Objective To evaluate the accuracy of a new generation bioimpedance cardiac output monitor as compared with thermodilution and end expiratory CO 2 techniques Methods Sixteen patients (14 males, 2 females) aged (58?12) years undergoing elective coronary artery bypass (CAB) surgery were studied Cardiac output was measured after CAB surgery in ICU using a new generation bioimpedance cardiac output monitor(Rheo Bioimpedance Hemodynamic monitor) and conventional thermodilution technique in 16 patients and end expiratory CO 2 technique in 10 patients Cardiac output was also measured with Rheo Bioimpedance Hemodynamic monitor in 200 healthy volunteers consisting of equal numbers of male and female The volunteers of each sex were further divided into 5 equal groups of 20 each: (1)20 29 years, (2)30 39 years, (3)40 49 years, (4)50 59 years and (5)60 70 years Results Cardiac outputs measured by bioimpedance and thermodilution techniques were well correlated (r=0 83) and there was also a good correlation between cardiac outputs measured by bioimpedance and end expiratory CO 2 techniques(r=0 88) Cardiac out measured with Rheo Bioimpedance Hemodynamic monitor in 200 healthy volunteers showed that there was a significant difference in cardiac output between 60 70 years age group and the other age groups in both male and female Conclusions Cardiac output and other hemodynamic parameters measured with the new generation bioimpedance hemodynamic monitor are accurate and can be used for preoperative cardiovascular function evaluation and postoperative monitoring of dynamic changes in circulatory function

Background Aheration of eyeball wall caused by ocular axial extension is associated with multiple complications of high myopia.However,the study on quantitative analysis of choroidal thickness and axial length in adult high myopic patients is less.Objective This study was to investigate the choroidal thickness in high myopic eyes of adult patients and estimate the correlation of choroidal thickness with axial length,age,and spherical equivalent(SE).Methods A prospective cohort study was designed.Seventy-five eyes of 75 adult patients with high myopia were entrolled from December 2012 to May 2013,and 70 eyes of 70 age-and gendermatched healthy volunteers were included in Renmin Hospital of Wuhan University.Enhanced depth imaging (EDI)on Cirrus spectral-domain optical coherence tomography (SD-OCT) was used to measure the choroidal thickness from the outer border of the retinal pigment epithelium through the inner scleral boarder among the 11 meridians in a 500 μm intervals and range of 2 500 μm for each from fovea toward temporal and nasal lateral.The differences of choroidal thickness and axial length were compared between the high myopia group and normal control group,and the correlation of choroidal thickness with axial length,age,SE were analyzed.Results The subfoveal and mean choroidal thickness values were (146±52) μm and (142±63) μm in the high myopia group,and those in the normal control group were (306±60) μm and (271 ±71) μm,with significant differences between the two groups (t =-17.130,P=0.000; t=-15.890,P=0.000).Choroid was thickest in the temporal and then was subfovea and nasal in the high myopia group,but in the normal control group,it was subfovea,temporal and nasal in turn,and the choroidal thicknesses in various areas were thinner in the high myopia group than those in the normal control group.A negative correlation was found between the choroidal thickness and axial length in high myopia group(r =-0.580,P =0.000),and the regression equation determined a decrease of 17.943 μm per millimeter of axial length.Conclusions SD-OCT determines that choroidal thickness is decreased in highly myopic eyes compared with normal eyes.Choroidal thickness varies with the change of axial length in adult high myopia patient.These findings indicate that abnormalities of the choroids may play a role in the pathogenesis of complication of high myopia.

OBJECTIVETo explore the impact of titanium implant on the growth and development of pediatric mandible after suffering from mandibular fracture and undergoing open reduction and internal fixation (ORIF) compared with those that underwent titanium plate removal postoperatively.

METHODSFifteen pediatric patients with mandibular fracture who underwent ORIF were included in this study. Eight patients did not undergo titanium implant removal postoperatively, whereas the other seven patients underwent the routine. The postoperative data of the pediatrics were collected for comparative analysis by taking the patients' frontal and lateral photos, recording the inter-incisor distance, and measuring the height of mandibular ramus, length of the mandibular body, and combined length of the mandible in three-dimensional reconstruction image.

RESULTSAll patients had acceptable facial contour, mouth opening, and occlusion, without obvious abnormalities. The radiography showed no significant difference between the bilateral mandibular lengths in the two groups of patients (P>0.05).

CONCLUSIONThe titanium plants have no significant impact on the growth and development of pediatric mandible postoperatively; hence, the question on whether the titanium plates should be removed or not may be neglected. The removal operation may lead to secondary trauma; thus, performing titanium plate removal routinely is not recommended.

Bone Plates ; Dental Implants ; Dental Occlusion ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Mandible ; Mandibular Fractures ; Prostheses and Implants ; Time Factors ; Titanium

Aged, 80 and over ; Aspergillus ; isolation & purification ; Fever of Unknown Origin ; etiology ; Humans ; Invasive Pulmonary Aspergillosis ; complications ; microbiology ; pathology ; Length of Stay ; Long-Term Care ; Lung Diseases, Interstitial ; complications ; pathology ; Male ; Pulmonary Alveoli ; pathology ; Respiratory Distress Syndrome, Adult ; complications ; pathology

BACKGROUND:The design and communication of cosmetic operation is more refined than that of traumatic operation. Thus, more accurate data should be acquired and more precise three-dimensional models should be reconstructed.
OBJECTIVE:To investigate the prospect of 3D laser scanner and matched graphics-processing software which acquire and analyze facial morphological data in the modern cosmetic surgery.
METHODS: We obtained the point clouds of the facial surface in two cases of facial soft tissue defects or dissatisfied facial appearance using a hand-held laser scanner to reconstruct a visualized facial model, which was used for measurement of facial profile, simulation of cosmetic operation and evaluation of the therapeutic effects.
RESULTS AND CONCLUSION:We simulated and designed upon the NURBS model before the operation primarily. Then the three-dimensional comparison was done between the simulate model and the postoperative model. Deviation analysis showed that the ratio of variation degree of the two models within 1 mm was more than 80%. It enables the rapid three-dimensional reconstruction of the facial surface by the combination of reverse engineering and laser scanning, thus providing accurate three-dimensional data for cosmetic design and quantitative evaluation of therapeutic effects in cosmetic surgery.

Objective To discuss the microstructure and properties of vascular puncture with a blunt needle Pix'L filling injection.Methods Scanning electron microscopy (SEM) and photoelectron spectroscopy were employed for the analysis of the different morphology and elements,and a rat model was established to study thrusts of different microcannulas and hypodermic needle when stabing vessels.Ultimately we analyzed the correlation between the morphology and puncture force of different microcannulas.Results The SEM images of microcannulas from different manufacturers were different,and revealed the different technics of different manufacturers.Puncture forces of different microcannulas corresponded to the cross-section and smooth degree of the tips.Conclusions The SEM morphology and puncture force of microcannulas from different manufacturers are different,which indicate the different characters and usability.Plastic surgeons should select to use them more judiciously.

Objective To investigate the imaging features of sarcomatoid carcinoma(SC)of lung on chest radiography and CT and to improve knowledge of SC.Methods The chest plain films,CT images and clinical data of all 7 cases of pathologically proved lung SC were retrospectively analyzed.Results All cases presented with a spheroid solid lung mass ranged from 3 to 11 cm in diameter(average 7 cm).All the lesions were located in middle and lower fields of the lung:3 lesions in right lower lobe,2 in right middle lobe,and the other 2 in left lower lobe.Among the 7 cases:6 cases were of peripheral type and 1 case was of central type.The peripheral-typed lesions of 5 cases had clear margin and 3 of them were lobulated.Three massess were homogenous in density,and the other 4 were inhomogeneous in density with formation of central cavity or calcification.After intravenous contrast administration.Three lesions showed homogeneous enhancement,and the other 4 lesions had inhomogeneous enhancement.The lesions with diameter larger than 6 cm showed marginal or patch-like enhancement.Five cases had pleural or chest walls invasion.Two cases had mediastinal lymph nodes metastases.One case had multiple remote metastasis.Conclusion There are some relatively specific features of lung SC on chest radiography and CT,which may be helpful for diagnosis.

Objective To observe the angiographic features of patients with retinal vein occlusion (RVO) by ultra-wide-field fluorescein angiography (UWFA) and compare with the conventional 7 standard field (7SF) imaging. Methods This is a retrospective clinical description study. Fifty-eight eyes of 56 RVO patients were included. There were 25 males (26 eyes) and 31 females (32 eyes). The age ranged from 25 to 69 years, with a mean age of (48.12±18.56) years. The course of disease was from 2 days to 25 months, with a mean course of (12.78±11.35) months. Thirty eyes were diagnosed with central RVO (51.72%), 26 eyes were diagnosed with branch RVO (44.83%) and 2 eyes were diagnosed with hemicentral RVO (3.45%). Retinal laser photocoagulation was performed in 11 eyes (18.97%). All patients received examinations of UWFA (British Optomap 200Tx imaging system) and optical coherence tomography (OCT). Using the protocol for obtaining 7SF images as described in the Early Treatment Diabetic Retinopathy Study, 7 circular regions with a range of 30 degrees were combined as the 7SF template to determine the observation area. This template was then overlaid on the UWFA image to identify the potential viewable area of 7SF. The visualized retinal area, retinal non-perfusion area, retinal neovascularization area, and laser spot area of UWFA and 7SF were quantified by a retinal specialist. In addition, the OCT images of the affected eye were observed and analyzed to confirm the existence of macular edema. Correlation analysis was done between retinal non-perfusion, retinal neovascularization and macular edema detected by UWFA. Results The results of UWFA and 7SF examination were the same. Compared with 7SF, UWFA showed 3.53 times more retinal visual area, 3.31 times more non-perfusion area, 1.94 times more neovascularization area, and 3.59 times more laser spots (t=72.13, 4.69, 1.76, 5.78;P=0.000, 0.005, 0.102, 0.000). Lesions of 11 eyes (18.97%) were found outside the range of 7SF images. By UWFA, non-perfusion area correlated with neovascularization and macular edema (χ2=12.13, 4.82;P=0.000, 0.028;C=0.42, 0.28). Non-perfusion area anterior to the equator have significantly correlations with macular edema (χ2=6.32, P=0.012, C=0.31), but non-perfusion posterior to the globe equator have no relevance with macular edema (χ2=2.88, P=0.090, C=0.22). Conclusions UWFA can detect more peripheral retinal lesions than 7SF images. By UWFA, non-perfusion area has correlation with neovascularization and macular edema.

Objective To observe the ocular fundus features and consistency of classification of diabetic retinopathy (DR) by ultra-wide-field fluorescein angiography (UWFA) and the simulated early treatment diabetic retinopathy study (ETDRS) 7 standard field (7SF) imaging. Methods This is a retrospective clinical description study. Ninety-six eyes of 55 DR patients were included. The ages ranged from 25 to 73 years, with a mean age of (41.34±15.07) years. UWFA examination (British Optos 200Tx imaging system) using the protocol for obtaining 7SF images as described in the ETDRS, 7 circular regions with a range of 30 degrees are spliced as 7SF templates to determine the observation range. This template was then overlaid on the UWFA image to identify the potential viewable area of 7SF. And the visualized area of the retina, retinal non-perfusion (NP) area, retinal neovascularization (NV) area, and pan-retinal photocoagulation (PRP) area of UWFA and 7SF were quantified by a retinal specialist. Results UWFA imaging and 7SF imaging have a high degree of consistency in judging DR classification (kappa=0.851, P=0.000). The retinal visual area, NP area, NV area and PRP area of the UWFA imaging were 3.16, 3.38, 2.22 and 3.15 times more comparing with the simulated 7SF imaging (t=213.430, 45.013, 22.644, 142.665;P=0.000, 0.000, 0.003, 0.000). The lesions of 8 eyes were found outside the range of simulated 7SF imaging, including peripheral NP in 5 eyes, NV areas in 3 eyes, respectively. Conclusion UWFA imaging and simulated 7SF imaging are consistent to judge DR classification, but UWFA can find more peripheral retinal lesions.

BACKGROUNDAn important purpose of orthodontic treatment is to gain the harmonic soft tissue profile. This article describes a novel way to build patient-specific models of facial soft tissues by transforming a standard finite element (FE) model into one that has two stages: a first transformation and a second transformation, so as to evaluate the facial soft tissue changes after orthodontic treatment for individual patients.

METHODSThe radial basis functions (RBFs) interpolation method was used to transform the standard FE model into a patient-specific one based on landmark points. A combined strategy for selecting landmark points was developed in this study: manually for the first transformation and automatically for the second transformation. Four typical patients were chosen to validate the effectiveness of this transformation method.

RESULTSThe results showed good similarity between the transformed FE models and the computed tomography (CT) models. The absolute values of average deviations were in the range of 0.375 - 0.700 mm at the lip-mouth region after the first transformation, and they decreased to a range of 0.116 - 0.286 mm after the second transformation.

CONCLUSIONSThe modeling results show that the second transformation resulted in enhanced accuracy compared to the first transformation. Because of these results, a third transformation is usually not necessary.

Computer Simulation ; Face ; Finite Element Analysis ; Humans ; Models, Theoretical