[Show abstract][Hide abstract] ABSTRACT: Background:
Pelvic-floor anatomy is usually studied by artifact-prone dissection or imaging, which requires prior anatomical knowledge. We used the serial-section approach to settle contentious issues and an interactive 3D-pdf to make the results widely accessible.
3D reconstructions of undeformed thin serial anatomical sections of 4 females and 2 males (21-35y) of the Chinese Visible Human database.
Based on tendinous septa and muscle-fiber orientation as segmentation guides, the anal-sphincter complex (ASC) comprised the subcutaneous external anal sphincter (EAS) and the U-shaped puborectal muscle, a part of the levator ani muscle (LAM). The anococcygeal ligament fixed the EAS to the coccygeal bone. The puborectal-muscle loops, which define the levator hiatus, passed around the anorectal junction and inserted anteriorly on the perineal body and pubic bone. The LAM had a common anterior attachment to the pubic bone, but separated posteriorly into puborectal and "pubovisceral" muscles. This pubovisceral muscle was bilayered: its internal layer attached to the conjoint longitudinal muscle of the rectum and the rectococcygeal fascia, while its outer, patchy layer reinforced the inner layer. ASC contraction makes the ano-rectal bend more acute and lifts the pelvic floor. Extensions of the rectal longitudinal smooth muscle to the coccygeal bone (rectococcygeal muscle), perineal body (rectoperineal muscle), and endopelvic fascia (conjoint longitudinal and pubovisceral muscles) formed a "diaphragm" at the inferior boundary of the mesorectum that suspended the anorectal junction. Its contraction should straighten the anorectal bend.
The serial-section approach settled contentious topographic issues of the pelvic floor. We propose that the ASC is involved in continence and the rectal diaphragm in defecation.
PLoS ONE 08/2015; 10(8):e0132226. DOI:10.1371/journal.pone.0132226 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In level set methods, the re-initialization remedy is widely applied to periodically replace the degraded level set function (LSF) with a signed distance function to maintain its regularity. Due to its various limitation, the energy functional regularization based methods using variational technique (e.g. distance, Gaussian, and reaction–diffusion based regularization methods) are recently introduced to replace this remedy. However, the relationship among them seems to be less investigated. In this paper, an enhanced distance regularized level set evolution (DRLSE-E) completely free of the re-initialization procedure is proposed based on analyzing these recent regularization models. DRLSE-E has an intrinsic capability of maintaining LSF׳s regularity, particularly the desirable signed distance property in a vicinity of the zero level set and the flat property out of this vicinity, which ensures accurate computation and stable level set evolution. Like other re-initialization free methods, DRLSE-E has simple and efficient numerical scheme in implementation, flexible initialization. Furthermore, DRLSE-E has the advantage of faster evolving speed and more numerical accuracy than distance regularized methods because of its forward and backward diffusion rate considering two competing components during the evolution. As an application example, DRLSE-E is used to typical edge-based and region-based active contour models for image segmentation and shows its competitiveness. Considering DRLSE-E is general, it can be easily incorporated into various existing level set models for image segmentation, filtering, and other tasks.
[Show abstract][Hide abstract] ABSTRACT: We propose a novel region-based geometric active contour model
that uses region-scalable discriminant and fitting energy functional for handling the intensity inhomogeneity and weak boundary problems in medical image segmentation. The region-scalable discriminant and fitting energy functional is defined to capture the image intensity characteristics in local and global regions for driving the evolution of active contour. The discriminant term in the model aims at separating background and foreground in scalable regions while the fitting term tends to fit the intensity in these regions. This model is then transformed into a variational level set formulation with a level set regularization term for accurate computation. The new model utilizes intensity information in the local and global regions as much as possible; so it not only handles better intensity inhomogeneity, but also allows more robustness to noise and more flexible initialization in comparison to the original global region and regional-scalable based models. Experimental results for synthetic and real medical image segmentation show the advantages of the proposed method in terms of accuracy and robustness.
Computational and Mathematical Methods in Medicine 07/2014; 2014:357684. DOI:10.1155/2014/357684 · 0.77 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: During scanning of the right hypochondrium and right intercostal regions with an ultrasonic transducer, several ultrasonic images of oblique sections are obtained. It is still a challenge for ultrasonography to divide these non-conventional sections into an accurate hepatic segmentation pattern. The aim of this research was to investigate the value of the virtual hepatic segment model (VHSM) in assisting the ultrasonic localization of space-occupying hepatic lesions.
VHSM was constructed via 3D reconstruction according to the first Chinese visible human dataset. Preoperative ultrasonography, contrast-enhanced CT scan and VHSM techniques were performed in 100 patients with space-occupying focal lesions in the liver parenchyma for segmental localization. The results of these three techniques were compared with the operative findings.
VHSM was successfully detected on 2D sectional images by 3D reconstruction through surface rendering and volume rendering. The model could simulate ultrasonic directions to conduct a virtual dissection on any section plane, and fine liver segmentation could be displayed in any virtual plane. In 100 patients, there were 112 liver space-occupying focal lesions distributed in 148 liver segmentations. Regarding the positioning accuracies for lesions of different sizes and the lesion segmental distribution accuracies estimated using the three methods mentioned above, ultrasonography exhibited a significantly lower accuracy than VHSM for the segmental localization of lesions (P < 0.05), and contrast-enhanced CT was not significantly different from ultrasonography plus VHSM (P > 0.05).
VHSM increased the accuracy of ultrasonic localization of space-occupying hepatic lesions, particularly in hepatic hypovascular regions.
Chinese medical journal 12/2013; 126(23):4417-22. DOI:10.3760/cma.j.issn.0366-6999.20121349 · 1.05 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to distinguish the individual bundles of the anterior cruciate ligament (ACL) using the Chinese Visible Human (CVH) dataset and images obtained by low-field routine magnetic resonance imaging (MRI) in the oblique and coronal planes. Sectional anatomical data of the knee were selected from the CVH dataset and reconstructed in 3D. MRI of normal knees was performed with a low-field-strength magnet in the coronal plane. The shape of the ACL was clearly displayed. Using the oblique coronal plane, the anteromedial (AM) and posterolateral (PL) bundles of the ACL were distinguished in the reconstructed anatomical data and the MR images. The double-bundle structure of the ACL was evaluated in the CVH 3D reconstructions and MR images. Using the oblique coronal plane, it was possible to review the ACL structure in the knee. The study demonstrated the feasibility of distinguishing the two bundles in the ACL with CVH 3D reconstruction and low-field strength MRI. The accuracy in the grading of ACL injury in presurgical planning may be improved.
Experimental and therapeutic medicine 08/2013; 6(2):606-610. DOI:10.3892/etm.2013.1169 · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Post-traumatic stress disorder (PTSD) is characterized by dysfunction of several discrete brain regions such as medial prefrontal gyrus with hypoactivation and amygdala with hyperactivation. However, alterations of large-scale whole brain topological organization of structural networks remain unclear. METHODS: Seventeen patients with PTSD in motor vehicle accident survivors and 15 normal controls were enrolled in our study. Large-scale structural connectivity network (SCN) was constructed using diffusion tensor tractography, followed by thresholding the mean factional anisotropy matrix of 90 brain regions. Graph theory analysis was then employed to investigate their aberrant topological properties. RESULTS: Both patient and control group showed small-world topology in their SCNs. However, patients with PTSD exhibited abnormal global properties characterized by significantly decreased characteristic shortest path length and normalized characteristic shortest path length. Furthermore, the patient group showed enhanced nodal centralities predominately in salience network including bilateral anterior cingulate and pallidum, and hippocampus/parahippocamus gyrus, and decreased nodal centralities mainly in medial orbital part of superior frontal gyrus. LIMITATIONS: The main limitation of this study is the small sample of PTSD patients, which may lead to decrease the statistic power. Consequently, this study should be considered an exploratory analysis. CONCLUSIONS: These results are consistent with the notion that PTSD can be understood by investigating the dysfunction of large-scale, spatially distributed neural networks, and also provide structural evidences for further exploration of neurocircuitry models in PTSD.
[Show abstract][Hide abstract] ABSTRACT: Digital flexor tendon repair poses a significant challenge for hand surgeons. Currently, extrasynovial tendon grafts are frequently used in clinical settings to bridge flexor tendon defects. However, the healing process is always accompanied by postoperative adhesion. This is mostly due to the fact that no synovial membrane covers the extrasynovial tendon surface, in contrast to the intrasynovial tendon. In this study, we present an efficient method of developing a functional synovial biomembrane on the surface of the extrasynovial tendon. Synoviocytes were isolated from the knee joint of a Japanese white rabbit. After being infected with lentivirus, the over-expression of synoviolin in these synoviocytes was confirmed by semi-quantitative RT-PCR and western blotting. Cellular proliferation and increased hyaluronic acid secretion were confirmed in the synoviolin over-expressing synoviocytes by MTT-based method, cell cycle assays and ELISA. Furthermore, the synoviolin over-expressing synoviocytes were co-cultured with extrasynovial tendons that were harvested from the hind leg of rabbits. After being co-cultured in vitro for 3 and 7 days, these infected synoviocytes were found to accelerate the formation of a biomembrane on the tendon surface compared to the control group. More importantly, Alcian blue staining confirmed the ability of this cultured biomembrane to produce specific matrices containing acidic carboxyl mucopolysaccharides (mainly hyaluronic acid). All these results demonstrate that the over-expression of synoviolin stimulates the proliferation and HA secretion of synoviocytes and facilitates the formation of a functional synovial biomembrane.
Journal of Biomedical Materials Research Part A 07/2012; 100(7):1761-9. DOI:10.1002/jbm.a.33286 · 3.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Segmentation is a necessary step when creating realistic three-dimensional (3D) models. In order to build 3D models of whole body structures and have a wider lateral application, the thin sectional anatomical images of the Chinese Visible Human (CVH) dataset should be segmented. The more detailed structures are segmented to provide greater potential for wider application of the segmented images.
All the images based on the CVH male and female dataset were segmented semi-automatically using PHOTOSHOP software. This research lasted about 7 years.
In this study, 869 structures of CVH male and 860 structures of CVH female were semi-automatically segmented, and the formats for the segmented color-filled image data were PSD and PNG. In these segmented structures, nearly all skeletal muscles included muscle belly and tendon, and hollow organs included their organ walls and their lumen. Most nerve trunks, small arteries, lymph nodes, and lymph ducts were also segmented. Many surface-rendering and volume-rendering organ models were created using these segmented images.
The CVH male and female images represent the normal Asian population. After segmentation, the images can be reconstructed directly in 3D and greatly facilitate the biological modeling of physical and physiological information, a great help in improving medical and biological science in China.
Computerized medical imaging and graphics: the official journal of the Computerized Medical Imaging Society 03/2012; 36(4):336-42. DOI:10.1016/j.compmedimag.2012.01.003 · 1.22 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To establish a digital transjugular intrahepatic portosystemic shunt (TIPS) model and provide morphological data for radiological diagnosis and interventional radiology to reduce portal vein pressure, 400 serial sectional images from the internal jugular vein superior margin to the lower edge of the liver were chosen from the Chinese Visible Human dataset. Surface and volume reconstructions were performed using 3D-DOCTOR 3.5 software on an ordinary personal computer. Volume and surface renderings were employed to perform data segmentation and image edge detection for reconstruction of the internal jugular vein, brachiocephalic vein, superior vena cava, heart, inferior vena cava, hepatic vein, and portal vein for computerized 3D reconstruction of the TIPS pathway and construction of a 3D visible model of different structures along it. The model can also display pathway and distribution characteristics and interactively show the spatial structural relationships between intrahepatic venous lines from any position and angle, plus complete data acquisition for any range and angle for 3D reconstruction with stereopsis and measurements using any visualization platform. The digital reconstruction of the TIPS pathway correctly reflected the complicated anatomic structural characteristics and spatial adjacency relationships between intrahepatic venous lines, providing a reference 3D morphology for image diagnostics and interventional TIPS therapy.
[Show abstract][Hide abstract] ABSTRACT: Recent studies have demonstrated that the coracohumeral ligament (CHL) is shortened and thickened in a frozen shoulder. We analyzed the rate in CHL visualization between patients with frozen shoulder and normal volunteers using Magnetic Resonance Imaging (MRI) to determine the CHL thickness in the patients with a frozen shoulder.
There were 72 shoulder joints in 72 patients (50 femles and 22 males with a mean age of 53.5 years) with clinical evidence and MR imaging evidence of frozen shoulder. These were prospectively analyzed to identify and measure the maximum thickness of the CHL. The control group, which included 120 shoulder joints in 60 normal volunteer individuals (30 females and 30 males with a mean age of 50.5 years) was also referred for MR imaging. A chi-square test was used to analyze the data of the rate of CHL visualization between the patients with frozen shoulder and the control group. A two-way ANOVA was used to analyze the mean maximal thickness of CHL. The CHL was visualized in 110 out of 120 shoulders in the control group (91.7%), and in 57 out of 72 shoulders for the frozen shoulder group (79.2%), there was significant difference, using a chi-square test (P<0.05). The CHL was not visualized in 10 out of 120 shoulders in the control group (8.3%), and 15 out of 72 shoulders in the frozen shoulder group (20.8%), there was a significant difference (P<0.05). The CHL thickness (3.99±1.68 mm) in the patients with frozen shoulder was significantly greater than that thickness (3.08±1.32 mm) in the control group, using a two-way ANOVA (P<0.001). The CHL thickness (3.52±1.52 mm, n = 97) in the female shoulders was no significantly greater than that thickness (3.22±1.49 mm, n = 70) in the male shoulders, using a two-way ANOVA (P>0.05).
MR Imaging is a satisfactory method for CHL depiction, and a thickened CHL is highly suggestive of frozen shoulder.
PLoS ONE 12/2011; 6(12):e28704. DOI:10.1371/journal.pone.0028704 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Although the incidence of osteoarticular tuberculosis is increasing, glenohumeral joint tuberculosis is rare and often misdiagnosed in its early stages. Our objective was to study the incidence of the initial misdiagnosis as frozen shoulder and the duration of the prediagnostic period among patients with glenohumeral joint tuberculosis.
The clinical records of 21 patients with tuberculosis of the shoulder joint were retrospectively analyzed.
Among the 16 patients with glenohumeral joint tuberculosis, 14 (87.5%) were initially diagnosed as having frozen shoulder instead of glenohumeral joint tuberculosis at their primary care clinics. Two patients actually showed both shoulder pain and limited range of motion, although they did not have a record of initial diagnosis with frozen shoulder. Consequently, 14 (87.5%) of the patients in our study with glenohumeral joint tuberculosis were likely misdiagnosed as having frozen shoulder. On the other hand, this group accounted for 3.6% (n = 16) of 450 patients who, during the same period, had been initially diagnosed with frozen shoulder at our institution. The mean prediagnostic period to attain the final, correct diagnosis of glenohumeral joint tuberculosis for this group was 14.5 months.
It appears that misdiagnosis is common and early diagnosis of tubercular infection in the glenohumeral joint has become increasingly difficult. Glenohumeral joint tuberculosis should be suspected in cases of longstanding pain in the shoulder. It is necessary to re-examine these frozen shoulder patients with repeated plain radiographs followed by further imaging studies, especially magnetic resonance imaging, if conservative therapy fails.
Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 10/2011; 21(9):1207-12. DOI:10.1016/j.jse.2011.07.026 · 2.29 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The objective of the present study was to explore the role of the inhibitor of apoptosis protein (IAP) Livin in radioresistance in nonsmall cell lung cancer (NSCLC).
Lung adenocarcinoma cell lines A549 and SPC-A1 were used for this study. Using the technique of molecular cloning and gene transfection, two Livin isoforms, Livinα and β, respectively, were expressed in A549 cells with the purpose of exploring the role of Livin in radiation resistance of A549 cells. Moreover, a Livin-specific gene-silencing system was developed using SPC-A1 cell line with the purpose of increasing radiosensitivity of SPC-A1 cells. Results: A549 cells were induced by radiation to express Livin isoforms, Livinα and β. A549 cells expressed Livin isoforms stably after gene transfection and the transfected cells demonstrated characteristics of antiradiation. However, Livin gene-silenced SPC-A1 cells exhibited remarkably enhanced radiation sensitivity.
The IAP Livin is an important molecule in antiradiotherapy of NSCLC. Livin-specific gene silencing is likely to be an effective means to enhance radiation sensitivity of lung cancer.
[Show abstract][Hide abstract] ABSTRACT: Performing surgeries on the craniocervical junction presents a technical challenge for operating surgeons. Three-dimensional (3D) reconstruction and surgical simulation have improved the efficacy and success rate of surgeries. The aim of this study was to create a 3D, digitized visible model of the craniocervical junction region to help realize accurate simulation of craniocervical surgery on a graphic workstation. Transverse sectional anatomy data for the study were chosen from the first Chinese visible human. Manual axial segmentation of the skull base, cervical spine, cerebellum, vertebral artery, internal carotid artery, sigmoid sinus, internal jugular vein, brain stem, and spinal cord were carried out by using Photoshop software. The segmented structures were reconstructed in 3 dimensions with surface and volume rendering to accurately display 3D models spatially. In contrast to conventional 3D reconstruction techniques that are based on computed tomography and magnetic resonance imaging Digital Imaging and Communications in Medicine (DICOM) inputs and provide mostly osseous details, this technique can help to illustrate the surrounding soft tissue structure and provide a realistic surgical simulation. The reconstructed 3D model was successfully used in simulating complex procedures in the virtual environment, including the transoral approach, bone drillings, and clivus resection.
International surgery 07/2011; 96(3):274-80. DOI:10.9738/CC14.1 · 0.47 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study aimed to determine the miRNA profile in breast cancer stem cells (BCSCs) and to explore the functions of characteristic BCSC miRNAs.
We isolated ESA+CD44+CD24-/low BCSCs from MCF-7 cells using fluorescence-activated cell sorting (FACS). A human breast cancer xenograft assay was performed to validate the stem cell properties of the isolated cells, and microarray analysis was performed to screen for BCSC-related miRNAs. These BCSC-related miRNAs were selected for bioinformatic analysis and target prediction using online software programs.
The ESA+CD44+CD24-/low cells had up to 100- to 1000-fold greater tumor-initiating capability than the MCF-7 cells. Tumors initiated from the ESA+CD44+CD24-/low cells were included of luminal epithelial and myoepithelial cells, indicating stem cell properties. We also obtained miRNA profiles of ESA+CD44+CD24-/low BCSCs. Most of the possible targets of potential tumorigenesis-related miRNAs were oncogenes, anti-oncogenes or regulatory genes.
We identified a subset of miRNAs that were differentially expressed in BCSCs, providing a starting point to explore the functions of these miRNAs. Evaluating characteristic BCSC miRNAs represents a new method for studying breast cancer-initiating cells and developing therapeutic strategies aimed at eradicating the tumorigenic subpopulation of cells in breast cancer.
Journal of Experimental & Clinical Cancer Research 12/2010; 29(1):174. DOI:10.1186/1756-9966-29-174 · 4.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We managed to provide three-dimensional digitized visible model of the prostate and its adjacent structures and to provide morphological data for imaging diagnosis and male urological surgery. With 3D-DOCTOR software, the contour line of prostate and its adjacent structures including rectum, bladder, male urethra, ureter, seminal vesicle, ductus deferens, ejaculatory ducts, obturator internus, levator ani, coccygeus, male pelvis, femur, prostatic nervous and venous plexus, internal and external iliac arteries were segmented from the Chinese visible human (CVH)-1 data set and the three-dimensional surfaces of intrapelvic visceras were successfully and accurately reconstructed via surface rendering, which can also be manipulated individually and interactively. Combined with AMIRA software, surface rendering reconstructed model of male urological organs and its adjacent structures via volume rendering reconstruction can be displayed together clearly and actually. It provides a learning tool of practicing virtual anatomy and virtual urological surgery for medical students and younger surgeons.
[Show abstract][Hide abstract] ABSTRACT: The mechanisms that regulate mitochondrial inheritance are not yet clear, even though it is 100 years since the first description of non-Mendelian genetics. Here, we quantified the copy numbers of mitochondrial DNA (mtDNA) in the gametic cells of angiosperm species. We demonstrate that each egg cell from Arabidopsis thaliana, Antirrhinum majus, and Nicotiana tabacum possesses 59.0, 42.7, and 73.0 copies of mtDNA on average, respectively. These values are equivalent to those in Arabidopsis mesophyll cells, at 61.7 copies per cell. On the other hand, sperm or generative cells from Arabidopsis, A. majus, and N. tabacum possess minor amounts of mtDNA, at 0.083, 0.47, and 1 copy on average, respectively. We further reveal a 50-fold degradation of mtDNA during pollen development in A. majus. In contrast, markedly high levels of mtDNA are found in the male gametic cells of Cucumis melo and Pelargonium zonale (1296.3 and 256.7 copies, respectively). Our results provide direct evidence for mitochondrial genomic insufficiency in the eggs and somatic cells and indicate that a male gamete of an angiosperm may possess mtDNA at concentrations as high as 21-fold (C. melo) or as low as 0.1% (Arabidopsis) of the levels in somatic cells. These observations reveal the existence of a strong regulatory system for the male gametic mtDNA levels in angiosperms with regard to mitochondrial inheritance.
The Plant Cell 07/2010; 22(7):2402-16. DOI:10.1105/tpc.109.071902 · 9.34 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Comparing with two dimensional (2D) imaging, both in diagnosis and treatment, three dimensional (3D) imaging has many advantages in clinical medicine. 3D reconstruction makes the target easier to identify and reveals the volume and shape of the organ much better than 2D imaging. A 3D digitized visible model of the liver was built to provide anatomical structure for planing of hepatic operation and for realizing accurate simulation of the liver on the computer.
Transverse sections of abdomen were chosen from the Chinese Visible Human dataset. And Amira software was selected to segment and reconstruct the structures of the liver. The liver was reconstructed in three-dimensions with both surface and volume rendering reconstruction.
Accurately segmented images of the main structures of the liver were completed. The reconstructed structures can be displayed singly, in small groups or as a whole and can be continuously rotated in 3D space at different velocities.
The reconstructed liver is realistic, which demonstrates the natural shape and exact position of liver structures. It provides an accurate model for the automated segmentation algorithmic study and a digitized anatomical mode of viewing the liver.
Chinese medical journal 01/2010; 123(2):146-50. · 1.05 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To explore and develop three-dimension (3D) virtual reality (VR) liver model and convert computed tomography data into a fully 3D VR environment for display, measure and manipulation.
3D-reconstruction of liver was restored from spiral computed tomography (CT) data by using LiVirtue software. Dextrobeam was used to view the 3D model in the VR environment. The liver and its anatomic structure were reconstructed to illuminate the location of the tumor and its related vessels.
3D models of liver, tumor and their relative vessels were reconstructed successfully. These models could be viewed and manipulated in the VR environment on personal computer.38 patients underwent liver resection, including 21 right hemihepatectomy, 14 left hemihepatectomy and 3 extended right hemihepatectomy. The intraoperative contrast with preoperative simulation confirmed the reliability of our 3D operative planning system.
The preoperative simulation in 3D VR facilitated liver resection by the ability to view tumor and its relative vessels. This preoperative estimation from 3D model of liver benefits a lot to complicated liver resection.
Zhonghua wai ke za zhi [Chinese journal of surgery] 11/2009; 47(21):1620-3.