Microscope Eyepiece Research Articles

CHARACTERISTICS OF IMMUNOREACTIVITY IN THE RAT UNDER CONDITIONS OF TOXIC INJURY WITH ACETAMINOPHEN

The aim of this work was to to determine the integral leukocyte indices in animals with toxic damage by acetaminophen on the background of protein deficiency. The study was conducted on 4 groups of animals: Group I - control animals (K); II – rats kept on a low-protein diet (LPD); ІІІ – animals with acetaminophen-induced liver injury receiving complete ration (AII); IV – animals with acetaminophen-induced liver injury that were previously maintained on semi-synthetic low-protein ration (LPD/AII). Preparation of blood smears, their fixation and staining was carried out by the generally accepted method. The ratio of different types of leukocytes in stained blood smears was calculated using a standard method using a leukocyte counter and a microscope (eyepiece × 10, objective × 100). Standard formulas were used to calculate integral hematological indices. It was established that the supply of protein in the diet is critical for the functioning of the immune system under conditions of acetaminophen intoxication, since under these conditions there is a change in leukocyte indices, in particular, the index of immunoreactivity, the index of leukocyte shift, the index of the ratio of neutrophils and lymphocytes, the index of the reactive response of neutrophils, which indicates the intensification of inflammatory processes in the body and the formation of defects in the cellular link of immunity, disruption of the mechanisms of the specific immune response and the formation of a state of endotoxicosis. The obtained results can be used to develop approaches to the early diagnosis of impaired immunoreactivity in animals with toxic damage by acetaminophen against the background of dietary protein deficiency, while the studied integral hematological indicators can be used as additional early diagnostic markers of impaired immunoreactivity and endotoxicosis. Key words: acetaminophen, dietary protein deficiency, leukocytes, immunoreactivity indices

Randomized trial comparing the effects of a 3D head-up system and microscope eyepiece-assisted simulated vitrectomy with intraocular illumination on the ocular surface of an operator

BackgroundTo compare the effects of a 3D head-up system and microscope eyepiece-assisted simulated vitrectomy intraocular illumination on the ocular surface of an operator.MethodsThis was a prospective randomized controlled study. According to the application system, thirty ophthalmic operators (60 eyes) were randomly divided into 3D and eyepiece groups. Under different intensities of intraocular illumination, operators in both groups viewed the fundus model through a 3D display screen or microscopic eyepiece for 2 h. Objective examinations and a subjective symptom questionnaire were used immediately after the test to evaluate the ocular surface of the operators. Objective examinations included nonintrusion tear meniscus height (NIKTMH), nonintrusion break-up time (NIKBUT), and bulbar redness and strip meniscometry tube (SMTube) measurements. Statistical analyses were performed by using SPSS 26.0 software.ResultsAfter the test, the NIKTMH, NIKBUT and SMTube measurements decreased; however, the degree of change varied among the groups of different systems. The differences between the 3D group and the eyepiece group in NIKTMH measurements, SMTube measurements, subjective symptom scores (eye dryness, difficulty focusing, and cervical pain), and light intensity reaching the ocular surface of the operators were statistically significant (P < 0.05). All of the objective and subjective tests showed that the 3D group had fewer effects on the NIKTMH and SMTube measurements, and the subjective comfort of the 3D group was greater.ConclusionFor both 3D screens and eyepieces, simulated vitrectomy with intraocular illumination for two hours can lead to discomfort and abnormalities in the operator’s ocular surface; however, these abnormalities are less severe in the 3D group.Trial registrationThis trial was registered on December 22, 2022, at the Chinese Clinical Trials Registry with NO. ChiCTR2200066989.

Evolution of the meta-neurosurgeon: A systematic review of the current technical capabilities, limitations, and applications of augmented reality in neurosurgery.

Augmented reality (AR) applications in neurosurgery have expanded over the past decade with the introduction of headset-based platforms. Many studies have focused on either preoperative planning to tailor the approach to the patient's anatomy and pathology or intraoperative surgical navigation, primarily realized as AR navigation through microscope oculars. Additional efforts have been made to validate AR in trainee and patient education and to investigate novel surgical approaches. Our objective was to provide a systematic overview of AR in neurosurgery, provide current limitations of this technology, as well as highlight several applications of AR in neurosurgery. We performed a literature search in PubMed/Medline to identify papers that addressed the use of AR in neurosurgery. The authors screened three hundred and seventy-five papers, and 57 papers were selected, analyzed, and included in this systematic review. AR has made significant inroads in neurosurgery, particularly in neuronavigation. In spinal neurosurgery, this primarily has been used for pedicle screw placement. AR-based neuronavigation also has significant applications in cranial neurosurgery, including neurovascular, neurosurgical oncology, and skull base neurosurgery. Other potential applications include operating room streamlining, trainee and patient education, and telecommunications. AR has already made a significant impact in neurosurgery in the above domains and has the potential to be a paradigm-altering technology. Future development in AR should focus on both validating these applications and extending the role of AR.

ALTERNATIVE METHODOLOGY SIMULATING CAMERA LUCIDA FOR DRAWING MICROSCOPIC IMAGES

The camera lucida is an ancient equipment that is still used today to illustrate images through a microscope and stereomicroscope. Although it is not an overly expensive equipment, it can be inaccessible to some laboratories, and it has certain drawbacks that can be easily overcome with current technology. This work aimed at developing and testing a technique to replace the camera lucida. To this end, a microscope, a smartphone, a computer with a printer, and a light table made with low-cost materials were used, whose construction schemes are detailed in this work. A micrograph was obtained with the smartphone positioned in the microscope eyepiece. The micrograph was printed on an A4 paper sheet that was adhered to the light table, and, over the image, was placed a second paper sheet. With the light table turned on, the printed image became clearly visible on the blank paper sheet by transparency and could then be easily drawn. It is concluded that the technique described here allows excellent results, being an efficient alternative to the camera lucida in optical equipment.

Pathologists light level preferences using the microscope—study to guide digital pathology display use

BackgroundCurrently, there is a paucity of guidelines relating to displays used for digital pathology making procurement decisions, and optimal display configuration, challenging.Experience suggests pathologists have personal preferences for brightness when using a conventional microscope which we hypothesized could be used as a predictor for display setup. MethodsWe conducted an online survey across six NHS hospitals, totalling 108 practicing pathologists, to capture brightness adjustment habits on both microscopes and displays.A convenience subsample of respondents was then invited to take part in a practical task to determine microscope brightness and display luminance preferences, in the normal working environment. A novel adaptation for a lightmeter was developed to directly measure the light output from the microscope eyepiece. ResultsThe survey (response rate 59% n=64) indicates 81% of respondents adjust the brightness on their microscope. In comparison, only 11% report adjusting their digital display. Display adjustments were more likely to be for visual comfort and ambient light compensation rather than for tissue factors, common for microscope adjustments. Part of this discrepancy relates to lack of knowledge of how to adjust displays and lack of guidance on whether this is safe; But, 66% felt that the ability to adjust the light on the display was important.Twenty consultants took part in the practical brightness assessment. Light preferences on the microscope showed no correlation with display preferences, except where a pathologist has a markedly brighter microscope light preference. All of the preferences in this cohort were for a display luminance of <500 cd/m2, with 90% preferring 350 cd/m2 or less. There was no correlation between these preferences and the ambient lighting in the room. ConclusionsWe conclude that microscope preferences can only be used to predict display luminance requirements where the microscope is being used at very high brightness levels. A display capable of a brightness of 500 cd/m2 should be suitable for almost all pathologists with 300 cd/m2 suitable for the majority. Although display luminance is not frequently changed by users, the ability to do so was felt to be important by the majority of respondents.Further work needs to be undertaken to establish the relationship between diagnostic performance, luminance preferences, and ambient lighting levels.

Realtime assessment of vascular occlusion and reperfusion in animal models of intraoperative imaging- a pilot study.

Intraoperative monitoring of blood flow (BF) remains vital to guiding surgical decisions. Here, we report the use of SurgeON™ Blood Flow Monitor (BFM), a prototype system that attaches to surgical microscopes and implements laser speckle contrast imaging (LSCI) to noninvasively obtain and present vascular BF information in real-time within the microscope's eyepiece. The ability of SurgeON BFM to monitor BF status during reversible vascular occlusion procedures was investigated in two large animal models: occlusion of saphenous veins in six NZW rabbit hindlimbs and clipping of middle cerebral artery (MCA) branches in four Dorset sheep brain hemispheres. SurgeON BFM acquired, presented, and stored LSCI-based blood flow velocity index (BFVi) data and performed indocyanine green video angiography (ICG-VA) for corroboration. Stored BFVi data were analyzed for each phase: pre-occlusion (baseline), with the vessel occluded (occlusion), and after reversal of occlusion (re-perfusion). In saphenous veins, BFVi relative to baseline reduced to 5.2±3.7 % during occlusion and returned to 102.9±14.9 % during re-perfusion. Unlike ICG-VA, SurgeON BFM was able to monitor reduced BFVi and characterize re-perfusion robustly during five serial occlusion procedures conducted 2-5 min apart on the same vessel. Across four sheep MCA vessels, BFVi reduced to 18.6±7.7 % and returned to 120.1±27.8 % of baseline during occlusion and re-perfusion phases, respectively. SurgeON BFM can noninvasively monitor vascular occlusion status and provide intuitive visualization of BF information in real-time to an operating surgeon. This technology may find application in vascular, plastic, and neurovascular surgery.

Immunophysiological State of Dogs According to the Immunoregulatory Index of Their Blood and Spleens.

In this study, the immunological characteristics of a dog's body were established, allowing for a quick reaction to any changes in the immune status and the development of an immunodeficiency state. The immunoregulatory blood index was determined to indicate the ratio of T-helpers and T-suppressors. The immunoregulatory index of the spleen was determined as the ratio of CD4+ cells to CD8+ cells in the field of view of a microscope (eyepiece 10, objective 40) after obtaining histological preparations according to generally accepted methods. It was found that the number of T-helpers decreased by 0.13 × 1012/L, while the number of T-suppressors increased non-significantly by 0.01 × 1012/L after intensive exercise during tasks. The immunoregulatory blood index of dogs was 2.1 ± 0.1 and 1.7 ± 0.13 before and after intensive exercise, respectively. Lymphocytes with markers CD4+ and CD8+ were located almost all in the white pulp; in the red pulp, they were found alone, and their share was 3.4% and 1.9%, respectively. Lymphocytes with CD4+ markers in the spleen's white pulp were mainly concentrated in lymphoid nodules (60.7%), of which 20.1% were focused on the marginal zone, and slightly less in the light center (19.4%) and the periarterial zone (18.1%). Lymphocytes with CD8+ markers in the spleen's white pulp were also mainly concentrated in lymphoid nodules, but their number was 8.1% higher (68.8%). The immunoregulatory index of the spleen is 1.9. These findings emphasize the need for the assessment of the immunoregulatory index in service dogs to prevent the development of secondary immunodeficiency and allow them to properly perform their official duties.

Taxonomic significance of leaf architecture in the genus Basella Linn. in Nigeria

This study seeks to use the leaf architecture as a taxonomic tool for members of the genus Basella Linn. in Nigeria, namely, B. rubra Linn., B. alba Linn., B. cordifolia Lamk. and a form, B. alba round because the taxonomy of the genus Basella Linn. is not clear and there is no information on the leaf architecture of the genus. For studies of the venation pattern of the leaves, sizeable portions were taken from the standard median portion of mature leaves. Cleared leaves were stored in 50% alcohol for anatomical studies. Leaves were stained in Safranin O for 3 minutes and counterstained in Alcian blue and then were rinsed in water to remove excess stain. Stained cleared leaves were treated in serial grades of alcohol for differentiation and dehydration. Stained materials were mounted in dilute glycerol for microscopic examination. Photomicrographs were taken with the aid of 3013 ACCU-SCOPE Trinocular Microscope with Digital Camera. The areolar area was calculated from the length and breadth of the areoles measured using a micrometer inserted into the microscope eyepiece. Basella species have common generic features. Areoles are closed in B. rubra but others have veinlet endings. The area of areole is diagnostic because in B. rubra the area is 305,370±1808.91 μm2; B. alba is 501,796.75±3217.38 μm2, B. cordifolia’s area of areole is 396,394.75±2670.67 μm2 while that of B. alba round is 540,058.75±3702.28 μm2. The arrangement of druses in the areoles is also diagnostic.

PHARMACOGNOSTIC STUDY OF COSMOS BIPINNATUS CAV. (FAM. ASTERACEАE), CULTURED IN THE WESTERN CAUCASIAN REGION

The purpose of the work: to reveal the study of the morpho-anatomical composition and composition of biologically active groups – compounds, carboxylic acids and trace elements of the aerial part of various species of Cosmos bipinnatus Cav.: ‘Purity’, ‘Rosea’ and ‘Dazzler’.&#x0D; Materials and methods. The object of the study is the cultivation of three species of space plants in Europe, collected in the flowering phase at the beginning of 2020. Micropreparations were obtained using a Biomed-2 microscope (eyepiece 16x, objective 4x, 10x) in accordance with the procedures of the State Pharmacopoeia of the Russian Federation, XVI edition (SP XVI). Carbohydrate complexes are isolated from dried raw materials by the method of N.K. Kochetkov and M. Sinner. Quantify the content of each assessment gravimetrically. The monosaccharide composition is established after acid hydrolysis by paper chromatography. Identification of acid consumption is carried out using thin layer chromatography. The elemental and amino acid composition is examined by capillary electrophoresis.&#x0D; Results and discussion. Certain characteristic microscopic features of Cosmos bipinnatus Cav., Aster varieties ‘Rosea’, ‘Dazzler’, ‘Purity’ for various morphological parts of plants (leaves, flowers, inflorescence involucre, stem), revealing the identified signs of the alleged medicinal source as a source of biologically active connections. A comparative analysis of the composition of carbohydrates, carboxylic acids and carbohydrates of shoots (leaves and stems) showed that water-soluble polysaccharides are arabinose fructose, rhamnose and galactose, pectin monosaccharides are galacturonic acid, glucose and arabinose detection, and hemicelluloses A and B are xylose, glucose and galactose. In all known varieties, succinic acid is noted. A high content of proline and essential amino acids: leucine, methionine, valine, threonine, as well as the ability of all the studied sources to collect potassium, magnesium, iron and boron ions were noted.&#x0D; Conclusion. It has been established that the unusual colors of the flowers are predominantly the color of the stems. The anatomical features of different species are practically the same. It was revealed that the ‘Purity’ variety surpasses the objects in terms of the content of water-soluble polysaccharides, cellulose-hemi A and B, other essential amino acids, aliphatic amino acids, iron and boron. Variety ‘Dazzler’ is the richest in pectin doses and potassium ions. ‘Rosea’ variety contains the maximum amount of high content of amino acids.

Using virtual lines of navigation for a successful transcortical approach.

Neuronavigation systems have become essential tools in image-guided neurosurgery that aid in the accurate resection of brain tumors. Recent advancements to these devices can indicate the precise location of lesions but can also project an augmented reality (AR) image on the microscope eyepiece to facilitate a successful surgical operation. Although the transcortical approach is a very popular method in neurosurgery, it can lead to disorientation and can cause unnecessary brain damage when the distance from the brain surface to the lesion is long. Herein, we report on an actual case in which a virtual line from AR images was used to assist the transcortical approach. A virtual line connecting the entry point and the target point, which were set as the navigation route, was created using Stealth station S7® (Medtronic, Minneapolis, USA). This line was projected as an AR image on the microscope eyepiece. It was possible to reach the target point by proceeding through the white matter along the displayed virtual line. The lesion was reached within a short duration using virtual line without disorientation. Setting a virtual line as an AR image using neuronavigation is a simple and accurate method that can effectively support the conventional transcortical approach.

Determination of Platelet Count Estimation Factor on Peripheral Blood Smear Confirmation Using Field Number 22 Microscope

The automatic platelet count sometimes requires confirmation on the peripheral blood smear. Platelet count estimation can also be used for reporting platelet count if an automatic cell counter is not available, with an estimation factor according to the Field Number (FN) of the microscope used. This study aimed to determine the platelet count estimation factor based on peripheral blood smear confirmation using an FN 22 microscope. An observational cross-sectional study was carried out in patients who had routine hematological and peripheral blood smear examinations during September 2021 by determination of platelet count using the automatic cell counter method and an average number of platelet counts per field of view with 100x objective magnification. The estimation factor is the total ratio divided by sample size. The total ratio of 254 samples was 4.086. The platelet count estimation factor was 16, indicating that 1 platelet per field of view was equivalent to 16x103/µL. There was a very strong significant correlation between mean platelet count per field of view and platelet count using the automatic cell counter (p&lt;0.001, R&gt;0.750). The field number is the image diameter of the microscope eyepiece. The latest generations of microscope use FN 20 or more, which provides a wider field of view, enabling the observation of more platelets. Factor estimation was used to determine the estimated platelet count on a peripheral blood smear. A big difference between automatic cell counter and peripheral blood smear might indicate pre-analytic, analytic, and post-analytic errors. The platelet count estimation factor based on peripheral blood smear confirmation using the FN 22 microscope was 16. Each laboratory needs to determine the estimation factor according to the FN microscope used.

Vegetative anatomical characteristics and trichome morphology of the monotypic Martynia annua L. (Martyniaceae) for use in identification and crude drug search

Background: Leaf epidermis and indumenta structure of M. annua were studied with the aid of microscopy for easy identification&nbsp; of the plant materials when in fragments and for crude drug search. Stomata and trichome morphology appear significant in identifying the species. Paracytic and anomocytic stomatal types are basic but polocytic is additional on the abaxial surface of theepidermis.The overwhelming reports on the folkloric uses of Martynia annua L. (Martyniaceae) and the sole reliance on exo-morphology for its identification which gives room to error form the basis for this study. Moreso, the need to utilize as many data as possible for accurate identification of the plant is another important reason for its choice for investigation. Methods: A total of 20 plant samples were examined. 100 leaves and 40 stems, petioles and midribs obtained from both herbarium samples of the plant were examined. The epidermis was recovered after treatment with concentrated trioxonitrate (v) acid (HNO3) in capped specimen bottles for about 8–24hrs to macerate the mesophyll. Samples were stained with acidified phloroglucinol and then one drop of toluidine blue. They were mounted on glass slides and examined under the microscope (XSZ- 170BN Olympus) and photomicrographs were taken with microscope eyepiece camera (Toupview 3.7). Line drawings were made with camera lucida drawing instrument. Results: Interesting folia epidermal features were encountered. These include 3 stomatal types, two main types of trichomes namely: - Type 1: Long to short multicellular-glandular trichomes with globular heads and Type 2: Unicellular non-glandular globular-headed trichomes with stalk or no stalk. Conclusion: The report of leaf teeth in M. annua which is the begonioid type is novel and cell shape of the perivascular structures is oval to polyhedral.Asuite of these characters will aid identification of M. annua when a whole fresh plant specimen is absent.

The Lightfield Microscope Eyepiece.

Lightfield microscopy has raised growing interest in the last few years. Its ability to get three-dimensional information about the sample in a single shot makes it suitable for many applications in which time resolution is fundamental. In this paper we present a novel device, which is capable of converting any conventional microscope into a lightfield microscope. Based on the Fourier integral microscope concept, we designed the lightfield microscope eyepiece. This is coupled to the eyepiece port, to let the user exploit all the host microscope’s components (objective turret, illumination systems, translation stage, etc.) and get a 3D reconstruction of the sample. After the optical design, a proof-of-concept device was built with off-the-shelf optomechanical components. Here, its optical performances are demonstrated, which show good matching with the theoretical ones. Then, the pictures of different samples taken with the lightfield eyepiece are shown, along with the corresponding reconstructions. We demonstrated the functioning of the lightfield eyepiece and lay the foundation for the development of a commercial device that works with any microscope.

Early Experience With Virtual and Synchronized Augmented Reality Platform for Preoperative Planning and Intraoperative Navigation: A Case Series.

BACKGROUNDVirtual reality (VR) allows for presurgical planning. Intraoperatively, augmented reality (AR) enables integration of segmented anatomic information with neuronavigation into the microsurgical scene to provide guidance without workflow disruption. Combining VR and AR solutions may help guide microsurgical technique to improve safety, efficiency, and ergonomics.OBJECTIVETo describe a VR/AR platform that provides VR planning and intraoperative guidance via microscope ocular injection of a comprehensive AR overlay of patient-specific 360°/3D anatomic model aligned and synchronized with neuronavigation.METHODSCustom 360° models from preoperative imaging of 49 patients were utilized for preoperative planning using a VR-based surgical rehearsal platform. Each model was imported to SyncAR, the platform's intraoperative counterpart, which was coregistered with Medtronic StealthStation S8 and Zeiss or Leica microscope. The model was injected into the microscope oculars and referenced throughout by adjusting overlay opacity. For anatomic shifts or misalignment, the overlay was reregistered via manual realignment with known landmarks.RESULTSNo SyncAR-related complications occurred. SyncAR contributed positively to the 3D understanding of patient-specific anatomy and ability to operate. Preoperative planning and intraoperative AR with 360° models allowed for more precise craniotomy planning and execution. SyncAR was useful for guiding dissection, identifying critical structures including hidden anatomy, understanding regional anatomy, and facilitating resection. Manual realignment was performed in 48/49 surgeries. Gross total resection was achieved in 34/40 surgeries. All aneurysm clipping and microvascular decompression procedures were completed without complications.CONCLUSIONSyncAR combined with VR planning has potential to enhance surgical performance by providing critical information in a user-friendly, continuously available, heads-up display format.

Digital Pathology in Cameroon.

PURPOSECancer is becoming increasingly prevalent among the group of treatable diseases in African countries. There is a shortage of clinicians and pathologists available for cancer diagnosis and treatment. These limited resources must be efficiently used to maximize the number of patients treated. One of the critical factors in treatment efficiency is the correct and timely diagnosis of specimens by pathologists. However, there is currently a significant shortage of cancer care clinicians in Africa and an even more considerable shortage of pathologists. This article presents an example in which telepathology was used to mitigate the lack of pathologists in Cameroon.METHODSThe telepathology workaround was implemented in a district hospital based in Cameroon's Adamawa region, where a European surgeon provides cancer treatment. A small histology laboratory there is run by one histotechnologist who processes surgical biopsies into histology slides. As there are no pathologists on site, these slides are digitally scanned using a mobile phone and a whole slide imaging (WSI) scanner. The slides are then shared electronically with a volunteering pathologist in Europe who provides a diagnostic report.RESULTSFrom 2018 to July 2019, specimens for 101 patients were photographed through an iPhone connected to a microscope eyepiece producing several individual images per specimen. From July 2019 to December 2020, slides from 282 patients were scanned using WSI and digitally transmitted.CONCLUSIONWSI on hematoxylin and eosin histology slides for remote diagnosis can increase cancer treatment efficacy and reduce overtreatment of tumors clinically suspicious for malignancy in under-resourced countries with a lack of pathologists.

Artificial intelligence for solid tumour diagnosis in digital pathology

Tumour diagnosis relies on the visual examination of histological slides by pathologists through a microscope eyepiece. Digital pathology, the digitalization of histological slides at high magnification with slides scanners, has raised the opportunity to extract quantitative information due to image analysis. In the last decade, medical image analysis has made exceptional progress due to the development of artificial intelligence (AI) algorithms. AI has been successfully used in the field of medical imaging and more recently in digital pathology. The feasibility and usefulness of AI assisted pathology tasks have been demonstrated in the very last years and we can expect those developments to be applied to routine histopathology in the future. In this review, we will describe and illustrate this technique and present the most recent applications in the field of tumour histopathology. LINKED ARTICLES: This article is part of a themed issue on Molecular imaging - visual themed issue. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v178.21/issuetoc.

A High-Definition 3-Dimensional Exoscope With the ARTip Cruise System as an Effective New Tool for Phonosurgery: A Preliminary Report.

The aim of phonosurgery is to improve voice quality and efficiency by performing precise, minimally invasive, conservative treatment. Magnified visualization of the vocal folds is mandatory to achieve optimal results; operative microscopy has been utilized so far to perform phonosurgery. In recent decades, the use of an exoscope (extracorporeal telescope) has been proposed in several fields of surgery that necessitate magnification. Further technological advancements have enabled 3-dimensional (3D) technology to be added to existing exoscopes. Recently, a motorized holding arm (the ARTip Cruise System) was developed to allow smooth precise positioning of the 3D Vitom exoscope (Karl Storz, Tuttlingen, Germany) by the surgeon without need for assistance. To evaluate the feasibility of phonosurgery by means of this innovative system, we utilized it for six consecutive procedures for benign laryngeal pathologies, including two vocal fold polyps, two cysts, one Reinke's edema and one unilateral vocal fold paralysis treated by fat augmentation. All procedures were performed without any technical difficulty and with excellent results at follow-up, as demonstrated by GRBAS, VHI-10 and maximal phonation time evaluations. Main advantages of this technique were the enhanced depth of field and high definition of anatomical details. Communication with the operating room team was facilitated by the shared view of the same images on screen; furthermore, the surgeon could perform the procedures visualizing the surgical site without need to position the eyes on the microscope eyepieces and so being able to wear full face protection, which was of paramount importance in the era of the COVID-19 pandemic. In conclusion, the 4K 3D exoscope system with the ARTip Cruise System represents a promising innovation in the field of voice surgery to allow highly precise procedures optimizing safety and co-operation with the operating room team.

Use of the heads-up NGENUITY 3D Visualization System for vitreoretinal surgery: a retrospective evaluation of outcomes in a French tertiary center

Heads-up three-dimensional (3D) surgical visualization systems allow ophthalmic surgeons to replace surgical microscope eyepieces with high-resolution stereoscopic cameras transmitting an image to a screen. We investigated the effectiveness and safety of the heads-up NGENUITY 3D Visualization System in a retrospective evaluation of 241 consecutive vitreoretinal surgeries performed by the same surgeon using conventional microscopy (CM group) over a 1-year period versus the NGENUITY System (3D group) over a consecutive 1-year period. We included for study vitreoretinal surgeries for treatment of retinal detachment (RD) (98 surgeries), macular hole (MH) (48 surgeries), or epiretinal membrane (ERM) (95 surgeries). A total of 138 and 103 eyes were divided into 3D and CM groups, respectively. We found no differences in 3-month postoperative rates of recurrence of RD (10% versus 18%, p = 0.42), MH closure (82% versus 88%, p = 0.69), or decrease in central macular thickness of ERMs (134 ± 188 µm versus 115 ± 105 µm, p = 0.57) between the 3D and CM groups, respectively. Surgery durations and visual prognosis were also similar between both groups. We consolidate that the NGENUITY System is comparable in terms of visual and anatomical outcomes, giving it perspectives for integration into future robotized intervention.

Visual display for surgical targeting: concepts and usability study

PurposeInteractive image-guided surgery technologies enable accurate target localization while preserving critical nearby structures in many surgical interventions. Current state-of-the-art interfaces largely employ traditional anatomical cross-sectional views or augmented reality environments to present the actual spatial location of the surgical instrument in preoperatively acquired images. This work proposes an alternative, simple, minimalistic visual interface intended to assist during real-time surgical target localization.MethodsThe estimated 3D pose of the interventional instruments and their positional uncertainty are intuitively presented in a visual interface with respect to the target point. A usability study with multidisciplinary participants evaluates the proposed interface projected in surgical microscope oculars against cross-sectional views. The latter was presented on a screen both stand-alone and combined with the proposed interface. The instruments were electromagnetically navigated in phantoms.ResultsThe usability study demonstrated that the participants were able to detect invisible targets marked in phantom imagery with significant enhancements for localization accuracy and duration time. Clinically experienced users reached the targets with shorter trajectories. The stand-alone and multi-modal versions of the proposed interface outperformed cross-sectional views-only navigation in both quantitative and qualitative evaluations.ConclusionThe results and participants’ feedback indicate potential to accurately navigate users toward the target with less distraction and workload. An ongoing study evaluates the proposed system in a preclinical setting for auditory brainstem implantation.

Cervical cytology screening facilitated by an artificial intelligence microscope: A preliminary study.

Cervical cytology screening is usually laborious with a heavy workload and poor diagnostic consistency. The authors have developed an artificial intelligence (AI) microscope that can provide onsite diagnostic assistance for cervical cytology screening in real time. A total of 2167 cervical cytology slides were selected from a cohort of 10,601 cases from Shenzhen Maternity and Child Healthcare Hospital, and the training data set consisted of 42,073 abnormal cervical epithelial cells. The recognition results of an AI technique were presented in a microscope eyepiece by an augmented reality technique. Potentially abnormal cells were highlighted with binary classification results in a 10× field of view (FOV) and with multiclassification results according to the Bethesda system in 20× and 40× FOVs. In addition, 486 slides were selected for the reader study to evaluate the performance of the AI microscope. In the reader study, which compared manual reading with AI assistance, the sensitivities for the detection of low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial lesions were significantly improved from 0.837 to 0.923 (P < .001) and from 0.830 to 0.917 (P < .01), respectively; the κ score for atypical squamous cells of undetermined significance (ASCUS) was improved from 0.581 to 0.637; the averaged pairwise κ of consistency for multiclassification was improved from 0.649 to 0.706; the averaged pairwise κ of consistency for binary classification was improved from 0.720 to 0.798; and the averaged pairwise κ of ASCUS was improved from 0.557 to 0.639. The results of this study show that an AI microscope can provide real-time assistance for cervical cytology screening and improve the efficiency and accuracy of cervical cytology diagnosis.