Measurement of the frontal area of a swimmer: Alternative methods and uncertainty analysis

Background: Recent anatomic studies have confirmed the presence of a true ligament structure, the anterolateral ligament (ALL), in the anterolateral region of the knee. This structure is involved in the rotatory instability of the knee and might explain why some isolated reconstructions of the anterior cruciate ligament result in a residual pivot shift. Therefore, when considering the least invasive method for reconstruction of this structure, it is important to identify the corresponding bony landmarks on radiographic images. Purpose: To establish radiographic femoral and tibial landmarks for the ALL in frontal and lateral views. Study Design: Descriptive laboratory study. Methods: Ten unpaired cadaver knees were dissected. The attachments of the ALL were isolated and its anatomic parameters were quantified. Its origin and insertion were marked with a 2-mm-diameter metallic sphere, and radiographs were taken from frontal and lateral views. The obtained images were analyzed and the ALL parameters established. Results: The origin of the ALL in the lateral view was found at a point an average ± SD of 47.5% ± 4.3% from the anterior edge of the femoral condyle and about 3.7 ± 1.1 mm below the Blumensaat line. In the frontal view, the origin was about 15.8 ± 1.9 mm from the distal condyle line. The ALL insertion was an average of 53.2% ± 5.8% from the anterior edge of the lateral tibial plateau in the lateral view and 7.0 ± 0.5 mm below the lateral tibial plateau in the frontal view. In anatomic dissections, the origin of the ALL was 1.9 ± 1.4 mm anterior and 4.1 ± 1.1 mm distal to the lateral collateral ligament, and the insertion was 4.4 ± 0.8 mm below the lateral tibial plateau cartilage. Conclusion: The ALL origin on an absolute lateral radiograph of the knee is approximately 47% of the anterior-posterior size of the condyle and 3.7 mm caudal to the Blumensaat line. In a frontal radiograph, the ALL is 15.8 mm from the posterior bicondyle line. The ALL insertion is approximately 53.2% of the anterior-posterior size of the plateau in the lateral view and 7.0 mm below the articular line in the frontal view. Clinical Relevance: Knowledge of the anatomic landmarks of the ALL on radiography will permit minimally invasive surgical reconstruction with lower morbidity.

Directional coronary atherectomy (DCA) is effective for bifurcation lesions but carries a risk of coronary perforation, due to geographical and recognition errors during the procedure. Geographical errors involve incorrect targeting of plaque-free areas, whereas recognition errors stem from the misinterpretation of visual information during catheter alignment. To minimize these risks and improve procedural safety and efficacy, it is crucial to align the DCA catheter accurately with the target plaque by utilizing the morphological characteristics of the housing. This study aimed to determine whether visual recognition of DCA housing from the front or side, as opposed to an oblique angle, reduces cutting errors. Fifteen physicians and five medical staff members performed a bench test in which a DCA catheter was rotated 0° (frontal view), 45° clockwise (oblique view), and 90° clockwise (lateral view) under fluoroscopy. The error angles at each position were compared (p < 0.05). Error angles were 4.4 ± 3.4° (frontal view), 10.1 ± 4.6° (lateral view), and 13.6 ± 7.5° (oblique view). The frontal view showed fewer errors than the lateral and oblique views (p = 0.0016 and p < 0.0001, respectively). No significant differences were observed between the physicians and medical staff. Recognizing DCA housing from the frontal or lateral view calculated from intravascular ultrasound (IVUS) significantly reduces recognition errors in plaque cutting, enables safer and more effective procedures, even for less experienced operators, and has the potential to improve the safety and outcomes of DCA procedures.

Certain head positions can optimize topical irrigation distribution to specific sinuses. No studies have assessed whether patients attain these positions when irrigating. The purpose of this study was to assess head and bottle angles achieved when patients irrigate based on instructions from an irrigation device or from a Rhinologist. Study approval was obtained from Henry Ford Health System's Institutional Review Board (10604). Forty-two patients with various rhinologic conditions were equally divided into groups based on irrigation instruction type: pictoral instructions from an irrigation device or written/verbal instructions from a Rhinologist. Both groups' instructions directed nose-to-floor head positioning. Simulating home irrigations, patients irrigated 120 mL of saline into each naris using 240 mL squeeze bottles. Frontal and lateral views were captured using video cameras. On frontal view, angles were measured between (1) nasal dorsum (ND) and bottle tip (BT; n = 84) and (2) ND and vertical (V; n = 84). On lateral view, angles were measured between (1) line from nasion-to-pogonion (NTP) and horizontal (H) (n = 73) and (2) NTP and BT (n = 73). On lateral view, average angle between NTP and H was 20.0° (standard deviation [SD] = 13.1, 95% confidence interval [CI] = 17.0-23.0) and between NTP and BT was 59.4° (SD = 15.8, 95% CI = 55.8-63.1). On frontal view, average angle between ND and V was 9.5° (SD = 19.5, 95% CI = 5.3-13.6) and between ND and BT was 24.5° (SD = 12.0, 95% CI = 21.9-27.0). There were no significant angle differences between sides or instruction types. When instructed to irrigate in the nose-to-floor head position, patients achieved a head position uprotated 20° on lateral view and vertex rotated 10° away from the side of irrigation on frontal view.

The Endosomal Protein Appl1 Mediates Akt Substrate Specificity and Cell Survival in Vertebrate Development

The value of the lateral chest radiograph, often considered a useful adjunct in the detection of hilar adenopathy, was evaluated in a prospective study of 449 children assessed for tuberculosis. Of these children 298 presented to the hospital with signs and symptoms suggestive of tuberculosis, while 151 were investigated in a regional clinic solely because they were in close contact with an adult household member on treatment for tuberculosis. Tuberculosis was confirmed by culture in 176 of the 449 children (39%). In 40 of these (23%) hilar adenopathy was visible on frontal and lateral view, in 19 of the 176 confirmed cases (11%) only on a frontal view and in 22 (13%) on a lateral view only. Probable tuberculosis was diagnosed in a further 140 of the 449 children (31%), and hilar adenopathy was visible on frontal and lateral views in 39 of these children (28%), on the frontal view only in 8 (6%) and on the lateral view only in 27 (19%). In the symptomatic children investigated in the hospital, and the asymptomatic children investigated in the clinic, hilar adenopathy was detected on the lateral chest radiograph only in 36 (12%) and 14 (9%) cases respectively. Lateral chest radiographs will considerably improve the accuracy of the diagnosis of childhood tuberculosis.

The clinical utility of a one-shot energy subtraction method for thoracic spine radiography

The World Health Organization recommends that the routine investigation of children with suspected pneumonia should not include lateral chest x-rays. However, the reliability of the frontal view alone in the diagnosis of pulmonary opacities has not been reported. The authors studied prospectively 373 consecutive chest x-rays of children, ranging in age from 0 to 17 years, who were examined for suspected pneumonia. One radiologist interpreted the frontal view, and the diagnoses were compared with those of three radiologists who interpreted both frontal and lateral x-rays. William's index for rater reliability was 0.98 for all ages (95% confidence interval: 0.94, 1.00). Thus, a radiologist using only a frontal view would agree with members of an independent group using both frontal and lateral views as often as an isolated member of that group would agree with the other group members. Detecting a definite pulmonary opacity on the frontal view alone predicts its presence on frontal-lateral views. However, the interpretation of bronchial thickening and peribronchial alveolar confluences as opacities is a problem remaining on either frontal or frontal-lateral views.

In recent years, fracture image diagnosis using a convolutional neural network (CNN) has been reported. The purpose of the present study was to evaluate the ability of CNN to diagnose distal radius fractures (DRFs) using frontal and lateral wrist radiographs. We included 503 cases of DRF diagnosed by plain radiographs and 289 cases without fracture. We implemented the CNN model using Keras and Tensorflow. Frontal and lateral views of wrist radiographs were manually cropped and trained separately. Fine-tuning was performed using EfficientNets. The diagnostic ability of CNN was evaluated using 150 images with and without fractures from anteroposterior and lateral radiographs. The CNN model diagnosed DRF based on three views: frontal view, lateral view, and both frontal and lateral view. We determined the sensitivity, specificity, and accuracy of the CNN model, plotted a receiver operating characteristic (ROC) curve, and calculated the area under the ROC curve (AUC). We further compared performances between the CNN and three hand orthopedic surgeons. EfficientNet-B2 in the frontal view and EfficientNet-B4 in the lateral view showed highest accuracy on the validationdataset, and these models were used for combined views. The accuracy, sensitivity, and specificity of the CNN based on both anteroposterior and lateral radiographs were 99.3, 98.7, and 100, respectively. The accuracy of the CNN was equal to or better than that of three orthopedic surgeons. The AUC of the CNN on the combined views was 0.993. The CNN model exhibited high accuracy in the diagnosis of distal radius fracture with a plain radiograph.

Breast cancer is one of the major concerns for highest mortality rate among women in India. The gold standard imaging modality such as mammography fails to detect the breast abnormalities in denser breasts and it can indicate a tumor only after it attains a certain size. Breast thermography which is non-intrusive and non-painful overcomes these limitations. It is proved to be a promising technique in detecting even the onset of tumors through temperature pattern on the breast. This paper illustrates feature-based analysis implemented on lateral view breast thermograms acquired in mass screening camps. The images were analyzed using texture transform based features. The objective of this study is to examine the significance of acquiring the thermograms in lateral views. The lateral views cover the whole breast for thermal analysis which greatly helps the radiologist to investigate the images further. Texture-based Grey Level Co-occurrence Matrix features and discrete wavelet transform based features are extracted to study the frontal and lateral view breast thermograms. The statistical analysis using one way ANOVA and independent t-test indicate significant values that clearly distinguish between normal and abnormal thermograms. These features are then fed into classifiers to validate that lateral view breast thermograms prove to be efficient in detecting the abnormalities better than in frontal views. The classification performance results show higher sensitivity rate of 82%, specificity rate of 83% and accuracy rate of 87% for lateral views when compared to the frontal views.

Adolescent idiopathic scoliosis (AIS) patients suffer from restrictive impairment of pulmonary function (PF) as a consequence of spinal and ribcage deformity. Statistic modelling of scoliotic geometry has been well-established based on low-dose biplanar X-ray device (EOS) imaging. However, the postoperative lung morphology change derived from EOS has not yet been studied adequately till now. Twenty-five female AIS patients with severe right-sided major thoracic curve (aged 13-31 years; Cobb angle 45°-92°) underwent posterior spinal fusion (PSF) were prospectively recruited for standing EOS imaging at preoperative, postoperative, and 1-year follow-up (1Y-FU) stages. EOS-based lung morphology at frontal and lateral view was measured respectively to assess serial statistical changes in area and height. At frontal view, left lung area significantly increased postoperatively (104.7 vs. 125.1 cm2; P<0.001) but without continuous increase at 1Y-FU (125.1 vs. 124.5 cm2; P=0.084), whereas right lung area showed a slight but insignificant interval increase (median: 143.8, 146.5, 148.4 cm2 at preoperative, postoperative, 1Y-FU stage, respectively; all P>0.05). At lateral view, the increase in left lung area was slight without statistically difference (median: 175.8, 178.4, 182.5 cm2 at preoperative, postoperative, 1Y-FU stage, respectively; all P>0.05), while right lung area did not significantly change postoperatively (median: 209.9, 206.7, 212.4 cm2 at preoperative, postoperative, 1Y-FU stage, respectively; all P>0.05). At both frontal and lateral view, left lung height significantly improved at both postoperative and 1Y-FU stage (all P<0.05), while preoperative right lung height was not significantly different from postoperative and 1Y-FU value (all P>0.05). EOS imaging demonstrates that left lung area in severe AIS may improve after PSF surgery. EOS may provide useful information about lung morphology change after PSF in severe AIS.

Effects of horizontal dimensional malocclusion on changes in smile measurements in frontal, oblique, and lateral views

Nondestructive, high-resolution 3-dimensional (3D) imaging of the embryonic heart remains a challenge in cardiovascular development research. In the past, several imaging techniques (eg, magnetic resonance microscopy, optical coherence tomography) were tested for their suitability to visualize the 3D morphology of embryonic hearts. Most of these imaging tools have their drawbacks with respect to resolution and depth penetration. Here we present, to the best of our knowledge, the first high-resolution 3D images of normal and malformed embryonic chick hearts at the 10 μm level generated by microcomputed tomography (micro-CT) examination of critical point-dried heart specimens. Cardiac anatomy is demonstrated in great details with respect to myocardial fiber arrangement and trabeculations as well as atrioventricular (AV) and semilunar valves. Positions of great vessels with associated ventricular septal defects are visualized in high quality in malformed hearts. Figure 1A shows the normal 4-chambered heart of a day 9 chick embryo with correct positioning of the heart chambers and great vessels. Figure 1B depicts an image of a malformed embryonic chick heart in which both great arteries are significantly shifted toward the right side with extreme dextroposition of the aorta, and both great arteries arise from the right ventricle (double outlet right ventricle [DORV]). Note also that both atrial appendages are located to the left of the great arteries (left juxtaposition of atrial appendages [LJAA]). The cardiac defect that we present here in the chick embryo resembles a rare complex heart defect known in humans, as depicted in a classic drawing by Frank Netter, MD, in the Netter Collection of Medical Illustrations – Heart (Figure 1C, reproduced with permission from netterimages.com). Figure 1. Photographs of day 9 embryonic chick hearts (A and B, respectively) and a drawing of a malformed human …

Objective To describe the morphological characteristics and asymmetries between the left and right mandibular condyles in Brazilian cadaveric specimens. Material and Methods Thirty-two jaws were placed on a rigid support for image acquisition of the frontal and lateral views. The shapes of the mandibular condyles were classified, and measurements of the distance between the anatomical landmarks in the lateral and frontal views were performed. Results Mandibular length and width were not different between the right and left sides. Regarding the shapes of the mandibular condyles, the rounded type was the most frequent, followed by marked medial slope; flattened; overhanging lateral and medial slopes; downward flattening of both slopes and their merger in a single, extensive surface; and deformity and marked lateral slope with flaring and flattening. Asymmetry between the left and right mandibular condyles was present in 40% of the specimens. Conclusion The anatomy of mandibular condyles varies greatly, and this knowledge can avoid misdiagnosis by image examination of the anatomic variations.

We present an automatic animatable 3D character reconstruction method from frontal and lateral RGB pictures of the person to reconstruct. We propose a method where, after obtaining a 3D reconstruction from a frontal view, we adapt the template of the Skinned Multi-Person Linear Model (SMPL) to it. This frontal modified SMPL is then used in a second step as an input to reconstruct the character from the lateral view, thus obtaining a correct person reconstruction in all dimensions. Our method enables the creation of 3D animatable characters focusing on two main aspects: shape and texture. The obtained results show that the proposed method achieves an accurate automatic 3D character reconstruction from only two views that enhances current methods while offering a reproducible work-flow.

Hypocretins/orexins are neuropeptides involved in the regulation of sleep and energy balance in mammals. Conservation of gene sequence, hypothalamic localization of cell bodies, and projection patterns in adult zebrafish suggest that the architecture and function of the hypocretin system are conserved in fish. We report on the complete genomic structure of the zebrafish and Tetraodon hypocretin genes and the complete predicted hypocretin protein sequences from five teleosts. Using whole mount in situ hybridization, we have traced the development of hypocretin cells in zebrafish from onset of expression at 22 h post-fertilization through the first week of development. Promoter elements of similar size from zebrafish and Tetraodon were capable of driving efficient and specific expression of enhanced green fluorescent protein in developing zebrafish embryos, thus defining a minimal promoter region able to accurately mimic the native hypocretin pattern. This enhanced green fluorescent protein expression also revealed a complex pattern of projections within the hypothalamus, to the midbrain, and to the spinal cord. To further analyze the promoter, a series of deletion and substitution constructs were injected into embryos, and resulting promoter activity was monitored in the first week of development. A critical region of 250 base pairs was identified containing a core 13-base pair element essential for hypocretin expression.