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Study Design Biomechanical study. Purpose To investigate the mechanical characteristics of bone models created from medical images. Overview of Literature Recent advancements in three-dimensional (3D) printing technology have affected its application in surgery. However, a notable gap exists in the analyses of how patient’s dimorphism and variations in vertebral body anatomy influence the maximum insertional torque (MIT) and pullout strength (POS) of pedicle screws (PS) in osteoporotic vertebral bone models derived from medical images. Methods Male and female patients with computed tomography data were selected. Dimensions of the first thoracic (T1), fourth lumbar (L4), and fifth lumbar (L5) vertebrae were measured, and bone models consisting of the cancellous and cortical bones made from polyurethane foam were created. PS with diameters of 4.5 mm, 5.5 mm, and 6.5 mm were used. T1 PS were 25 mm long, and L4 and L5 PS were 40 mm long. The bone models were secured with cement, and the MIT was measured using a calibrated torque wrench. After MIT testing, the PS head was attached to the machine’s crosshead. POS was then calculated at a crosshead speed of 5 mm/min until failure. Results The L4 and L5 were notably larger in female bone models, whereas the T1 vertebra was larger in male bone models. Consequently, the MIT and POS for L4 and L5 were higher in female bone models across all PS diameters than in male bone models. Conversely, the MIT for T1 was higher in male bone models across all PS; however, no significant differences were observed in the POS values for T1 between sexes. Conclusions The mechanical properties of the proposed bone models can vary based on the vertebral structure and size. For accurate 3D surgical and mechanical simulations in the creation of custom-made medical devices, bone models must be constructed from patient-specific medical images.

Abstract Background To date, no suitable model tooth has been available for all standard restorative and prosthodontic procedures. To fill this gap, a realistic multilayer tooth with enamel, dentin, integrated caries, pulp, and electrometric and X-ray imaging abilities was developed. The aim of this study was to test the printed tooth while focusing on caries excavation and pulp capping. Methods Based on micro-CT data, a tooth was designed and produced via 3D printing. A total of 396 teeth were tested and evaluated by 66 fourth- and fifth-year students experienced in caries excavation at standard typodonts, extracted teeth and patients. They excavated the caries and capped the pulp on six teeth and rated them in a questionnaire. Results Compared with natural teeth, the printed teeth were generally rated positively and significantly better in all criteria than typodonts used previously (p

Abstract Accurate sex estimation is crucial for comprehensive analysis of the biological profiles of unidentified human skeletal remains. However, there is a notable lack of research specifically addressing the morphometrics of the hard palate. Therefore, this study aimed to derive discriminant equations using the hard palate and assess their applicability for sexing partial skeletal remains in a contemporary Korean population. Statistical analyses were performed for 24 measurements derived from three-dimensional models of the hard palate, generated using computed tomography scans of 301 individuals (156 males, 145 females). Descriptive statistics revealed significant sexual dimorphism in the mean comparison of hard palate sizes between Korean males and females, with males exhibiting larger palates across all measurements (p

ObjectiveThe objective of this study was to develop a sonographic technique using two-dimensional (2D) markers for detecting isolated fetal cleft palate (no cleft lip) and to evaluate the ability of 2D and three-dimensional (3D) sonography to image the normal and abnormal palate. Methods Seventy-three fetuses with a high risk of cleft palate at 12-39 weeks of gestation were referred for specialist ultrasound. A detailed evaluation of the palate was performed through 2D ultrasound, which revealed the appearance of the palatine line in the sagittal plane; the palate and alveolar ridge in the coronal plane of the fetal face; the horizontal plate of the palatine bone in the axial maxillary plane; and the soft palate in the transverse plane of the cavum pharyngis. Subsequently, 3D ultrasound imaging of the palate was performed in all fetuses. Antenatal diagnoses were compared with postnatal findings or autopsy findings. Results Visualization of 2D markers was accomplished in all fetuses, and 3D assessment was achieved in 97% of fetuses. Cleft palate was suspected in 16 cases (21.9%), among which 14 were suspected on the basis of both 2D and 3D evaluation, and two were suspected only on the basis of 3D evaluation. A normal palate was observed in 57 fetuses (78.1%). The mean gestational age was 27 weeks (range of 12 weeks to 39 weeks). All 16 fetuses with suspected cleft palate were confirmed by postnatal or autopsy findings, no false-positives were observed, and one case with a bifid uvula was missed among 57 fetuses with a presumed normal palate. Conclusions The fetal palate can be evaluated with 2D markers and 3D sonography. The detection of isolated cleft palate is more sensitive when 2D markers are present in all four planes.

Background and aim: To compare the marginal and internal adaptation of full veneer crowns cast from wax patterns fabricated by three-dimensional printing and conventional wax-up technique employing two different convergence angles.Material and methods: Two metal master dies, each with a convergence angle of 6 and 12-degrees, were duplicated 24 times to obtain 48 stone dies. Twelve dies from each group were randomly chosen for conventional wax-up (Group A) and the other twelve for the three-dimensional printed wax pattern (Group B) fabrication. Cobalt-chromium full veneer crowns were cemented onto the dies using glass ionomer cement. The cemented crowns and dies were sectioned in the midline buccolingually to measure the marginal and internal gaps using a stereomicroscope and digital image analysis software (Image J). Data obtained were recorded in microns, and an independent 't' test was used to compare quantitative parameters between categories.Results: Group B showed a statistically significant reduction in marginal discrepancy in crowns with a 6-degree taper (114.4 ± 37.5) compared to Group A (160.4 ±58.1). Group B did not demonstrate any significant difference when the 6-degree and 12-degree tapers were compared, but Group A showed a significant improvement in marginal and internal adaptation with the 12-degree taper.Conclusions: For the 6-degree taper, three-dimensional printing resulted in better marginal and internal fit than conventional wax patterns. Conventional and three-dimensional Printing offered similar accuracy within the acceptable range for a 12-degree taper.

Clear Aligner Treatment (CAT) is an orthodontic technique used to align teeth with removable and scarcely visible appliances. Conventionally, these are produced through the process of thermoforming. The inherent disadvantages of thermoforming include increased surface roughness leading to plaque accumulation, compromised biomechanics due to a reduction in force delivered and flexure of the aligner, and altered mechanical properties, such as increased opacity, water sorption, and hardness. Direct Three-dimensional (3D)-printed aligners, or Direct Printed Aligners (DPA), introduce a new frontier to aligner technology and are a recent addition to the ever-improving field of orthodontics. Through 3D printing, the various disadvantages of thermoformed aligners like surface roughness, extent and definition of aligner borders, undercuts, and differential thickness of the aligner can be controlled to enhance the accuracy of aligner fit with lesser reliance on attachments. 3D printing of aligners is more environmentally friendly since there is no subtractive process for thermoforming or post-processing of the TA. Various methods of 3D printing, such as selective laser melting, selective laser sintering, Stereolithography (SLA), and Digital Light Processing (DLP), can be applied to the printing of clear aligners. Challenges in printing primarily involve maintaining transparency and designing support during the printing process. The present review aimed to include a detailed description of all aspects of direct 3D-printed aligners.

Minimally invasive methods for creating models of focal coronary narrowing in large animals are challenging. Rapid prototyping using three-dimensionally (3D) printed coronary implants can be employed to percutaneously create a focal coronary stenosis. However, reliable delivery of the implants can be difficult without the use of ancillary equipment. We describe the use of a mother-and-child coronary guide catheter for stabilization of the implant and for effective delivery of the 3D printed implant to any desired location along the length of the coronary vessel. The focal coronary narrowing was confirmed under coronary cineangiography and the functional significance of the coronary stenosis was assessed using gadolinium-enhanced first-pass cardiac perfusion MRI. We showed that reliable delivery of 3D printed coronary implants in swine models (n = 11) of ischemic heart disease can be achieved through repurposing mother-and-child coronary guide catheters. Our technique simplifies the percutaneous delivery of coronary implants to create closed-chest swine models of focal coronary artery stenosis and can be performed expeditiously, with a low procedural failure rate.

Objective To evaluate the relationship between femoral muscle volume (FMV) and physiological outcomes after trans-femoral amputations (TFAs) affecting overall locomotor function in patients. Methods Seven individuals who underwent TFA and had been using a prosthesis participated in this cross-sectional study. Gait and balance were assessed using clinical tests, such as 10-m walk test, 6-minute walk test, Berg Balance Scale, and automatic balance system. Respiratory gas analysis was performed to check oxygen consumption rate. Five participants were evaluated for bilateral FMV by MR imaging and FMV was reconstructed using three-dimentional remodeling. Results In five participants, significant differences were found between the non-involved and involved sides in femur length, total FMV, and functional muscle volume (all p

Key Clinical Message Three‐dimensional transesophageal ultrasound of the spinal cord is a new and promising imaging modality that could easily be used clinically for real‐time evaluation of the spinal cord anatomy or for intraoperative guidance.

Skeletal angle class Ⅲ malocclusion with mandibular deviation involves the rotation and translation of the cranial base, maxilla, mandible, and soft tissue. It compromises the patients’ appearance and stomatognathic function. The treatment outcome is not satisfactory, and correct evaluation is of great significance. The causal relationship between skeletal Class Ⅲ with mandibular deviation and TMD remains controversial. This review focuses on the structural alterations of hard and soft tissue, the etiology, the choice of treatment methods, and the association with TMD in patients with skeletal class Ⅲ malocclusion with mandibular deviation. The results show that mandibular deviation is a complex disease with unclear etiology. It involves morphological changes, rotation and displacement of the cranial base, maxilla and mandible, morphological changes of the soft tissue, and occlusal changes, which also compromise the temporomandibular joint and mandibular function. Skeletal Class Ⅲ malocclusion is common in patients with mandibular deviation. Early treatment is needed; however, the treatment methods vary. The correct evaluation of the morphological changes of soft and hard tissues leading to facial asymmetry is the premise of treatment. Orthodontic and orthognathic treatment (combined with soft tissue repair when necessary) is an effective method for the treatment of skeletal class Ⅲ malocclusion with mandibular deviation. In addition, there is a close relationship between mandibular deviation and TMD, which needs to be fully considered in the design of treatment.

Objective: This study aimed to analyze the morphological characteristics of rheumatic (RMVD) and degenerative mitral valve diseases (DMVD) based on three-dimensional (3D) printing model before and after surgery and to explore the potential implication of the 3D printing model for mitral valve (MV) repair.Methods: 3D transesophageal echocardiography (TEE) data of the MV were acquired in 45 subjects (15 with RMVD, 15 with DMVD, and 15 with normal MV anatomy). 3D printing models of the MV were constructed by creating molds to be printed with water-soluble polyvinyl alcohol, then filled with room temperature vulcanizing silicone. The parameters of the annulus and leaflet of the MV were acquired and analyzed using the 3D printing model. Mitral valve repair was simulated on 3D printing models of 10 subjects and compared with the actual operation performed on patients. The effects of surgery were assessed by evaluating the changes in coaptation length (CL) and the annular height to commissural width ratio (AHCWR) before and after MV repairs. The correlations of the grade of mitral regurgitation with CL and AHCWR were analyzed.Results: 3D silicone MV models were all successfully constructed based on 3D TEE data. Compared with the normal groups, the mitral annulus size in the RMVD groups showed no significant differences. In contrast, mitral annulus in DMVD groups was dilated and flattened with diameters of anteroposterior, anterolateral-posteromedial, commissural width, annular circumferences, and area increased. Mitral repair was successfully simulated on 10 models with significant increase in leaflet coaptation area both in vivo and in vitro. Good agreement was observed in CL and AHCWR after surgery in the 3D printing model compared with real surgery on the patient valve. The grade of mitral regurgitation correlated inversely with CL (r = –0.87, P < 0.01) and AHCWR (r = –0.79, P < 0.01). Mitral valve repair was performed twice in one model to assess which provided a better outcome.Conclusions: 3D printing models of the MV based on 3D TEE data could be used in morphological analysis of the MV before and after surgery in RMVD and DMVD. Surgery simulation on 3D printing models could provide valuable information concerning morphological changes after surgery, with are closely associated with clinical outcomes.

Abstract Background A virtual reality (VR) simulator is utilized as an inexpensive tool for gaining basic technical competence in robotic-assisted surgery (RAS). We evaluated operator 3D motion sickness while using a VR simulator and assessed whether it can be reduced by repeating the training. Methods This prospective observational study was conducted at the Department of Urology, Iwate Medical University, a tertiary training hospital in an urban setting. A total of 30 undergraduate medical students participated in the study. We compared whether the VR simulator improved the students’ skills in operating the da Vinci robot. Fifteen students underwent training with a VR simulator for 4 h a day for 5 days. Then, motion sickness was determined using the Visual Analog Scale and Simulator Sickness Questionnaire (SSQ) before and after the training. Results Manipulation time significantly improved after training compared to before training (293.9 ± 72.4 versus 143.6 ± 18.4 s; p

Objective: This study aimed to compare the diagnostic performance of three-dimensional ultrasound (3D-US) and automated breast volume scanner (ABVS) for the characterization of benign and malignant breast lesions. Methods: Ninety patients who underwent surgery and preoperative conventional ultrasound (US), 3D-US, and ABVS examinations were enrolled in this study. The image quality and adjacent structures of the lesions in the coronal plane were compared. The combination of US, 3D-US, and ABVS for retraction phenomenon of the lesion was compared and the diagnostic performance of each combination was analyzed. Results: ABVS displayed better image quality and adjacent structures than 3D-US (P < 0.001). The area under the curve (AUC) was 0.913, 0.842, and 0.871 for US, 3D-US, and ABVS, respectively. The AUC of the retraction phenomenon of the lesion was 0.732 and 0.810 for 3D-US and ABVS, respectively. When they were combined, US+ABVS showed the highest AUC of 0.924. No significant difference of diagnostic performances was found among conventional US, US+3D-US, and US+ABVS(P > 0.05). Conclusions: Compared with 3D-US, ABVS seems to be superior in showing the retraction phenomenon of breast lesions and in the characterization of breast lesions alone or in combination with conventional US. Although no significant difference was observed between them, both ABVS and 3D-US provided valuable information in the coronal plane and improved our confidence level in breast lesion characterization, especially when combined with the conventional US.

ABSTRACT Three-dimensional printing is a technology in expansion in the medical field. It also presents many applications in orthopedics. Our review article aims to describe 3D printing, types of 3D printers, and its use in the orthopedic field. 3D models can be created using tomography scans. Those models can then be manipulated, even simulating surgeries. It is possible to print biomodels, which will help us understand deformities and plan surgeries. Orthopedic surgeons must be updated in these disruptive technologies that may help their daily practice. Level of Evidence V, Expert opinion.

ABSTRACT Objective: This study aimed to explore the clinical application of preoperative precise design for 3D printing and thumb reconstruction, which could help manage the patients with thumb defect and achieve better function and appearance. Methods: This was a retrospective study of 20 patients who underwent the surgery of harvesting toe transplant and thumb reconstruction between January 2015 and December 2016. The 3D model of the thumb defect was created and printed. The dimensions of skin and bones from donor site were precisely designed as reference for surgical operation. The surgery was performed according to the model. Results: Perfect repair of defects was achieved with satisfying appearance and function. The reconstructed thumbs all survived (survival rate of 100%). Follow-up was 3-9 months. The maximum dorsiflexion was 8-30° and the maximum flexion was 38-58°. The two-point sensory discrimination was 9-11 mm. In total, 17 patients reposted “Excellent” satisfaction and three “Good”, each for the reconstructed thumb and hand function, respectively. The satisfaction rate was 85%. Conclusion: Preoperative digital design and 3D printing according to the donor and recipient sites allowed a tailored operation. The operation was more precise, the appearance of the reconstructed thumb was good. Level of Evidence II, Retrospective Study.

Management of calcified canals is always challenging and is much more prone to mishaps such as perforations and ledge formations. The Two-dimensional (2D) imaging has a limitation, the 2D image of a Three-dimensional (3D) structure overlaps adjacent structures even over the root canals. This can create large confusion during treatment. Here, we are reporting a case where 2D imaging misled the treatment and 3D imaging evolved as a magical tool. A 32-year-old female, presented with complaints of pain, blackish discolouration and repeated sinus tract formation after her initial sitting of previous root canal treatment with upper right front tooth #11. On the radiograph, improper obturation and periapical radiolucency were evident. Hence, re-root canal treatment was advised and initiated. Gutta-percha was removed and radiographs were taken to ensure the removal of gutta-percha followed by working length estimation, which was satisfactory. After following all irrigation protocols, calcium hydroxide was placed as intracanal medicament but the patient came after two days with a draining pus sinus. The same happened with double antibiotic paste. Hence, Cone-beam Computed Tomography (CBCT) was advised. A buccal perforation and calcified unnegotiated canal were evident in all sections of CBCT. With the consent of the patient, the canal was again negotiated and guided with multiple angled radiographs. Intraoperative CBCT was advised with a master gutta-percha cone to verify the correct position of the canal. After verification, perforation was sealed with biodentine followed by obturation with crown placement in subsequent visits. Thus, 2D imaging can be misleading and 3D imaging is a guiding tool.

In this study, in tuberculum majus fractures, which are proximal humerus fractures; Morphometric measurements were made to guide surgeons and future implants. With the morphometric measurement of the greater tubercle, the length of the base, the length of the height, the length at its widest part, and its circumference were calculated. A 3D scanning device (Faro Focus 3D S120 Scanner Rental) was used to scan the proximal part of the humerus, and the proximal ends of the scanned humerus were transferred to the computer and morphometric measurements were made with the software program. As a result of the measurements made: Average base length of the large tubercle 26±2.34 mm, average anterior height of the greater tubercle 30±2.50 mm, average posterior height of the greater tubercle 9.5±0.4 mm and average Widest sagittal length of the greater tubercle 28.75±2.02 mm. We think that the morphological and morphometry of the tuberculum majus, which is one of the formations at the proximal end of the humerus, will guide surgeons with anatomically designed implants in surgical applications. [Med-Science 2021; 10(2.000): 555-9]

Background: In neurovascular therapy, normally surgeons directly instruct a radiologist to operate a computer on their behalf to maintain sterility in the operative field when reconfirming medical images. This process, however, takes time and causes psychological burden.Methods: A touchless interface operated by hand-gestures and voice named "Opect3D" was developed to resolve the above issues. Initially, the Opect3D and conventional verbal communication were compared preclinically. The operation time for deciding the rotation angle and the angular difference against the targeted position were measured and calculated, respectively. Afterwards, Opect3D was utilized in unruptured cerebral aneurysms and the usefulness and psychological burden were surveyed.Results: The mean time using the verbal communication was 24.1 ± 7.9 sec, while using Opect3D was 12.8 ± 5.3 sec per single interaction (p < 0.01). The angular difference using the verbal communication was 9.0 ± 8.4 degrees and 9.4 ± 6.1 degrees using Opect3D (p = 0.87). The survey of usefulness and psychological burden of using Opect3D yielded 4.03 ± 0.73 (p < 0.02) and 4.67 ± 0.54 (p < 0.01), respectively, as a mean value. Scores ranged from 1 (worst) to 5 (best), with 3 corresponding to the verbal communication. Significance was evaluated from the score of 3.Conclusions: Usage of Opect3D was effective in reducing operation time and stress, thus enhancing efficiency and ease of operation.

Background and aim: It is worth noting that cone beam computed tomography (CBCT) can differentiate between success and failure of treatment plans. Therefore, the main objective of this systematic review was to fulfil an outcome evaluation of CBCT for treatment plan success and failure. Materials and methods: For this purpose, the databases of Embase, PubMed, Cochrane Library, MEDLINE, Google Scholar, and the Institute for Scientific Information (ISI) were searched to perform a systematic review of the related literature on the subject matter published up to May 2020. To manage the study titles electronically, the EndNote x8 software was further utilized. Employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), this systematic review was accordingly completed. Two reviewers then assessed the quality of the selected studies using the Methodological Index for Non-Randomized Studies (MINORS) tool. Results: A total number of 354 relevant titles and abstracts were retrieved during the electronic searches into the subject-matter literature. Ultimately, six studies were in line with the inclusion criteria in this systematic review. As well, the sample size in all studies was found to be 388 cases, and CBCT had been exercised in each one. Moreover, the follow-up timing of CBCT scans was not the same in the selected studies. Conclusion: CBCT can be useful in successful treatment, CBCT systems have highly efficient for reconstructing the 3D image of the cortical bone with a thickness of more than 1 mm vs less than 0.5 mm thickness.

Background: The real-time image-guided system can aid us in localization for complex neurological diseases. Aim: The study aimed to survey the advantages and novel techniques of hybrid surgery in pediatric neurosurgery. Methods: Study design involves a retrospective cohort study. At our hybrid operation room (OR), 10 children at the ages from 16 months to 17 years underwent brain or spine surgery. Eight of them received procedures assisted with real-time images of flat-panel detector (FD)-based computed tomography, DynaCT: three patients underwent cerebrospinal fluid diversions, three frameless stereotactic aspirations (brain abscess 2, intracerebral hemorrhage 1), one frameless stereotactic skull and sinus biopsy, and one spine and neck surgery. Two of them received intraoperative digital subtraction angiography and three-dimensional rotational angiography (3D-RA) for arteriovenous malformation surgery. Results: All of our patients tolerated the whole procedures well. Frameless stereotactic aspiration with navigation was performed for one patient with brain abscess first, but the abscess progressed with mass effect later. The child underwent frameless stereotactic aspirations at the hybrid OR and recovered well within 2 weeks. One patient having neck and high cervical spinal lipoblastoma with the presentation of stridor received surgeries twice before. The patient was quite well without airway compression after tumor resection as maximal as possible with safety at the hybrid OR. Conclusions: For the treatment of complex neurological diseases in children, hybrid surgeries can be considered to be feasible, good alternative, or salvage surgical procedures.

Infantile hemangioma (IH) is the most prevalent type of vascular tumor in infants. The pathophysiology of IH is unknown. The tissue structure and physiology of two-dimensional cell cultures differ greatly from those in vivo, and spontaneous regression often occurs during tumor formation in nude mice and has severely limited research into the pathogenesis and development of IH. By decellularizing porcine aorta, we attempted to obtain vascular-specific extracellular matrix as the bioink for fabricating micropattern arrays of varying diameters via microcontact printing. We then constructed IH-derived CD31+ hemangioma endothelial cell three-dimensional microtumor models. The vascular-specific and decellularized extracellular matrix was suitable for the growth of infantile hemangioma-derived endothelial cells. The KEGG signaling pathway analysis revealed enrichment primarily in stem cell pluripotency, RAS, and PI3KAkt compared to the two-dimensional cell model according to RNA sequencing. Propranolol, the first-line medication for IH, was also used to test the model’s applicability. We also found that metformin had some impact on the condition. The three-dimensional microtumor models of CD31+ hemangioma endothelial cells were more robust and efficient experimental models for IH mechanistic exploration and drug screening.

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Major biological processes rely on the spatial organization of cells in complex, highly orchestrated three-dimensional (3D) tissues. Until the recent decade, most of information on spatial neural representation primarily came from microscopic imaging of “2D” (5-50 μm) tissue using traditional immunohistochemical techniques. However, serially sectioned and imaged tissue sections for tissue visualization can lead to unique non-linear deformations, which dramatically hinders scientists’ insight into the structural organization of intact organs. An emerging technique known as CLARITY renders large-scale biological tissues transparent for 3D phenotype mapping and thereby, greatly facilitates structure-function relationships analyses. Since then, numerous modifications and improvements have been reported to push the boundaries of knowledge on tissue clearing techniques in research on assembled biological systems. This review aims to outline our current knowledge on next-generation protocols of fast free-of-acrylamide clearing tissue (FACT) and passive CLARITY (PACT). The most important question is what method we should select for tissue clearing, FACT or PACT. This review also highlights how FACT differs from PACT on spanning multiple dimensions of the workflow. We systematically compared a number of factors including hydrogel formation, clearing solution, and clearing temperatures between free-acrylamide and acrylamide-based passive sodium dodecyl sulfate (SDS) tissue clearing and discussed negative effects of polyacrylamide on clearing, staining, and imaging in detail. Such information may help to gain a perspective for interrogating neural circuits spatial interactions between molecules and cells and provide guidance for developing novel tissue clearing strategies to probe deeply into intact organ.

Dyrosaurids were highly specialized, largely marine, relatives of living crocodylians, and one of the few archosaur lineages to survive the K-Pg extinction. Dyrosaurids lived during the Cretaceous to the Eocene and represent a unique combination of morphology and ecology not seen in living crocodylians. Little is known about their endocranial anatomy, leaving many questions about their neurosensory adaptations unaddressed. Recently, µCT (micro-computed tomography) scans were made of a well-preserved skull of Rhabdognathus, a Paleocene dyrosaurid from Mali. This marks the first time the braincase and neurosensory features of a dyrosaurid have been examined using CT. We focus our attention to three specific internal structures: the cranial endocast; the inner ear; and the paratympanic sinuses. The cranial endocast of Rhabdognathus revealed novel features including a unique conformation of its paratympanic system, a prominent dorsal venous system that communicates with the external skull table, extremely enlarged tympanic vestibules that meet at the midline of the endocranium, a prominent spherical cerebrum, and elongate olfactory tracts accounting for half the total endocast length. The bizarre laterally facing lateral Eustachian foramen of dyrosaurids is now understood to be a complex fossa including both a ventrally directed lateral Eustachian foramen and a laterally directed foramen for the basioccipital diverticulum. A novel median pterygopharyngeal canal was discovered connecting the pharynx to the adductor chamber. These revelations require a reinterpretation of the associated external foramina visible on the posterior of the skull in dyrosaurids and potentially their close relatives the pholidosaurids. The olfactory tract terminates in an enlarged olfactory region possessing complex bony projections—a unique morphology perhaps serving to increase surface area for olfaction. The inner ear of Rhabdognathus exhibits characteristics seen in both Pelagosaurus and Gavialis. The vestibule is spherical, as in Gavialis, but is significantly expanded. The semicircular canals are enlarged but pyramidal in shape as in the thalattosuchian Pelagosaurus. The proportion of the cochlear length to total endosseous labyrinth height is roughly 0.5 in Rhabdognathus implying that the hearing capabilities resemble that of thalattosuchians. A suite of expanded sense organs (e.g., bony olfactory lamina; hypertrophied vestibule of the inner ear), and the clear expansion of the cerebrum to a more symmetrical and spherical shape suggest that dyrosaurids possess neuroanatomical modifications facilitating an agile predatory near-shore ecology.

Objectives The objective of this study was to compare maxillary dimensions and growth in newborns with Complete Unilateral Cleft Lip and Palate (UCLP) to healthy newborns before and after cheiloplasty. Additionally, a palatal growth curve is constructed to give more information about the natural growth before surgical intervention. Methods Twenty-eight newborns with complete UCLP were enrolled in this study. Multiple plaster-casts of each child during their first year were collected and grouped in before and after cheiloplasty. A previous developed semi-automatic segmentation tool was used to assess the maxillary dimensions and were compared to a healthy control group. Z-scores were calculated to indicate differences between the two populations and if cheiloplasty had influence on maxillary growth. Furthermore, the prediction model created in a previous study was used to indicate differences between predictions and the outcome in UCLP measurements. The analysis was tested for inter- and intra-observer variability. Results Results show differences in alveolar and palatal shape in UCLP patients in comparison with healthy controls. Prior to cheiloplasty an increased width and alveolar length was observed while the palatal depth was decreased. After cheiloplasty the widths moved towards normal but were still significantly larger. Conclusion Infants with unilateral cleft lip and palate show a wider maxillary arch in comparison with the control population. Initial treatment has most influence on the width of the arch, which decreased towards normal.

Purpose: To investigate the feasibility of a polycaprolactone (PCL) scaffold fabricated by three-dimensional (3D) printing for tissue engineering applications for tunica albuginea. Materials and Methods: PCL scaffolds were fabricated by use of a 3D printing system. Two scaffolds were fabricated that differed in the architecture of the lay-down pattern: a 90°PCL scaffold and a 45°PCL scaffold. Mechanical properties were measured to compare tensile strength between the two scaffold types. The scaffolds were characterized by scanning electron microscope (SEM) images. The scaffolds were seeded with fibroblast cells, and the ability of these scaffolds to support the cells was evaluated by immunofluorescence staining. Results: The PCL scaffolds had well-structured shapes, regular arrays, and good interconnection in SEM images. The horizontal and vertical Young’s modulus coefficients were 13 and 12 MPa for the 90°PCL scaffold and 19 and 21 MPa for the 45°PCL scaffold, respectively. Microscopy images revealed that human fibroblast cells covered the entire scaffold surface. Immunofluorescence staining of ER-TR7 confirmed that the fibroblast cells remained viable and proliferated throughout the time course of the culture. Conclusions: This preliminary study provides experimental evidence for the feasibility of 3D printing of PCL scaffolds for tissue engineering applications of tunica albuginea.

Abstract Background Transcatheter mitral valve repair (TMVR) has been shown to have acute effects on mitral valve geometry in patients with functional mitral regurgitation (FMR). This study investigates the impact of MitraClip® therapy-induced annular remodeling on clinical outcome and mitral regurgitation in heart failure patients. Methods TMVR was performed successfully in 45 patients with FMR. In this study, mitral valve datasets were obtained before and directly after MitraClip® implantation using three-dimensional (3D) transesophageal echocardiography, and were analyzed offline retrospectively using dedicated 3D reconstruction software. Patients underwent clinical and echocardiographic evaluation at baseline and after 6 months. At follow-up, the patients were allocated into two groups according to their improvement in New York Heart Association (NYHA) functional class: a Low Responder group with ΔNYHA

Abstract 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.

The microfabrication and packaging of novel, three-dimensional, polyimide-based, highly flexible, microscale electrocorticography multi-electrode arrays for enhanced epicortical recording of local field potentials is presented. A polyimide foil embeds metallic structures relating to 32 taper-type electrode sites, contact pads as well as interconnecting conductor paths which are integrated in the planar portion of the electrode substrate material. Circular exposed and, thus, active electrode sites are 50 μm in diameter and employed center-to-center pitches range from 250 μm to 1 mm, respectively. As-fabricated 3D-μECoG-MEAs provide taper heights of approximately 4 μm as well as 59 μm being distinguished by characteristic impedances of about 368.9 kΩ at 1 kHz measured in saline electrolyte. The applied packaging strategies favor flip-chip bonding and vapor phase soldering of the polymer substrates to customized printed circuit boards.

Study DesignProspective study based on magnetic resonance (MR) imaging of the lumbar spinal root of the intervertebral foramen.PurposeThis study was to compare MR three-dimensional (3D) sequences for the evaluation of the lumbar spinal root of the intervertebral foramen.Overview of LiteratureThe diagnosis of spinal disorders by MR imaging is commonly performed using two-dimensional T1- and T2-weighted images, whereas 3D MR images can be used for acquiring further detailed data using thin slices with multi-planar reconstruction.MethodsOn twenty healthy volunteers, we investigated the contrast-to-noise ratio (CNR) of the lumbar spinal root of the intervertebral foramen with a 3D balanced sequence. The sequences used were the fast imaging employing steady state acquisition and the coherent oscillatory state acquisition for the manipulation of image contrast (COSMIC). COSMIC can be used with or without fat suppression (FS). We compared these sequence to determine the optimized visualization sequence for the lumbar spinal root of the intervertebral foramen.ResultsFor the CNR between the nerve root and the peripheral tissue, these were no significant differences between the sequences at the entry of foramen. There was a significant difference and the highest CNR was seen with COSMIC-FS for the intra- and extra-foramen.ConclusionsIn this study, the findings suggest that the COSMIC-FS sequences should be used for the internal or external foramen for spinal root disorders.

Background: Colorectal cancer (CRC) is a heterogeneous disease; current research relies on cancer cell lines and animal cancer models, which may not precisely imitate inner human tumors and guide clinical medicine. The purpose of our study was to explore and further improve the process of producing three-dimensional (3D) organoid model and impel the development of personalized therapy. Methods: We subcutaneously injected surgically resected CRC tissues from a patient into BALB/c-nu mice to build patient-derived xenografts (PDXs). Isolated cells from PDXs at appropriate tumor size were mingled with Matrigel, and then seeded in ultra-low attachment 96-well plates at four cell densities (500, 1000, 2000, and 4000 single cells/well). Cells were cultured with advanced Dulbecco′s Modified Eagle Medium/F12 medium additional with various factors added to maintain tumor′s biological traits and growth activity. The growth curves of the four cell densities were measured after 24 h of culture until 25 days. We evaluated the effects of four chemotherapeutic agents on organoid model by the CellTiter-Glo ® Luminescent Cell Viability Assay. Hematoxylin and eosin (H and E) staining of 3D organoids was performed and compared with patient and CRC PDX tissues. Furthermore, immunohistochemistry was performed, in which the organoids were stained with the proliferation marker, Ki-67. During the experimental process, a phase-contrast microscope was used. Results: Phenotype experimental results showed that 3D organoids were tightly packed together and grew robustly over time. All four densities of cells formed organoids while that composed of 2000 cells/well provided an adequate cultivation system and grew approximately 8-fold at the 25 th day. The chemosensitivity of the four conventional drugs was [s]-10-hydroxycamptothecin > mitomycin C > adriamycin > paclitaxel, which can guide clinical treatment. Histological features of CRC patient′s tumor tissues and mice tumor xenograft tissues were highly similar, with high-column-like epithelium and extracellular matrix. H and E-stained sections showed heterogeneous cell populations harbored in cancer organoids and were histologically similar to tumor tissues. The proliferation index was only 8.33% within spheroids, which exhibited confined proliferative cells that might be cancer stem cells. Conclusions: We successfully constructed a CRC organoid model that grew robustly over 25 days and demonstrated that 2000 cells/well in 96-well plate was a prime seeding density for cells to form organoids. The results confirmed that organoid model can be used for agent screening and personalized medicine.

This paper proposes a new methodology to quantify patterns of egg shape variation using geometric morphometrics of three-dimensional landmarks captured on digitally reconstructed eggshells and demonstrates its performance in capturing shape variation at multiple biological levels. This methodology offers unique benefits to complement established linear measurement or two-dimensional (2D) contour profiling techniques by (i) providing a more precise representation of eggshell curvature by accounting for variation across the entire surface of the egg; (ii) avoids the occurrence of correlations from combining multiple egg shape features; (iii) avoids error stemming from projecting a highly-curved three-dimensional (3D) object into 2D space; and (iv) enables integration into 3D workflows such as finite elements analysis. To demonstrate, we quantify patterns of egg shape variation and estimate morphological disparity at multiple biological levels, within and between clutches and among species of four passerine species of different lineages, using volumetric dataset obtained from micro computed tomography. The results indicate that species broadly have differently shaped eggs, but with extensive within-species variation so that all four-focal species occupy a range of shapes. Within-species variation is attributed to between-clutch differences in egg shape; within-clutch variation is surprisingly substantial. Recent comparative analyses that aim to explain shape variation among avian taxa have largely ignored potential biases due to within-species variation, or use methods limited to a narrow range of egg shapes. Through our approach, we suggest that there is appreciable variation in egg shape across clutches and that this variation needs to be accounted for in future research. The approach developed in this study to assess variation in shape is freely accessible and can be applied to any spherical-to-conical shaped object, including eggs of non-avian dinosaurs and reptiles through to other extant taxa such as poultry.

The simultaneous imaging and manipulating of neural activity could enable the functional dissection of neural circuits. Here we have combined two-photon optogenetics with simultaneous volumetric two-photon calcium imaging to measure and manipulate neural activity in mouse neocortex in vivo in three-dimensions (3D) with cellular resolution. Using a hybrid holographic approach, we simultaneously photostimulate more than 80 neurons over 150 μm in depth in layer 2/3 of the mouse visual cortex, while simultaneously imaging the activity of the surrounding neurons. We validate the usefulness of the method by photoactivating in 3D selected groups of interneurons, suppressing the response of nearby pyramidal neurons to visual stimuli in awake animals. Our all-optical approach could be used as a general platform to read and write neuronal activity.

Three-dimensional speckle-tracking echocardiography (3DSTE) is accepted as a reliable and feasible method in the quantification of left ventricular (LV) volumes, strains and rotational characteristics. This case aimed to demonstrate the diagnostic importance of 3DSTE in volumetric and functional assessment of an LV aneurysm