Objectives: Measurements of stone features may vary according to the non-contrast computed tomography (NCCT) technique. Using magnifi ed bone window is the most accurate method to measure urinary stones. Possible differences between stone measurements in different NCCT windows have not been evaluated in stones located in the kidney. The aim of this study is to compare measurements of kidney stone features between NCCT bone and soft tissue windows in patients submitted to retrograde intrarenal surgery (RIRS). Materials and Methods: Preoperative and 90th postoperative day NCCT were performed in 92 consecutive symptomatic adult patients (115 renal units) with kidney stones between 5 mm to 20 mm (< 15 mm in the lower calyx) treated by RIRS. NCCT were evaluated in the magnifi ed bone window and soft tissue window in three axes in a different time by a single radiologist blinded for the measurements of the NCCT other method. Results: Stone largest size (7.92±3.81 vs. 9.13±4.08; mm), volume (435.5±472.7 vs. 683.1±665.0; mm3) and density (989.4±330.2 vs. 893.0±324.6; HU) differed between bone and soft-tissue windows, respectively (p<0.0001) 5.2% of the renal units (6/115) were reclassifi ed from residual fragments > 2 mm on soft tissue window to 0-2 mm on bone window. Conclusion: Kidney stone measurements vary according to NCCT window. Measurements in soft tissue window NCCT of stone diameter and volume are larger and stone density is lesser than in bone window. These differences may have impact on clinical decisions.
Introduction
The anatomy of the temporal bone is complex due to the large number of structures and functions grouped in this small bone space, which do not exist in any other region in the human body. With the difficulty of obtaining anatomical parts and the increasing number of ear, nose and throat (ENT) doctors, there was a need to create alternatives as real as possible for training otologic surgeons.
Objective
Developing a technique to produce temporal bone models that allow them to maintain the external and internal anatomical features faithful to the natural bone.
Methods
For this study, we used a computed tomography (CT) scan of the temporal bones of a 30-year-old male patient, with no structural morphological changes or any other pathology detected in the examination, which was later sent to a 3D printer in order to produce a temporal bone biomodel.
Results
After dissection, the lead author evaluated the plasticity of the part and its similarity in drilling a natural bone as grade “4” on a scale of 0 to 5, in which 5 is the closest to the natural bone and 0 the farthest from the natural bone. All structures proposed in the method were found with the proposed color.
Conclusion
It is concluded that it is feasible to use biomodels in surgical training of specialist doctors. After dissection of the bone biomodel, it was possible to find the anatomical structures proposed, and to reproduce the surgical approaches most used in surgical practice and training implants.
Thirty-four Candida isolates were analyzed by random amplified polymorphic DNA using the primer OPG-10: 24 Candida albicans; 4 Candida tropicalis; 2 Candida parapsilosis; 2 Candida dubliniensis; 1 Candida glabrata and 1 Candida krusei. The UPGMA-Pearson correlation coefficient was used to calculate the genetic distance between the different Candida groupings. Samples were classified as identical (correlation of 100%); highly related samples (90%); moderately related samples (80%) and unrelated samples (< 70%). The results showed that the RAPD proposed was capable of classifying the isolates coherently (such that same species were in the same dendrogram), except for two isolates of Candida parapsilosis and the positive control (Netherlands, 1973), probably because they are now recognized as three different species. Concerning the only fluconazole-resistant Candida tropicalis isolate with a genotype that was different to the others, the data were insufficient to affirm that the only difference was the sensitivity to fluconazole. We concluded that the Random Amplified Polymorphic DNA proposed might be used to confirm Candida species identified by microbiological methods.
IntroductionThree-dimensional (3D) printing has become an affordable tool for assisting
heart surgeons in the aorta endovascular field, both in surgical planning,
education and training of residents and students. This technique permits the
construction of physical prototypes from conventional medical images by
converting the anatomical information into computer aided design (CAD)
files.ObjectiveTo present the 3D printing feature on developing prototypes leading to
improved aortic endovascular surgical planning, as well as transcatheter
aortic valve implantation, and mainly enabling training of the surgical
procedure to be performed on patient's specific condition.MethodsSix 3D printed real scale prototypes were built representing different aortic
diseases, taken from real patients, to simulate the correction of the
disease with endoprosthesis deployment.ResultsIn the hybrid room, the 3D prototypes were examined under fluoroscopy, making
it possible to obtain images that clearly delimited the walls of the aorta
and its details. The endovascular simulation was then able to be performed,
by correctly positioning the endoprosthesis, followed by its deployment.ConclusionThe 3D printing allowed the construction of aortic diseases realistic
prototypes, offering a 3D view from the two-dimensional image of computed
tomography (CT) angiography, allowing better surgical planning and surgeon
training in the specific case beforehand.
The making of three-dimensional virtual models is a promising technology in preoperative planning, but that is not used in the treatment of anorectal fistulas. The objective of this work is to describe the development and initial experience of the construction of a virtual three-dimensional model of the pelvic anatomy of a patient, allowing the exact identification of the relationships between the fistulous tracts of complex anorectal fistulas and the other pelvic structures. An MRI was performed on this patient, and the images were exported to the Vitrea fX Workstation® software. A radiologist did the analysis and segmentation of the images that were then sent to a three-dimensional image processor (Meshlab v. 1.3.3 – ISTI – CNR Research Center, Pisa University, Italy). The final 3D color image was analyzed by the surgeon and used to guide the catheterization of the fistulous pathways, the internal orifice and to assist in the identification of adjacent structures. The final three-dimensional model presented a high correlation with the intraoperative findings and facilitated the surgical planning.
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