Identification Of Plane Research Articles

Measurement of the neutral plane of an internal fire whirl using the background-oriented Schlieren technique for a vertical shaft model of a high-rise building

Since the height of the neutral plane is related to the direction of the high-temperature smoke and airflow diffusion of fires in high-rise buildings, the identification of the neutral plane is important for both the evacuation of residents and the safety of fire fighters. As yet, there are no effective methods for directly measuring the constantly changing neutral plane position. There are complex internal fire whirl phenomena in the inner space in particular cases. In this study, the background-oriented Schlieren (BOS) technique was used to visualize the neutral plane when a fire whirl occurs in a vertical shaft with a single corner gap. With n-propanol used as the fuel, the scale modeling experiments of fuel trays 5.8cm and 7cm in diameter were tested in a 34cm (W)×35cm (L)×145cm (H) model for open and covered roof types. It is observed in the experimental process that the height of the neutral plane changes dynamically as the fire whirl is formed. The thermocouples were used to measure the temperature variation at different heights of openings to validate the measurement accuracy of the BOS technique. It is found that once a fire whirl occurs in the inner space of a high-rise building, the height of the neutral plane increases instantly. The experimental results demonstrate that the BOS technique can measure the neutral plane position of a large-scale model of a high-rise building fire scene directly, immediately and accurately.

Near‐infrared laparoscopic fluorescence to guide fascial plane identification in total mesorectal excision for rectal cancer: A Video Vignette

Fluorescence lymph node mapping in colorectal cancer has most often being examined for utility in its identification of specific nodes either within or without standard resection fields. Indeed, we have detailed is use elsewhere in this supplement for determination of potentially significant lymph node basins on the pelvic side wall 1 and also previously regarding mescolic node mapping for colon cancer 2. Others have suggested its incorporation alongside TEM resection 3 where the mesorectal nodes may be selectively targetted from within the rectum via the mural excision site. However it may also be of more elementary value in simply guiding the surgeon easily and efficently along embryological planes in order to ensure explicit intraoperative clarity of dissection in total mesorectal or complete mesocolic excision (TME or CME respectively). It may also guide the level of high arterial ligation to secure inclusion of the apex node within the resected specimen. The associated video demonstrates this. The concept is based on the fact that submucosal injection of 2–3 ml indocyanine green (ICG) at the tumor site will provide a depot of dye that continally and passively leaches into and through the lymphatics and nodal basin within the fascial compartment targeted with TME or CME surgery. While early laparoscopic assessment may allow identification of the first draining lymph node, re-examination of the same areas later in the operation will show additional and perhaps all of the lymph nodes within the fascial envelope being resected. This can help guide the surgeon or interested and especially perhaps inexperienced observers, trainees or students in understanding the embryological planes required for effective and efficient oncological surgery. This may be especially useful when the rectum and mesorectum are being mobilised and also for determining precisely the level of arterial ligation to ensure the highest node is included and specifically labelled with the specimen sent for pathological analysis. The authors have no conflicts of interest to declare. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Identification of the cleavage planes in molecular crystals: topological and energetic aspects

Identification of the cleavage planes in molecular crystals: topological and energetic aspects

SU‐E‐T‐52: A New Device for Quality Assurance of a Single Isocenter Technique for the Simultaneous Treatment of Multiple Brain Metastases

Purpose:Comprehensive quality assurance (QA) of a single isocenter technique for the simultaneous treatment of multiple brain metastases is presently impractical due to the time consuming nature of measuring each lesion's dose on film or with a micro‐chamber. Three dimensional diode array and full field film measurements are sometimes used to evaluate these plans, but gamma analysis may not reveal local errors that have significant effects on one or a few of several targets. This work aimed to design, build and test a phantom to simplify comprehensive measurement and evaluation.Methods:A phantom was designed with 28 stackable slabs. The top and bottom slabs are 1.5 centimeters (cm) in thickness, and central 26 slabs are 0.5 cm thick. When assembled with radiochromic film in all 27 gaps, the phantom measures 16.5 × 15 × 19 cm. Etchings were designed to aide in identification of specific film planes on computed tomography (CT) images and correlation of individual PTVs with closest bisecting planes. Patient verification plans with a total of 16 PTVs were calculated on the phantom CT, and test deliveries both with and without couch kicks were performed to test the ability to identify correct film placements and subsequent PTV specific dose distributions on the films.Results:Bisecting planes corresponding to PTV locations were easily identified, and PTV specific dose distributions were clear for all 16 targets. For deliveries with couch kicks, the phantom PTV dose distributions closely approximated those calculated on the patient's CT. For deliveries without couch kicks, PTV specific dosimetry was also possible, although the distributions had ‘ghosts’ equaling the number of couch kicks, with distance between ghosts increasing with distance from the isocenter.Conclusion:A new phantom facilitates fast comprehensive commissioning validation and PTV specific dosimetry for a single isocenter technique for treating multiple brain metastases.This work was partially funded by CIRS, Inc.

Real-time ultrasound image classification for spine anesthesia using local directional Hadamard features.

Injection therapy is a commonly used solution for back pain management. This procedure typically involves percutaneous insertion of a needle between or around the vertebrae, to deliver anesthetics near nerve bundles. Most frequently, spinal injections are performed either blindly using palpation or under the guidance of fluoroscopy or computed tomography. Recently, due to the drawbacks of the ionizing radiation of such imaging modalities, there has been a growing interest in using ultrasound imaging as an alternative. However, the complex spinal anatomy with different wave-like structures, affected by speckle noise, makes the accurate identification of the appropriate injection plane difficult. The aim of this study was to propose an automated system that can identify the optimal plane for epidural steroid injections and facet joint injections. A multi-scale and multi-directional feature extraction system to provide automated identification of the appropriate plane is proposed. Local Hadamard coefficients are obtained using the sequency-ordered Hadamard transform at multiple scales. Directional features are extracted from local coefficients which correspond to different regions in the ultrasound images. An artificial neural network is trained based on the local directional Hadamard features for classification. The proposed method yields distinctive features for classification which successfully classified 1032 images out of 1090 for epidural steroid injection and 990 images out of 1052 for facet joint injection. In order to validate the proposed method, a leave-one-out cross-validation was performed. The average classification accuracy for leave-one-out validation was 94 % for epidural and 90 % for facet joint targets. Also, the feature extraction time for the proposed method was 20 ms for a native 2D ultrasound image. A real-time machine learning system based on the local directional Hadamard features extracted by the sequency-ordered Hadamard transform for detecting the laminae and facet joints in ultrasound images has been proposed. The system has the potential to assist the anesthesiologists in quickly finding the target plane for epidural steroid injections and facet joint injections.

A new fluorescent anatomic pulmonary segmentectomy using PDD endoscope system™ and vitamin B2: evaluation in a clinical setting using living animal

Identification of intersegmental planes is essential for successful anatomic pulmonary segmentectomy. We have previously reported a new fluorescence technique using a PDD endoscope system™ and vitamin B2 for identification of intersegmental planes in ex vivo experiments. In the present study, we investigated and evolved this technique to perform ideal anatomic segmentectomy in a clinical setting using living pig models. Cranial segmentectomy in the cranial lobe of the right lung was performed in six pigs using our fluorescence technique. The fluorescent cranial segmentectomy was as follows. After identification of the cranial segmental bronchus, vitamin B2 solution as a fluorescent substance was injected via bronchoscopy. The fluorescent segment was observed using a PDD endoscope system, and the identified intersegmental plane was cut using electric cautery. The operative data collected were the rates of accurate identification of the pulmonary segment and perioperative complications. The duration and light intensity of fluorescence of the target segment were recorded to provide an objective measurement of success. In all procedures, it was possible to identify the target segment by its clear yellow-green fluorescence. The rate of accurate identification of the pulmonary segment was 100%. The fluorescence continued for more than 1 h with adequate light intensity. No perioperative complications were encountered. No unexpected injuries of the major segmental bronchi or vessels occurred. Hemorrhage and air leakage from the transected intersegmental plane were negligible. Our new fluorescence technique in a clinical setting involving a PDD endoscope system™ vitamin B2 enabled accurate and safe anatomic pulmonary segmentectomy, with enough strong and long fluorescence in living pig lungs.

An automatic system for deciding bend sequence of bending parts

To decide a proper bend sequence for manufacturing a defect-free bending part on a bending die is tedious, time-consuming and highly experience-based activity. This article presents the research work involved in the development of an automated system for determining bend sequence of a bending part. The proposed system is structured in form of five modules developed, respectively, for part feature extraction, identification of base plane, categorisation of bends, grouping of bends in various categories and prioritisation of bend groups. The system finally gives its output in form of proper bend sequence for manufacturing bending part. System modules are coded in Visual Basic 6.0 and integrated with CAD software. The CAD software is used for pre- and post-processing of bend sequencing. The system has been tested successfully on various bending parts taken from sheet metal industries.

MP81-08 HOW WELL CAN UROLOGY TRAINEES DETECT SUBURETHRAL MESH USING TRANSLABIAL ULTRASOUND IN COMPARISON TO A RADIOLOGIST?

INTRODUCTION AND OBJECTIVES: Suburethral mesh implantation for stress urinary incontinence can result in erosion, extrusion, infection, pain, and irritative voiding symptoms. Surgical mesh removal can be challenging when operative records are not available, portions of mesh have been removed, mesh position has changed, or it’s not palpated on physical exam. Translabial ultrasonography is a diagnostic tool that can detect synthetic mesh. The purpose of this study was to compare a group of Urology trainees’ and a radiologist’s ability to identify pelvic landmarks, localize and assess completeness of suburethral mesh. METHODS: Eight urology trainees received a 15-minute lecture on anatomical landmarks and techniques of translabial ultrasound as well as instruction on detection of suburethral mesh. The trainees then reviewed 18 different US studies. Trainees were asked a total of 126 questions including identification of anatomical planes, pelvic structures in different planes, mesh presence, disruption of mesh, and its location along the urethra. The overall correct response rate of all questions was compared to a Board-certified radiologist specialized in translabial ultrasound, which served as our control. The radiologist and trainees were blinded to patient history, clinical, and operative findings. RESULTS: Overall, trainees answered correct on average 83.9% (105/126) of all questions compared to the radiologist 94.4% (119/126; p1⁄40.023). Per category the average trainee was able to correctly identify the anatomical plane in 94.4% (17/18) of questions, detect presence or absence of mesh in 95.8% (17/18), determine mesh disruption in 83.3% (15/18), correctly identify pelvic anatomical structures in 83.3% (15/18), and determine location of mesh in correspondence to the urethra in 72.2 % (13/18). CONCLUSIONS: Urology trainees can learn in a reasonable time how to identify anatomical landmarks on translabial ultrasound and consistently detect the presence of suburethral mesh. Translabial ultrasound can be utilized by urologists to aid in preoperative planning for mesh removal or clinical diagnostics for symptomatic mesh.

Evaluating the learning curve for the transversus abdominal plane block: a prospective observational study

Anesthesia is a medical specialty where a large number of technical skills need to be mastered with the learning curve for these skills depending on both the technique and the individual involved. The transversus abdominis plane (TAP) block has demonstrated its effectiveness especially in postoperative analgesia following midline laparotomy. It is usually described as a simple technique even though little is known about the learning curve for this block. The purpose of this study was to determine the learning curve for ultrasound-guided TAP block in anesthesiologists who had no prior experience performing the block. This was a prospective observational study performed in gynecological and general surgery patients at the University Hospital Center of Nancy (France) between November2011 and June2012. After a short theoretical training, sixresidents were asked to perform, 20TAP blocks under the supervision of a senior staff physician. The success of the procedure involved the visualization and identification of the different muscle planes, the peritoneum, the tip of the needle, an evaluation of the effectiveness of the block (sensory block), the absence of intervention from the supervisor, the absence of complications, less than three attempts, and a satisfaction score by the supervisor>7 on a 0-10 rating scale. A learning curve/cummulative summation (LC-CUSUM) was generated. The six residents performed all 20 TAP blocks. All residents had already performed ultrasound-guided procedures. The procedure was considered mastered after performing 16 blocks on average for a 90% success rate. The average time (SD) to complete the block decreased from 6.8 (4.1min) at the beginning to 2.8 (1.3) min at the end of the study. There was a decrease in the number of repositionings of the needle and in the number of interventions by the supervisor throughout the study. The LC-CUSUM analysis revealed that all residents had acquired the TAP block technique within 20 procedures. This study demonstrates that the TAP block can be rapidly mastered even if the learning curve varies due to inter-individual differences in dexterity and in the ease of obtaining the ultrasound images.

Fostering spatial skill acquisition by general chemistry students

The study of chemistry requires the understanding and use of spatial relationships, which can be challenging for many students. Prior research has shown that there is a need to develop students' spatial reasoning skills. To that end, this study implemented guided activities designed to strengthen students' spatial skills, with the aim of improving their understanding of spatial relationships that exist within and between molecules. Undergraduate STEM majors, taking the second semester of a two-semester general chemistry course, engaged in these activities. This study followed a quasi-experimental design, in which the experimental (n = 209) and the control group (n = 212) were administered a pre-test. At the completion of the semester, both groups participated in a post-test designed to measure spatial skill acquisition. A one-way ANOVA confirmed that student performance differed significantly between the three interventions and the control group. Students who completed three activities scored higher than those who completed only two, suggesting continuity is an important feature of spatial training. In particular, our results show improvement in three skill areas: symmetry plane identification, visualization of molecules and translation between 2D and 3D representations. The results of this study show that spatial skills can be successfully enhanced through the use of relevant guided activities designed to improve student understanding of external representations. Our findings show that the use of activities which require students to sketch molecular models from different perspectives, locate a plane of symmetry on a 3D model and on a 2D sketch of the same molecule, as well as position physical models to match 2D sketches containing dash/wedge cues is an effective approach to the teaching and learning of spatial skills in general chemistry.

Methylene Blue Staining: A New Technique for Identifying Intersegmental Planes in Anatomic Segmentectomy

Pulmonary segmentectomy is being increasingly used to resect small lung nodules; however, identifying the intersegmental plane is difficult. We describe a new methylene blue staining technique that we developed to identify the intersegmental planes in anatomic segmentectomy using video-assisted thoracic surgery (VATS) or thoracotomy and to evaluate its feasibility and safety. Between October 2013 and December 2013, 14 consecutive patients with lung disease underwent anatomic segmentectomy at our institution (10 VATS, 4 conventional thoracotomy). Methylene blue 0.1% (20 mL) was slowly injected into the bronchus of the target pulmonary segments using an intravenous needle after division of the artery, vein, and bronchus of the target segments, and the boundaries were detected, followed by anatomic segmentectomy. The staining took only 3 min. The target pulmonary segments stained blue, allowing for the clear identification of the intersegmental plane on both the surface and in the lung parenchyma, and all operations were successfully completed. Staining did not affect pathologic examination of the resected specimens. The fluid that drained from the chest tube and the patients' sputum, urine, and feces were not blue. There were no perioperative deaths or major complications. To our knowledge, this study is the first to report a safe and feasible methylene blue staining method for identifying the lung segment borders that does not require any special equipment. More importantly, this method can clearly detect the intersegmental planes on the pleural surface and within the lung parenchyma, enabling thoracic surgeons to accurately perform anatomic segmentectomy.

Global optimization of general nonconvex problems with intermediate polynomial substructures

This work considers the global optimization of general nonconvex nonlinear and mixed-integer nonlinear programming problems with underlying polynomial substructures. We incorporate linear cutting planes inspired by reformulation-linearization techniques to produce tight subproblem formulations that exploit these underlying structures. These cutting plane strategies simultaneously convexify linear and nonlinear terms from multiple constraints and are highly effective at tightening standard linear programming relaxations generated by sequential factorable programming techniques. Because the number of available cutting planes increases exponentially with the number of variables, we implement cut filtering and selection strategies to prevent an exponential increase in relaxation size. We introduce algorithms for polynomial substructure detection, cutting plane identification, cut filtering, and cut selection and embed the proposed implementation in BARON at every node in the branch-and-bound tree. A computational study including randomly generated problems of varying size and complexity demonstrates that the exploitation of underlying polynomial substructures significantly reduces computational time, branch-and-bound tree size, and required memory.

Slip Knot Bronchial Ligation Method for Thoracoscopic Lung Segmentectomy

We report a novel monofilament slip knot technique for bronchial ligation and for visualization of the anatomic plane during lung segmentectomy. After threading the bronchus, a slip knot is made outside the thorax. During lung ventilation, one end of the string is pulled, and the knot slips to reach the bronchus without a knot-pusher. Bronchial ligation is then performed to block the outflow of segmental air while the segment remains expanded, whereas the other segments become collapsed. This technique allows identification of the anatomic intersegmental plane, facilitating thoracoscopic anatomic lung segmentectomy.

Use of indocyanine green to facilitate intersegmental plane identification during robotic anatomic segmentectomy

Use of indocyanine green to facilitate intersegmental plane identification during robotic anatomic segmentectomy

Completely medial versus hybrid medial approach for laparoscopic complete mesocolic excision in right hemicolon cancer

To explore the feasibilities between operational approaches for laparoscopic complete mesocolic excision (CME) to right hemicolon cancer. This prospective randomized controlled trial included patients admitted to a Shanghai minimally invasive surgical center to receive laparoscopic CME from September 2011 to January 2013 randomized into two groups: hybrid medial approach (HMA) and completely medial approach (CMA). The feasibilities and strategies of the two techniques were studied and compared. Furthermore, the operation time and vessel-related complications were designed to be the primary end points, and other operational findings, including the classification of the surgical plane and postoperative recovery, were designed to be the secondary end points for this study. After screening, 50 cases were allocated to the HMA group and 49 to the CMA group. Within the HMA group, there were 48 cases graded with mesocolic plane and 2 with intramesocolic plane. For the CMA group, there were 42 cases graded with mesocolic plane and seven with intramesocolic plane. The differences between the two were insignificant, as were the number of lymph nodes retrieved. The mean±standard deviation total operation time for the CMA group was 128.3±36.4min, which was significantly shorter than that for the HMA group, 142.6±34.8min. For the CMA group, the time involved in central vessel ligations and laparoscopic procedures was 58.5%, 14.1 and 81.2±23.5min, respectively, which were shorter than the HMA group. The vessel-related complication rate was significantly higher in the HMA group. Laparoscopic CME via the total medial approach is technically feasible after the precise identification of the surgical planes and spaces for the right hemicolon. The procedure has a shorter operation time and fewer vessel-related complications.

Anatomical segmentectomy of the lung: tip of identifying the intersegmental plane

A pulmonary segmentectomy requires identification of the segmental planes, making it technically more difficult than a lobectomy. Therefore, we present a selective segmental-inflation technique using a butterfly needle. This paper discusses anatomical segmenectomy with special reference to identifying the intersegmental plane. Methods First, the lung is deflated and the pulmonary vessels to the involved segment are divided. The segmental bronchus is divided using a stapling device or ligation. Then, using a butterfly needle, oxygen (approximately 1 L/min.) is instilled into the targeted bronchus to inflate the involved segment, and the involved segment is severed and removed using electrocautery or a stapling device. The raw surface is covered with an absorbable sealing material to prevent air leaks. Results Fifty-three (M:F = 33:33) patients underwent anatomical segmentectomy with the selective segmental-inflation technique using a butterfly needle. Their median age was 64.9 years. The diseases were malignant lung disease in 52 patients and benign lung disease in 14. The surgical procedure was segmentectomy only in 60 and segmentectomy combined with lobectomy in six. The median operating time was 170 min; the blood loss was 82 g; and the postoperative stay was 8 days. The duration of chest tube drainage was 3 days. No major complication occurred. Conclusions In summary, anatomical segmentectomy was performed successfully with the selective segmental-inflation technique using a butterfly needle. Advantages: Surgeons can control every manipulation. No special device is needed; a butterfly needle is sufficient. It is useful regardless of the situation of proximal bronchus. Ultraselective air instillation into the subsegmental bronchus depends on the needle direction. Disadvantages: The proximal site of the targeted bronchus must be identified. Care is needed to avoid systemic air embolism.

Brain symmetry plane detection based on fractal analysis

In neuroimage analysis, the automatic identification of symmetry plane has various applications. Despite the considerable amount of research, this remains an open problem. Most of the existing work based on image intensity is either sensitive to strong noise or not applicable to different imaging modalities. This paper presents a novel approach for identifying symmetry plane in three-dimensional brain magnetic resonance (MR) images based on the concepts of fractal dimension and lacunarity analysis which characterizes the complexity and homogeneity of an object. Experimental results, evaluation, and comparison with two other state-of-the-art techniques show the accuracy and the robustness of our method.

New Technique for Lung Segmentectomy Using Indocyanine Green Injection

One of the most difficult aspects of complete segmentectomy of the lung is the identification of the intersegmental plane. Instead of a conventional residual segment inflation method, we have developed a new technique for detecting intersegmental planes using indocyanine green medium. The technique is simple and consists of (1) ligation of the segmental vein to prevent loss of the indocyanine green and (2) injection of indocyanine green through the segmental bronchus. These two steps result in easy identification of intersegmental planes by a change of color not only of the surface but also of the parenchyma of the lung. This technique can be indicated for atypical segmentectomy.

Computational Experience with Applications of Bilinear Cutting Planes

This work analyzes the effectiveness of cutting planes applied during the global optimization of nonconvex nonlinear and mixed-integer nonlinear programming problems arising from process synthesis and process operations. In a previous publication, we introduced algorithms for bilinear substructure detection, cutting plane identification, cut filtering, and cut selection. Our implementation embeds reformulation–linearization, lift-and-project, and advanced convex envelope construction techniques that exploit underlying bilinear substructures and tighten factorable programming reformulations at every node in the branch-and-bound tree. In this work, we utilize industrial examples to demonstrate a variety of relaxation tightening strategies afforded by these bilinear cutting plane algorithms. A detailed description and associated computational experience are presented for applied cutting planes.

Laparoscopic Transvesical Approach for Vesicovaginal Fistula Repair

Study ObjectiveTo access the technical feasibility of performing laparoscopic repair of vesicovaginal fistula. Material and MethodsWe attempted a laparoscopic repair of vesicovaginal fistula in five women with a history of urinary leakage via the vagina after vaginal hysterectomy. Five pelvic ports were used. The surgical procedure was performed using the same principles as for open surgery, i.e., separation of the vaginal wall from the bladder wall, repair of the fistula, and interposition of the omentum. ResultsThere was early recovery of the patients in terms of continence, with less chance of recurrence. Results were comparable to those with the vaginal approach. ConclusionThe use of minimally invasive surgery for vesicovaginal fistula repair helps to ease the suturing deep in the pelvis, and the magnification facilitates good identification of tissues planes and thus better mobilization of the vaginal and bladder walls and decreases postoperative morbidity.