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At least 145 records · Page 8Linked to original sources
PubMed2002

Craniofacial reconstruction with computer-generated HTR patient-matched implants: use in primary bony tumor excision.

The aim of this clinical series is to report the effectiveness and safety of using computer-generated alloplastic hard tissue replacement (HTR) implants for the reconstruction of large defects of the cranio-orbital region when combined with simultaneous bone tumor excision. Seven patients who had large nonmalignant bony lesions of the anterior cranial vault and orbit underwent simultaneous bony excision and reconstruction with preoperatively fabricated custom alloplastic implants. Preoperatively, a 3D computed tomography (CT) scan was obtained from which an anatomical model was fabricated. On the anatomical model, the predicted amount of bone excision was performed. The defect in the model was then used to create an alloplastic (HTR polymer) implant for reconstruction and surgical placement. At the time of surgery, the implant was secured into position with either metal or resorbable plates and screws. In cases where the frontal sinus was in proximity to the implant, it was either cranialized and covered with a pericranial flap or obliterated with hydroxyapatite cement. All computer-generated implants required some modification intraoperatively due to a larger amount of bony excision than was preoperatively planned. This was accomplished by modifying the sterile back-up of the implant as an addition to the original implant or completing reconstruction of the bony defect with hydroxyapatite cement. All patients have healed uneventfully with a minimum of 1 year follow-up (average, 2.6 years). In all cases, excellent contours have been maintained and all patients have remained infection-free. In the management of large benign bony tumors of the cranio-orbital region, simultaneous reconstruction with custom implants fabricated from porous, hydrophilic HTR polymer can be preoperatively fabricated based on an estimate of the subsequent bony defect. The successful use of this approach depends on a favorable tissue quality of the recipient site, a generous preoperative estimate of the amount of bone that will be resected so that the implant is adequate, intraoperative techniques of expanding the implant reconstruction, and intraoperative methods to assure a partitioning of the implant from the frontal sinus.

Absorbable Implants↗
PubMed1992

An anatomical heart model with applications to myocardial activation and ventricular mechanics.

A three-dimensional finite element model of the mechanical and electrical behavior of the heart is being developed in a collaboration among Auckland University, New Zealand; the University of California at San Diego, U.S.; and McGill University, Canada. The equations of continuum mechanics from the theory of finite deformation elasticity are formulated in a prolate spheroidal coordinate system and solved using a combination of Galerkin and collocation techniques. The finite element basis functions used for the dependent and independent variables range from linear Lagrange to cubic Hermite, depending on the degree of spatial variation and continuity required for each variable. Orthotropic constitutive equations derived from biaxial testing of myocardial sheets are defined with respect to the microstructural axes of the tissue at the Gaussian quadrature points of the model. In particular, we define the muscle fiber orientation and the newly identified myocardial sheet axis orientation throughout the myocardium using finite element fields with nodal parameters fitted by least-squares to comprehensive measurements of these variables. Electrical activation of the model is achieved by solving the FitzHugh-Nagumo equations with collocation at fixed material points of the anatomical finite element model. Electrical propagation relies on an orthotropic conductivity tensor defined with respect to the local material axes. The mechanical constitutive laws for the Galerkin continuum mechanics model are (1) an orthotropic "pole-zero" law for the passive mechanical properties of myocardium and (2) a Wiener cascade model of the active mechanical properties of the muscle fibers. This chapter concentrates on two aspects of the model: first, grid generation, including both the generation of nodal coordinates for the finite element mesh and the generation of orthotropic material axes at each computational point, and, second, the formulation of constitutive laws suitable for numerically intensive finite element computations. Extensions to this model and applications to the mechanical and electrical function of the heart are described in Chapter 16 by McCulloch and co-workers.

Animals↗
PubMed1995

Simulation of the uptake of a reactive gas in a rat respiratory tract model with an asymmetric tracheobronchial region patterned on complete conducting airway cast data.

Generally, the uptake of reactive gases by the respiratory tract is simulated assuming that all paths from the trachea to the most distal airspaces are equivalent. As this is not the case, especially for nonhumans, the adequacy of this approach to predict doses that can be useful in the fields of toxicology and risk assessment is subject to question. To explore this issue, a dosimetry model is developed which combines the use of one-dimensional convection-dispersion equations in conjunction with multiple path anatomic models so that the dosimetry model simultaneously simulates transport and uptake in all the airways and airspaces of the anatomic model. For this work, the anatomic model of the tracheobronchial (TB) region is patterned on cast data which describe the dimensions and branching network of the 4807 airways of the TB region of a rat. Distal to each of the 2404 terminal bronchioles of the anatomical model, the air space is modeled as a single path. The results presented are preliminary; they focus on the predictions themselves to obtain an understanding of what the model has to say about uptake in a complex set of branching airways. Results include the following predictions: (1) Regardless of path there is a similarity along different paths in the shape of concentration profiles as well as a similarity in the shape of dose profiles. (2) Along a path in the TB or pulmonary region, dose decreases distally. (3) Generally, proximal alveolar region (PAR, a region of major morphological damage due to O3 and NO2) dose decreases the more distal the PAR. (4) There is considerable variation in the doses of the different airways or alveolar surfaces in the same generation. (5) The maximum and minimum PAR doses do not correspond to paths with, respectively, the smallest and largest number of generations from the trachea to the PAR. (6) The ratio of the maximum to minimum PAR dose is very sensitive to tidal volume. These results give a more realistic understanding of respiratory tract gas transport and uptake. The model also predicts aspects that equivalent path models cannot, such as the dose distribution of different but morphologically equivalent sites.

Algorithms↗
PubMed2000

Relationships between the epileptic focus and hand area in central epilepsy: combining dipole models and anatomical landmarks.

OBJECT: When considering resection of epileptic generators near the central sulcus, it is essential to define the spatial relationship between the epileptic generator and the primary sensorimotor hand area. In this study, the authors assessed the accuracy of dipole modeling of electroencephalographic spikes and median nerve somatosensory evoked potentials (SSEPs) in defining this relationship preoperatively and noninvasively. METHODS: Epileptic spikes and SSEPs in patients with focal central area epilepsy were represented by dipole models coregistered onto global magnetic resonance images. In patients who underwent surgery, spike dipoles were also compared with findings of electrocorticography (ECoG) and with the resection area. To improve the accuracy of the dipole models, anatomical landmarks of the hand area were used to assess the error in SSEP dipole location, and this error measure was used to correct the location of spike dipoles. Five patients with central epilepsy were studied, three of whom underwent ECoG-guided surgical resections. The location of SSEP dipoles correlated well with anatomical landmarks of the primary sensory hand area. The relative position of the spike and SSEP dipoles correlated well with the patients' ictal symptoms, ECoG findings, and the location of the epileptic focus (as defined by the resection cavity in patients who became seizure free postoperatively). Corrected spike dipoles were located even closer to the resection cavity. CONCLUSIONS: The calculation of the relative location of spike and SSEP dipoles is a simple noninvasive method of determining the relationship between the primary hand area and an epileptic focus in the central area. The spatial resolution of this technique can be further improved using easily identifiable anatomical landmarks.

Adolescent↗
PubMed1995

Spectral analysis of magnetic fields from domestic appliances and corresponding induced current densities in an anatomically based model of the human head.

Magnetic fields emitted by electric appliances such as razors, hair dryers, and drills were measured in the frequency domain. Results show the presence of high-frequency components (up to 96 kHz for razors, up to 3.4 kHz for hair dryers, and up to 8.6 kHz for drills) in the harmonic content of the fields. The measured fields were used to calculate the induced current densities in an anatomically based model of the human head (resolution 1.31 cm) by using the impedance method. The harmonic field contribution to the current density was higher than that from the carrier frequency for all the tested appliances.

Electronics↗
PubMed2007

Feasibility of preoperative planning using anatomical facsimile models for mandibular reconstruction.

BACKGROUND: Functional and aesthetic mandibular reconstruction after ablative tumor surgery continues to be a challenge even after the introduction of microvascular bone transfer. Complex microvascular reconstruction of the resection site requires accurate preoperative planning. In the recent past, bone graft and fixation plates had to be reshaped during the operation by trial and error, often a time-consuming procedure. This paper outlines the possibilities and advantages of the clinical application of anatomical facsimile models in the preoperative planning of complex mandibular reconstructions after tumor resections. METHODS: From 2003 to 2005, in the Department of Maxillofacial Surgery of the University of Udine, a protocol was applied with the preoperative realization of stereolithographic models for all the patients who underwent mandibular reconstruction with microvascular flaps. 24 stereolithographic models were realized prior to surgery before emimandibulectomy or segmental mandibulectomy. The titanium plates to be used for fixation were chosen and bent on the model preoperatively. The geometrical information of the virtual mandibular resections and of the stereolithographic models were used to choose the ideal flap and to contour the flap into an ideal neomandible when it was still pedicled before harvesting. RESULTS: Good functional and aesthetic results were achieved. The surgical time was decreased on average by about 1.5 hours compared to the same surgical kind of procedures performed, in the same institution by the same surgical team, without the aforesaid protocol of planning. CONCLUSION: Producing virtual and stereolithographic models, and using them for preoperative planning substantially reduces operative time and difficulty of the operation during microvascular reconstruction of the mandible.

Computer Simulation↗
PubMed1995

Modeling respiratory anatomy and physiology in VR.

In trauma, many injuries impact anatomical structures, which may in turn affect physiological processes--not only those processes within the structures, but ones occurring in physical proximity to them as well. Our goal is to endow a 3D anatomical model with physiological mechanisms to demonstrate such effects. Our approach couples deformable object simulation for organs with physiological modeling, in a way that supports three-dimensional animated simulation. We demonstrate our approach through our current model of respiratory mechanics in a virtual 3D environment. Anatomical models that can capture physiological and pathophysiological changes can serve as an infrastructure for more detailed modeling, as well as benefiting surgical planning, surgical training, and general medical education.

Computer Simulation↗
PubMed1999

Sensitivity of single-equivalent trunk extensor muscle models to anatomical and functional assumptions.

Single-equivalent muscle models are often used to estimate loads on the lumbosacral joint after net extension moments have been calculated by means of inverse dynamics. These models usually ignore the effects trunk flexion has on the extensor lever arm. In addition, no systematic analysis of the sensitivity to the anatomical and functional assumptions made in these models is available. In the present study a series of single-equivalent models incorporating trunk flexion dependence was derived from a detailed description of the trunk musculature. Each model was based on different anatomical and functional assumptions. The differences of estimates of compression and shear forces on the lumbosacral disc during a lifting movement resulting from these models were analysed. The results show that these load estimates heavily depend on assumptions regarding anthropometry, lumbar curvature and coactivity of abdominal muscles and only moderately on assumptions regarding force sharing between extensor muscles. Fairly simple single-equivalent models with the net moment and thorax orientation as input can be used to predict lumbosacral compression and shear.

Biomechanical Phenomena↗
PubMed2004

Respiratory system simulations and modeling.

Simulators and models of the respiratory system range from simple mechanical devices to complex systems that include sophisticated computers. These systems have considerable utility in clinician education, guiding therapies, evaluating new devices and techniques, and in improving our understanding of the cardiorespiratory system. Simulators and models are of 3 types: signs-and-symptoms simulators, anatomic models, and physiologic models. Signs-and-symptoms simulators range from human actors to computer-controlled patient mannequins. Clinical scenarios, from minor abnormalities to catastrophic emergencies, can be simulated. As has been found with aircraft cockpit simulators, improved clinician performance in simulated emergencies should translate into improved performance in real patient-care situations. Anatomic modeling can simulate basic anatomy for training clinicians. Three-dimensional reconstruction of the airways, using real patient data, can help to plan therapy, understand the disease process, and warn of safety issues. Anatomic modeling with radiographs and magnetic resonance images, sometimes created using radiolabeled tracer gases, can create 3-dimensional images of regional lung anatomy and function. Physiologic signals such as carbon dioxide production, oxygen consumption, and washout/washin of various tracer gases can be used to model ventilation-perfusion and ventilation-volume relationships, and those models can improve understanding of disease processes and guide therapies.

Computer Graphics↗
PubMed1996

Alterations in equine guttural pouch morphology with head position: observations using a new technique for producing accurate casts.

BACKGROUND: An improved technique for preparing casts of the equine guttural pouch is described. The new technique is simplified and inexpensive in comparison to previous techniques and produces highly accurate anatomic models which are both durable and flexible. METHODS: Silicone rubber bathtub caulk was injected into the guttural pouches of horse cadavers. The silicone was allowed to cure overnight, and casts were removed by dissection. The new technique was then used to evaluate changes in the shape of the guttural pouch with changes in head position. RESULTS: With flexion of the atlanto-occipital joint, the lateral compartment of the guttural pouch in particular was found to change considerably in size in shape. The angle of inclination of the ventral border of this pouch increased with flexion, as did the depth of the impression made by the rostral portion of the stylohyoid bone. In addition, the lateral compartment diminished in thickness rostrally in casts from flexed animals. CONCLUSIONS: The viscous silicone caulk resulted in superior casts of the equine guttural pouch. Observations of changed pouch shape with head position agree well with previous reports of increased difficulty in draining the lateral compartment of the horse's guttural pouch when the head is held in the flexed position.

Animals↗
PubMed2001

Predicted SAR in Sprague-Dawley rat as a function of permittivity values.

Specific absorption rate (SAR) value is dependent on permittivity value. However, variability in the published permittivity values for human and animal tissue and the development of sophisticated 3-dimensional digital anatomical models to predict SAR values has resulted in the need to understand how model parameters (permittivity value) affect the predicted whole body and localized SAR values. In this paper, we establish the partial derivative of whole body SARs and localized SAR values (defined as SAR for individual organs with respect to a change in the permittivity values of all tissue types, as well as for those tissues with the most variable permittivity values. Variations in the published permittivity values may substantially influence whole body and localized SAR values, but only under special conditions. Orientation of the exposed object to the incident electromagnetic wave is one of the most crucial factors. Published 2001 Wiley-Liss, Inc.

Animals↗
PubMed1988

Superimposition of an average three-dimensional pattern of brain structures on CT scans.

A method is described for the superimposition of an averaged telencephalic anatomical model and individual CT scans. The model is digitally available and derived from 3-D measurements of 30 post-mortem brains. It is averaged in size in relation to the midintercommissural point. The midintercommissural point in the individual brain is gained from reformed parasagittal projection images. The model is adjusted to the individual CT scan series by scaling and rotating according to the best fit and correspondence of the position of the central sulcus. The method needs no invasive neuroradiological techniques but is based on current computer algorithms.

Brain↗
PubMed1984

The use of the fascia of the lower leg as a roll-over flap: its possible clinical applications in reconstructive surgery.

In two patients we have used the fascia of the lower leg as a roll-over flap to heal defects of the skin and subcutaneous tissues. The case reports are preceded by the description of an experimental anatomical model to illustrate the attachments, blood supply and the potential range of movement of the fascia of the medial intermuscular compartment of the leg. The rationale for the procedures that were performed and the problems encountered are discussed.

Fasciotomy↗
PubMed1987

The effect of tongue position on division of airflow in the presence of velopharyngeal defects.

Results of studies of nasal to oral airflow ratios are reported using simple and accurate anatomical models to record the effect of differing positions of lips, tongue and soft palate, with particular reference to the effect of the position of the dorsum of the tongue and various sizes of velopharyngeal defect. The resistances to airflow produced by the labial, palatolingual, velopharyngeal and naral valves were found to be interdependent. Variations in tongue position alone could allow the same nasal airflow during a more than three-fold variation in the size of velopharyngeal defects. The degree of nasal escape of air which is responsible for the typical "cleft palate" type of speech cannot be assessed by observation of the size of the velopharyngeal defect alone.

Cleft Palate↗
PubMed2005

In vitro flow analysis of a patient-specific intraatrial total cavopulmonary connection.

BACKGROUND: Understanding the hemodynamics of the total cavopulmonary connection may lead to further optimization of the connection design and surgical planning, which in turn may lead to improved surgical outcome. Although most experimental and numerical investigations have mainly focused on somewhat simplified geometries, investigation of the flow field of true anatomic configurations is necessary for a true understanding. METHODS: An intraatrial connection was reconstructed from patient magnetic resonance images and manufactured using transparent stereolithography. Power loss, flow visualization, and digital particle image velocimetry as well as computational fluid dynamics simulations were performed to characterize the anatomic flow structure. Given the complexity of the anatomic flow, two simplified versions of the geometry were manufactured and run through power loss and flow visualization studies. RESULTS: Experimental measurements revealed complex, unsteady, and highly three-dimensional flow structures within the anatomic model, leading to high pressure drops and power losses. The small vessel diameters were the primary cause of these losses. Numerical simulations demonstrated that most of the dissipation occurred in the pulmonary arteries. Finally, asymmetric pulmonary diameters together with the bulgy intraatrial connection favored the rise of flow unsteadiness and unbalanced lung perfusion. CONCLUSIONS: The technique developed in this study enabled a deeper understanding of the hemodynamics behind an intraatrial connection. Future endeavors would be to study variation among differing surgical techniques, comparing intraatrial and extracardiac approaches.

Adolescent↗
PubMed1976

The effects of orthopedic forces on the craniofacial complex utilizing cervical and headgear appliances.

1. A three-dimensional anatomic model of a human skull was produced with birefringent materials for photoelastic analysis. By means of photoelastic techniques during application of high-pull and cervical extraoral traction, stresses were visualized within the model. 2. Extraoral anchorage affected the position of the maxillary molar and its resulting alveolar development. Cervical headgear had a much greater tipping effect on the maxillary molar than did the high-pull headgear. Both appliances examined could produce stresses which may be transmitted to distant eraniofacial sutures. As opposed to high-pull traction, cervical pull in general stressed more areas and to a much greater degree. 4. The pterygoid plates of the sphenoid bone, the zygomatic arches, the junction of the maxilla with the lacrimal bone and the ethmoid, and the maxillary teeth were affected by both types of headgear. 5. Only cervical traction produced stresses at the frontal process of the maxilla and the Zygomaticofrontal suture. 6. There were two findings which had not been previously reported: First, cervical traction tended to open the palate in the posterior region. Second, high-pull traction produced compressive stresses at the junction of the right and left maxillae inferior to the anterior nasal spine.

Facial Bones↗
PubMed2001

Determination of vibration-related spinal loads by numerical simulation.

OBJECTIVE: Dynamic spinal loads due to human whole body vibrations are extremely difficult to determine experimentally. However, they can be predicted by numerical simulation. This paper presents an approach for the prediction of dynamic spinal loads caused by whole body vibrations, as well as some basic considerations concerning the process of numerical simulation. BACKGROUND: Long-term whole body vibrations have been found to cause health risks for the lumbar spine. As an increasing percentage of the population is exposed to whole body vibrations at work, more and more people have to face the risk of whole body vibrations-related injury. Knowledge about the actual loads in the lumbar spine is essential when spinal loads are to be compared with spinal strength in order to assess the possible health risks caused by whole body vibrations. METHODS: Since an extrapolation of results to unknown data such as spinal loads can only be done using anatomical models of the human body, a simplified finite-element model is presented which is adaptable to body height, body mass, and posture of any specific subject under investigation. The model has been built by reducing a very detailed, nonlinear finite-element model of seated man in its complexity (number of degrees of freedom). Furthermore, the simplified model has been linearised to avoid nonlinear solution procedures. RESULTS: The model has been verified for vertical and horizontal excitation at the seat. Model results have been compared to measurements on subjects. Individual exposure-effect relationships may be predicted by this model, due to the adaptability to a specific subject. Additionally, a new phenomenological method of eliminating the influence of local skin-accelerometer vibrations on vibration measurements on the skin surface is discussed. This method may provide data about bone acceleration that can be used in the process of model verification. CONCLUSIONS: Integral loading measures, such as spinal loads, may be predicted with simplified finite-element models. Quantitative judgements of these loads may be performed for individual conditions. Linearised models may be used for limited ranges of excitation intensities. Energy dissipation should be modeled by discrete dashpot elements instead of proportional damping. RELEVANCE: In order to assess the risk of an injury to the lumbar spine due to whole body vibrations, spinal loads have to be compared with spinal strength. This paper presents the development and verification of a simplified finite-element model of the human body which is based on human anatomy and therefore well-suited to occupational/clinical biomechanics for the prediction of spinal loads.

Acceleration↗