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For anyone desiring to cast anatomical models, a simplified technique for external casting has been developed using dental impression materials readily available in dental supply houses. These impressions yield life-like permanent models retaining topographical features of normal as well as pathological skin and nails.
Models of the lung airways of a rat were developed from complete measurements of the tracheobronchial airways. A silicone rubber cast of the tracheobronchial airways of a rat lung was prepared and all individual airway segments down to and including the terminal bronchioles were measured to obtain the segment diameters, lengths, branching angles and angles of inclination to gravity. Models of the rat tracheobronchial airways were constructed based on the original measurements and the subsequent analysis. Some mathematical assumptions about acinar anatomy distal to terminal bronchioles were made to extend the models to include pulmonary regions. Emphasis was placed on the "Typical Path Lung Model" which used one typical pathway to represent either a whole lung or a lobe of the lung. The models are simple and can be applied in calculation of physiologic variables or particle deposition during inhalation in various lobes of the lung.
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A system for preplanning interstitial treatment of gynecologic malignancies with a CT-based 3-dimensional planning system is presented. The preplan produces a custom template design that optimizes catheter placement. The procedure begins with a CT scan with a vaginal cylinder and blank template in place. Contours of the anatomic structures of interest, cylinder, and template are entered into the system, and 3-D surfaces are generated. The first view evaluated is oriented in a "cylinder's-eye view," which shows the path of the catheters placed parallel to the cylinder. In most cases this path to the tumor is obstructed by the pubic bones and bladder. By rotating the view posteriorly, the catheters can travel under the symphysis and bladder to the tumor. Once the optimum angle for visualization of the tumor has been determined, an array of catheters is designed to optimize the dose to the tumor. This array includes the special distribution in the oblique plane as well as the depth of insertion for each catheter. The design is then used in drilling the appropriate guide holes in the template. Orthogonal film dosimetry as well as CT verification of source placement will be compared to the preplan distribution.
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Numerous procedures to expose the anterior clival region have been described, including the transoral, transcervical, transseptal-transsphenoidal, transantral, transnasal, bilateral Le Fort I maxillotomy, transbasal, transpalatal, and modifications of the Caldwell-Luc approach. Despite the large number of surgical options available, it may be necessary to have wider access to the midline skull base than these approaches provide. We have developed a microsurgical transmaxillary-transnasal approach to the anterior clivus that has been studied in both dry skull and cadaveric preparations and used clinically. The surgical technique has four stages: 1) antromaxillary; 2) nasal; 3) sphenoidal; and 4) clival. The wider access of this approach is achieved mainly by an osteotomy of the frontal process of the maxilla, which transforms the nasal cavity and the antrum into a single cavity while preserving the functional anatomy of the nose. Cosmesis is preserved by replacement of the cartilaginous nasal septum and the frontal process at the end of the procedure. The technique provides the good cosmetic results of the sublabial approaches and prevents vascular and neural injury in the same way that other anterior approaches do. This transmaxillary-transnasal technique may be used in combination with other approaches for extensive tumors.
Direct visualization of the three-dimensional architecture of the tubal musculature (myosalpinx) was made possible by a technique involving chemical digestion of interstitial connective tissue, followed by ultrasonic microdissection and final observations under the scanning electron microscope. The isthmic myosalpinx in the guinea pig, rabbit and in humans consists of muscular bundles that tend to lie longitudinally, circularly or oblique. The muscular bundles along the tubal wall change direction, branch and intermingle with one another, giving rise to an irregular network in which distinct layers are not readily distinguishable. In the ampulla, the muscle bundles form a very irregular three-dimensional network of fibres that follow different orientations. The authors suggest a primary role for such a structure in the random pendular transport of the gametes as well as in the denudation of the egg by deformation of the myotubal wall.
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A simple anatomic model for studying the scintigraphic appearance of various skeletal structures is described. The technique makes use of the fact that technitium pyrophosphate uptake in bone occurs by chemisorption to the surface of crystals in the bone matrix. By soaking clean bones in solutions of technetium pyrophosphate they can be rendered radioactive and subsequently studied by various imaging techniques.
An anatomical model for teaching the practical aspects of routine oral surgery in a clinical or laboratory environment, is described. Replaceable sections allow the model to be rapidly re-used so that successive students may practise procedures such as incisions, flap reflection, bone removal, tooth removal, apicectomy and suturing. Keeping the cost per procedure to a minimum was considered to be of fundamental importance and this has been achieved through the use of 'factory produced' replacement parts.
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We have used the finite-difference time-domain (FDTD) method to calculate induced current densities in a 1.31-cm (nominal 1/2 in) resolution anatomically based model of the human body for exposure to purely electric, purely magnetic, and combined electric and magnetic fields at 60 Hz. This model based on anatomic sectional diagrams consists of 45,024 cubic cells of dimension 1.31 cm for which the volume-averaged tissue properties are prescribed. It is recognized that the conductivities of several tissues (skeletal muscle, bone, etc.) are highly anisotropic for power-line frequencies. This has, however, been neglected in the first instance and will be included in future calculations. Because of the quasi-static nature of coupling at the power-line frequencies, a higher quasi-static frequency f' may be used for irradiation of the model, and the internal fields E' thus calculated can be scaled back to the frequency of interest, e.g., 60 Hz. Since in the FDTD method one needs to calculate in the time domain until convergence is obtained (typically 3-4 time periods), this frequency scaling to 5-10 MHz for f' reduces the needed number of iterations by over 5 orders of magnitude. The data calculated for the induced current and its variation as a function of height are in excellent agreement with the data published in the literature. The average current densities calculated for the various sections of the body for the magnetic field component (H) are considerably smaller (by a factor of 20-50) than those due to the vertically polarized electric field component when the ratio E/H is 377 ohms. We have also used the previously described impedance method to calculate the induced current densities for the anatomically based model of the human body for the various orientations of the time-varying magnetic fields, namely from side to side, front to back, or from top to bottom of the model, respectively.
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.
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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.
Recently an anatomic model was reported for adults that standardized the platform height for step tests using an individual's stature and a specified hip angle. In order to determine if the model could be used to predict the platform height for children, platform heights were calculated and hip angles were measured in 146 boys and 140 girls ages 6 to 18 years who were divided into four age groups (6 to 8, 9 to 11, 12 to 15, and 16 to 18 years old). There were no statistical differences between measured and calculated hip angles in any of the age groups. In order to determine the validity for predicting maximal oxygen consumption from stepping using a calculated platform height, three step tests were employed using one platform height and stepping frequencies of 22, 26, or 30 ascents/min. Each of the tests was administered to 93 6- to 18-year-olds. Correlation coefficients between the 15-second recovery heart rate after stepping and maximal oxygen consumption measured on a treadmill were .80 at 30 ascents/min, .79 at 26 ascents/min, and .81 at 22 ascents/min. Each of the correlation coefficients was significant at the P less than .01 level. It can be concluded that the model is valid for standardizing the platform height for children for use with a single stage step test for estimating maximal oxygen consumption.
A method for the three-dimensional reconstruction of CT-image data permits manufacturing of natural size anatomical models thus enabling preoperative measurements of relevant parameters (length, areas, and volumes). The methods described allow for new perspectives in preoperative planning of dental implants, particularly for the maxillary problem area. The use of 3D image data for manufacturing individual alloplastic implants simplifies the exact reconstruction of symmetrical bone structures, which up to now was impossible to achieve with conventional methods. Applications in the fields of orthodontic surgery and in neurological surgery are suggested. Refinement of available techniques is possible by means of additional segmentation of soft tissues, and by implementation of more sophisticated software for better visualisation and smoothly shaped surfaces. Future applications may even include aesthetic surgery.
The mechanism of second-degree external rotational injury of the ankle, with fracture of the lower end of the fibula, is discussed with reference to experiments on an anatomical model. It is concluded that with this type of injury there is lateral displacement of the talus because the deltoid ligament is ruptured, but there is no diastasis of the inferior tibiofibular syndesmosis. The results of conservative treatment of 10 patients with second-degree external rotational injury of tha ankle are reviewed.