Horizontal Section Images Research Articles

Quantitative classification of melasma with photoacoustic microscopy: a pilot study.

The classification of melasma is critical for correct clinical diagnosis, treatment selection, and postoperative measures. However, preoperative quantitative determination of melasma type remains challenging using conventional Wood's lamp and optical dermoscopy techniques. Using photoacoustic microscopy (PAM) to simultaneously obtain the two diagnostic indicators of melanin and blood vessels for melasma classification and perform quantitative analysis to finally achieve accurate classification, rather than relying solely on physicians' experience. First, the patients were classified by experienced dermatologists with Wood's lamp and optical dermoscopy. Next, the patients were examined in vivo using the PAM imaging system. Further, the horizontal section images ( plane) of epidermal melanin and dermal vascular involvement were extracted from the 3D photoacoustic imaging results, which are important basis for PAM to quantitatively classify melasma. PAM can quantitatively reveal epidermal thickness and dermal vascular morphology in each case and obtain the quantitative diagnostic indicators of melanin and blood vessels. The mean vascular diameter in lesional skin () of epidermal M+V-type was much larger than that in non-lesional skin (), and the mean vascular density in lesional skin was more than three times that in non-lesional skin. Importantly, vascular diameter and density are important parameters for distinguishing M type from M+V type. PAM can obtain the data of epidermal thickness, pigment depth, subcutaneous vascular diameter, and vascular density, and realize the dual standard quantitative melasma classification by combining the parameters of melanin and blood vessels. In addition, PAM can provide new diagnostic information for uncertain melasma types and further refine the typing.

A prospective randomized controlled study to assess the effectiveness of super FIXSORB WAVE® for sternal stabilization after sternotomy.

We developed a new sternal fixation device, Super FIXSORB WAVE®, a corrugated plate made of u-HA/PLLA, to improve sternal stability after sternotomy. This present study aimed to evaluate the new device clinically. This prospective, single-blinded, multicenter trial randomized 69 patients to either wire cerclage only (group C, n = 30) or wire cerclage plus Super FIXSORB WAVE® (group W, n = 39). The primary endpoint was a degree of sternal displacement at six months. Displacement of the sternal halves in the anteroposterior and lateral directions was measured using computed tomography horizontal section images at the third costal and fourth intercostal levels. The secondary endpoints were sternal pain and quality-of-life over 6 months. Group W showed significantly reduced sternal anteroposterior displacement at both the third costal (0 [0-1.9] mm vs. 1.1 [0-2.1] mm; P = 0.014) and fourth intercostal (0 [0-1.0] mm) vs. 1.0 [0-1.8] mm; P = 0.015) levels than group C. In group W, lateral displacement was suppressed without a significant increase from 2weeks to 6months, while it increased in group C. There was no significant difference in postoperative sternal pain and quality-of-life between the two groups. No adverse events, such as infection, inflammation, or foreign body reaction, were observed with this device. Using Super FIXSORB WAVE®, sternal displacement was significantly suppressed in both the anteroposterior and lateral directions. The use of this device results in safe and easy sternal reinforcement without any adverse events, and sternal healing can be accelerated. This study was registered in the Japan Registry of Clinical Trials (February 21, 2019; jRCTs032180146).

Investigation of the link between the human skin relief and the dermal fibers network by coupling topographic analysis and LC-OCT imaging before and during folding tests

Knowing the evolution of the skin’s response to mechanical solicitations and understanding its origin is important in medicine, surgery, and cosmetics. Studies performed in vitro and ex vivo show that links exist between the topographic skin properties and the collagen and elastin fibers network in the dermis. But, to our knowledge, no in vivo study shows this link. In this study we propose a combination of experimental tests to demonstrate the link between the topographic skin properties and the fibers network in the dermis in vivo. The first method consists in analyzing the skin relief images. The second method uses a recently developed imaging technique of human skin in vivo with a high spatial resolution: Line-field Confocal Optical Coherence Tomography (LC-OCT). This technology provides two types of images modalities: vertical and horizontal section images. The skin relief images and its internal layers are carried out for the skin at rest and during a folding test. The latter is performed using a folding system developed in this study. From these images, we calculate the density of the skin lines printed on the skin surface and their orientations. Thanks to the two modalities of LC-OCT, we obtain the full 3D image of the skin volume. From these images we extract the fibers density and their orientation in the plans parallel and perpendicular to the outer skin surface. The study is carried out on 42 volunteers aged from 20 to 55 years-old. Skin relief analysis and LC-OCT images are performed on the skin of the forearm and thigh. The results show similar distributions of the skin lines on the surface and of its fibers in the volume. We could observe a correlation between the skin lines at the surface and the structure in depth of its layers in the volume (0.40 < rSpearman < 0.73).

Volume Index Measured Using Magnetic Resonance Imaging for Diagnosing Cervical Cancer Tumors

Diagnosis of cervical cancer with tumor diameter <2 cm using magnetic resonance imaging alone has not been investigated. Moreover, whether tumor volume can be used for diagnosing the true tumor diameter remains unknown. Here, we investigated the utility of early cervical cancer volume index in diagnosing cervical cancer with a tumor diameter of <2 cm, which can be treated using more conservative surgery. This single-center retrospective study analyzed women who underwent radical hysterectomy for cervical cancer with a tumor diameter of <2 cm and clinical stages IA2, IB1, IB2, IB3, and IIA1 at our institute between January 2009 and April 2022. The volume index, defined as the product of the maximum longitudinal diameter along the uterine axis, maximum anteroposterior diameter (thickness) on a sagittal section image, and maximum horizontal diameter on a horizontal section image, was evaluated using either T2-weighted magnetic resonance imaging or gadolinium-enhanced T1-weighted imaging. The receiver operating characteristic curve for the volume index was also calculated. The sensitivity and specificity of magnetic resonance imaging for measuring the tumor diameter were 0.92 and 0.84, respectively. The calculated cut-off value was 2.60, whereas the volume index area under the curve was 0.955, with a sensitivity of 0.92 and specificity of 0.93. Considering the specificity and low incidence of false-negative results, the volume index can be used for preoperative diagnosis of pT1B1 cervical cancer, which can be treated with more conservative surgery.

Nanoparticles: Untying the Gordian Knot in Conventional Computed Tomography Imaging

X-ray computed tomography (CT) imaging plays an essential role in disease diagnosis due to its noninvasive, painless mode and superior penetration depth. However, the resolution of the soft tissue ...

Line-field confocal optical coherence tomography for three-dimensional skin imaging.

This paper reports on the latest advances in line-field confocal optical coherence tomography (LC-OCT), a recently invented imaging technology that now allows the generation of either horizontal (x × y) section images at an adjustable depth or vertical (x × z) section images at an adjustable lateral position, as well as three-dimensional images. For both two-dimensional imaging modes, images are acquired in real-time, with real-time control of the depth and lateral positions. Three-dimensional (x × y × z) images are acquired from a stack of horizontal section images. The device is in the form of a portable probe. The handle of the probe has a button and a scroll wheel allowing the user to control the imaging modes. Using a supercontinuum laser as a broadband light source and a high numerical microscope objective, an isotropic spatial resolution of ∼1 µm is achieved. The field of view of the three-dimensional images is 1.2 mm × 0.5 mm × 0.5 mm (x × y × z). Images of skin tissues are presented to demonstrate the potential of the technology in dermatology.

Dual-mode line-field confocal optical coherence tomography for ultrahigh-resolution vertical and horizontal section imaging of human skin in vivo.

Line-field confocal optical coherence tomography (LC-OCT) is a recently introduced technique for ultrahigh-resolution vertical section (B-scan) imaging of human skin in vivo. This work presents a new implementation of the LC-OCT technique to obtain horizontal section images (C-scans) in addition to B-scans. C-scan imaging is achieved with this dual-mode LC-OCT system using a mirror galvanometer for lateral scanning along with a piezoelectric chip for modulation of the interferometric signal. A quasi-identical spatial resolution of ∼ 1 µm is measured for both B-scans and C-scans. The images are acquired in both modes at a rate of 10 frames per second. The horizontal field of view of the C-scans is 1.2 × 0.5 mm2, identical to the vertical field of view of the B-scans. The user can switch between the two modes by clicking a button. In vivo cellular-resolution imaging of human skin is demonstrated in both B-scan and C-scan modes, with the possibility to navigate within the skin tissues in real time.

Capillary imbibition of ethanol in cement paste traced by X-ray computed tomography with CsCl-enhancing technique

This study reported the capillary imbibition of ethanol in a cement paste traced by X-ray computed tomography (X-CT) enhanced by CsCl. Results show that CsCl can promote the contrast of X-CT images due to the significant X-ray absorption of Cs. The grey value distributions of horizontal section images were calculated to identify the penetration fronts of the CsCl-ethanol solution in the cement paste. The relationship between imbibition height and time follows the Lucas-Washburn equation. The method of enhancing X-ray sorption by CsCl paves a wide path to in situ monitor liquid imbibition in porous materials for assessing their microstructures and properties.

Accuracy of Percutaneous Pedicle Screw Placement in Thoracolumbar Spines: A Comparison Study Between Experienced Spine Surgeons and Residents

Purpose: The aim of this study was to investigate the difference in the accuracy of percutaneous pedicle screws (PPSs) insertion between spine surgery specialists and residents in cases of thoracolumbar surgery. Methods: We evaluated the insertion accuracy of 355 PPSs (left 178, right 177) used in 38 patients with thoracolumbar diseases surgically treated in our hospital between April 2009 and March 2016. A spine surgery specialist served as the main operator in 20 cases and a resident served as the main operator in 18 cases with a spine surgery specialist as the assistant. Using CT horizontal section images obtained within 2 weeks after surgery, the site of PPS insertion was evaluated according to four grades (Excellent, Good, Fair, Poor) in terms of six locations (Ia, Ib, IIa, IIb, IIIa, IIIb), mechanical fixation, and risk of occurrence of complications. Results: Among all 355 PPSs, Ia (Excellent) was achieved in 343 (96.6%). Twelve PPS insertions were classified as other grades, showing a deviation rate of 3.4%. All 12 of these insertions were rated as Ib (Good), and no other grades were identified. Spine surgery specialists performed 3 PPS insertions rated as Ib (Good), whereas residents performed 9 insertions rated as Ib (Good). There was no statistically significant difference between specialists and residents (P=0.083). All 12 insertions rated as other than Ia (Excellent) were insertions on the right side, but there was no consistent trend in terms of patient age or gender, disease, presence/absence of osteoporosis, spinal level, PPS model, or the location of the fluoroscopic system. Conclusion: PPS fixation is a safe procedure that allows for very accurate screw insertion by operators with limited clinical experience.

Age estimation using the maxillary canine pulp/tooth ratio in Korean adults: A CBCT buccolingual and horizontal section image analysis

Abstract Various age estimation approaches have been proposed in dental clinic, and it is necessary to have a simple, easy, fast and conservative method that can be applied to living individuals. In this study, an age estimation model was established by measuring the change in the pulp/tooth ratio that occurs due to the progression of pulp calcification associated with aging. This was done using CBCT to image the buccolingual and horizontal dimensions of the maxillary canine. Two hundred and five clinical CBCT images (age range: 20–77 years) were analyzed. In this study, we used the largest pulp/tooth area (S, sagittal pulp/tooth area ratio %) on the buccolingual sectional image in order to overcome the limitations of using a superimposed image in 2D. In addition, horizontal section images were obtained from the CEJ(HC, horizontal pulp/tooth area ratio % on CEJ) and 1/2 of root length(HA, horizontal pulp/tooth area ratio % on mid-root) positions, where the greatest degree of calcification takes place. The pulp/root area ratios were calculated from these images using a numerical analysis software. According to the resultant age estimation model, age can be. This method uses the largest buccolingual and horizontal sectional CBCT canine images without image distortion. Bucolingual sectional image(S) is the largest predictor variables(36.4%) compared to HC(29.7%) and HA(22.4%). This model involves the use of a numerical analysis software, which is quick and easy to use, because it calculate pulp and tooth area by semi-automatic.

Facial pillars in dogs: an anatomical study.

This study describes the facial pillar system in dolichocephalic and brachycephalic breeds of dogs, and highlights its differences. Knowledge of facial pillar system anatomy is imperative to carry out successful fracture repair. The aim of our study was to describe the pillar system of the facial skeleton in dogs, and compare different shapes of dog skulls using native skulls, radiographs and computed tomography (CT). The heads of brachycephalic and dolichocephalic dogs were investigated following a maceration process using trans-illumination, radiography and CT. Ground sections were created from bones of the facial skeleton for investigation of osteon directions. This study has revealed that the facial skeleton of the dog has numerous sinuses supported by vertically and horizontally oriented bone pillars. These pillars can be divided into five principal regions in dolichocephalic skulls and six principal regions in brachycephalic skulls. Radiographic imaging of both the brachiocephalic and dolichocephalic skulls was not capable of discerning bone pillars. Computed tomography transverse and horizontal section images discerned all pillars observed in the illuminated skulls.

Clinical significance of tumor volume in endometrial cancer: A Japan–Korea cooperative study

ObjectiveThe aim of this study was to elucidate the significance of tumor volume as a risk factor for predicting lymph node metastasis. MethodsWe applied the tumor volume index to the data that were collected for 327 Korean patients with endometrial cancer who underwent preoperative assessment including magnetic resonance imaging (MRI) and subsequent surgery including systematic lymphadenectomy. The volume index, which we previously reported in the literature, was defined as the product of maximum longitudinal diameter along the uterine axis, maximum anteroposterior diameter in a sagittal section image, and maximum horizontal diameter in a horizontal section image according to MRI data, from 425 Japanese women with endometrial cancer. Relationships between lymph node metastasis and results of preoperative examinations including volume index were analyzed by logistic regression analysis. ResultsThe prevalence of affected lymph nodes was 14.2%. Multivariate analysis showed that high-grade histology assessed by endometrial biopsy [odds ratio (OR); 2.9, 95% confidence interval (CI): 1.4–6.4], volume index (OR; 2.4, 95% CI: 1.1–5.3), node enlargement assessed by MRI (OR; 4.2, 95% CI: 1.4–13.2), and high serum cancer antigen (CA)125 level (OR; 3.6, 95% CI: 1.6–8.1) were significantly and independently related to lymph node metastasis. When volume index was excluded from the analysis, myoinvasion assessed by MRI was an independent risk factor for lymph node metastasis as well as high-grade histology, node enlargement, and high serum CA125 level. ConclusionVolume index is compatible with myometrial invasion as a factor for predicting lymph node metastasis in endometrial cancer.

Tumor volume successively reflects the state of disease progression in endometrial cancer

ObjectiveThis study aimed to clarify the clinical significance of tumor volume in endometrial cancer. MethodsA total of 667 patients with endometrial cancer who underwent preoperative MRI and surgical treatment including lymphadenectomy were enrolled. As the surrogate marker of actual tumor volume, the volume index was defined as the product of the maximum longitudinal diameter along the uterine axis, the maximum intersecting anteroposterior diameter of the sagittal section image, and the maximum horizontal diameter of the horizontal section image from the MRI data. The volume index was divided into five categories: Group 1 (<8), Group 2 (8 to <27), Group 3 (27 to <64), Group 4 (64 to <125), and Group 5 (125 or more). The relationships between various clinicopathologic factors and volume index were investigated, and Cox regression analysis was conducted to assess the significance of volume index with respect to prognosis. ResultsHigh-risk clinicopathologic findings increased with tumor volume. The lymph node metastasis rate was 3% in Group 1, 9% in Group 2, 17% in Group 3, 25% in Group 4, and 53% in Group 5. Cox regression analysis showed that the volume index (≥36) was a prognostic factor (hazard ratio: 2.0, 95% confidence interval: 1.3–3.1) independent of older age (≥58years), high-risk histological grade/subtype, deep myoinvasion, lymph node metastasis, and type of surgery. ConclusionTumor volume successively reflects the state of disease progression in endometrial cancer. The volume index can give information on both the staged prognosis and surgical management.

The Role of the β1 Subunit of the Na,K-ATPase and Its Glycosylation in Cell-Cell Adhesion

Based on recent data showing that overexpression of the Na,K-ATPase beta(1) subunit increased cell-cell adhesion of nonpolarized cells, we hypothesized that the beta(1) subunit can also be involved in the formation of cell-cell contacts in highly polarized epithelial cells. In support of this hypothesis, in Madin-Darby canine kidney (MDCK) cells, the Na,K-ATPase alpha(1) and beta(1) subunits were detected as precisely co-localized with adherens junctions in all stages of the monolayer formation starting from the initiation of cell-cell contact. The Na,K-ATPase and adherens junction protein, beta-catenin, stayed partially co-localized even after their internalization upon disruption of intercellular contacts by Ca(2+) depletion of the medium. The Na,K-ATPase subunits remained co-localized with the adherens junctions after detergent treatment of the cells. In contrast, the heterodimer formed by expressed unglycosylated Na,K-ATPase beta(1) subunit and the endogenous alpha(1) subunit was easily dissociated from the adherens junctions and cytoskeleton by the detergent extraction. The MDCK cell line in which half of the endogenous beta(1) subunits in the lateral membrane were substituted by unglycosylated beta(1) subunits displayed a decreased ability to form cell-to-cell contacts. Incubation of surface-attached MDCK cells with an antibody against the extracellular domain of the Na,K-ATPase beta(1) subunit specifically inhibited cell-cell contact formation. We conclude that the Na,K-ATPase beta(1) subunit is involved in the process of intercellular adhesion and is necessary for association of the heterodimeric Na,K-ATPase with the adherens junctions. Further, normal glycosylation of the Na,K-ATPase beta(1) subunit is essential for the stable association of the pump with the adherens junctions and plays an important role in cell-cell contact formation.

歯科における画像診断の進歩と可能性

Diagnostic imaging in dentistry has been performed mainly by intraoral and panoramic radiography. Computed tomography and magnetic resonance imaging were put in practical use in 1972 and 1980, respectively. Now it is possible to observe distinct horizontal section images of the human body which could hardly be obtained before. These advanced imagings have been utilized also in oral and maxillofacial region for diagnoses of TMJ disorders, tumors and so forth. Furthermore, through utilization of ultrasonography, scintigraphy and 3-D reconstructed images, these current diagnostic imagings have become much more important tools for diagnosis in the oral and maxillofacial region.Advanced diagnostic imagings mainly of TMJ disorders and dental implant were considered from the view point of prosthodontic treatment.

Ultrasonographic Guidance in Placing a Catheter for Continuous Axillary Brachial Plexus Block

To the Editor: For performing regional anesthesia to make surgical interventions possible, and for continuous analgesia management, brachial plexus block can be applied through the axillary approach [1]. Even though the technique for single-dose application is quite simple [2], the placement of the catheter in the axillary sheath to ensure continuous anesthesia and analgesia is difficult and has a high failure rate [3]. Therefore, different techniques are proposed [4,5]. We have utilized sonography (color Doppler sonograph) for tracing large arteries and veins and for inserting the catheter into the axillary sheath. A 21-yr-old male was hospitalized for a pollicization operation on his left hand. He was a good candidate for insertion of an axillary sheath catheter and brachial plexus block for peroperative anesthesia and postoperative analgesia. Informed consent was obtained from the patient before performing the procedure. The left axillary region of the patient was properly exposed in the supine position. After local anesthesia under standard sterile conditions, the axillary artery and vein were detected and localized in a horizontal section image obtained by the sonography unit (ACUSON 128 XP). For this purpose, a 7.5-mHz linear transducer covered with a sterile drape was used. (The skin was moistened to slide ethyl alcohol onto it.) Sloping the probe distally up to 45 degrees, a Contiplex cannula (18-gauge, 1 3/4 in., O 1.2 times 45 mm Contiplex Registered Trademark Katheterset; B. Braun, Germany) was inserted through the anesthesized skin parallel to the probe, and its tip was pointing to the proximal axilla. The needle catheter was then pushed forward along the anterior arterial wall with the guidance of a sonographic image Figure 1. Our location was confirmed via sagittal image by rotating the probe. While holding the plastic part of the cannula at this site, the metalic needle was withdrawn and instead a catheter (O 0.45 times 0.85 mm, 40-cm Contiplex Registered Trademark Katheterset) previously filled with contrast material (1/4 contrast, 3/4 normal saline) was inserted into the cannula. While holding the catheter in place and removing the plastic cannula, an image was obtained by the Siemens Digitron 2 digital substraction angiography unit. Through an intravenous cannula inserted from the ipsilateral antecubital region, 3 mL dilute radiocontrast was injected to see the relation of the catheter to the axillary vein. After blood flow washed away the injected intravenous contrast material, 5 mL dilute radiocontrast was reinjected from the axillary catheter to show the axillary sheath Figure 2. After connecting an antibacterial filter to the catheter, it was fastened in a sterile manner onto the skin, and the patient was taken to the operating room. After routine monitoring in this way, 0.5% bupivacaine, 20 mL, was administered. Twenty-five minutes after this application, a complete sensory and motor block occurred. Surgical intervention was performed successfully and without pain.Figure 1: The needle of the cannula is between artery and vein. Horizontal sonogram is shown. a, Artery; v, vein; arrow points to the top of the needle.Figure 2: The catheter in the axillary sheath. (Axillary sheath is visible by means of radiopaque material.)Postoperative analgesia was required approximately 5 h after perioperative local anesthetic injections, and a mixture of 0.5% bupivacaine, 2 mL; fentanil, 1 mL; and 0.9% normal saline, 7 mL, was administered through the axillary catheter. The effect of this lasted for another 5.5 h. The procedure was then repeated when necessary. With the help of this newly presented procedure, brachial plexus block via the axillary route is easier to perform, and a high success rate may be expected (except in cases of anatomic deformities). Although digital substraction angiography was utilized in our study to probe the efficacy of the procedure, ordinary sonographic imaging will be enough for successful results. Among continuous brachial plexus block applications via the axillary route, we suggest this procedure for surgical anesthesia and continuous long-term analgesia, since it is easy to perform, safe, inexpensive, and has no adverse effects. M. Erdal Guzeldemir, MD* Bahri Ustunsoz, MD dagger Departments of *Anesthesia and dagger Radiology, GATA Medical Faculty, Ankara, Turkey

Untersuchungen der Hornhaut und der Kammerwinkelregion mit dem Laser Tomographie Scanner (LTS)

The Laser Tomographic Scanner LTS based on laser scanning and confocal detection is a system to generate and measure optical section images. The periphery of the cornea and the anterior chamber angle region is shown in the horizontal section image with high image quality and high signal-to-noise ratio. 130 patients and 163 eyes were examined in this way. First experience shows possible applications for special clinical situations. Using horizontal optical section images, a procedure is generated to measure the anterior chamber angle without contact or local anesthesia with a reproducibility of 2 degrees. Horizontal section images clearly demonstrate changes of anterior chamber angle depth following e.c. cataract extraction and implantation of posterior chamber IOLs. Using the generated measurement procedure, these changes could be quantified.

Some observations on the dimensions of follicles and of other structures in the skin of sheep

1. Data are presented on the volume and other dimensional relations of structures in the skin of four sheep of the Romney Marsh breed, namely a lamb aged 1 month, a ram aged 2½ years and two 8-year-old ewes. All the animals were in good condition when the skin samples were obtained, yet the skin of both ewes contained structures believed to be degenerating follicles.2. A method was developed by which it was possible to measure the volume of follicles and other structures in the skin, with an error of less than 1%. This method involved the tracing of projected images of horizontal sections of a selected follicle bundle throughout its depth in the skin, and measurement, by means of a planimeter, of the areas of structures shown on each tracing. The volume was calculated from the sum ofall the areas multiplied by the thickness of the sections. A method was also evolved of measuring the curled length, as distinct from the ‘depth’, of a follicle. The difference between the length and depth of the majority of the follicles in these samples was less than 10%.