A novel RBF-based predictive tool for facial distraction surgery in growing children with syndromic craniosynostosis.

Purpose: Predicting changes in face shape from corrective surgery is challenging in growing children with syndromic craniosynostosis. A prediction tool mimicking composite bone and skin movement during facial distraction would be useful for surgical audit and planning. To model surgery, we used a radial basis function (RBF) that is smooth and continuous throughout space whilst corresponding to measured distraction at landmarks.

Recognising facial surfaces.

The extent to which faces depicted as surfaces devoid of pigmentation and with minimal texture cues ('head models') could be matched with photographs (when unfamiliar) and identified (when familiar) was examined in three experiments. The head models were obtained by scanning the three-dimensional surface of the face with a laser, and by displaying the surface measured in this way by using standard computer-aided design techniques. Performance in all tasks was above chance but far from ceiling.

The identification of competencies for an NHS response to chemical, biological, radiological, nuclear and explosive (CBRNe) emergencies.

Unlabelled: Emergency planning is a new science and there is a lack of UK standardisation in regard to NHS emergency planning. A first step to achieving standardisation within emergency planning is elucidation of national training competencies.

Aim: This study was designed to find consensus amongst multi-agency chemical, biological, radiological, nuclear and explosive (CBRNe) experts on the factors that must be included in future NHS CBRNe competencies.

Improvements in cheek volume in lipoatrophic individuals switching away from thymidine nucleoside reverse transcriptase inhibitors.

Background: Thymidine nucleoside reverse transcriptase inhibitors (NRTIs) are associated with subcutaneous fat loss. Facial changes cannot be assessed by dual-energy X-ray absorptiometry (DEXA) scans. There are limited objective data on the reversibility of facial lipoatrophy.

Image-enhanced surgical navigation for endoscopic sinus surgery: evaluating calibration, registration and tracking.

Background: Endoscopic sinus surgery (ESS) is generally applied to treat sinusitis when medication is not effective in eliminating the symptoms. Images captured by the endoscope are viewed on a monitor placed near the surgeon. Due to the separation of the handling of the endoscope from the viewing of the image, ESS requires surgeons to have well-trained hand-eye coordination.

Minimally-compressive, three- and four-dimensional ultrasound imaging of the clitoris: a feasibility study.

There has been no objective means for imaging the three-dimensional (3D) morphology of the clitoris-a poorly understood, complex structure. A Live 3D ultrasound system with a matrix-array transducer was used for data acquisition from eight women. The transducer was positioned in front of and about 3 cm away from the clitoris, with a gel pad or water pad being placed in between.

Emergency care nurse training.

James Bird presents an interesting case for specialised emergency care during student nurse training in the June issue of Emergency Nurse. However the answer to his opening question, 'Is general nursing coming to an end?', is surely 'No'; it already has.

Three-dimensional MRI of the male urethrae with implanted artificial sphincters: initial results.

The aim of this study was to develop a method for simultaneous 3D visualization of a new type of artificial urethral sphincter (AUS) and adjacent urinary structures. Serial MR tomograms were acquired from seven men after AUS implantation. 3D reconstruction was performed by thresholding original (positive) and inverted (negative) image intensity and by subsequently fusing positive and negative images.

Real-time three-dimensional ultrasound visualization of erection and artificial coitus.

To investigate the feasibility of imaging penile erection and coitus in real time and in three dimensions, a 'Live' three-dimensional (3-D) ultrasound system was used to acquire the volume of interest at 25 Hz from five healthy men. Water baths and gel-made artificial vaginas were devised to facilitate the 3-D scans without the probe being in direct contact with the penis. For the first volunteer scanned with the water bath alone, the penis failed to erect within 30 min.

On a relaxation-labelling algorithm for quantitative assessment of tumour vasculature in tissue section images.

Although tumour vasculature constitutes a biological factor playing a crucial role in the radiation response of tumours, the current procedures of assessment are semiquantitative, typically employing visual examination of stained histological material. Such techniques are also time consuming, and inefficient of extracting essential information on the vascular network. Image analysis has yet to contribute significantly in this direction, and most studies to date focus on blood vessel segmentation through empirical, user-selected thresholds.

Size and shape differences between male and female foot bones: is the female foot predisposed to hallux abducto valgus deformity?

This study introduces a new technique to measure bone size and shape. A three-dimensional laser scan was taken of the talus, navicular, medial cuneiform, and first metatarsal from 107 skeletons of known age and sex. The bones were analyzed for differences in bone morphology between the sexes and the ability of each bone to contribute to the adducted position of the first metatarsal.

A survey on histological image analysis-based assessment of three major biological factors influencing radiotherapy: proliferation, hypoxia and vasculature.

Image analysis is a rapidly evolving field with growing applications in science and engineering. In cancer research, it has played a key role in advancing techniques of major diagnostic importance, minimising human intervention and providing vital clinical information. Especially in the field of tissue microscopy, the use of computers for the automated analysis of histological sections is becoming increasingly important.

Overcoming subjectivity in assessing facial lipoatrophy: is there a role for three-dimensional laser scans?

Background: Prevalence and incidence rates of lipodystrophy vary widely and frequently rely upon self- and/or clinician reports. Currently no validated assessment tool for facial lipoatrophy is available.

Aims And Objectives: To illustrate that assessment of the severity of facial lipoatrophy by patients and clinicians is subjective.

An image analysis-based approach for automated counting of cancer cell nuclei in tissue sections.

Background: Semiquantitative evaluation and manual cell counting are the commonly used procedures to assess positive staining of molecular markers in tissue sections. Manual counting is also a laborious task in which consistent objectivity is difficult to achieve. Recently, image analysis has been explored, but the studies reported were limited to histological images acquired at high magnification and containing uniformly stained cells.

Tumor hypoxia and blood vessel detection: an image analysis technique for simultaneous tumor hypoxia grading and blood vessel detection in tissue sections.

We have developed a multistage image analysis technique for the simultaneous segmentation of blood vessels and hypoxic regions in dual-stained tumor tissue sections. The algorithm, which is integrated in a task-oriented image analysis system developed on-site, initially uses the K-nearest neighbor classification rule in order to label the image pixels. Classification is based on a training set selected from manually drawn regions corresponding to the areas of interest.

Real-time three-dimensional fetal echocardiography--optimal imaging windows.

A total of 15 fetuses were scanned using 2-D array volumetric ultrasound (US). Acquired cardiac data were converted for rendering dynamic 3-D surface views and reformatting cross-sectional views. The image usefulness was compared between the data obtained from subcostal/subxiphoid and other imaging windows; the former are usually free of acoustic shadowing.

Dynamic three-dimensional color Doppler ultrasound of human fetal intracardiac flow.

Objectives: To develop dynamic three-dimensional ultrasound techniques for prenatal imaging of the intracardiovascular flow as well as the cardiovascular structure to address difficulties in assessing the spatially complex hemodynamics and morphology of the fetal heart.

Methods: Gray-scale and color (velocity) Doppler echocardiography were performed on 12 fetuses to provide serial anatomical and rheological tomograms which were spatially registered in three dimensions. Using a second ultrasound machine simultaneously, spectral Doppler ultrasound was performed to record umbilical arterial waveforms, thus providing the temporal (fourth) dimension in terms of the cardiac cycle and facilitating removal of motion artifacts.

Conversion of umbilical arterial Doppler waveforms to cardiac cycle triggering signals: a preparatory study for online motion-gated three-dimensional fetal echocardiography.

To remove motion artefacts, a device was built to convert "noisy" umbilical arterial Doppler waveforms (UADWs) from an ultrasound (US) system into sharp ECG R-wave-like cardiac cycle triggering signals (CCTSs). These CCTSs were then used to gate a simultaneous (online) 3-D acquisition of sectional fetal echocardiograms from another US system. To test the conversion performance, a study was carried out in sheep fetal twins.

Online motion-gated dynamic three-dimensional echocardiography in the fetus--preliminary results.

The aim of this study was to visualise the fetal heart in dynamic three dimensions (4-D) during an ultrasound (US) scan (online), rather than after (offline). With special pairing and sequential setting to minimise interference between two scanners, umbilical arterial Doppler waveforms (UADWs) from one scanner were used as an online motion gating source to trigger simultaneous 3-D cardiac structural data acquisition by another. Of 25 data sets from 10 fetuses, 18 were acquired in 15 to 30 s per set with > or = 50% Doppler waveforms efficiently converted to triggering signals.

Simultaneous use of two ultrasound scanners for motion-gated three-dimensional fetal echocardiography.

The aim of this study was to determine whether or not simultaneous use of an additional Doppler transducer could provide sufficient cardiovascular motion information without significantly interfering with three-dimensional (3-D) cardiac structural data acquisition by a primary two-dimensional (2-D) transducer. To determine sources of interference, paired transducers were activated alternatively and simultaneously in and out of a water bath, with and without electrical insulating and electromagnetic shielding. To determine factors affecting interference, pairs were tested on a phantom with different separating distances and angles between paired ultrasound (US) beams and under different 2-D depths and Doppler scales.

Novel technique for three-dimensional visualisation and quantification of deformable, moving soft-tissue body parts.

Background: Three-dimensional (3D) imaging of delicate, moving soft-tissue body parts is very difficult. Our understanding of the muscles that control lip movements is based largely on histological and cadaveric studies, which provide scant information about dynamic morphology. Our aim was to develop an innovative scanning technique for the imaging and reconstruction of dynamic orofacial morphology by use of 3D and four-dimensional (4D, ie, 3D plus time) ultrasonography.

A prospective study of computer-aided design and manufacture of titanium plate for cranioplasty and its clinical outcome.

The use of computerized three dimensional imaging and automated milling of models to produce accurate titanium plates for the reconstruction of craniofacial defects is described. A total of 148 patients have had extensive calvarial defects repaired using this (computer aided design and manufacture) technique developed in our unit. Of these, 141 were repaired secondarily (delayed cranioplasty), whilst seven were repaired immediately following craniectomy (single stage cranioplasty).