From a retrospective analysis of 22 cases of pancreatic insulinoma operated in our center, we have determined the predictive value of various pre‐ and intraoperative localization procedures. In 18 patients, solitary insulinomas were localized by selective arteriography (SA) in 55.5% of cases, by transhepatic catheterization with pancreatic venous sampling (THVS) in 64% of cases, but by ultrasonography (US) and computed tomography (CT) in only 11% of cases. The combination of SA and THVS allowed the preoperative localization of the tumor in 83% of cases. Intraoperative palpation, ultrasonography, and blood glucose monitoring localized a single tumor in all cases.
When the insulinomas were multiple, the various preoperative investigations were not reliable. In the 4 cases of multiple insulinoma, various investigations (SA, US, CT, THVS) localized only 8 (28%) tumors of 28. Intraoperative palpation was also unreliable. Only intraoperative ultrasonography and continuous blood glucose monitoring localizeall multiple tumors (the diameter of the smallest tumor was 4 mm). These 2 intraoperative investigations are now the procedures of choice for the detection of small pancreatic insulinomas.
Objective: Human body models have the potential to better describe the human anatomy and variability than dummies. However, data sets available to verify the human response to impact are typically limited in numbers, and they are not size or gender specific. The objective of this study was to investigate the use of model morphing methodologies within that context. Methods: In this study, a simple human model scaling methodology was developed to morph two detailed human models (Global Human Body Model Consortium models 50th male, M50, and 5th female, F05) to the dimensions of post mortem human surrogates (PMHS) used in published literature. The methodology was then successfully applied to 52 PMHS tested in 14 impact conditions loading the abdomen. The corresponding 104 simulations were compared to the responses of the PMHS and to the responses of the baseline models without scaling (28 simulations). The responses were analysed using the CORA method and peak values.
Results:The results suggest that model scaling leads to an improvement of the predicted force and deflection but has more marginal effects on the predicted abdominal compressions. M50 and F05 models scaled to the same PMHS were also found to have similar external responses, but large differences were found between the two sets of models for the strain energy densities in the liver and the spleen for mid-abdomen impact simulations. These differences, which were attributed to the anatomical differences in the abdomen of the baseline models, highlight the importance of the selection of the impact condition for simulation studies, especially if the organ location is not known in the test. Conclusions: While the methodology could be further improved, it shows the feasibility of using model scaling methodologies to compare human models of different sizes and to evaluate scaling approaches within the context of human model validation.
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