Biomedical subjects

A Linney

Publications and source records attributed to A Linney.

10 recordsLinked to original sources

PubMed2003

Overcoming subjectivity in assessing facial lipoatrophy: is there a role for three-dimensional laser scans?

BACKGROUND: Prevalence and incidence rates of lipodystrophy vary widely and frequently rely upon self- and/or clinician reports. Currently no validated assessment tool for facial lipoatrophy is available. AIMS AND OBJECTIVES: To illustrate that assessment of the severity of facial lipoatrophy by patients and clinicians is subjective. To evaluate the reproducibility of facial three-dimensional surface laser scans. METHODS: Twenty-three HIV-positive men were recruited from an inner London HIV outpatient clinic in September 2001. CD4 count, viral load, antiretroviral history and body mass index were recorded. Patients and clinicians independently assessed the severity of facial lipoatrophy on a four-point scale and the level agreement was measured. Seventeen of the 23 patients (73.9%) underwent two scans 1 week apart, which were then superimposed. The volume difference (mm3) and mean difference (mm) between the scans for five regions of the face were measured and compared with the self-reported grade of facial lipoatrophy. RESULTS: For each pair of clinicians (P=0.03, 0.005 and 0.0002, respectively), and for one patient-clinician pair (P=0.004), there was a significant systematic difference between the two sets of gradings of facial lipoatrophy. The level of disagreement was generally higher for patients reporting facial lipoatrophy (n=17) compared to those not reporting it (n=6). The mean volume difference and mean difference between any region were within 200 mm3 and 0.25 mm, respectively. Reproducibility was unaffected by the self-reported grade of facial lipoatrophy. CONCLUSIONS: Assessment of the severity of facial lipoatrophy by patients and clinicians is subjective. Three-dimensional facial laser scans are reproducible and may provide an objective tool for monitoring changes in facial lipoatrophy.

Adult↗

PubMed1999

The effect of posture and anesthesia on the occlusal relationship in orthognathic surgery.

PURPOSE: This study investigated the differences in centric occlusion (intercuspal-CO) and centric relation contact position (CR) in patients in an upright and supine posture when conscious and when supine under general anesthesia to rationalize planning for complex bimaxillary osteotomies. PATIENTS AND METHODS: Twenty-four men and 37 women, with a mean age of 24.7 +/- 4.5 years were included in this study. Occlusal records on each patient included 1 in CO and 3 in CR in each of the following postures: conscious upright, conscious supine, and anesthetized supine. Casts were mounted in the Denar Mark II articulator and transferred to the Denar Vericheck (Denar Corp, Anaheim, CA) recording tool for measurements. The centric relation displacement vectors (CO-CR) were projected in various axes by 3D graphics. RESULTS: The upright conscious CO-CR (mm) vectors were significantly different from both the supine conscious and anesthetized positions in the anteroposterior plane. The difference in the vertical plane was only significant in Class II division 1 patients. CONCLUSION: The posterior change in centric relation explains the apparent occlusal discrepancies created by rigid fixation of the mandible applied in the supine anesthetized position. By taking the CR records in the supine conscious position, the "loss" of maxillary advancement can be avoided.

Adult↗

PubMed1999

A prospective study of computer-aided design and manufacture of titanium plate for cranioplasty and its clinical outcome.

The use of computerized three dimensional imaging and automated milling of models to produce accurate titanium plates for the reconstruction of craniofacial defects is described. A total of 148 patients have had extensive calvarial defects repaired using this (computer aided design and manufacture) technique developed in our unit. Of these, 141 were repaired secondarily (delayed cranioplasty), whilst seven were repaired immediately following craniectomy (single stage cranioplasty). All cases were assessed for accuracy of fit, restoration of natural skull contour and aesthetics. Seventy-two patients were reviewed after 1 year to determine the effect on adverse preoperative symptoms. Of the plates 97% had an excellent or good intraoperative fit. The modal insertion time was only 15 minutes. Postoperatively 98% resulted in the restoration of natural skull shape and symmetry. After 1 year, 82% of patients had complete resolution or diminution in severity of the adverse symptoms. A staphylococcus infection necessitated the temporary removal of one plate.

Adolescent↗

PubMed1997

Tele-education: the virtual medical laboratory.

The virtual medical laboratory (VML) was conceived to provide an Internet-accessible resource, offering access for clinicians and scientists to an invaluable data archive at the institute of Laryngology and Otology, London. The Institute is home to the largest collection of temporal bone, laryngeal, skull and sinus sections in Europe. The skull and sinus collections include an extensive section consisting of animal material. These were contributions from zoos around the world. Over the last 50 years, samples have been carefully sectioned and stained by specialized technicians to produce histology slices of most regions of the head and neck. The aim of the project is to create a virtual medical laboratory, which will provide access to archived histological material as well as computerized tomography and magnetic resonance data. Central to this aim is the reconstruction of the internal anatomy of the temporal bone from two-dimensional histology slices, to create three-dimensional views that can be used for anatomical simulation and surgical training in otolaryngology. State-of-the-art three-dimensional reconstruction and rendering technology allows us to develop such a model. Computer-generated simulation could be made available to all hospitals in which otolaryngology is practised, via digital communication networks. We aim to develop core technology in our own specialty that is applicable to other fields of higher education, which have not been exposed to such modern teaching modalities. This has the potential to become an invaluable teaching resource for anatomists, surgeons and other scientists.

Computer Communication Networks↗

PubMed1996

A comparative study of two arbitrary face-bow transfer systems for orthognathic surgery planning.

The relative reproducibility of two widely used arbitrary face-bow transfer systems, the Denar Slidematic and the Dentatus type AEB, was assessed for use in orthognathic surgery planning. A novel method was also developed to determine any variation in three-dimensional spatial position and orientation of the maxillary cast. This envelope of movement enabled realistic comparisons to be made for each face-bow system, operator, and skeletal type. The overall face-bow/articulator procedure showed poor reproducibility. However, the Denar Slidematic face-bow was better (P < 0.001) than the Dentatus type AEB standard face-bow, and the errors were higher in the anteroposterior and lateral directions than the vertical direction. There was no significant difference between operators for each system.

Analysis of Variance↗

PubMed1994

Three-dimensional computed tomography cholangiography: a new technique for biliary tract imaging.

Knowledge of the segmental anatomy and intersegmental biliary connections is an essential prerequisite to the effective management of patients with complex biliary strictures. Three dimensional (3D) imaging has the ability to demonstrate complex anatomical relationships that are difficult to appreciate on simple non-invasive two dimensional (2D) imaging. Our aim was to develop a technique for accurate, non-invasive 3D computed tomography (CT) cholangiography. Contiguous 4 mm CT sections were obtained through the liver during a dynamic bolus of 200 ml IV contrast. 3D surface reconstructions were then performed, the biliary system was isolated from surrounding hepatic parenchyma using segmentation and contrast threshold algorithms. 14 patients (six females, eight males, median age 68 years (range 48-82)) were studied. 13/14 had malignant biliary obstruction and one had obstruction secondary to a pancreatic pseudocyst. Obstruction was at the liver hilum in eight, the common bile duct in five and the common hepatic duct in one. Four patients had biliary endoprostheses but were symptomatic from inadequate drainage. There was good demonstration of the biliary anatomy, obstructed segments and intersegmental biliary connections in 13/14; irregular biliary dilatation secondary to primary sclerosing cholangitis rendered interpretation difficult in one. 3D cholangiography provided a useful adjunct to other imaging techniques. In particular, in patients with complex hilar strictures it aided implementation of appropriate interventional drainage procedures.

Aged↗

PubMed1993

Sex discrimination: how do we tell the difference between male and female faces?

People are remarkably accurate (approaching ceiling) at deciding whether faces are male or female, even when cues from hair style, makeup, and facial hair are minimised. Experiments designed to explore the perceptual basis of our ability to categorise the sex of faces are reported. Subjects were considerably less accurate when asked to judge the sex of three-dimensional (3-D) representations of faces obtained by laser-scanning, compared with a condition where photographs were taken with hair concealed and eyes closed. This suggests that cues from features such as eyebrows, and skin texture, play an important role in decision-making. Performance with the laser-scanned heads remained quite high with 3/4-view faces, where the 3-D shape of the face should be easiest to see, suggesting that the 3-D structure of the face is a further source of information contributing to the classification of its sex. Performance at judging the sex from photographs (with hair concealed) was disrupted if the photographs were inverted, which implies that the superficial cues contributing to the decision are not processed in a purely 'local' way. Performance was also disrupted if the faces were shown in photographic negatives, which is consistent with the use of 3-D information, since negation probably operates by disrupting the computation of shape from shading. In 3-D, the 'average' male face differs from the 'average' female face by having a more protuberant nose/brow and more prominent chin/jaw. The effects of manipulating the shapes of the noses and chins of the laser-scanned heads were assessed and significant effects of such manipulations on the apparent masculinity or femininity of the heads were revealed. It appears that our ability to make this most basic of facial categorisations may be multiply determined by a combination of 2-D, 3-D, and textural cues and their interrelationships.

Adolescent↗

PubMed1991

Recognising facial surfaces.

The extent to which faces depicted as surfaces devoid of pigmentation and with minimal texture cues ('head models') could be matched with photographs (when unfamiliar) and identified (when familiar) was examined in three experiments. The head models were obtained by scanning the three-dimensional surface of the face with a laser, and by displaying the surface measured in this way by using standard computer-aided design techniques. Performance in all tasks was above chance but far from ceiling. Experiment 1 showed that matching of unfamiliar head models with photographs was affected by the resolution with which the surface was displayed, suggesting that subjects based their decisions, at least in part, on three-dimensional surface structure. Matching accuracy was also affected by other factors to do with the view-points shown in the head models and test photographs, and the type of lighting used to portray the head model. In experiment 2 further evidence for the importance of the nature of the illumination used was obtained, and it was found that the addition of a hairstyle (not that of the target face) did not facilitate matching. In experiment 3 identification of the head models by colleagues of the people shown was compared with identification of photographs where the hair was concealed and eyes were closed. Head models were identified less well than these photographs, suggesting that the difficulties in their recognition are not solely due to the lack of hair. Women's heads were disproportionately difficult to recognise from the head models. The results are discussed in terms of their implications for the use of such three-dimensional head models in forensic and surgical applications.

Adolescent↗

PubMed1991

Computerized densitometric analysis of interproximal bone levels in a controlled clinical study into the treatment of periodontal bone defects with ceramic hydroxyapatite implant material.

The aim of this controlled clinical study was to utilize computer-assisted densitometric analysis of radiographs to assess the effectiveness of treating periodontal osseous defects with a sintered hydroxyapatite implant material. It was found that over the 2-year period of the study for the osseous defects treated by the implant material, there was a gain in the height of the hard tissue relative to the cemento-enamel junction; this gain was statistically significant compared with the results for the control sites.

Absorptiometry, Photon↗

PubMed1989

A microcomputer system for the analysis of dental radiographs.

A system for the digital storage and computer analysis of dental radiographs is described. The system is based on popular microcomputer, of a type commonly used for other purposes in general dental practice. The analysis system includes methods to compensate for variations due to exposure and development in serial radiographs. Interactive software allows a detailed analysis of the radiograph, producing qualitative and quantitative data for diagnosis and monitoring. An example of its application is given.

Alveolar Process↗