matching of the final image series. The proposed method was evaluated on phantom and in vivo data using the highly undersampled, variable-density spiral trajectory and compared with the original MRF method. The benefits of additional sparsity constraints were also evaluated. When available, gold standard parameter maps were used to quantify the performance of each method. The proposed approach allowed convergence to accurate parametric maps with as few as 300 time points of acquisition, as compared to 1000 in the original MRF work. Simultaneous quantification of T1, T2, proton density (PD), and B0 field variations in the brain was achieved in vivo for a 256 × 256 matrix for a total acquisition time of 10.2 s, representing a three-fold reduction in acquisition time. The proposed iterative multiscale reconstruction reliably increases MRF acquisition speed and accuracy. Magn Reson Med 75:2481-2492, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  11. Jejunal Replacement of Stomach in Two Children with Total Gastric Necrosis

    Directory of Open Access Journals (Sweden)

    Onder Ozden

    2014-04-01

    Full Text Available Total gastrectomy is an extremely rare procedure in children and experience with its replacement is very limited. We present two patients who had jejunal replacement due to total gastric necrosis. The first patient was a- 2-year-old boy who admitted with a history of caustic ingestion. He was taken operation because of gastric perforation and necrosis. Anastomosis was applied by using jejunal segments. The second patient was an 11-years-old girl who left diaphragmatic hernia and acute gastric volvulus. At laparotomy, Total gastrectomy and Hunt-Lawrence type gastroesophostomy were made. Reconstruction with jejunum is thought as a good option in total gastric necrosis according to our 2 patient experiences. [Cukurova Med J 2014; 39(2.000: 403-407

  12. Overview of image reconstruction

    International Nuclear Information System (INIS)

    Marr, R.B.

    1980-04-01

    Image reconstruction (or computerized tomography, etc.) is any process whereby a function, f, on R/sup n/ is estimated from empirical data pertaining to its integrals, ∫f(x) dx, for some collection of hyperplanes of dimension k < n. The paper begins with background information on how image reconstruction problems have arisen in practice, and describes some of the application areas of past or current interest; these include radioastronomy, optics, radiology and nuclear medicine, electron microscopy, acoustical imaging, geophysical tomography, nondestructive testing, and NMR zeugmatography. Then the various reconstruction algorithms are discussed in five classes: summation, or simple back-projection; convolution, or filtered back-projection; Fourier and other functional transforms; orthogonal function series expansion; and iterative methods. Certain more technical mathematical aspects of image reconstruction are considered from the standpoint of uniqueness, consistency, and stability of solution. The paper concludes by presenting certain open problems. 73 references

  13. Virtual 3-D Facial Reconstruction

    Directory of Open Access Journals (Sweden)

    Martin Paul Evison

    2000-06-01

    Full Text Available Facial reconstructions in archaeology allow empathy with people who lived in the past and enjoy considerable popularity with the public. It is a common misconception that facial reconstruction will produce an exact likeness; a resemblance is the best that can be hoped for. Research at Sheffield University is aimed at the development of a computer system for facial reconstruction that will be accurate, rapid, repeatable, accessible and flexible. This research is described and prototypical 3-D facial reconstructions are presented. Interpolation models simulating obesity, ageing and ethnic affiliation are also described. Some strengths and weaknesses in the models, and their potential for application in archaeology are discussed.

  14. Mandibular kinematics and maximum voluntary bite force following segmental resection of the mandible without or with reconstruction.

    Science.gov (United States)

    Linsen, Sabine S; Oikonomou, Annina; Martini, Markus; Teschke, Marcus

    2018-05-01

    The purpose was to analyze mandibular kinematics and maximum voluntary bite force in patients following segmental resection of the mandible without and with reconstruction (autologous bone, alloplastic total temporomandibular joint replacement (TMJ TJR)). Subjects operated from April 2002 to August 2014 were enrolled in the study. Condylar (CRoM) and incisal (InRoM) range of motion and deflection during opening, condylar retrusion, incisal lateral excursion, mandibular rotation angle during opening, and maximum voluntary bite force were determined on the non-affected site and compared between groups. Influence of co-factors (defect size, soft tissue deficit, neck dissection, radiotherapy, occlusal contact zones (OCZ), and time) was determined. Twelve non-reconstructed and 26 reconstructed patients (13 autologous, 13 TMJ TJR) were included in the study. InRoM opening and bite force were significantly higher (P ≤ .024), and both condylar and incisal deflection during opening significantly lower (P ≤ .027) in reconstructed patients compared with non-reconstructed. Differences between the autologous and the TMJ TJR group were statistically not significant. Co-factors defect size, soft tissue deficit, and neck dissection had the greatest impact on kinematics and number of OCZs on bite force. Reconstructed patients (both autologous and TMJ TJR) have better overall function than non-reconstructed patients. Reconstruction of segmental mandibular resection has positive effects on mandibular function. TMJ TJR seems to be a suitable technique for the reconstruction of mandibular defects including the TMJ complex.

  15. Preconditioned alternating projection algorithms for maximum a posteriori ECT reconstruction

    International Nuclear Information System (INIS)

    Krol, Andrzej; Li, Si; Shen, Lixin; Xu, Yuesheng

    2012-01-01

    We propose a preconditioned alternating projection algorithm (PAPA) for solving the maximum a posteriori (MAP) emission computed tomography (ECT) reconstruction problem. Specifically, we formulate the reconstruction problem as a constrained convex optimization problem with the total variation (TV) regularization. We then characterize the solution of the constrained convex optimization problem and show that it satisfies a system of fixed-point equations defined in terms of two proximity operators raised from the convex functions that define the TV-norm and the constraint involved in the problem. The characterization (of the solution) via the proximity operators that define two projection operators naturally leads to an alternating projection algorithm for finding the solution. For efficient numerical computation, we introduce to the alternating projection algorithm a preconditioning matrix (the EM-preconditioner) for the dense system matrix involved in the optimization problem. We prove theoretically convergence of the PAPA. In numerical experiments, performance of our algorithms, with an appropriately selected preconditioning matrix, is compared with performance of the conventional MAP expectation-maximization (MAP-EM) algorithm with TV regularizer (EM-TV) and that of the recently developed nested EM-TV algorithm for ECT reconstruction. Based on the numerical experiments performed in this work, we observe that the alternating projection algorithm with the EM-preconditioner outperforms significantly the EM-TV in all aspects including the convergence speed, the noise in the reconstructed images and the image quality. It also outperforms the nested EM-TV in the convergence speed while providing comparable image quality. (paper)

  16. System Characterizations and Optimized Reconstruction Methods for Novel X-ray Imaging Modalities

    Science.gov (United States)

    Guan, Huifeng

    In the past decade there have been many new emerging X-ray based imaging technologies developed for different diagnostic purposes or imaging tasks. However, there exist one or more specific problems that prevent them from being effectively or efficiently employed. In this dissertation, four different novel X-ray based imaging technologies are discussed, including propagation-based phase-contrast (PB-XPC) tomosynthesis, differential X-ray phase-contrast tomography (D-XPCT), projection-based dual-energy computed radiography (DECR), and tetrahedron beam computed tomography (TBCT). System characteristics are analyzed or optimized reconstruction methods are proposed for these imaging modalities. In the first part, we investigated the unique properties of propagation-based phase-contrast imaging technique when combined with the X-ray tomosynthesis. Fourier slice theorem implies that the high frequency components collected in the tomosynthesis data can be more reliably reconstructed. It is observed that the fringes or boundary enhancement introduced by the phase-contrast effects can serve as an accurate indicator of the true depth position in the tomosynthesis in-plane image. In the second part, we derived a sub-space framework to reconstruct images from few-view D-XPCT data set. By introducing a proper mask, the high frequency contents of the image can be theoretically preserved in a certain region of interest. A two-step reconstruction strategy is developed to mitigate the risk of subtle structures being oversmoothed when the commonly used total-variation regularization is employed in the conventional iterative framework. In the thirt part, we proposed a practical method to improve the quantitative accuracy of the projection-based dual-energy material decomposition. It is demonstrated that applying a total-projection-length constraint along with the dual-energy measurements can achieve a stabilized numerical solution of the decomposition problem, thus overcoming the

  17. Image quality of iterative reconstruction in cranial CT imaging: comparison of model-based iterative reconstruction (MBIR) and adaptive statistical iterative reconstruction (ASiR).

    Science.gov (United States)

    Notohamiprodjo, S; Deak, Z; Meurer, F; Maertz, F; Mueck, F G; Geyer, L L; Wirth, S

    2015-01-01

    The purpose of this study was to compare cranial CT (CCT) image quality (IQ) of the MBIR algorithm with standard iterative reconstruction (ASiR). In this institutional review board (IRB)-approved study, raw data sets of 100 unenhanced CCT examinations (120 kV, 50-260 mAs, 20 mm collimation, 0.984 pitch) were reconstructed with both ASiR and MBIR. Signal-to-noise (SNR) and contrast-to-noise (CNR) were calculated from attenuation values measured in caudate nucleus, frontal white matter, anterior ventricle horn, fourth ventricle, and pons. Two radiologists, who were blinded to the reconstruction algorithms, evaluated anonymized multiplanar reformations of 2.5 mm with respect to depiction of different parenchymal structures and impact of artefacts on IQ with a five-point scale (0: unacceptable, 1: less than average, 2: average, 3: above average, 4: excellent). MBIR decreased artefacts more effectively than ASiR (p ASiR was 2 (p ASiR (p ASiR. As CCT is an examination that is frequently required, the use of MBIR may allow for substantial reduction of radiation exposure caused by medical diagnostics. • Model-Based iterative reconstruction (MBIR) effectively decreased artefacts in cranial CT. • MBIR reconstructed images were rated with significantly higher scores for image quality. • Model-Based iterative reconstruction may allow reduced-dose diagnostic examination protocols.

  18. Pre-Hawking radiation may allow for reconstruction of the mass distribution of the collapsing object

    Energy Technology Data Exchange (ETDEWEB)

    Dai, De-Chang, E-mail: diedachung@gmail.com [Institute of Natural Sciences, Shanghai Key Lab for Particle Physics and Cosmology, and Center for Astrophysics and Astronomy, Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai 200240 (China); Stojkovic, Dejan [HEPCOS, Department of Physics, SUNY, University at Buffalo, Buffalo, NY 14260-1500 (United States)

    2016-07-10

    Hawking radiation explicitly depends only on the black hole's total mass, charge and angular momentum. It is therefore generally believed that one cannot reconstruct the information about the initial mass distribution of an object that made the black hole. However, instead of looking at radiation from a static black hole, we can study the whole time-dependent process of the gravitational collapse, and pre-Hawking radiation which is excited because of the time-dependent metric. We compare radiation emitted by a single collapsing shell with that emitted by two concentric shells of the equivalent total mass. We calculate the gravitational trajectory and the momentum energy tensor. We show that the flux of energy emitted during the collapse by a single shell is significantly different from the flux emitted by two concentric shells of the equivalent total mass. When the static black hole is formed, the fluxes become indistinguishable. This implies that an observer studying the flux of particles from a collapsing object could in principle reconstruct information not only about the total mass of the collapsing object, but also about the mass distribution.

  19. Pre-Hawking radiation may allow for reconstruction of the mass distribution of the collapsing object

    Directory of Open Access Journals (Sweden)

    De-Chang Dai

    2016-07-01

    Full Text Available Hawking radiation explicitly depends only on the black hole's total mass, charge and angular momentum. It is therefore generally believed that one cannot reconstruct the information about the initial mass distribution of an object that made the black hole. However, instead of looking at radiation from a static black hole, we can study the whole time-dependent process of the gravitational collapse, and pre-Hawking radiation which is excited because of the time-dependent metric. We compare radiation emitted by a single collapsing shell with that emitted by two concentric shells of the equivalent total mass. We calculate the gravitational trajectory and the momentum energy tensor. We show that the flux of energy emitted during the collapse by a single shell is significantly different from the flux emitted by two concentric shells of the equivalent total mass. When the static black hole is formed, the fluxes become indistinguishable. This implies that an observer studying the flux of particles from a collapsing object could in principle reconstruct information not only about the total mass of the collapsing object, but also about the mass distribution.

  20. REGEN: Ancestral Genome Reconstruction for Bacteria.

    Science.gov (United States)

    Yang, Kuan; Heath, Lenwood S; Setubal, João C

    2012-07-18

    Ancestral genome reconstruction can be understood as a phylogenetic study with more details than a traditional phylogenetic tree reconstruction. We present a new computational system called REGEN for ancestral bacterial genome reconstruction at both the gene and replicon levels. REGEN reconstructs gene content, contiguous gene runs, and replicon structure for each ancestral genome. Along each branch of the phylogenetic tree, REGEN infers evolutionary events, including gene creation and deletion and replicon fission and fusion. The reconstruction can be performed by either a maximum parsimony or a maximum likelihood method. Gene content reconstruction is based on the concept of neighboring gene pairs. REGEN was designed to be used with any set of genomes that are sufficiently related, which will usually be the case for bacteria within the same taxonomic order. We evaluated REGEN using simulated genomes and genomes in the Rhizobiales order.

  1. SU-D-206-03: Segmentation Assisted Fast Iterative Reconstruction Method for Cone-Beam CT

    International Nuclear Information System (INIS)

    Wu, P; Mao, T; Gong, S; Wang, J; Niu, T; Sheng, K; Xie, Y

    2016-01-01

    Purpose: Total Variation (TV) based iterative reconstruction (IR) methods enable accurate CT image reconstruction from low-dose measurements with sparse projection acquisition, due to the sparsifiable feature of most CT images using gradient operator. However, conventional solutions require large amount of iterations to generate a decent reconstructed image. One major reason is that the expected piecewise constant property is not taken into consideration at the optimization starting point. In this work, we propose an iterative reconstruction method for cone-beam CT (CBCT) using image segmentation to guide the optimization path more efficiently on the regularization term at the beginning of the optimization trajectory. Methods: Our method applies general knowledge that one tissue component in the CT image contains relatively uniform distribution of CT number. This general knowledge is incorporated into the proposed reconstruction using image segmentation technique to generate the piecewise constant template on the first-pass low-quality CT image reconstructed using analytical algorithm. The template image is applied as an initial value into the optimization process. Results: The proposed method is evaluated on the Shepp-Logan phantom of low and high noise levels, and a head patient. The number of iterations is reduced by overall 40%. Moreover, our proposed method tends to generate a smoother reconstructed image with the same TV value. Conclusion: We propose a computationally efficient iterative reconstruction method for CBCT imaging. Our method achieves a better optimization trajectory and a faster convergence behavior. It does not rely on prior information and can be readily incorporated into existing iterative reconstruction framework. Our method is thus practical and attractive as a general solution to CBCT iterative reconstruction. This work is supported by the Zhejiang Provincial Natural Science Foundation of China (Grant No. LR16F010001), National High-tech R

  2. SU-D-206-03: Segmentation Assisted Fast Iterative Reconstruction Method for Cone-Beam CT

    Energy Technology Data Exchange (ETDEWEB)

    Wu, P; Mao, T; Gong, S; Wang, J; Niu, T [Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Institute of Translational Medicine, Zhejiang University, Hangzhou, Zhejiang (China); Sheng, K [Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA (United States); Xie, Y [Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong (China)

    2016-06-15

    Purpose: Total Variation (TV) based iterative reconstruction (IR) methods enable accurate CT image reconstruction from low-dose measurements with sparse projection acquisition, due to the sparsifiable feature of most CT images using gradient operator. However, conventional solutions require large amount of iterations to generate a decent reconstructed image. One major reason is that the expected piecewise constant property is not taken into consideration at the optimization starting point. In this work, we propose an iterative reconstruction method for cone-beam CT (CBCT) using image segmentation to guide the optimization path more efficiently on the regularization term at the beginning of the optimization trajectory. Methods: Our method applies general knowledge that one tissue component in the CT image contains relatively uniform distribution of CT number. This general knowledge is incorporated into the proposed reconstruction using image segmentation technique to generate the piecewise constant template on the first-pass low-quality CT image reconstructed using analytical algorithm. The template image is applied as an initial value into the optimization process. Results: The proposed method is evaluated on the Shepp-Logan phantom of low and high noise levels, and a head patient. The number of iterations is reduced by overall 40%. Moreover, our proposed method tends to generate a smoother reconstructed image with the same TV value. Conclusion: We propose a computationally efficient iterative reconstruction method for CBCT imaging. Our method achieves a better optimization trajectory and a faster convergence behavior. It does not rely on prior information and can be readily incorporated into existing iterative reconstruction framework. Our method is thus practical and attractive as a general solution to CBCT iterative reconstruction. This work is supported by the Zhejiang Provincial Natural Science Foundation of China (Grant No. LR16F010001), National High-tech R

  3. Total variation regularization for a backward time-fractional diffusion problem

    International Nuclear Information System (INIS)

    Wang, Liyan; Liu, Jijun

    2013-01-01

    Consider a two-dimensional backward problem for a time-fractional diffusion process, which can be considered as image de-blurring where the blurring process is assumed to be slow diffusion. In order to avoid the over-smoothing effect for object image with edges and to construct a fast reconstruction scheme, the total variation regularizing term and the data residual error in the frequency domain are coupled to construct the cost functional. The well posedness of this optimization problem is studied. The minimizer is sought approximately using the iteration process for a series of optimization problems with Bregman distance as a penalty term. This iteration reconstruction scheme is essentially a new regularizing scheme with coupling parameter in the cost functional and the iteration stopping times as two regularizing parameters. We give the choice strategy for the regularizing parameters in terms of the noise level of measurement data, which yields the optimal error estimate on the iterative solution. The series optimization problems are solved by alternative iteration with explicit exact solution and therefore the amount of computation is much weakened. Numerical implementations are given to support our theoretical analysis on the convergence rate and to show the significant reconstruction improvements. (paper)

  4. Tissue engineering of ligaments for reconstructive surgery.

    Science.gov (United States)

    Hogan, MaCalus V; Kawakami, Yohei; Murawski, Christopher D; Fu, Freddie H

    2015-05-01

    The use of musculoskeletal bioengineering and regenerative medicine applications in orthopaedic surgery has continued to evolve. The aim of this systematic review was to address tissue-engineering strategies for knee ligament reconstruction. A systematic review of PubMed/Medline using the terms "knee AND ligament" AND "tissue engineering" OR "regenerative medicine" was performed. Two authors performed the search, independently assessed the studies for inclusion, and extracted the data for inclusion in the review. Both preclinical and clinical studies were reviewed, and the articles deemed most relevant were included in this article to provide relevant basic science and recent clinical translational knowledge concerning "tissue-engineering" strategies currently used in knee ligament reconstruction. A total of 224 articles were reviewed in our initial PubMed search. Non-English-language studies were excluded. Clinical and preclinical studies were identified, and those with a focus on knee ligament tissue-engineering strategies including stem cell-based therapies, growth factor administration, hybrid biomaterial, and scaffold development, as well as mechanical stimulation modalities, were reviewed. The body of knowledge surrounding tissue-engineering strategies for ligament reconstruction continues to expand. Presently, various tissue-engineering techniques have some potential advantages, including faster recovery, better ligamentization, and possibly, a reduction of recurrence. Preclinical research of these novel therapies continues to provide promising results. There remains a need for well-designed, high-powered comparative clinical studies to serve as a foundation for successful translation into the clinical setting going forward. Level IV, systematic review of Level IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Optimization of number and signal to noise ratio radiographs for defects 3D reconstruction in industrial control

    International Nuclear Information System (INIS)

    Bruandet, J.-P.

    2001-01-01

    Among numerous techniques for non-destructive evaluation (NOE), X-rays systems are well suited to inspect inner objects. Acquiring several radiographs of inspected objects under different points of view enables to recover a three dimensional structural information. In this NOE application, a tomographic testing is considered. This work deals with two tomographic testing optimizations in order to improve the characterization of defects that may occur into metallic welds. The first one consists in the optimization of the acquisition strategy. Because tomographic testing is made on-line, the total duration for image acquisition is fixed, limiting the number of available views. Hence, for a given acquisition duration, it is possible either to acquire a very limited number of radiographs with a good signal to noise ratio in each single acquisition or a larger number of radiographs with a limited signal to noise ratio. The second one consists in optimizing the 3D reconstruction algorithms from a limited number of cone-beam projections. To manage the lack of data, we first used algebraic reconstruction algorithms such as ART or regularized ICM. In terms of acquisition strategy optimization, an increase of the number of projections was proved to be valuable. Taking into account specific prior knowledge such as support constraint or physical noise model in attenuation images also improved reconstruction quality. Then, a new regularized region based reconstruction approach was developed. Defects to reconstruct are binary (lack of material in a homogeneous object). As a consequence, they are entirely described by their shapes. Because the number of defects to recover is unknown and is totally arbitrary, a level set formulation allowing handling topological changes was used. Results obtained with a regularized level-set reconstruction algorithm are optimistic in the proposed context. (author) [fr

  6. Semiquantitative evaluation of {sup 99}mTctrodat1 binding potential by two methods of SPECT image reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Melissa Furlaneto Lellis; Reis, Marilia Alves dos; Oliveira, Cassio Miri; Castiglioni, Mario Luiz Vieira; Bressan, Rodrigo Affonseca, E-mail: mefurlaneto@hotmail.com, E-mail: rodrigoabressan@gmail.com, E-mail: mario.castiglioni@uol.com.br [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil)

    2017-11-01

    TRODAT-1 is a radiopharmaceutical derived from tropane and linked to Technetium-99m ([{sup 99m}Tc] TRODAT-1) has been used in studies of dopamine transporter (DAT) in central nervous system. Associated with the SPECT technique of acquisition, is able to detect changes in neurological disorders like Parkinson´s disease, evaluating the binding potential (BP) of DAT. The aim of this study was to evaluate the influence of the image reconstruction methods, Filtered Back Projection (FBP) and iterative reconstruction (OSEM), in BP values at the striatal region in 30 healthy volunteers. Images were analyzed by visual inspection and semi-quantitative analysis. Regions of interest (ROI) were made over striatal areas on both sides. Nonparametric Wilcoxon statistical analysis was performed between the BP values from the FBP and OSEM methods. Our results showed that the reconstruction methods have a statistical significant BP values difference in the total striatum (Z = -2,2787 p = 0.005), right striatum (Z = -2,602 p = 0.009) and left striatum (Z= 2,746 p = 0.006). The effect size was calculated to see if there influence in this test: the 'large effect size' for all measurements was observed (total striatum r= -0.51; right striatum r= -0.48; left striatum r= -0.50). FBP is the usual method of reconstruction for brain SPECT images, and our results showed influence of the OSEM method in BP. It is concluded that the method of image reconstruction adopted should be standardized to avoid incorrect evaluations of BP values using [{sup 99m}Tc]TRODAT-1. (author)

  7. Semiquantitative evaluation of "9"9mTctrodat1 binding potential by two methods of SPECT image reconstruction

    International Nuclear Information System (INIS)

    Leite, Melissa Furlaneto Lellis; Reis, Marilia Alves dos; Oliveira, Cassio Miri; Castiglioni, Mario Luiz Vieira; Bressan, Rodrigo Affonseca

    2017-01-01

    TRODAT-1 is a radiopharmaceutical derived from tropane and linked to Technetium-99m (["9"9"mTc] TRODAT-1) has been used in studies of dopamine transporter (DAT) in central nervous system. Associated with the SPECT technique of acquisition, is able to detect changes in neurological disorders like Parkinson´s disease, evaluating the binding potential (BP) of DAT. The aim of this study was to evaluate the influence of the image reconstruction methods, Filtered Back Projection (FBP) and iterative reconstruction (OSEM), in BP values at the striatal region in 30 healthy volunteers. Images were analyzed by visual inspection and semi-quantitative analysis. Regions of interest (ROI) were made over striatal areas on both sides. Nonparametric Wilcoxon statistical analysis was performed between the BP values from the FBP and OSEM methods. Our results showed that the reconstruction methods have a statistical significant BP values difference in the total striatum (Z = -2,2787 p = 0.005), right striatum (Z = -2,602 p = 0.009) and left striatum (Z= 2,746 p = 0.006). The effect size was calculated to see if there influence in this test: the 'large effect size' for all measurements was observed (total striatum r= -0.51; right striatum r= -0.48; left striatum r= -0.50). FBP is the usual method of reconstruction for brain SPECT images, and our results showed influence of the OSEM method in BP. It is concluded that the method of image reconstruction adopted should be standardized to avoid incorrect evaluations of BP values using ["9"9"mTc]TRODAT-1. (author)

  8. Patient satisfaction with postmastectomy breast reconstruction: a comparison of saline and silicone implants.

    Science.gov (United States)

    McCarthy, Colleen M; Klassen, Anne F; Cano, Stefan J; Scott, Amie; Vanlaeken, Nancy; Lennox, Peter A; Alderman, Amy K; Mehrara, Babak J; Disa, Joseph J; Cordeiro, Peter G; Pusic, Andrea L

    2010-12-15

    At a time when the safety and effectiveness of breast implants remains under close scrutiny, it is important to provide reliable and valid evidence regarding patient outcomes. In the setting of postmastectomy reconstruction, patient satisfaction and quality of life may be the most significant outcome variables when evaluating surgical success. The objective of the current study was to identify predictors of patient satisfaction with breast appearance, including implant type, in a large sample of women who underwent breast reconstruction surgery using implants. A multicenter, cross-sectional study design was used. A total of 672 women who had completed postmastectomy, implant-based reconstruction at 1 of 3 centers in North America were asked to complete the BREAST-Q (Reconstruction Module). Multivariate linear regression modeling was performed. Completed questionnaire data were available for 482 of the 672 patients. In 176 women, silicone implants were placed and in 306, saline implants were used. The multivariate model confirmed that patients' satisfaction with their breasts was significantly higher in patients with silicone implants (P = .016). The receipt of postmastectomy radiotherapy was found to have a significant, negative effect on breast satisfaction (Pimplant recipients. In addition, for women who received either silicone or saline implants, satisfaction diminished over time (P = .017). In the setting of postmastectomy reconstruction, patients who received silicone breast implants reported significantly higher satisfaction with the results of reconstruction than those who received saline implants. This information can be used to optimize shared medical decision-making by providing patients with realistic postoperative expectations. Copyright © 2010 American Cancer Society.

  9. REGEN: Ancestral Genome Reconstruction for Bacteria

    Directory of Open Access Journals (Sweden)

    João C. Setubal

    2012-07-01

    Full Text Available Ancestral genome reconstruction can be understood as a phylogenetic study with more details than a traditional phylogenetic tree reconstruction. We present a new computational system called REGEN for ancestral bacterial genome reconstruction at both the gene and replicon levels. REGEN reconstructs gene content, contiguous gene runs, and replicon structure for each ancestral genome. Along each branch of the phylogenetic tree, REGEN infers evolutionary events, including gene creation and deletion and replicon fission and fusion. The reconstruction can be performed by either a maximum parsimony or a maximum likelihood method. Gene content reconstruction is based on the concept of neighboring gene pairs. REGEN was designed to be used with any set of genomes that are sufficiently related, which will usually be the case for bacteria within the same taxonomic order. We evaluated REGEN using simulated genomes and genomes in the Rhizobiales order.

  10. Computer Based Road Accident Reconstruction Experiences

    Directory of Open Access Journals (Sweden)

    Milan Batista

    2005-03-01

    Full Text Available Since road accident analyses and reconstructions are increasinglybased on specific computer software for simulationof vehicle d1iving dynamics and collision dynamics, and forsimulation of a set of trial runs from which the model that bestdescribes a real event can be selected, the paper presents anoverview of some computer software and methods available toaccident reconstruction experts. Besides being time-saving,when properly used such computer software can provide moreauthentic and more trustworthy accident reconstruction, thereforepractical experiences while using computer software toolsfor road accident reconstruction obtained in the TransportSafety Laboratory at the Faculty for Maritime Studies andTransport of the University of Ljubljana are presented and discussed.This paper addresses also software technology for extractingmaximum information from the accident photo-documentationto support accident reconstruction based on the simulationsoftware, as well as the field work of reconstruction expertsor police on the road accident scene defined by this technology.

  11. Data-parallel tomographic reconstruction : A comparison of filtered backprojection and direct Fourier reconstruction

    NARCIS (Netherlands)

    Roerdink, J.B.T.M.; Westenberg, M.A

    1998-01-01

    We consider the parallelization of two standard 2D reconstruction algorithms, filtered backprojection and direct Fourier reconstruction, using the data-parallel programming style. The algorithms are implemented on a Connection Machine CM-5 with 16 processors and a peak performance of 2 Gflop/s.

  12. Multiscale Reconstruction for Magnetic Resonance Fingerprinting

    Science.gov (United States)

    Pierre, Eric Y.; Ma, Dan; Chen, Yong; Badve, Chaitra; Griswold, Mark A.

    2015-01-01

    Purpose To reduce acquisition time needed to obtain reliable parametric maps with Magnetic Resonance Fingerprinting. Methods An iterative-denoising algorithm is initialized by reconstructing the MRF image series at low image resolution. For subsequent iterations, the method enforces pixel-wise fidelity to the best-matching dictionary template then enforces fidelity to the acquired data at slightly higher spatial resolution. After convergence, parametric maps with desirable spatial resolution are obtained through template matching of the final image series. The proposed method was evaluated on phantom and in-vivo data using the highly-undersampled, variable-density spiral trajectory and compared with the original MRF method. The benefits of additional sparsity constraints were also evaluated. When available, gold standard parameter maps were used to quantify the performance of each method. Results The proposed approach allowed convergence to accurate parametric maps with as few as 300 time points of acquisition, as compared to 1000 in the original MRF work. Simultaneous quantification of T1, T2, proton density (PD) and B0 field variations in the brain was achieved in vivo for a 256×256 matrix for a total acquisition time of 10.2s, representing a 3-fold reduction in acquisition time. Conclusions The proposed iterative multiscale reconstruction reliably increases MRF acquisition speed and accuracy. PMID:26132462

  13. Vertex Reconstruction in ATLAS Run II

    CERN Document Server

    Zhang, Matt; The ATLAS collaboration

    2016-01-01

    Vertex reconstruction is the process of taking reconstructed tracks and using them to determine the locations of proton collisions. In this poster we present the performance of our current vertex reconstruction algorithm, and look at investigations into potential improvements from a new seed finding method.

  14. Pedicled Temporalis Muscle Flap for Craniofacial Reconstruction: A 35-Year Clinical Experience with 366 Flaps.

    Science.gov (United States)

    Spanio di Spilimbergo, Stefano; Nordera, Paolo; Mardini, Samir; Castiglione, Giusy; Chim, Harvey; Pinna, Vittore; Brunello, Massimo; Cusino, Claudio; Roberto, Squaquara; Baciliero, Ugo

    2017-02-01

    In the past 130 years, the temporalis muscle flap has been used for a variety of different indications. In this age of microsurgery and perforator flaps, the temporalis muscle flap still has many useful applications for craniofacial reconstruction. Three hundred sixty-six temporalis muscle flaps were performed in a single center between 1978 and 2012. The authors divided the cases into two series-before and after 1994-because, after 1994, they started to perform free flap reconstructions, and indications for reconstruction with a temporalis muscle flap were changed RESULTS:: In the series after 1994, flaps were most commonly used for reconstruction of defects in the maxilla, mandible, and oropharynx, in addition to facial reanimation and filling of orbital defects. Complications included total flap necrosis (1.6 percent) and partial flap necrosis (10.7 percent). The rate of material extrusion at the donor site decreased after porous polyethylene was uniformly used for reconstruction from 17.1 to 7.9 percent. The pedicled temporalis muscle flap continues to have many applications in craniofacial reconstruction. With increasing use of free flaps, the authors' indications for the pedicled temporalis muscle flap are now restricted to (1) orbital filling for congenital or acquired anophthalmia; (2) filling of unilateral maxillectomy defects; and (3) facial reanimation in selected cases of facial nerve palsy. Therapeutic, IV.

  15. Attenuation correction for the HRRT PET-scanner using transmission scatter correction and total variation regularization

    DEFF Research Database (Denmark)

    Keller, Sune H; Svarer, Claus; Sibomana, Merence

    2013-01-01

    scatter correction in the μ-map reconstruction and total variation filtering to the transmission processing. Results: Comparing MAP-TR and the new TXTV with gold standard CT-based attenuation correction, we found that TXTV has less bias as compared to MAP-TR. We also compared images acquired at the HRRT......In the standard software for the Siemens high-resolution research tomograph (HRRT) positron emission tomography (PET) scanner the most commonly used segmentation in the μ -map reconstruction for human brain scans is maximum a posteriori for transmission (MAP-TR). Bias in the lower cerebellum...

  16. CRUCIATE LIGAMENT RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    A. V. Korolev

    2016-01-01

    Full Text Available Purpose: To evaluate long-term results of meniscal repair during arthroscopic ACL reconstruction.Materials and methods: 45 patients who underwent meniscal repair during arthroscopic ACL reconstruction between 2007 and 2013 by the same surgeon were included in the study. In total, fifty meniscus were repaired (26 medial and 24 lateral. Procedures included use of one up to four Fast-Fix implants (Smith & Nephew. In five cases both medial and lateral meniscus were repaired. Cincinnati, IKDC and Lysholm scales were used for long-term outcome analysis.Results: 19 male and 26 female patients were included in the study aging from 15 to 59 years (mean age 33,2±1,5. Median time from injury to surgical procedure was zero months (ranging zero to one. Mean time from surgery to scale analysis was 55,9±3 months (ranged 20-102. Median Cincinnati score was 97 (ranged 90-100, with excellent results in 93% of cases (43 patients and good results in 7% (3 patients. Median IKDC score was 90,8 (ranged 86,2-95,4, with excellent outcomes in 51% of cases (23 patients, good in 33% (15 patients and satisfactory in 16% (7 patients. Median Lysholm score was 95 (ranged 90-100, with excellent outcomes in 76% of cases (34 patients and good in 24% (11 patients. Authors identified no statistical differences when comparing survey results in age, sex and time from trauma to surgery.Conclusions: Results of the present study match the data from orthopedic literature that prove meniscal repair as a safe and efficient procedure with good and excellent outcomes. All-inside meniscal repair can be used irrespectively of patients' age and is efficient even in case of delayed procedures.

  17. Giant basal cell carcinoma of the face: surgical management and challenges for reconstruction.

    Science.gov (United States)

    Maimaiti, A; Mijiti, A; Yarbag, A; Moming, A

    2016-02-01

    Giant basal cell carcinoma, in which the tumour measures 5 cm or greater in diameter, is a very rare skin malignancy that accounts for less than 1 per cent of all basal cell tumours. Very few studies have reported on the incidence, resection and reconstruction of this lesion worldwide. In total, 17 patients with giant basal cell carcinoma of the head and neck region underwent surgical excision and reconstruction at our hospital. Medical charts were retrospectively reviewed and analysed. The lesion was usually in the forehead, eyelid, lips or nasal-cheek region. The greatest diameter ranged from 5 to 11 cm, with 5-6 cm being the most common size at the time of presentation. All patients had their tumour resected and reconstructed in a single-stage procedure, mostly with a local advancement flap, and with no post-operative flap failure. Giant basal cell carcinoma of the head and neck can be successfully treated with a local flap in a single-stage approach.

  18. Beard reconstruction: A surgical algorithm.

    Science.gov (United States)

    Ninkovic, M; Heidekrueger, P I; Ehrl, D; von Spiegel, F; Broer, P N

    2016-06-01

    Facial defects with loss of hair-bearing regions can be caused by trauma, infection, tumor excision, or burn injury. The presented analysis evaluates a series of different surgical approaches with a focus on male beard reconstruction, emphasizing the role of tissue expansion of regional and free flaps. Locoregional and free flap reconstructions were performed in 11 male patients with 14 facial defects affecting the hair-bearing bucco-mandibular or perioral region. In order to minimize donor-site morbidity and obtain large amounts of thin, pliable, hair-bearing tissue, pre-expansion was performed in five of 14 patients. Eight of 14 patients were treated with locoregional flap reconstructions and six with free flap reconstructions. Algorithms regarding pre- and intraoperative decision making are discussed and long-term (mean follow-up 1.5 years) results analyzed. Major complications, including tissue expander infection with the need for removal or exchange, partial or full flap loss, occurred in 0% (0/8) of patients with locoregional flaps and in 17% (1/6) of patients undergoing free flap reconstructions. Secondary refinement surgery was performed in 25% (2/8) of locoregional flaps and in 67% (4/6) of free flaps. Both locoregional and distant tissue transfers play a role in beard reconstruction, while pre-expansion remains an invaluable tool. Paying attention to the presented principles and considering the significance of aesthetic facial subunits, range of motion, aesthetics, and patient satisfaction were improved long term in all our patients while minimizing donor-site morbidity. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Management of chronic lateral instability due to lateral collateral ligament deficiency after total knee arthroplasty: a case report

    Directory of Open Access Journals (Sweden)

    Petersilge William J

    2010-05-01

    Full Text Available Abstract Introduction Lateral instability following total knee arthroplasty (TKA is a rare condition with limited report of treatment options. The objective of this case presentation is to demonstrate the outcomes of different surgical procedures performed in a single patient with lateral collateral ligament (LCL deficiency. Case presentation We present a case of chronic lateral instability due to LCL deficiency after primary TKA in a 47-year-old Caucasian woman with an obesity problem. Multiple treatment options have been performed in order to manage this problem, including the following: ligament reconstruction; combined ligament reconstruction and constrained implant; and rotating-hinge knee prosthesis that was the most recent surgery. All ligament reconstruction procedures failed within one year. The varus-valgus constrained prosthesis provided stability for six years. Conclusions Ligament reconstruction alone cannot provide enough stability for the treatment of chronic lateral instability in patients with obesity problems and LCL deficiency. When the reconstruction fails, a salvage procedure with rotating-hinge knee is still available.

  20. Satisfactory outcomes following combined unicompartmental knee replacement and anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Volpin, Andrea; Kini, S G; Meuffels, D E

    2017-03-31

    There exist limited options for treatment of patients with combined medial compartment arthritis and anterior cruciate ligament (ACL) deficiency. Ideal treatment is one that offers lasting relief of symptoms not compromising any future surgery. Unicompartmental knee replacement has shown consistently good results in the relatively young and active population, but there is a high reported incidence of failure up to 20%, if performed in ACL-deficient knees. One of the recognized treatment modality is combined ACL reconstruction and unicompartmental arthroplasty. A systematic review was conducted looking at the demographics, techniques, complications and outcome of combined ACL reconstruction with unicompartmental knee arthroplasty. A systematic literature search within the online Medline, PubMed Database, EMBASE, Web of Science, Cochrane and Google Scholar was carried out until October 2016 to identify relevant articles. A study was defined eligible if it met the following inclusion criteria: the surgical procedure combined unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction; patient's clinical and/or functional outcomes were reported; any complications intra-operatively and post-operatively were reported; and the full-text articles, written in English, German, Italian, Dutch or Spanish, were available. Quality and risk of bias assessments were done using standardized criteria set. A total of 8 studies met the inclusion criteria encompassing 186 patients who were treated with simultaneous ACL reconstruction and unicompartmental knee arthroplasty. The mean age was 50.5 years (range from 44 to 56) with a mean follow-up of 37.6 months (range from 24 to 60). There was an improvement in mean Oxford Score from 27.5 to 36.8. Complications reported included tibial inlay dislocation (n = 3), conversion to a total knee arthroplasty (n = 1), infection requiring two-stage revision (n = 2), deep-vein thrombosis (n = 1), stiffness requiring

  1. Forensic Facial Reconstruction: The Final Frontier.

    Science.gov (United States)

    Gupta, Sonia; Gupta, Vineeta; Vij, Hitesh; Vij, Ruchieka; Tyagi, Nutan

    2015-09-01

    Forensic facial reconstruction can be used to identify unknown human remains when other techniques fail. Through this article, we attempt to review the different methods of facial reconstruction reported in literature. There are several techniques of doing facial reconstruction, which vary from two dimensional drawings to three dimensional clay models. With the advancement in 3D technology, a rapid, efficient and cost effective computerized 3D forensic facial reconstruction method has been developed which has brought down the degree of error previously encountered. There are several methods of manual facial reconstruction but the combination Manchester method has been reported to be the best and most accurate method for the positive recognition of an individual. Recognition allows the involved government agencies to make a list of suspected victims'. This list can then be narrowed down and a positive identification may be given by the more conventional method of forensic medicine. Facial reconstruction allows visual identification by the individual's family and associates to become easy and more definite.

  2. Morphology of the copulatory apparatus of the spotted tinamou Nothura maculosa (Aves: Tinamiformes).

    Science.gov (United States)

    de Oliveira, C A; Mahecha, G A

    2000-03-01

    The components of the copulatory apparatus of Nothura maculosa were identified and studied by means of dissections, parenteral latex injections and standard histological and histochemical techniques. N. maculosa possesses an intromittent phallus with a tubular cavity, within which a fixed base and a tubular portion can be distinguished. An ejaculatory groove, which is supported by a fibrous body, runs dorsally at the base of the phallus. The tubular portion of the phallus inserts into the fibrous body, the former possessing two continuous but morphologically distinct parts, one of which is eversible and is extruded during erection while the other is a fixed non-eversible glandular portion. The walls of both parts are formed by the mucosa, an intermediate layer of connective tissue containing a wide lymphatic space which surrounds the whole perimeter of the tube, and an external layer of dense connective tissue. The mucosa of the eversible portion, which lodges the phallic groove, is lined by a non-keratinized stratified squamous epithelium. In the fixed tubular portion, the tubular lumen is reduced in size, the phallic groove disappears, the mucosa becomes folded and there occurs an abrupt change to a pseudostratified columnar secretory epithelium. The copulatory apparatus of N. maculosa includes the vascular bodies of the phallus, which show morphofunctional continuity with the phallic structures, thus forming a single system involved in erection. On erection, the eversible portion of the phallus evaginates and emerges from the cloacal opening as a spiral shaped structure directed towards the left.

  3. Analysis on the reconstruction accuracy of the Fitch method for inferring ancestral states

    Directory of Open Access Journals (Sweden)

    Grünewald Stefan

    2011-01-01

    Full Text Available Abstract Background As one of the most widely used parsimony methods for ancestral reconstruction, the Fitch method minimizes the total number of hypothetical substitutions along all branches of a tree to explain the evolution of a character. Due to the extensive usage of this method, it has become a scientific endeavor in recent years to study the reconstruction accuracies of the Fitch method. However, most studies are restricted to 2-state evolutionary models and a study for higher-state models is needed since DNA sequences take the format of 4-state series and protein sequences even have 20 states. Results In this paper, the ambiguous and unambiguous reconstruction accuracy of the Fitch method are studied for N-state evolutionary models. Given an arbitrary phylogenetic tree, a recurrence system is first presented to calculate iteratively the two accuracies. As complete binary tree and comb-shaped tree are the two extremal evolutionary tree topologies according to balance, we focus on the reconstruction accuracies on these two topologies and analyze their asymptotic properties. Then, 1000 Yule trees with 1024 leaves are generated and analyzed to simulate real evolutionary scenarios. It is known that more taxa not necessarily increase the reconstruction accuracies under 2-state models. The result under N-state models is also tested. Conclusions In a large tree with many leaves, the reconstruction accuracies of using all taxa are sometimes less than those of using a leaf subset under N-state models. For complete binary trees, there always exists an equilibrium interval [a, b] of conservation probability, in which the limiting ambiguous reconstruction accuracy equals to the probability of randomly picking a state. The value b decreases with the increase of the number of states, and it seems to converge. When the conservation probability is greater than b, the reconstruction accuracies of the Fitch method increase rapidly. The reconstruction

  4. Computed Tomography Imaging of a Hip Prosthesis Using Iterative Model-Based Reconstruction and Orthopaedic Metal Artefact Reduction: A Quantitative Analysis.

    Science.gov (United States)

    Wellenberg, Ruud H H; Boomsma, Martijn F; van Osch, Jochen A C; Vlassenbroek, Alain; Milles, Julien; Edens, Mireille A; Streekstra, Geert J; Slump, Cornelis H; Maas, Mario

    To quantify the combined use of iterative model-based reconstruction (IMR) and orthopaedic metal artefact reduction (O-MAR) in reducing metal artefacts and improving image quality in a total hip arthroplasty phantom. Scans acquired at several dose levels and kVps were reconstructed with filtered back-projection (FBP), iterative reconstruction (iDose) and IMR, with and without O-MAR. Computed tomography (CT) numbers, noise levels, signal-to-noise-ratios and contrast-to-noise-ratios were analysed. Iterative model-based reconstruction results in overall improved image quality compared to iDose and FBP (P < 0.001). Orthopaedic metal artefact reduction is most effective in reducing severe metal artefacts improving CT number accuracy by 50%, 60%, and 63% (P < 0.05) and reducing noise by 1%, 62%, and 85% (P < 0.001) whereas improving signal-to-noise-ratios by 27%, 47%, and 46% (P < 0.001) and contrast-to-noise-ratios by 16%, 25%, and 19% (P < 0.001) with FBP, iDose, and IMR, respectively. The combined use of IMR and O-MAR strongly improves overall image quality and strongly reduces metal artefacts in the CT imaging of a total hip arthroplasty phantom.

  5. Alternative reconstruction after pancreaticoduodenectomy

    Directory of Open Access Journals (Sweden)

    Cooperman Avram M

    2008-01-01

    Full Text Available Abstract Background Pancreaticoduodenectomy is the procedure of choice for tumors of the head of the pancreas and periampulla. Despite advances in surgical technique and postoperative care, the procedure continues to carry a high morbidity rate. One of the most common morbidities is delayed gastric emptying with rates of 15%–40%. Following two prolonged cases of delayed gastric emptying, we altered our reconstruction to avoid this complication altogether. Subsequently, our patients underwent a classic pancreaticoduodenectomy with an undivided Roux-en-Y technique for reconstruction. Methods We reviewed the charts of our last 13 Whipple procedures evaluating them for complications, specifically delayed gastric emptying. We compared the outcomes of those patients to a control group of 15 patients who underwent the Whipple procedure with standard reconstruction. Results No instances of delayed gastric emptying occurred in patients who underwent an undivided Roux-en-Y technique for reconstruction. There was 1 wound infection (8%, 1 instance of pneumonia (8%, and 1 instance of bleeding from the gastrojejunal staple line (8%. There was no operative mortality. Conclusion Use of the undivided Roux-en-Y technique for reconstruction following the Whipple procedure may decrease the incidence of delayed gastric emptying. In addition, it has the added benefit of eliminating bile reflux gastritis. Future randomized control trials are recommended to further evaluate the efficacy of the procedure.

  6. Outcomes and complications following graft reconstruction for anterior sternoclavicular joint instability.

    Science.gov (United States)

    Willinger, Lukas; Schanda, Jakob; Herbst, Elmar; Imhoff, Andreas B; Martetschläger, Frank

    2016-12-01

    Publications describing tendon graft reconstruction for anterior sternoclavicular joint (SCJ) instability are rare and usually refer to small patient numbers. The aim of this study was to systematically review the literature regarding outcomes and complications following tendon graft reconstruction techniques for anterior SCJ instability. An online database was systematically searched to identify studies on graft reconstruction for anterior SCJ instability. Reported outcome scores were graded as excellent, good, fair and poor to summarize the study results. All reported complications were recorded. Five articles with a total of 80 patients met the inclusion criteria. Reported outcomes were excellent in 10 %, good in 89 % and fair in 1 %. Recurrent instability was found in 10 % of the patients, and 5 % underwent revision surgery due to persistent impairment of shoulder function related to SCJ instability or osteoarthritis. Surgical stabilization techniques for the SCJ using autologous tendon grafts have shown to be safe and reliable and make better patients' pain situation and shoulder function. However, a certain amount of impairment might persist, which needs to be discussed with patients. Severe complications were rare and revision rates were as low as 5 %. Therefore, graft reconstruction techniques should be considered for patients with chronic anterior SCJ instability after a course of failed conservative treatment. This study is valuable for clinicians in daily clinical practice when dealing with this difficult-to-treat pathology and can help surgeons to better predict the clinical outcomes and complications following SCJ graft reconstruction. It should, however, not lead to underestimation of the potential risks of the procedure. Systematic review, Level IV.

  7. Study of DNA reconstruction enzymes

    Energy Technology Data Exchange (ETDEWEB)

    Sekiguchi, M [Kyushu Univ., Fukuoka (Japan). Faculty of Science

    1976-12-01

    Description was made of the characteristics and mechanism of 3 reconstructive enzymes which received from M. luteus or E. coli or T4, and of which natures were clarified as reconstructive enzymes of DNA irradiated with ultraviolet rays. As characteristics, the site of breaking, reaction, molecular weight, electric charge in the neutrality and a specific adhesion to DNA irradiated with ultraviolet rays were mentioned. As to mutant of ultraviolet ray sensitivity, hereditary control mechanism of removal and reconstruction by endo-nuclease activation was described, and suggestion was referred to removal and reconstruction of cells of xedoderma pigmentosum which is a hereditary disease of human. Description was also made as to the mechanism of exonuclease activation which separates dimer selectively from irradiated DNA.

  8. Reconstructing random media

    International Nuclear Information System (INIS)

    Yeong, C.L.; Torquato, S.

    1998-01-01

    We formulate a procedure to reconstruct the structure of general random heterogeneous media from limited morphological information by extending the methodology of Rintoul and Torquato [J. Colloid Interface Sci. 186, 467 (1997)] developed for dispersions. The procedure has the advantages that it is simple to implement and generally applicable to multidimensional, multiphase, and anisotropic structures. Furthermore, an extremely useful feature is that it can incorporate any type and number of correlation functions in order to provide as much morphological information as is necessary for accurate reconstruction. We consider a variety of one- and two-dimensional reconstructions, including periodic and random arrays of rods, various distribution of disks, Debye random media, and a Fontainebleau sandstone sample. We also use our algorithm to construct heterogeneous media from specified hypothetical correlation functions, including an exponentially damped, oscillating function as well as physically unrealizable ones. copyright 1998 The American Physical Society

  9. Industrial dynamic tomographic reconstruction

    International Nuclear Information System (INIS)

    Oliveira, Eric Ferreira de

    2016-01-01

    The state of the art methods applied to industrial processes is currently based on the principles of classical tomographic reconstructions developed for tomographic patterns of static distributions, or is limited to cases of low variability of the density distribution function of the tomographed object. Noise and motion artifacts are the main problems caused by a mismatch in the data from views acquired in different instants. All of these add to the known fact that using a limited amount of data can result in the presence of noise, artifacts and some inconsistencies with the distribution under study. One of the objectives of the present work is to discuss the difficulties that arise from implementing reconstruction algorithms in dynamic tomography that were originally developed for static distributions. Another objective is to propose solutions that aim at reducing a temporal type of information loss caused by employing regular acquisition systems to dynamic processes. With respect to dynamic image reconstruction it was conducted a comparison between different static reconstruction methods, like MART and FBP, when used for dynamic scenarios. This comparison was based on a MCNPx simulation as well as an analytical setup of an aluminum cylinder that moves along the section of a riser during the process of acquisition, and also based on cross section images from CFD techniques. As for the adaptation of current tomographic acquisition systems for dynamic processes, this work established a sequence of tomographic views in a just-in-time fashion for visualization purposes, a form of visually disposing density information as soon as it becomes amenable to image reconstruction. A third contribution was to take advantage of the triple color channel necessary to display colored images in most displays, so that, by appropriately scaling the acquired values of each view in the linear system of the reconstruction, it was possible to imprint a temporal trace into the regularly

  10. Indications for Elective Tracheostomy in Reconstructive Surgery in Patients With Oral Cancer.

    Science.gov (United States)

    Leiser, Yoav; Barak, Michal; Ghantous, Yasmine; Yehudai, Noam; Abu El-Naaj, Imad

    2017-01-01

    Oral cancer surgery carries a high risk of upper airway obstruction; yet optimal airway management approach remains controversial. The purpose of the present study was to evaluate the use of tracheostomy in oncological patients undergoing oral cancer surgery with intra oral flap reconstruction. The study cohort included 75 patients with oral cancer, who underwent major intraoral resections and reconstruction with vascularized flaps. Thirty-six percent of the patients received elective tracheostomy (27 patients). Mean hospital stay of the patients with tracheostomy was 28.4 ± 12.5 days compared with 9.7 ± 2.1 days in the nontracheostomy patients. A scoring system rendered from this study suggests that patients with a total scoring at or above 8 should be considered for elective tracheostomy. With appropriate postoperative monitoring, selected patients can be managed without routine elective tracheostomy, yet, patients with comorbidities, mostly elderly patients, which undergo surgical resection and reconstruction in high-risk areas that can result in a bulky flap that pose danger to the postoperative airway, should receive elective tracheostomy.

  11. The Type of Breast Reconstruction May Not Influence Patient Satisfaction in the Chinese Population: A Single Institutional Experience

    Science.gov (United States)

    Chen, Jiaying; Chen, Ying; Hu, Zhen; Liu, Guangyu; Shen, Zhenzhou; Shao, Zhimin; Wu, Jiong

    2015-01-01

    Background The goal of this study was to evaluate patient satisfaction with four common types of breast reconstruction performed at our institution: latissimus dorsi myocutaneous (LDM) flap reconstruction with or without implants, pedicled transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction, and free deep inferior epigastric perforator (DIEP) flap reconstruction. Methods A custom survey consisting of questions that assessed general and aesthetic satisfaction was sent to patients who had undergone breast reconstruction in the last 5 years. The clinical data and details of the surgery were also collected from the patients who returned the surveys. We compared satisfaction rates across the four breast reconstruction types and analyzed the effects of various factors on overall general and aesthetic satisfaction rates using a binary logistic regression model. Result A total of 207 (72%) patients completed the questionnaires. Overall, significant differences in general and aesthetic satisfaction among the four procedures were not observed. A multivariate analysis revealed that the factor “complications” (p = 0.001) played a significant role in general satisfaction and that the factors “> 2 years since reconstruction” (p = 0.043) and “age > 35 years” (p = 0.05) played significant roles in overall aesthetic satisfaction. Conclusion The present study demonstrated that the type of breast reconstruction might not influence satisfaction in Chinese patients. PMID:26562294

  12. Application of TACT registered to the evaluation of total joint arthroplasty

    International Nuclear Information System (INIS)

    Fahey, Frederic H.; Webber, Richard L.; Chew, Felix S.-K.; Dickerson, Bryon A.

    2003-01-01

    Three-dimensional imaging may be valuable in the evaluation of total joint arthroplasty. The partial-volume effect and streak artifacts from the metallic components of these devices limit the applicability of computed tomography (CT) to this application. Tuned-aperture computed tomography registered (TACT registered ) is a tomographic approach that has been successfully used in other medical applications. In TACT, the acquisition geometry is inferred from the localization of fiducial markers in a series of projection images. The flexibility and robustness of TACT, as well as the fact that through an appropriate choice of reconstruction algorithms it can suppress streak artifacts, potentially makes it an appropriate approach for evaluating total joint arthroplasty. A simple computer-simulated model of a total knee replacement (TKR) was generated and used to evaluate the accuracy and artifacts associated with three-dimensional (3-D) renderings produced using TACT. A knee specimen from a cadaver that had received a TKR was used to investigate further the potential of TACT for this application. In both tests, TACT provided high-quality 3-D representations of the object. Both simple back-projection and minimum pixel back-projection were used to reconstruct the data. Minimum pixel back-projection provided high-contrast images that appeared to be relatively free of tomosynthetic artifacts. In summary, the potential of TACT in the evaluation of total joint arthroplasty was demonstrated. Future investigations will study TACT's ability to quantify the spatial relationship between the metallic components of these devices as well as TACT's ability to identify bony changes of diagnostic consequence

  13. Delayed reconstruction of mangled lower extremities: soft tissue management

    OpenAIRE

    Tiftikçioğlu, Yiğit Özer; Erçin, Burak Sercan; Erdem, Mehmet; Biçer, Ahmet; Özkayın, Nadir; Özek, Cüneyt

    2018-01-01

    Objectives: This study aims to propose a new, practical and versatile algorithm for the management of traumatic lower limb soft tissue wounds for patients who did not undergo early reconstruction.Materials and methods: A total of 81 patients (54 males, 27 females; mean age 37.1 years; range 11 to 64 years) managed due to complex lower limb injuries at our institution between January 2008 and December 2012 were analyzed retrospectively in this study. Age and gender of the patients, type of tra...

  14. An efficient reconstruction algorithm for differential phase-contrast tomographic images from a limited number of views

    International Nuclear Information System (INIS)

    Sunaguchi, Naoki; Yuasa, Tetsuya; Gupta, Rajiv; Ando, Masami

    2015-01-01

    The main focus of this paper is reconstruction of tomographic phase-contrast image from a set of projections. We propose an efficient reconstruction algorithm for differential phase-contrast computed tomography that can considerably reduce the number of projections required for reconstruction. The key result underlying this research is a projection theorem that states that the second derivative of the projection set is linearly related to the Laplacian of the tomographic image. The proposed algorithm first reconstructs the Laplacian image of the phase-shift distribution from the second-derivative of the projections using total variation regularization. The second step is to obtain the phase-shift distribution by solving a Poisson equation whose source is the Laplacian image previously reconstructed under the Dirichlet condition. We demonstrate the efficacy of this algorithm using both synthetically generated simulation data and projection data acquired experimentally at a synchrotron. The experimental phase data were acquired from a human coronary artery specimen using dark-field-imaging optics pioneered by our group. Our results demonstrate that the proposed algorithm can reduce the number of projections to approximately 33% as compared with the conventional filtered backprojection method, without any detrimental effect on the image quality

  15. The Role of Resorbable Plate and Artificial Bone Substitute in Reconstruction of Large Orbital Floor Defect

    Directory of Open Access Journals (Sweden)

    Ho Kwon

    2016-01-01

    Full Text Available It is essential to reduce and reconstruct bony defects adequately in large orbital floor fracture and defect. Among many reconstructive methods, alloplastic materials have attracted attention because of their safety and ease of use. We have used resorbable plates combined with artificial bone substitutes in large orbital floor defect reconstructions and have evaluated their long-term reliability compared with porous polyethylene plate. A total of 147 patients with traumatic orbital floor fracture were included in the study. Surgical results were evaluated by clinical evaluations, exophthalmometry, and computed tomography at least 12 months postoperatively. Both orbital floor height discrepancy and orbital volume change were calculated and compared with preoperative CT findings. The average volume discrepancy and vertical height discrepancies were not different between two groups. Also, exophthalmometric measurements were not significantly different between the two groups. No significant postoperative complication including permanent diplopia, proptosis, and enophthalmos was noted. Use of a resorbable plate with an artificial bone substitute to repair orbital floor defects larger than 2.5 cm2 in size yielded long-lasting, effective reconstruction without significant complications. We therefore propose our approach as an effective alternative method for large orbital floor reconstructions.

  16. An Algorithmic Approach for the Reconstruction of Nasal Skin Defects: Retrospective Analysis of 130 Cases

    Directory of Open Access Journals (Sweden)

    Berrak Akşam

    2016-06-01

    Full Text Available Objective: Most of the malignant cutaneous carcinomas are seen in the nasal region. Reconstruction of nasal defects is challenging because of the unique anatomic properties and complex structure of this region. In this study, we present our algorithm for the nasal skin defects that occurred after malignant skin tumor excisions. Material and Methods: Patients whose nasal skin was reconstructed after malignant skin tumor excision were included in the study. These patients were evaluated by their age, gender, comorbities, tumor location, tumor size, reconstruction type, histopathological diagnosis, and tumor recurrence. Results: A total of 130 patients (70 female, 60 male were evaluated. The average age of the patients was 67.8 years. Tumors were located mostly at the dorsum, alar region, and tip of the nose. When reconstruction methods were evaluated, primary closure was preferred in 14.6% patients, full thickness skin grafts were used in 25.3% patients, and reconstruction with flaps were the choice in 60% patients. Different flaps were used according to the subunits. Mostly, dorsal nasal flaps, bilobed flaps, nasolabial flaps, and forehead flaps were used. Conclusion: The defect-only reconstruction principle was accepted in this study. Previously described subunits, such as the dorsum, tip, alar region, lateral wall, columella, and soft triangles, of the nose were further divided into subregions by their anatomical relations. An algorithm was planned with these sub regions. In nasal skin reconstruction, this algorithm helps in selection the methods for the best results and minimize the complications.

  17. Maxillary reconstruction: Current concepts and controversies

    Directory of Open Access Journals (Sweden)

    Subramania Iyer

    2014-01-01

    Full Text Available Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented.

  18. Maxillary reconstruction: Current concepts and controversies

    Science.gov (United States)

    Iyer, Subramania; Thankappan, Krishnakumar

    2014-01-01

    Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented. PMID:24987199

  19. Freestyle multiple propeller flap reconstruction (jigsaw puzzle approach) for complicated back defects.

    Science.gov (United States)

    Park, Sung Woo; Oh, Tae Suk; Eom, Jin Sup; Sun, Yoon Chi; Suh, Hyun Suk; Hong, Joon Pio

    2015-05-01

    The reconstruction of the posterior trunk remains to be a challenge as defects can be extensive, with deep dead space, and fixation devices exposed. Our goal was to achieve a tension-free closure for complex defects on the posterior trunk. From August 2006 to May 2013, 18 cases were reconstructed with multiple flaps combining perforator(s) and local skin flaps. The reconstructions were performed using freestyle approach. Starting with propeller flap(s) in single or multilobed design and sequentially in conjunction with adjacent random pattern flaps such as fitting puzzle. All defects achieved tensionless primary closure. The final appearance resembled a jigsaw puzzle-like appearance. The average size of defect was 139.6 cm(2) (range, 36-345 cm(2)). A total of 26 perforator flaps were used in addition to 19 random pattern flaps for 18 cases. In all cases, a single perforator was used for each propeller flap. The defect and the donor site all achieved tension-free closure. The reconstruction was 100% successful without flap loss. One case of late infection was noted at 12 months after surgery. Using multiple lobe designed propeller flaps in conjunction with random pattern flaps in a freestyle approach, resembling putting a jigsaw puzzle together, we can achieve a tension-free closure by distributing the tension to multiple flaps, supplying sufficient volume to obliterate dead space, and have reliable vascularity as the flaps do not need to be oversized. This can be a viable approach to reconstruct extensive defects on the posterior trunk. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Digital artery perforator (DAP) flaps: modifications for fingertip and finger stump reconstruction.

    Science.gov (United States)

    Mitsunaga, Narushima; Mihara, Makoto; Koshima, Isao; Gonda, Koichi; Takuya, Iida; Kato, Harunosuke; Araki, Jun; Yamamoto, Yushuke; Yuhei, Otaki; Todokoro, Takeshi; Ishikawa, Shoichi; Eri, Uehara; Mundinger, Gerhard S

    2010-08-01

    Various fingertip reconstructions have been reported for situations where microsurgical finger replantation is impossible. One method is the digital artery perforator (DAP) flap. Herein we report 13 DAP flaps for fingertip and finger stump reconstruction following traumatic finger amputations, highlighting modifications to the originally described DAP flap. From October 1998 to December 2007, a total of 13 fingers (11 patients) underwent fingertip and finger stump reconstruction with modified DAP flaps following traumatic finger amputations. We performed six adipocutaneous flaps, three adipose-only flaps, two supercharged flaps and two extended flaps. Flap size ranged from 1.44 to 8 cm(2) (average 3.25 cm(2)). All flaps survived completely with the exception of partial skin necrosis in two cases. One of these cases required debridement and skin grafting. Our initial three cases used donor-site skin grafting. The donor site was closed primarily in the 10 subsequent cases. No patients showed postoperative hypersensitivity of repaired fingertips. Semmes-Weinstein (SW) test result for flaps including a digital nerve branch did not differ from those without (average 4.07 vs. 3.92). Modified DAP flaps allow for preservation of digital length, volume and finger function. They can be raised as adiposal-only flaps or extended flaps and supercharged through perforator-to-perforator anastomoses. The donor defect on the lateral pulp can be closed primarily or by skin grafting. For traumatic fingertip and finger stump reconstructions, DAP flaps deliver consistent aesthetic and functional results. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Image reconstruction by domain-transform manifold learning

    Science.gov (United States)

    Zhu, Bo; Liu, Jeremiah Z.; Cauley, Stephen F.; Rosen, Bruce R.; Rosen, Matthew S.

    2018-03-01

    Image reconstruction is essential for imaging applications across the physical and life sciences, including optical and radar systems, magnetic resonance imaging, X-ray computed tomography, positron emission tomography, ultrasound imaging and radio astronomy. During image acquisition, the sensor encodes an intermediate representation of an object in the sensor domain, which is subsequently reconstructed into an image by an inversion of the encoding function. Image reconstruction is challenging because analytic knowledge of the exact inverse transform may not exist a priori, especially in the presence of sensor non-idealities and noise. Thus, the standard reconstruction approach involves approximating the inverse function with multiple ad hoc stages in a signal processing chain, the composition of which depends on the details of each acquisition strategy, and often requires expert parameter tuning to optimize reconstruction performance. Here we present a unified framework for image reconstruction—automated transform by manifold approximation (AUTOMAP)—which recasts image reconstruction as a data-driven supervised learning task that allows a mapping between the sensor and the image domain to emerge from an appropriate corpus of training data. We implement AUTOMAP with a deep neural network and exhibit its flexibility in learning reconstruction transforms for various magnetic resonance imaging acquisition strategies, using the same network architecture and hyperparameters. We further demonstrate that manifold learning during training results in sparse representations of domain transforms along low-dimensional data manifolds, and observe superior immunity to noise and a reduction in reconstruction artefacts compared with conventional handcrafted reconstruction methods. In addition to improving the reconstruction performance of existing acquisition methodologies, we anticipate that AUTOMAP and other learned reconstruction approaches will accelerate the development

  2. Three-dimensional fracture visualisation of multidetector CT of the skull base in trauma patients: comparison of three reconstruction algorithms

    International Nuclear Information System (INIS)

    Ringl, Helmut; Schernthaner, Ruediger; Philipp, Marcel O.; Metz-Schimmerl, Sylvia; Czerny, Christian; Weber, Michael; Steiner-Ringl, Andrea; Peloschek, Philipp; Herold, Christian J.; Schima, Wolfgang; Gaebler, Christian

    2009-01-01

    The purpose of this study was to retrospectively assess the detection rate of skull-base fractures for three different three-dimensional (3D) reconstruction methods of cranial CT examinations in trauma patients. A total of 130 cranial CT examinations of patients with previous head trauma were subjected to 3D reconstruction of the skull base, using solid (SVR) and transparent (TVR) volume-rendering technique and maximum intensity projection (MIP). Three radiologists independently evaluated all reconstructions as well as standard high-resolution multiplanar reformations (HR-MPRs). Mean fracture detection rates for all readers reading rotating reconstructions were 39, 36, 61 and 64% for SVR, TVR, MIP and HR-MPR respectively. Although not significantly different from HR-MPR with respect to sensitivity (P = 0.9), MIP visualised 18% of fractures that were not reported in HR-MPR. Because of the relatively low detection rate using HR-MPRs alone, we recommend reading MIP reconstructions in addition to the obligatory HR-MPRs to improve fracture detection. (orig.)

  3. Overweight and obesity: overrepresentation in the pediatric reconstructive burn population.

    Science.gov (United States)

    Mayes, Theresa; Gottschlich, Michele M; Allgeier, Chris; Khoury, Jane; Kagan, Richard J

    2010-01-01

    Pediatric burn patients are predisposed to excessive weight gain in the reconstructive period, but the cause is unclear. An overweight (OW) or obese (OB) condition is associated with numerous health risks, decreased physical function, and increased morbidity. The purpose of this study was to compare the frequency of OW status in reconstructive, pediatric burn patients with the prevalence in the US population. The authors reviewed the records of 1533 pediatric patients, >1 year from acute burn, admitted for an elective reconstructive procedure. Body mass index between 85th and 95th percentile, according to the National Center for Health Statistics for 2000 growth charts, was classified as OW, and body mass index >95th percentile was classified as OB. Frequency of OW and OB and racial disparity was calculated as a percentage of total patients and compared with pediatric data from National Health and Nutrition Examination Survey for 1999 to 2006, a nationally representative sample. The rate of OW and OB was 16.3 and 24.1%, respectively, in the authors' pediatric burn population. White patients had OW and OB rates of 15.9 and 23.6%, respectively, compared with 18.2 and 30.2%, respectively, in black patients. All OW and OB rates were outside the 95% confidence interval of the nationally representative National Health and Nutrition Examination Survey population. The rates of OW and OB in pediatric reconstructive burn patients exceed the US population standard across age and race stratifications. The prevention and treatment of excessive weight gain should be a component of rehabilitation in pediatric burns.

  4. Daily Serum Collection after Acellular Dermal Matrix-Assisted Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Glenda Giorgia Caputo

    2015-05-01

    Full Text Available BackgroundThe acellular dermal matrix (ADM-assisted breast reconstruction technique is widely known, but discouraging results due to early postoperative complications have been reported. As the literature identifies seroma as the most common issue after breast surgery without identifying its pathogenesis, we aimed to report the trend of postoperative daily serum collection after ADM-assisted breast reconstruction and compare it with data in the literature in order to discover more about this little-known topic.MethodsA retrospective study on 28 consecutive patients who received ADM-assisted breast reconstruction between February 2013 and February 2014 was performed. In order to reduce the number of variables that could affect serum production, only one brand of ADM was used and all tissues were handled gently and precisely. The daily drainage volume was recorded per patient during the first four days of hospitalization. Likewise, postoperative complications were noted during routine follow-up.ResultsIn total, five (17.9% bilateral and 23 (82.1% unilateral ADM-assisted breast reconstructions (33 implants were performed. The mean age, body mass index, and length of hospital stay were 53.6 years, 21.3 kg/m2, and 4.5 days, respectively. One major complication led to implant loss (3.0%, and nine minor complications were successfully treated with ambulatory surgery (27.3%. Serum collection linearly decreased after 24 hours postoperatively.ConclusionsDaily drainage decreased following the theoretical decline of acute inflammation. In concordance with the literature, daily serum production may not be related to the use of ADM.

  5. A Reduction of the Graph Reconstruction Conjecture

    Directory of Open Access Journals (Sweden)

    Monikandan S.

    2014-08-01

    Full Text Available A graph is said to be reconstructible if it is determined up to isomor- phism from the collection of all its one-vertex deleted unlabeled subgraphs. Reconstruction Conjecture (RC asserts that all graphs on at least three vertices are reconstructible. In this paper, we prove that interval-regular graphs and some new classes of graphs are reconstructible and show that RC is true if and only if all non-geodetic and non-interval-regular blocks G with diam(G = 2 or diam(Ḡ = diam(G = 3 are reconstructible

  6. A pseudo-discrete algebraic reconstruction technique (PDART) prior image-based suppression of high density artifacts in computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Rizza; Park, Miran; Wi, Sunhee; Cho, Seungryong, E-mail: scho@kaist.ac.kr

    2016-12-21

    We propose a hybrid metal artifact reduction (MAR) approach for computed tomography (CT) that is computationally more efficient than a fully iterative reconstruction method, but at the same time achieves superior image quality to the interpolation-based in-painting techniques. Our proposed MAR method, an image-based artifact subtraction approach, utilizes an intermediate prior image reconstructed via PDART to recover the background information underlying the high density objects. For comparison, prior images generated by total-variation minimization (TVM) algorithm, as a realization of fully iterative approach, were also utilized as intermediate images. From the simulation and real experimental results, it has been shown that PDART drastically accelerates the reconstruction to an acceptable quality of prior images. Incorporating PDART-reconstructed prior images in the proposed MAR scheme achieved higher quality images than those by a conventional in-painting method. Furthermore, the results were comparable to the fully iterative MAR that uses high-quality TVM prior images. - Highlights: • An accelerated reconstruction method, PDART, is proposed for exterior problems. • With a few iterations, soft prior image was reconstructed from the exterior data. • PDART framework has enabled an efficient hybrid metal artifact reduction in CT.

  7. Real-Time 3D Tracking and Reconstruction on Mobile Phones.

    Science.gov (United States)

    Prisacariu, Victor Adrian; Kähler, Olaf; Murray, David W; Reid, Ian D

    2015-05-01

    We present a novel framework for jointly tracking a camera in 3D and reconstructing the 3D model of an observed object. Due to the region based approach, our formulation can handle untextured objects, partial occlusions, motion blur, dynamic backgrounds and imperfect lighting. Our formulation also allows for a very efficient implementation which achieves real-time performance on a mobile phone, by running the pose estimation and the shape optimisation in parallel. We use a level set based pose estimation but completely avoid the, typically required, explicit computation of a global distance. This leads to tracking rates of more than 100 Hz on a desktop PC and 30 Hz on a mobile phone. Further, we incorporate additional orientation information from the phone's inertial sensor which helps us resolve the tracking ambiguities inherent to region based formulations. The reconstruction step first probabilistically integrates 2D image statistics from selected keyframes into a 3D volume, and then imposes coherency and compactness using a total variational regularisation term. The global optimum of the overall energy function is found using a continuous max-flow algorithm and we show that, similar to tracking, the integration of per voxel posteriors instead of likelihoods improves the precision and accuracy of the reconstruction.

  8. Reconstructing Topological Graphs and Continua

    OpenAIRE

    Gartside, Paul; Pitz, Max F.; Suabedissen, Rolf

    2015-01-01

    The deck of a topological space $X$ is the set $\\mathcal{D}(X)=\\{[X \\setminus \\{x\\}] \\colon x \\in X\\}$, where $[Z]$ denotes the homeomorphism class of $Z$. A space $X$ is topologically reconstructible if whenever $\\mathcal{D}(X)=\\mathcal{D}(Y)$ then $X$ is homeomorphic to $Y$. It is shown that all metrizable compact connected spaces are reconstructible. It follows that all finite graphs, when viewed as a 1-dimensional cell-complex, are reconstructible in the topological sense, and more genera...

  9. Clinical investigation of flat panel CT following middle ear reconstruction: a study of 107 patients

    Energy Technology Data Exchange (ETDEWEB)

    Zaoui, K. [University Hospital Heidelberg, Ruprecht Karls University, Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg (Germany); Kromeier, J. [St. Josefs Hospital, RkK, Department of Radiology, Freiburg (Germany); Neudert, M.; Beleites, T.; Zahnert, T. [University Hospital Dresden, Technical University, Department of Otorhinolaryngology, Head and Neck Surgery, Dresden (Germany); Laszig, R.; Offergeld, C. [University Hospital Freiburg, Albert Ludwigs University, Department of Otorhinolaryngology, Head and Neck Surgery, Freiburg (Germany)

    2014-03-15

    After middle ear reconstruction using partial or total ossicular replacement prostheses (PORP/TORP), an air-bone gap (ABG) may persist because of prosthesis displacement or malposition. So far, CT of the temporal bone has played the main role in the diagnosis of reasons for postoperative insufficient ABG improvement. Recent experimental and clinical studies have evaluated flat panel CT (fpCT) as an alternative imaging technique that provides images with high isovolumetric resolution, fewer metal-induced artefacts and lower irradiation doses. One hundred and seven consecutive patients with chronic otitis media with or without cholesteatoma underwent reconstruction by PORP (n = 52) or TORP (n = 55). All subjects underwent preoperative and postoperative audiometric testing and postoperative fpCT. Statistical evaluation of all 107 patients as well as the sole sub-assembly groups (PORP or TORP) showed a highly significant correlation between hearing improvement and fpCT-determined prosthesis position. FpCT enables detailed postoperative information on patients with middle ear reconstruction. FpCT is a new imaging technique that provides immediate feedback on surgical results after reconstructive middle ear surgery. Specific parameters evaluated by fpCT may serve as a predictive tool for estimated postoperative hearing improvement. Therefore this imaging technique is suitable for postoperative quality control in reconstructive middle ear surgery. (orig.)

  10. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne

    2012-01-01

    We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during...... of radiation therapy was associated with a non-significantly increased risk of reoperation after both 1-stage (HR = 1.4; 95% CI: 0.7-2.5) and 2-stage (HR = 1.6; 95% CI: 0.9-3.1) procedures. Reconstruction failure was highest (13.2%) in the 2-stage procedures with a history of radiation therapy. Breast...... reconstruction approaches other than implants should be seriously considered among women who have received radiation therapy....

  11. Accuracy of fibula reconstruction using patient-specific CAD/CAM reconstruction plates and dental implants : A new modality for functional reconstruction of mandibular defects

    NARCIS (Netherlands)

    Schepers, Rutger H.; Raghoebar, Gerry M.; Vissink, Arjan; Stenekes, Martin W.; Kraeima, Joep; Roodenburg, Jan L.; Reintsema, Harry; Witjes, Max J.

    Background: The purpose of this study was to analyze the accuracy of mandibular reconstruction using patient-specific computer-aided designed and computer-aided manufactured (CAD/CAM) reconstruction plates as a guide to place fibula grafts and dental implants in a one-stage procedure using

  12. Reconstructing mass balance of Garabashi Glacier (1800–2005 using dendrochronological data

    Directory of Open Access Journals (Sweden)

    E. A. Dolgova

    2013-01-01

    Full Text Available The exploration whether tree-ring data can be effectually applied for the mass balance reconstruction in Caucasus was the main goal of this research. Tree-ring width and maximum density chronologies of pine (Pinus sylvestris L. at seven high-elevation sites in Northern Caucasus were explored for this purpose. As well as in other places of the temperate zone tree- ring width has complex climate signal controlled both temperature and precipitation. Instrumental mass balance records of Garabashi Gglacier started at 1983s. It is well known that Caucasus glaciers intensively retreat in the last decades and according to instrumental data mass balance variations are mostly controlled by the ablation, i.e. summer temperature variations. Maximum density chronology has statistically significant correlation with mass balance due to summer temperature sensitivity and great input of ablation to total mass balance variations. To include in our reconstruction different climatically sensitive parameters, stepwise multiple regression model was used. The strongest relation (r = 0.88; r2 = 0.78; p < 0.05 between two ring-width and one maximum density chronologies was identified. Cross-validation test (r = 0.79; r2 = 0.62; p < 0.05 confirmed model adequacy and it allowed to reconstruct Garabashi Glacier mass balance for 1800–2005ss. Reconstructed and instrumental mass balance values coincide well except the most recent period in 2000s, when the reconstructed mass balance slightly underestimated the real values. However even in this period it remained negative as well as the instrumental records. The bias can be explained by the weak sensitivity of the chronologies to winter precipitation (i.e. accumulation. The tree-ring based mass balance reconstruction was compared with one based on meteorological data (since 1905s. Both reconstructions have good interannual agreement (r = 0.53; p < 0.05 particularly for the period between 1975 and 2005. According to the

  13. Outcomes of single-stage total arch replacement via clamshell incision

    Directory of Open Access Journals (Sweden)

    Ishizaka Toru

    2011-09-01

    Full Text Available Abstract Background Treatment of complex aortic pathologies involving the transverse arch with extensive involvement of the descending aorta remains a surgical challenge. Since clamshell incision provides superior exposure of the entire thoracic aorta, we evaluated the use of this technique for single-stage total arch replacement by arch vessel reconstruction. Methods The arch-first technique combined with clamshell incision was used in 38 cases of aneurysm and aortic disease in 2008 and 2009. Extensive total arch replacement was used with clamshell incision for reconstruction of arch vessels under deep hypothermic circulatory arrest. Results Overall 30-day mortality was 13%. The mean operating time was approximately 8 hours. Deep hypothermia resulted in mean CPB time exceeding 4.5 hours and mean duration of circulatory arrest was 25 minutes. The overall postoperative temporary and permanent neurologic dysfunction rates were 3% and 3% for elective and 3% and 0% for emergency surgery, respectively. All patients except the five who died in hospital were discharged without nursing care after an average post-operative hospital stay of 35 days. Conclusions The arch-first technique, combined with clamshell incision, provides expeditious replacement of the thoracic aorta with an acceptable duration of hypothermic circulatory arrest and minimizes the risk of retrograde atheroembolism by using antegrade perfusion.

  14. Sports-specific differences in postsurgical infections after arthroscopically assisted anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Krutsch, Werner; Zellner, Johannes; Zeman, Florian; Nerlich, Michael; Koch, Matthias; Pfeifer, Christian; Angele, Peter

    2017-12-01

    Post-operative infection after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction is a rare but severe complication, particularly for young and active patients. It is unclear whether the prevalence of knee infection is correlated with the type of sports or the level of performance. From 2008 to 2012, the internal single-centre ACL registry of the FIFA Medical Centre of Excellence Regensburg was retrospectively screened for sex, age, time between isolated primary ACL rupture and surgery, surgical technique, rate of infection after ACL reconstruction and the type of sports practised. In total, 4801 ACL reconstructions had been conducted over 5 years, 4579 in amateur and 221 in professional athletes. After application of the exclusion criteria, 1809 athletes with ACL reconstruction were analysed regarding postsurgical infection and the type of sports practised. Professionals and amateurs did not significantly differ with regard to infection rates (n.s.) but in the timing of ACL repair (p sports (n.s.). Staphylococcus aureus and epidermidis were the predominant detected bacteria. All patients were hospitalised and successfully treated with arthroscopic lavage and antibiotic medication. ACL infections showed sports-related differences. Athletes practising summer outdoor sports such as football had a significantly higher risk of infection after ACL reconstruction than winter sports athletes. No difference was found between professional and amateur athletes. Relevant prevention strategies for postsurgical ACL infections should consider influencing patient factors such as the type of sports activity and attendant circumstances. III.

  15. Compressed Sensing, Pseudodictionary-Based, Superresolution Reconstruction

    Directory of Open Access Journals (Sweden)

    Chun-mei Li

    2016-01-01

    Full Text Available The spatial resolution of digital images is the critical factor that affects photogrammetry precision. Single-frame, superresolution, image reconstruction is a typical underdetermined, inverse problem. To solve this type of problem, a compressive, sensing, pseudodictionary-based, superresolution reconstruction method is proposed in this study. The proposed method achieves pseudodictionary learning with an available low-resolution image and uses the K-SVD algorithm, which is based on the sparse characteristics of the digital image. Then, the sparse representation coefficient of the low-resolution image is obtained by solving the norm of l0 minimization problem, and the sparse coefficient and high-resolution pseudodictionary are used to reconstruct image tiles with high resolution. Finally, single-frame-image superresolution reconstruction is achieved. The proposed method is applied to photogrammetric images, and the experimental results indicate that the proposed method effectively increase image resolution, increase image information content, and achieve superresolution reconstruction. The reconstructed results are better than those obtained from traditional interpolation methods in aspect of visual effects and quantitative indicators.

  16. Athletic Performance at the National Basketball Association Combine After Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Mehran, Nima; Williams, Phillip N; Keller, Robert A; Khalil, Lafi S; Lombardo, Stephen J; Kharrazi, F Daniel

    2016-05-01

    Anterior cruciate ligament (ACL) injuries are significant injuries in elite-level basketball players. In-game statistical performance after ACL reconstruction has been demonstrated; however, few studies have reviewed functional performance in National Basketball Association (NBA)-caliber athletes after ACL reconstruction. To compare NBA Combine performance of athletes after ACL reconstruction with an age-, size-, and position-matched control group of players with no previous reported knee injury requiring surgery. We hypothesized that there is no difference between the 2 groups in functional performance. Cross-sectional study; Level of evidence, 3. A total of 1092 NBA-caliber players who participated in the NBA Combine between 2000 and 2015 were reviewed. Twenty-one athletes were identified as having primary ACL reconstruction prior to participation in the combine. This study group was compared with an age-, size-, and position-matched control group in objective functional performance testing, including the shuttle run test, lane agility test, three-quarter court sprint, vertical jump (no step), and maximum vertical jump (running start). With regard to quickness and agility, both ACL-reconstructed athletes and controls scored an average of 11.5 seconds in the lane agility test and 3.1 seconds in the shuttle run test (P = .745 and .346, respectively). Speed and acceleration was measured by the three-quarter court sprint, in which both the study group and the control group averaged 3.3 seconds (P = .516). In the maximum vertical jump, which demonstrates an athlete's jumping ability with a running start, the ACL reconstruction group had an average height of 33.6 inches while the controls averaged 33.9 inches (P = .548). In the standing vertical jump, the ACL reconstruction group averaged 28.2 inches while the control group averaged 29.2 inches (P = .067). In athletes who are able to return to sport and compete at a high level such as the NBA Combine, there is no

  17. Distributed MRI reconstruction using Gadgetron-based cloud computing.

    Science.gov (United States)

    Xue, Hui; Inati, Souheil; Sørensen, Thomas Sangild; Kellman, Peter; Hansen, Michael S

    2015-03-01

    To expand the open source Gadgetron reconstruction framework to support distributed computing and to demonstrate that a multinode version of the Gadgetron can be used to provide nonlinear reconstruction with clinically acceptable latency. The Gadgetron framework was extended with new software components that enable an arbitrary number of Gadgetron instances to collaborate on a reconstruction task. This cloud-enabled version of the Gadgetron was deployed on three different distributed computing platforms ranging from a heterogeneous collection of commodity computers to the commercial Amazon Elastic Compute Cloud. The Gadgetron cloud was used to provide nonlinear, compressed sensing reconstruction on a clinical scanner with low reconstruction latency (eg, cardiac and neuroimaging applications). The proposed setup was able to handle acquisition and 11 -SPIRiT reconstruction of nine high temporal resolution real-time, cardiac short axis cine acquisitions, covering the ventricles for functional evaluation, in under 1 min. A three-dimensional high-resolution brain acquisition with 1 mm(3) isotropic pixel size was acquired and reconstructed with nonlinear reconstruction in less than 5 min. A distributed computing enabled Gadgetron provides a scalable way to improve reconstruction performance using commodity cluster computing. Nonlinear, compressed sensing reconstruction can be deployed clinically with low image reconstruction latency. © 2014 Wiley Periodicals, Inc.

  18. Tissue engineering for human urethral reconstruction: systematic review of recent literature.

    Science.gov (United States)

    de Kemp, Vincent; de Graaf, Petra; Fledderus, Joost O; Ruud Bosch, J L H; de Kort, Laetitia M O

    2015-01-01

    Techniques to treat urethral stricture and hypospadias are restricted, as substitution of the unhealthy urethra with tissue from other origins (skin, bladder or buccal mucosa) has some limitations. Therefore, alternative sources of tissue for use in urethral reconstructions are considered, such as ex vivo engineered constructs. To review recent literature on tissue engineering for human urethral reconstruction. A search was made in the PubMed and Embase databases restricted to the last 25 years and the English language. A total of 45 articles were selected describing the use of tissue engineering in urethral reconstruction. The results are discussed in four groups: autologous cell cultures, matrices/scaffolds, cell-seeded scaffolds, and clinical results of urethral reconstructions using these materials. Different progenitor cells were used, isolated from either urine or adipose tissue, but slightly better results were obtained with in vitro expansion of urothelial cells from bladder washings, tissue biopsies from the bladder (urothelium) or the oral cavity (buccal mucosa). Compared with a synthetic scaffold, a biological scaffold has the advantage of bioactive extracellular matrix proteins on its surface. When applied clinically, a non-seeded matrix only seems suited for use as an onlay graft. When a tubularized substitution is the aim, a cell-seeded construct seems more beneficial. Considerable experience is available with tissue engineering of urethral tissue in vitro, produced with cells of different origin. Clinical and in vivo experiments show promising results.

  19. Surface Reconstruction from Parallel Curves with Application to Parietal Bone Fracture Reconstruction.

    Directory of Open Access Journals (Sweden)

    Abdul Majeed

    Full Text Available Maxillofacial trauma are common, secondary to road traffic accident, sports injury, falls and require sophisticated radiological imaging to precisely diagnose. A direct surgical reconstruction is complex and require clinical expertise. Bio-modelling helps in reconstructing surface model from 2D contours. In this manuscript we have constructed the 3D surface using 2D Computerized Tomography (CT scan contours. The fracture part of the cranial vault are reconstructed using GC1 rational cubic Ball curve with three free parameters, later the 2D contours are flipped into 3D with equidistant z component. The constructed surface is represented by contours blending interpolant. At the end of this manuscript a case report of parietal bone fracture is also illustrated by employing this method with a Graphical User Interface (GUI illustration.

  20. Orbital Reconstruction: Patient-Specific Orbital Floor Reconstruction Using a Mirroring Technique and a Customized Titanium Mesh.

    Science.gov (United States)

    Tarsitano, Achille; Badiali, Giovanni; Pizzigallo, Angelo; Marchetti, Claudio

    2016-10-01

    Enophthalmos is a severe complication of primary reconstruction of orbital floor fractures. The goal of secondary reconstruction procedures is to restore symmetrical globe positions to recover function and aesthetics. The authors propose a new method of orbital floor reconstruction using a mirroring technique and a customized titanium mesh, printed using a direct metal laser-sintering method. This reconstructive protocol involves 4 steps: mirroring of the healthy orbit at the affected site, virtual design of a patient-specific orbital floor mesh, CAM procedures for direct laser-sintering of the customized titanium mesh, and surgical insertion of the device. Using a computed tomography data set, the normal, uninjured side of the craniofacial skeleton was reflected onto the contralateral injured side, and a reconstructive orbital floor mesh was designed virtually on the mirrored orbital bone surface. The solid-to-layer files of the mesh were then manufactured using direct metal laser sintering, which resolves the shaping and bending biases inherent in the indirect method. An intraoperative navigation system ensured accuracy of the entire procedure. Clinical outcomes were assessed using 3dMD photogrammetry and computed tomography data in 7 treated patients. The technique described here appears to be a viable method to correct complex orbital floor defects needing delayed reconstruction. This study represents the first step in the development of a wider experimental protocol for orbital floor reconstruction using computer-assisted design-computer-assisted manufacturing technology.

  1. 3-D image reconstruction in radiology

    International Nuclear Information System (INIS)

    Grangeat, P.

    1999-01-01

    In this course, we present highlights on fully 3-D image reconstruction algorithms used in 3-D X-ray Computed Tomography (3-D-CT) and 3-D Rotational Radiography (3-D-RR). We first consider the case of spiral CT with a one-row detector. Starting from the 2-D fan-beam inversion formula for a circular trajectory, we introduce spiral CT 3-D image reconstruction algorithm using axial interpolation for each transverse slice. In order to improve the X-ray detection efficiency and to speed the acquisition process, the future is to use multi-row detectors associated with small angle cone-beam geometry. The generalization of the 2-D fan-beam image reconstruction algorithm to cone beam defined direct inversion formula referred as Feldkamp's algorithm for a circular trajectory and Wang's algorithm for a spiral trajectory. However, large area detectors does exist such as Radiological Image Intensifiers or in a near future solid state detectors. To get a larger zoom effect, it defines a cone-beam geometry associated with a large aperture angle. For this case, we introduce indirect image reconstruction algorithm by plane re-binning in the Radon domain. We will present some results from a prototype MORPHOMETER device using the RADON reconstruction software. Lastly, we consider the special case of 3-D Rotational Digital Subtraction Angiography with a restricted number of views. We introduce constraint optimization algorithm using quadratic, entropic or half-quadratic constraints. Generalized ART (Algebraic Reconstruction Technique) iterative reconstruction algorithm can be derived from the Bregman algorithm. We present reconstructed vascular trees from a prototype MORPHOMETER device. (author)

  2. Mixed Total Variation and L1 Regularization Method for Optical Tomography Based on Radiative Transfer Equation

    Directory of Open Access Journals (Sweden)

    Jinping Tang

    2017-01-01

    Full Text Available Optical tomography is an emerging and important molecular imaging modality. The aim of optical tomography is to reconstruct optical properties of human tissues. In this paper, we focus on reconstructing the absorption coefficient based on the radiative transfer equation (RTE. It is an ill-posed parameter identification problem. Regularization methods have been broadly applied to reconstruct the optical coefficients, such as the total variation (TV regularization and the L1 regularization. In order to better reconstruct the piecewise constant and sparse coefficient distributions, TV and L1 norms are combined as the regularization. The forward problem is discretized with the discontinuous Galerkin method on the spatial space and the finite element method on the angular space. The minimization problem is solved by a Jacobian-based Levenberg-Marquardt type method which is equipped with a split Bregman algorithms for the L1 regularization. We use the adjoint method to compute the Jacobian matrix which dramatically improves the computation efficiency. By comparing with the other imaging reconstruction methods based on TV and L1 regularizations, the simulation results show the validity and efficiency of the proposed method.

  3. Sensation Following Immediate Breast Reconstruction with Implants.

    Science.gov (United States)

    Lagergren, Jakob; Wickman, Marie; Hansson, Per

    2010-01-01

    Sensation is a neglected aspect of the outcome of breast reconstructions with implants. The aim of this prospective study was to evaluate the cutaneous somatosensory status in breasts following mastectomy and immediate reconstruction with permanent adjustable prostheses and to analyze the patients' subjective experience of the sensation. Twenty-four consecutive patients diagnosed with invasive or in situ breast carcinoma were examined preoperatively and 2 years after mastectomy and reconstruction, for assessment of perception thresholds for touch, cold, warmth, and heat pain above and below the areola. Von Frey filaments and a Peltier element-based thermode were used. The patients completed a questionnaire concerning their experienced sensation in the reconstructed breast. Using quantitative somato-sensory testing, the sensation to all the examined modalities was significantly impaired compared to preoperatively. Most affected was the area above the areola. Patients given postoperative radiotherapy (n = 9) did not differ from those without radiotherapy (n = 15) regarding any of the modalities. All patients reported reduced sensation in the reconstructed breast compared to that preoperatively. Twenty-three patients stated that the reconstructed breast felt different from the other breast; nevertheless 16 reported that the reconstructed breast felt like a real breast. The study revealed sensation impairment following mastectomy and immediate reconstruction with implants. Patients should be informed about this effect preoperatively to allow adequate expectations regarding the sensation outcome. However, two-thirds of the study patients considered that the reconstructed breast felt like a real breast, which must be one of the main purposes of a breast reconstruction.

  4. Meta-analysis for psychological impact of breast reconstruction in patients with breast cancer.

    Science.gov (United States)

    Chen, Wanjing; Lv, Xiaoai; Xu, Xiaohong; Gao, Xiufei; Wang, Bei

    2018-07-01

    This meta-analysis aimed to evaluate the impact of breast reconstruction on the psychological aspects in patients with breast cancer. A literature search on PubMed, Embase, ScienceDirect and Google scholar databases was conducted up to September 2017. The pooled risk radio (RR) or standard mean difference (SMD) and the corresponding 95% confidence intervals (CIs) were calculated using the RevMan 5.3 software. A total of 5 studies were included in this meta-analysis. There were 551 breast cancer patients receiving mastectomy plus breast reconstruction and 574 breast cancer patients receiving mastectomy alone. The results showed that breast reconstruction can significantly decrease the incidence of anxiety (RR = 0.62, 95% CI 0.47-0.82, P = 0.0006)/depression (RR = 0.54, 95% CI 0.32-0.93, P = 0.02) and scale score for evaluating anxiety (SMD = - 0.20, 95% CI - 0.37 to - 0.03, P = 0.02)/depression (SMD = - 0.22, 95% CI - 0.39 to - 0.66, P = 0.007) compared with mastectomy alone. Breast reconstruction after mastectomy was benefit for improving the psychological damages in patients with breast cancer.

  5. Median prior constrained TV algorithm for sparse view low-dose CT reconstruction.

    Science.gov (United States)

    Liu, Yi; Shangguan, Hong; Zhang, Quan; Zhu, Hongqing; Shu, Huazhong; Gui, Zhiguo

    2015-05-01

    It is known that lowering the X-ray tube current (mAs) or tube voltage (kVp) and simultaneously reducing the total number of X-ray views (sparse view) is an effective means to achieve low-dose in computed tomography (CT) scan. However, the associated image quality by the conventional filtered back-projection (FBP) usually degrades due to the excessive quantum noise. Although sparse-view CT reconstruction algorithm via total variation (TV), in the scanning protocol of reducing X-ray tube current, has been demonstrated to be able to result in significant radiation dose reduction while maintain image quality, noticeable patchy artifacts still exist in reconstructed images. In this study, to address the problem of patchy artifacts, we proposed a median prior constrained TV regularization to retain the image quality by introducing an auxiliary vector m in register with the object. Specifically, the approximate action of m is to draw, in each iteration, an object voxel toward its own local median, aiming to improve low-dose image quality with sparse-view projection measurements. Subsequently, an alternating optimization algorithm is adopted to optimize the associative objective function. We refer to the median prior constrained TV regularization as "TV_MP" for simplicity. Experimental results on digital phantoms and clinical phantom demonstrated that the proposed TV_MP with appropriate control parameters can not only ensure a higher signal to noise ratio (SNR) of the reconstructed image, but also its resolution compared with the original TV method. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Reinforced aortic root reconstruction for acute type A aortic dissection involving the aortic root

    Directory of Open Access Journals (Sweden)

    Han Qing-qi

    2013-06-01

    Full Text Available OBJECTIVE: There are debates regarding the optimal approach for AAAD involving the aortic root. We described a modified reinforced aortic root reconstruction approach for treating AAAD involving the aortic root. METHODS: A total of 161 patients with AAAD involving the aortic root were treated by our modified reinforced aortic root reconstruction approach from January 1998 to December 2008. Key features of our modified approach were placement of an autologous pericardial patch in the false lumen, lining of the sinotubular junction lumen with a polyester vascular ring, and wrapping of the vessel with Teflon strips. Outcome measures included post-operative mortality, survival, complications, and level of aortic regurgitation. RESULTS: A total of 161 patients were included in the study (mean age: 43.3 1 15.5 years. The mean duration of follow-up was 5.1 1 2.96 years (2-12 years. A total of 10 (6.2% and 11 (6.8% patients died during hospitalization and during follow-up, respectively. Thirty-one (19.3% patients experienced postoperative complications. The 1-, 3-, 5-, and 10-year survival rates were 99.3%, 98%, 93.8%, and 75.5%, respectively. There were no instances of recurrent aortic dissection, aortic aneurysm, or pseudoaneurysm during the entire study period. The severity of aortic regurgitation dramatically decreased immediately after surgery (from 28.6% to 0% grade 3-4 and thereafter slightly increased (from 0% to 7.2% at 5 years and 9.1% at 10 years. CONCLUSION: This modified reinforced aortic root reconstruction was feasible, safe and durable/effective, as indicated by its low mortality, low postoperative complications and high survival rate.

  7. No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears

    DEFF Research Database (Denmark)

    Kiadaliri, Aliasghar A; Englund, Martin; Stefan Lohmander, L.

    2016-01-01

    Background To analyse 5-year cost-effectiveness of early versus optional delayed acute anterior cruciate ligament (ACL) reconstruction. Methods 121 young, active adults with acute ACL injury to a previously uninjured knee were randomised to early ACL reconstruction (n=62, within 10 weeks of injur...

  8. Controversies in orbital reconstruction-III. Biomaterials for orbital reconstruction : a review with clinical recommendations

    NARCIS (Netherlands)

    Dubois, L.; Steenen, S. A.; Gooris, P. J. J.; Bos, R. R. M.; Becking, A. G.

    The goal of orbital reconstruction is to repair trauma defects, to correct the position of the eye anatomically, avoiding enophthalmos, and to restore ocular function. For the reconstruction of (trauma) defects, many surgeons recommend materials that can be bent into an anatomical shape and that

  9. Analysis of dental root apical morphology: a new method for dietary reconstructions in primates.

    Science.gov (United States)

    Hamon, NoÉmie; Emonet, Edouard-Georges; Chaimanee, Yaowalak; Guy, Franck; Tafforeau, Paul; Jaeger, Jean-Jacques

    2012-06-01

    The reconstruction of paleo-diets is an important task in the study of fossil primates. Previously, paleo-diet reconstructions were performed using different methods based on extant primate models. In particular, dental microwear or isotopic analyses provided accurate reconstructions for some fossil primates. However, there is sometimes difficult or impossible to apply these methods to fossil material. Therefore, the development of new, independent methods of diet reconstructions is crucial to improve our knowledge of primates paleobiology and paleoecology. This study aims to investigate the correlation between tooth root apical morphology and diet in primates, and its potential for paleo-diet reconstructions. Dental roots are composed of two portions: the eruptive portion with a smooth and regular surface, and the apical penetrative portion which displays an irregular and corrugated surface. Here, the angle formed by these two portions (aPE), and the ratio of penetrative portion over total root length (PPI), are calculated for each mandibular tooth root. A strong correlation between these two variables and the proportion of some food types (fruits, leaves, seeds, animal matter, and vertebrates) in diet is found, allowing the use of tooth root apical morphology as a tool for dietary reconstructions in primates. The method was then applied to the fossil hominoid Khoratpithecus piriyai, from the Late Miocene of Thailand. The paleo-diet deduced from aPE and PPI is dominated by fruits (>50%), associated with animal matter (1-25%). Leaves, vertebrates and most probably seeds were excluded from the diet of Khoratpithecus, which is consistent with previous studies. Copyright © 2012 Wiley Periodicals, Inc.

  10. Breast reconstruction and post-mastectomy radiation practice

    International Nuclear Information System (INIS)

    Chen, Susie A; Hiley, Crispin; Nickleach, Dana; Petsuksiri, Janjira; Andic, Fundagul; Riesterer, Oliver; Switchenko, Jeffrey M; Torres, Mylin A

    2013-01-01

    The goal of this study was to explore the perspectives and practice of radiation oncologists who treat breast cancer patients who have had breast reconstruction. In 2010, an original electronic survey was sent to all physician members of the American Society of Radiation Oncology, National Cancer Research Institute-Breast Cancer Studies Group in the United Kingdom, Thai Society of Therapeutic Radiology and Oncology, Swiss Society of Radiation Oncology, and Turkish Radiation Oncology Society. We identified factors associated with radiation oncologists who treat breast cancer patients with reconstruction performed prior to radiation and obtained information regarding radiation management of the breast reconstruction. 358 radiation oncologists responded, and 60% of the physicians were from the United States. While 64% of participants agree or strongly agree that breast image affects a woman’s quality of life during radiation, 57% feel that reconstruction challenges their ability to deliver effective breast radiation. Compared with other countries, treatment within the United States was associated with a high reconstruction rate (>/= 50% of mastectomy patients) prior to radiation (p < 0.05). Delayed-immediate reconstruction with a temporary tissue expander was more common in the United States than in other countries (52% vs. 23%, p = 0.01). Among physicians who treat patients with tissue expanders, the majority (60%) prefer a moderately inflated implant with 150-250 cc of fluid rather than a completely deflated (13%) or inflated expander (28%) during radiation. Among radiation oncologists who treat reconstructions, 49% never use bolus and 40% never boost a breast reconstruction. United States physicians were more likely than physicians from other countries to boost or bolus the reconstruction irrespective of the type of reconstruction seen in their clinic patients (p < 0.01). Great variation in practice is evident from our study of radiation treatment for breast

  11. Boomerang flap reconstruction for the breast.

    Science.gov (United States)

    Baumholtz, Michael A; Al-Shunnar, Buthainah M; Dabb, Richard W

    2002-07-01

    The boomerang-shaped latissimus dorsi musculocutaneous flap for breast reconstruction offers a stable platform for breast reconstruction. It allows for maximal aesthetic results with minimal complications. The authors describe a skin paddle to obtain a larger volume than either the traditional elliptical skin paddle or the extended latissimus flap. There are three specific advantages to the boomerang design: large volume, conical shape (often lacking in the traditional skin paddle), and an acceptable donor scar. Thirty-eight flaps were performed. No reconstruction interfered with patient's ongoing oncological regimen. The most common complication was seroma, which is consistent with other latissimus reconstructions.

  12. Tailoring through Technology: A Retrospective Review of a Single Surgeon's Experience with Implant-Based Breast Reconstruction before and after Implementation of Laser-Assisted Indocyanine Green Angiography.

    Science.gov (United States)

    Harless, Christin A; Jacobson, Steven R

    2016-05-01

    Reported complication rates of implant-based breast reconstruction in the literature exceed 50%, with mastectomy skin flap necrosis reported to occur in up to 25% of cases. Laser-assisted indocyanine green angiography (LA-ICGA) technology allows the surgeon to optimize preservation of the mastectomy skin flap while avoiding skin necrosis. The purpose of this study was to determine if outcomes of breast reconstruction are beneficially affected by using LA-ICGA. A total 269 consecutive women (467 breast reconstructions) undergoing implant-based breast reconstruction from 2008 to 2013 were examined. The complication rates of those who underwent reconstruction prior to the implementation of LA-ICGA were compared with those who were reconstructed after implementation of LA-ICGA. A total of 254 consecutive breast reconstructions were performed prior to implementation of LA-ICGA, and 213 breasts were reconstructed with the use of LA-ICGA. After implementation of LA-ICGA System, the rate of mastectomy skin flap necrosis decreased by 86% (6.7% versus 0.9%, p = 0.02). The overall complication rate prior to LA-ICGA was 13.8% compared with 6.6% with the use of LA-ICGA (p = 0.01). After LA-ICGA was incorporated, the percentage of patients undergoing single-stage reconstruction increased from 12% to 32% (p = <0.001). Implementation of LA-ICGA provides the surgeon with an objective assessment of mastectomy flap perfusion resulting in a trend toward overall reduction in complications as well as an 86% decrease in the rate of subsequent skin necrosis. The objective assessment of mastectomy flap perfusion allows the surgeon to tailor breast reconstruction intraoperatively, in real-time, adjusting for the individual patient's mastectomy flap perfusion. © 2016 Wiley Periodicals, Inc.

  13. Additive manufacturing technology in reconstructive surgery.

    Science.gov (United States)

    Fuller, Scott C; Moore, Michael G

    2016-10-01

    Technological advances have been part and parcel of modern reconstructive surgery, in that practitioners of this discipline are continually looking for innovative ways to perfect their craft and improve patient outcomes. We are currently in a technological climate wherein advances in computers, imaging, and science have coalesced with resulting innovative breakthroughs that are not merely limited to improved outcomes and enhanced patient care, but may provide novel approaches to training the next generation of reconstructive surgeons. New developments in software and modeling platforms, imaging modalities, tissue engineering, additive manufacturing, and customization of implants are poised to revolutionize the field of reconstructive surgery. The interface between technological advances and reconstructive surgery continues to expand. Additive manufacturing techniques continue to evolve in an effort to improve patient outcomes, decrease operative time, and serve as instructional tools for the training of reconstructive surgeons.

  14. Complications in Postmastectomy Breast Reconstruction: One-year Outcomes of the Mastectomy Reconstruction Outcomes Consortium (MROC) Study.

    Science.gov (United States)

    Wilkins, Edwin G; Hamill, Jennifer B; Kim, Hyungjin M; Kim, John Y; Greco, Richard J; Qi, Ji; Pusic, Andrea L

    2018-01-01

    In postmastectomy reconstruction, procedure choice is heavily influenced by the relative risks of the various options. This study sought to evaluate complications in a large, multicenter patient population. Previous studies have reported widely varying complication rates, but have been limited by their single center designs and inadequate controlling for confounders in their analyses. Eleven sites enrolled women undergoing first time, immediate, or delayed reconstruction following mastectomy for cancer treatment or prophylaxis. Procedures included expander/implant, latissimus dorsi (LD), pedicle transverse rectus abdominis musculocutaneous (PTRAM), free TRAM (FTRAM), and deep inferior epigastric perforator (DIEP) techniques. Data were gathered pre- and postoperatively from medical records. Separate logistic regressions were conducted for all complications and major complications (those requiring rehospitalization and/or reoperation) within 1 year. Odds ratios (ORs) were calculated for procedure type, controlling for site, demographic, and clinical variables. Complication rates for 2234 patients were analyzed. Compared with expander/implant reconstructions, LD (OR) 1.95, P = 0.026), PTRAM (OR 1.89, P = 0.025), FTRAM (OR 1.94, P = 0.011), and DIEP (OR 2.22, P procedures were associated with higher risks of complications. Significantly higher risks were also associated with older age, higher body mass index (BMI), immediate reconstruction, bilateral procedures, and radiation. For major complications, regression showed significantly greater risks for PTRAM (OR 1.86, P = 0.044) and DIEP (OR 1.75, P = 0.004), than expander/implant reconstructions. Failure rates were relatively low, ranging from 0% for PTRAM to 5.9% for expander/implant reconstructions. In this multicenter analysis, procedure choice and other patient variables were significant predictors of 1-year complications in breast reconstruction. These findings should be considered in counseling patients on

  15. Simultaneous reconstruction of attenuation and activity in ToF PET/MRI with additional transmission data

    Energy Technology Data Exchange (ETDEWEB)

    D’Hoe, Ester [MEDISIP Medical Imaging and Signal Processing Group, Ghent University, IBBT-IBiTech, iMinds Medical IT, Ghent (Belgium); Department of Nuclear Medicine, Vrije Universiteit Brussel, Brussels (Belgium); Mollet, Pieter; Mikhaylova, Ekaterina [MEDISIP Medical Imaging and Signal Processing Group, Ghent University, IBBT-IBiTech, iMinds Medical IT, Ghent (Belgium); Defrise, Michel [Department of Nuclear Medicine, Vrije Universiteit Brussel, Brussels (Belgium); Vandenberghe, Stefaan [MEDISIP Medical Imaging and Signal Processing Group, Ghent University, IBBT-IBiTech, iMinds Medical IT, Ghent (Belgium)

    2015-05-18

    In Time-of-Flight PET/MRI systems accurate attenuation correction, based on the MRI image, is not straight forward. An alternative is attenuation correction based on emission data only. This is for instance done by simultaneous reconstruction of attenuation and activity with the MLAA algorithm, but the method as originally proposed has certain limits. The attenuation can only be determined up to a constant and in regions of low tracer uptake, the method results in less accurate attenuation values. An adapted MLAA algorithm has been proposed to overcome this issues and was successfully applied on simulation studies. The so called MLAA+ algorithm uses regular PET emission data as well as transmission data. This transmission data is acquired after insertion of an annulus shaped transmission source into the scanner bore. The Time-of-Flight information allows to separate transmission and emission data in a simultaneous acquisition. With the transmission data, an MLTR-based reference attenuation image is reconstructed. Afterwards, this attenuation image is used in the MLAA+ simultaneous reconstruction of attenuation and emission as a reference. We here propose the results of the reconstruction of patient data, based on the MLAA+ algorithm. In total, seven patients were scanned in a sequential PET/MRI scanner and afterwards in a CT scanner. The CT scan is used as an attenuation map to reconstruct the PET emission data with the well established MLEM algorithm. This reconstruction can be seen as the gold standard to which we can compare the MLAA and MLAA+ reconstructions. A preliminary study on one patient indicates that the MLAA+ algorithm results in better reconstructed emission and attenuation images as compared to the MLAA algorithm. If we compare the MLAA+ method to the gold standard, there is still room for improvement.

  16. Simultaneous reconstruction of attenuation and activity in ToF PET/MRI with additional transmission data

    International Nuclear Information System (INIS)

    D’Hoe, Ester; Mollet, Pieter; Mikhaylova, Ekaterina; Defrise, Michel; Vandenberghe, Stefaan

    2015-01-01

    In Time-of-Flight PET/MRI systems accurate attenuation correction, based on the MRI image, is not straight forward. An alternative is attenuation correction based on emission data only. This is for instance done by simultaneous reconstruction of attenuation and activity with the MLAA algorithm, but the method as originally proposed has certain limits. The attenuation can only be determined up to a constant and in regions of low tracer uptake, the method results in less accurate attenuation values. An adapted MLAA algorithm has been proposed to overcome this issues and was successfully applied on simulation studies. The so called MLAA+ algorithm uses regular PET emission data as well as transmission data. This transmission data is acquired after insertion of an annulus shaped transmission source into the scanner bore. The Time-of-Flight information allows to separate transmission and emission data in a simultaneous acquisition. With the transmission data, an MLTR-based reference attenuation image is reconstructed. Afterwards, this attenuation image is used in the MLAA+ simultaneous reconstruction of attenuation and emission as a reference. We here propose the results of the reconstruction of patient data, based on the MLAA+ algorithm. In total, seven patients were scanned in a sequential PET/MRI scanner and afterwards in a CT scanner. The CT scan is used as an attenuation map to reconstruct the PET emission data with the well established MLEM algorithm. This reconstruction can be seen as the gold standard to which we can compare the MLAA and MLAA+ reconstructions. A preliminary study on one patient indicates that the MLAA+ algorithm results in better reconstructed emission and attenuation images as compared to the MLAA algorithm. If we compare the MLAA+ method to the gold standard, there is still room for improvement.

  17. Automation of 3D reconstruction of neural tissue from large volume of conventional serial section transmission electron micrographs.

    Science.gov (United States)

    Mishchenko, Yuriy

    2009-01-30

    We describe an approach for automation of the process of reconstruction of neural tissue from serial section transmission electron micrographs. Such reconstructions require 3D segmentation of individual neuronal processes (axons and dendrites) performed in densely packed neuropil. We first detect neuronal cell profiles in each image in a stack of serial micrographs with multi-scale ridge detector. Short breaks in detected boundaries are interpolated using anisotropic contour completion formulated in fuzzy-logic framework. Detected profiles from adjacent sections are linked together based on cues such as shape similarity and image texture. Thus obtained 3D segmentation is validated by human operators in computer-guided proofreading process. Our approach makes possible reconstructions of neural tissue at final rate of about 5 microm3/manh, as determined primarily by the speed of proofreading. To date we have applied this approach to reconstruct few blocks of neural tissue from different regions of rat brain totaling over 1000microm3, and used these to evaluate reconstruction speed, quality, error rates, and presence of ambiguous locations in neuropil ssTEM imaging data.

  18. Progressive Reconstruction: A Methodology for Stabilization and Reconstruction Operations

    National Research Council Canada - National Science Library

    Rohr, Karl C

    2006-01-01

    ... these nations in accordance with stated United States' goals. The argument follows closely current and developing United States military doctrine on stabilization, reconstruction, and counterinsurgency operations...

  19. Instability of the proximal tibiofibular joint associated with total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Martin Bédard, MD, FRCSC

    2016-09-01

    Full Text Available To our knowledge, proximal tibiofibular joint instability has never been reported in a patient with a total knee arthroplasty (TKA. We present the case of a patient with anterolateral proximal tibiofibular joint instability associated with a complex primary TKA. In 2010, a male patient of 47 years was referred for TKA after posttraumatic osteoarthritis. The patient's history includes a fracture of the left lateral tibial plateau in 2008 and removal of osteosynthesis material in 2009. TKA with a lateral metal augment and intramedullary stem was performed in 2010. After TKA, instability of the left proximal tibiofibular joint (PTFJ was diagnosed. The patient underwent PTFJ arthrodesis and, at 5 years' follow-up, had no residual pain, with full range of motion. In this case, arthrodesis was the only possible surgical option because reconstruction surgeries require the establishment of bone tunnels in the tibia and fibula for the passage of a graft. Low bone quality and the use of an intramedullary stem with a metal augment in the tibia made any reconstruction technique unfeasible because the proximal tibia was obliterated. Although several PTFJ reconstruction techniques are available, they are difficult to apply to patients with a complex TKA.

  20. Titanium template for scaphoid reconstruction.

    Science.gov (United States)

    Haefeli, M; Schaefer, D J; Schumacher, R; Müller-Gerbl, M; Honigmann, P

    2015-06-01

    Reconstruction of a non-united scaphoid with a humpback deformity involves resection of the non-union followed by bone grafting and fixation of the fragments. Intraoperative control of the reconstruction is difficult owing to the complex three-dimensional shape of the scaphoid and the other carpal bones overlying the scaphoid on lateral radiographs. We developed a titanium template that fits exactly to the surfaces of the proximal and distal scaphoid poles to define their position relative to each other after resection of the non-union. The templates were designed on three-dimensional computed tomography reconstructions and manufactured using selective laser melting technology. Ten conserved human wrists were used to simulate the reconstruction. The achieved precision measured as the deviation of the surface of the reconstructed scaphoid from its virtual counterpart was good in five cases (maximal difference 1.5 mm), moderate in one case (maximal difference 3 mm) and inadequate in four cases (difference more than 3 mm). The main problems were attributed to the template design and can be avoided by improved pre-operative planning, as shown in a clinical case. © The Author(s) 2014.

  1. Dynamic dual-tracer PET reconstruction.

    Science.gov (United States)

    Gao, Fei; Liu, Huafeng; Jian, Yiqiang; Shi, Pengcheng

    2009-01-01

    Although of important medical implications, simultaneous dual-tracer positron emission tomography reconstruction remains a challenging problem, primarily because the photon measurements from dual tracers are overlapped. In this paper, we propose a simultaneous dynamic dual-tracer reconstruction of tissue activity maps based on guidance from tracer kinetics. The dual-tracer reconstruction problem is formulated in a state-space representation, where parallel compartment models serve as continuous-time system equation describing the tracer kinetic processes of dual tracers, and the imaging data is expressed as discrete sampling of the system states in measurement equation. The image reconstruction problem has therefore become a state estimation problem in a continuous-discrete hybrid paradigm, and H infinity filtering is adopted as the estimation strategy. As H infinity filtering makes no assumptions on the system and measurement statistics, robust reconstruction results can be obtained for the dual-tracer PET imaging system where the statistical properties of measurement data and system uncertainty are not available a priori, even when there are disturbances in the kinetic parameters. Experimental results on digital phantoms, Monte Carlo simulations and physical phantoms have demonstrated the superior performance.

  2. Oral rehabilitation of a patient with sub - total maxillectomy

    Directory of Open Access Journals (Sweden)

    Romesh Soni

    2011-01-01

    Full Text Available This clinical report describes oral rehabilitation of a patient with sub-total maxillectomy with palatine process of maxilla and horizontal plate of palatine bone intact to retain the maxillary obturator. Clinical examination has been performed to know the amount of favorable undercuts to be used for retention of the obturator for better functional efficiency. Successful prosthetic reconstruction of hemimaxillectomy defect is a challenging procedure that requires multidisciplinary expertise to achieve acceptable functional speech and swallowing outcomes. This article describes the oral rehabilitation of a patient with sub-total maxillectomy with a maxillary obturator. Oral rehabilitation of sub-total maxillectomy patient is a challenging task. Obturation of the defect depends on volume of the defect, and positioning of remaining hard and soft tissues to be used to retain, stabilize, and support the prosthesis. A maxillary obturator for edentulous patient must provide for retention, stability, support, patient comfort, and cleanliness.

  3. Oral rehabilitation of a patient with sub - total maxillectomy.

    Science.gov (United States)

    Soni, Romesh; Jindal, Shitu; Singh, B P; Mittal, Neelam; Chaturvedi, T P; Prithviraj, D R

    2011-01-01

    This clinical report describes oral rehabilitation of a patient with sub-total maxillectomy with palatine process of maxilla and horizontal plate of palatine bone intact to retain the maxillary obturator. Clinical examination has been performed to know the amount of favorable undercuts to be used for retention of the obturator for better functional efficiency. Successful prosthetic reconstruction of hemimaxillectomy defect is a challenging procedure that requires multidisciplinary expertise to achieve acceptable functional speech and swallowing outcomes. This article describes the oral rehabilitation of a patient with sub-total maxillectomy with a maxillary obturator. Oral rehabilitation of sub-total maxillectomy patient is a challenging task. Obturation of the defect depends on volume of the defect, and positioning of remaining hard and soft tissues to be used to retain, stabilize, and support the prosthesis. A maxillary obturator for edentulous patient must provide for retention, stability, support, patient comfort, and cleanliness.

  4. Connected Filtering by Reconstruction : Basis and New Advances

    NARCIS (Netherlands)

    Wilkinson, Michael H.F.

    2008-01-01

    Openings-by-reconstruction are the oldest connected filters, and indeed, reconstruction methodology lies at the heart of many connected operators such as levelings. Starting out from the basic reconstruction principle of iterated geodesic dilations, extensions such as the use of reconstruction

  5. CONNECTED FILTERING BY RECONSTRUCTION : BASIS AND NEW ADVANCES

    NARCIS (Netherlands)

    Wilkinson, Michael H. F.

    2008-01-01

    Openings-by-reconstruction are the oldest connected filters, and indeed, reconstruction methodology lies at the heart of many connected operators such as levelings. Starting out from the basic reconstruction principle of iterated geodesic dilations, extensions such as the use of reconstruction

  6. Tomographic reconstruction of binary fields

    International Nuclear Information System (INIS)

    Roux, Stéphane; Leclerc, Hugo; Hild, François

    2012-01-01

    A novel algorithm is proposed for reconstructing binary images from their projection along a set of different orientations. Based on a nonlinear transformation of the projection data, classical back-projection procedures can be used iteratively to converge to the sought image. A multiscale implementation allows for a faster convergence. The algorithm is tested on images up to 1 Mb definition, and an error free reconstruction is achieved with a very limited number of projection data, saving a factor of about 100 on the number of projections required for classical reconstruction algorithms.

  7. Precipitation Reconstructions and Periods of Drought in the Upper Green River Basin, Wyoming, USA

    Science.gov (United States)

    Follum, M.; Barnett, A.; Bellamy, J.; Gray, S.; Tootle, G.

    2008-12-01

    Due to recent drought and stress on water supplies in the Colorado River Compact States, more emphasis has been placed on the study of water resources in the Upper Green River Basin (UGRB) of Wyoming, Utah, and Colorado. The research described here focuses on the creation of long-duration precipitation records for the UGRB using tree-ring chronologies. When combined with existing proxy streamflow reconstructions and drought frequency analysis, these records offer a detailed look at hydrologic variability in the UGRB. Approximately thirty-three existing tree ring chronologies were analyzed for the UGRB area. Several new tree ring chronologies were also developed to enhance the accuracy and the geographical diversity of the resulting tree-ring reconstructions. In total, three new Douglas-fir (Pseudotsuga menziesii) and four new limber pine (Pinus flexilis) sites were added to the available tree-ring chronologies in this area. Tree-ring based reconstructions of annual (previous July through current June) precipitation were then created for each of the seventeen sub-watersheds in the UGRB. Reconstructed precipitation records extend back to at least 1654 AD, with reconstructions for some sub-basins beginning pre-1500. Variance explained (i.e. adjusted R2) ranged from 0.41 to 0.74, and the reconstructions performed well in a variety of verification tests. Additional analyses focused on stochastic estimation of drought frequency and return period, and detailed comparisons between reconstructed records and instrumental observations. Overall, this work points to the prevalence of severe, widespread drought in the UGRB. These analyses also highlight the relative wetness and lack of sustained dry periods during the instrumental period (1895-Present). Such long- term assessments are, in turn, vital tools as the Compact States contemplate the "Law of the River" in the face of climate change and ever-growing water demands.

  8. GPS tomography: validation of reconstructed 3-D humidity fields with radiosonde profiles

    Directory of Open Access Journals (Sweden)

    M. Shangguan

    2013-09-01

    Full Text Available Water vapor plays an important role in meteorological applications; GeoForschungsZentrum (GFZ therefore developed a tomographic system to derive 3-D distributions of the tropospheric water vapor above Germany using GPS data from about 300 ground stations. Input data for the tomographic reconstructions are generated by the Earth Parameter and Orbit determination System (EPOS software of the GFZ, which provides zenith total delay (ZTD, integrated water vapor (IWV and slant total delay (STD data operationally with a temporal resolution of 2.5 min (STD and 15 min (ZTD, IWV. The water vapor distribution in the atmosphere is derived by tomographic reconstruction techniques. The quality of the solution is dependent on many factors such as the spatial coverage of the atmosphere with slant paths, the spatial distribution of their intersections and the accuracy of the input observations. Independent observations are required to validate the tomographic reconstructions and to get precise information on the accuracy of the derived 3-D water vapor fields. To determine the quality of the GPS tomography, more than 8000 vertical water vapor profiles at 13 German radiosonde stations were used for the comparison. The radiosondes were launched twice a day (at 00:00 UTC and 12:00 UTC in 2007. In this paper, parameters of the entire profiles such as the wet refractivity, and the zenith wet delay have been compared. Before the validation the temporal and spatial distribution of the slant paths, serving as a basis for tomographic reconstruction, as well as their angular distribution were studied. The mean wet refractivity differences between tomography and radiosonde data for all points vary from −1.3 to 0.3, and the root mean square is within the range of 6.5–9. About 32% of 6803 profiles match well, 23% match badly and 45% are difficult to classify as they match only in parts.

  9. Preoperative cryotherapy use in anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Koyonos, Loukas; Owsley, Kevin; Vollmer, Emily; Limpisvasti, Orr; Gambardella, Ralph

    2014-12-01

    Unrelieved postoperative pain may impair rehabilitation, compromise functional outcomes, and lead to patient dissatisfaction. Preemptive multimodal analgesic techniques may improve outcomes after surgery. We hypothesized that patients using preoperative cryotherapy plus a standardized postoperative treatment plan will have lower pain scores and require less pain medication compared with patients receiving a standardized postoperative treatment plan alone after arthroscopically assisted anterior cruciate ligament reconstruction (ACLR). A total of 53 consecutive patients undergoing arthroscopically assisted ACLR performed by one of seven surgeons were randomly assigned to one of two groups. Group 1 received no preoperative cryotherapy and group 2 received 30 to 90 minutes of preoperative cryotherapy to the operative leg using a commercial noncompressive cryotherapy unit. Visual analog scale pain scores and narcotic use were recorded for the first 4 days postoperatively. Total hours of cold therapy and continuous passive motion (CPM) use and highest degree of flexion achieved were recorded as well. Group 1 consisted of 26 patients (15 allograft Achilles tendon and 11 autograft bone patellar tendon bone [BPTB]), and group 2 consisted of 27 patients (16 allograft Achilles tendon and 11 autograft BPTB). Group 2 patients reported less pain (average 1.3 units, p cryotherapy, hours of CPM use, or maximum knee flexion achieved. Complications did not occur in either group. This is the first report we are aware of showing the postoperative effects of preoperative cryotherapy. Our results support the safety and efficacy of preoperative cryotherapy in a multimodal pain regimen for patients undergoing ACL reconstruction. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Labral reconstruction: when to perform and how

    Directory of Open Access Journals (Sweden)

    Brian J White

    2015-07-01

    Full Text Available Over the past decade, the understanding of the anatomy and function of the hip joint has continuously evolved, and surgical treatment options for the hip have significantly progressed. Originally, surgical treatment of the hip primarily involved resection of damaged tissue. Procedures that maintain and preserve proper hip anatomy, such as labral repair and femoroacetabular impingement (FAI correction, have shown superior results, in terms of pain reduction, increased function, and ability to return to activities. Labral reconstruction is a treatment option that uses a graft to reconstruct the native labrum. The technique and outcomes of labral reconstruction have been described relatively recently, and labral reconstruction is a cutting edge procedure that has shown promising early outcomes. The aim of this article is to review the current literature on hip labral reconstruction. We will review the indications for labral reconstruction, surgical technique and graft options, and surgical outcomes that have been described to date. Labral reconstruction provides an alternative treatment option for challenging intra-articular hip problems. Labral reconstruction restores the original anatomy of the hip and has the potential to preserve the longevity of the hip joint. This technique is an important tool in the orthopaedic surgeon’s arsenal for hip joint treatment and preservation.

  11. CURRENT CONCEPTS IN ACL RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    Freddie H. Fu

    2008-09-01

    Full Text Available Current Concepts in ACL Reconstruction is a complete reference text composed of the most thorough collection of topics on the ACL and its surgical reconstruction compiled, with contributions from some of the world's experts and most experienced ACL surgeons. Various procedures mentioned throughout the text are also demonstrated in an accompanying video CD-ROM. PURPOSE Composing a single, comprehensive and complete information source on ACL including basic sciences, clinical issues, latest concepts and surgical techniques, from evaluation to outcome, from history to future, editors and contributors have targeted to keep the audience pace with the latest concepts and techniques for the evaluation and the treatment of ACL injuries. FEATURES The text is composed of 27 chapters in 6 sections. The first section is mostly about basic sciences, also history of the ACL, imaging, clinical approach to adolescent and pediatric patients are subjected. In the second section, Graft Choices and Arthroscopy Portals for ACL Reconstruction are mentioned. The third section is about the technique and the outcome of the single-bundle ACL reconstruction. The fourth chapter includes the techniques and outcome of the double-bundle ACL reconstruction. In the fifth chapter revision, navigation technology, rehabilitation and the evaluation of the outcome of ACL reconstruction is subjected. The sixth/the last chapter is about the future advances to reach: What We Have Learned and the Future of ACL Reconstruction. AUDIENCE Orthopedic residents, sports traumatology and knee surgery fellows, orthopedic surgeons, also scientists in basic sciences or clinicians who are studying or planning a research on ACL forms the audience group of this book. ASSESSMENT This is the latest, the most complete and comprehensive textbook of ACL reconstruction produced by the editorial work up of two pioneer and masters "Freddie H. Fu MD and Steven B. Cohen MD" with the contribution of world

  12. Climate Reconstructions

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Paleoclimatology Program archives reconstructions of past climatic conditions derived from paleoclimate proxies, in addition to the Program's large holdings...

  13. Top reconstruction and boosted top experimental overview

    CERN Document Server

    Skinnari, Louise

    2015-01-01

    An overview of techniques used to reconstruct resolved and boosted top quarks is presented. Techniques for resolved top quark reconstruction include kinematic likelihood fitters and pseudo- top reconstruction. Many tools and methods are available for the reconstruction of boosted top quarks, such as jet grooming techniques, jet substructure variables, and dedicated top taggers. Different techniques as used by ATLAS and CMS analyses are described and the performance of different variables and top taggers are shown.

  14. Sparse Image Reconstruction in Computed Tomography

    DEFF Research Database (Denmark)

    Jørgensen, Jakob Sauer

    In recent years, increased focus on the potentially harmful effects of x-ray computed tomography (CT) scans, such as radiation-induced cancer, has motivated research on new low-dose imaging techniques. Sparse image reconstruction methods, as studied for instance in the field of compressed sensing...... applications. This thesis takes a systematic approach toward establishing quantitative understanding of conditions for sparse reconstruction to work well in CT. A general framework for analyzing sparse reconstruction methods in CT is introduced and two sets of computational tools are proposed: 1...... contributions to a general set of computational characterization tools. Thus, the thesis contributions help advance sparse reconstruction methods toward routine use in...

  15. Medical image reconstruction. A conceptual tutorial

    International Nuclear Information System (INIS)

    Zeng, Gengsheng Lawrence

    2010-01-01

    ''Medical Image Reconstruction: A Conceptual Tutorial'' introduces the classical and modern image reconstruction technologies, such as two-dimensional (2D) parallel-beam and fan-beam imaging, three-dimensional (3D) parallel ray, parallel plane, and cone-beam imaging. This book presents both analytical and iterative methods of these technologies and their applications in X-ray CT (computed tomography), SPECT (single photon emission computed tomography), PET (positron emission tomography), and MRI (magnetic resonance imaging). Contemporary research results in exact region-of-interest (ROI) reconstruction with truncated projections, Katsevich's cone-beam filtered backprojection algorithm, and reconstruction with highly undersampled data with l 0 -minimization are also included. (orig.)

  16. Reconstruction design before tumour resection: A new concept of through-and-through cheek defect reconstruction.

    Science.gov (United States)

    Gong, Zhao-Jian; Ren, Zhen-Hu; Wang, Kai; Tan, Hong-Yu; Zhang, Sheng; Wu, Han-Jiang

    2017-11-01

    To explore a new method of reconstruction of through-and-through cheek defects and to evaluate this method's efficacy and patient prognosis. This retrospective study included 70 patients who underwent reconstruction of through-and-through cheek defects. The surgical approach, design of facial skin incisions, selection and design of flaps, postoperative quality of life and prognosis of patients were recorded and reported. Postoperative quality of life gradually increased over time, and the mean scores of University of Washington Quality of Life (UW-QOL) Questionnaire was more than 80 at 1-year postoperatively. The appearance, oral competence, chewing, swallowing, speech and other oral functions were well recovered in about 90% of patients at 1-year postoperatively. This new idea of reconstruction before tumour resection, brings the effect of plastic and reconstructive surgery to a new height. Copyright © 2017. Published by Elsevier Ltd.

  17. Lower Lip Reconstruction after Tumor Resection; a Single Author's Experience with Various Methods

    International Nuclear Information System (INIS)

    Rifaat, M.A.

    2006-01-01

    Background: Squamous cell carcinoma is the most frequently seen malignant tumor of the lower lip The more tissue is lost from the lip after tumor resection, the more challenging is the reconstruction. Many methods have been described, but each has its own advantages and its disadvantages. The author presents through his own clinical experience with lower lip reconstruction at tbe NCI, an evaluation of the commonly practiced techniques. Patients and Methods: Over a 3 year period from May 2002 till May 2005, 17 cases presented at the National Cancer Institute, Cairo University, with lower lip squamous cell carcinoma. The lesions involved various regions of the lower lip excluding the commissures. Following resection, the resulting defects ranged from 1/3 of lip to total lip loss. The age of the patients ranged from 28 to 67 years and they were 13 males and 4 females With regards to the reconstructive procedures used, Karapandzic technique (orbicularis oris myocutaneous flaps) was used in 7 patients, 3 of whom underwent secondary lower lip augmentation with upper lip switch flaps Primary Abbe (Lip switch) nap reconstruction was used in two patients, while 2 other patients were reconstructed with bilateral fan flaps with vermilion reconstruction by mucosal advancement in one case and tongue flap in the other The radial forearm free nap was used only in 2 cases, and direct wound closure was achieved in three cases. All patients were evaluated for early postoperative results emphasizing on flap viability and wound problems and for late results emphasizing on oral continence, microstomia, and aesthetic outcome, in addition to the usual oncological follow-up. Results: All flaps used in this study survived completely including the 2 free flaps. In the early postoperative period, minor wound breakdown occurred in all three cases reconstructed by utilizing adjacent cheek skin flaps, but all wounds healed spontaneously. The latter three cases Involved defects greater than 2

  18. Digital filtering and reconstruction of coded aperture images

    International Nuclear Information System (INIS)

    Tobin, K.W. Jr.

    1987-01-01

    The real-time neutron radiography facility at the University of Virginia has been used for both transmission radiography and computed tomography. Recently, a coded aperture system has been developed to permit the extraction of three dimensional information from a low intensity field of radiation scattered by an extended object. Short wave-length radiations (e.g. neutrons) are not easily image because of the difficulties in achieving diffraction and refraction with a conventional lens imaging system. By using a coded aperture approach, an imaging system has been developed that records and reconstructs an object from an intensity distribution. This system has a signal-to-noise ratio that is proportional to the total open area of the aperture making it ideal for imaging with a limiting intensity radiation field. The main goal of this research was to develope and implement the digital methods and theory necessary for the reconstruction process. Several real-time video systems, attached to an Intellect-100 image processor, a DEC PDP-11 micro-computer, and a Convex-1 parallel processing mainframe were employed. This system, coupled with theoretical extensions and improvements, allowed for retrieval of information previously unobtainable by earlier optical methods. The effect of thermal noise, shot noise, and aperture related artifacts were examined so that new digital filtering techniques could be constructed and implemented. Results of image data filtering prior to and following the reconstruction process are reported. Improvements related to the different signal processing methods are emphasized. The application and advantages of this imaging technique to the field of non-destructive testing are also discussed

  19. Considerations on Xi- reconstruction in LHCb

    CERN Document Server

    Brochu, F.M.

    2016-01-01

    This paper describes an alternative method of charged hyperon reconstruction applicable to the LHCb experiment. It extends the seminal work of the FOCUS collaboration to the specific detector layout of LHCb and addresses the reconstruction ambiguities reported in their earlier work, leading to improvements in the reconstruction efficiency for the specific cases of Xi- and Omega- baryon decays to a charged meson and a Lambda baryon.

  20. A multicenter evaluation of seven commercial ML-EM algorithms for SPECT image reconstruction using simulation data

    International Nuclear Information System (INIS)

    Matsumoto, Keiichi; Ohnishi, Hideo; Niida, Hideharu; Nishimura, Yoshihiro; Wada, Yasuhiro; Kida, Tetsuo

    2003-01-01

    The maximum likelihood expectation maximization (ML-EM) algorithm has become available as an alternative to filtered back projection in SPECT. The actual physical performance may be different depending on the manufacturer and model, because of differences in computational details. The purpose of this study was to investigate the characteristics of seven different types of ML-EM algorithms using simple simulation data. Seven ML-EM algorithm programs were used: Genie (GE), esoft (Siemens), HARP-III (Hitachi), GMS-5500UI (Toshiba), Pegasys (ADAC), ODYSSEY-FX (Marconi), and Windows-PC (original software). Projection data of a 2-pixel-wide line source in the center of the field of view were simulated without attenuation or scatter. Images were reconstructed with ML-EM by changing the number of iterations from 1 to 45 for each algorithm. Image quality was evaluated after a reconstruction using full width at half maximum (FWHM), full width at tenth maximum (FWTM), and the total counts of the reconstructed images. In the maximum number of iterations, the difference in the FWHM value was up to 1.5 pixels, and that of FWTM, no less than 2.0 pixels. The total counts of the reconstructed images in the initial few iterations were larger or smaller than the converged value depending on the initial values. Our results for the simplest simulation data suggest that each ML-EM algorithm itself provides a simulation image. We should keep in mind which algorithm is being used and its computational details, when physical and clinical usefulness are compared. (author)