Moderní technologie nacházejí stále větší využití i v medicíně a zkracuje se čas, za který se etablují jako její plnohodnotné součásti. Je to vidět právě na 3D tisku, kdy za poměrně krátkou dobu od přihlášení patentu je již nedílnou komponentou celé řady lékařských oborů, včetně ORL, maxilofaciální a plastické chirurgie. Jejímu rozšíření výrazně napomáhá pokles pořizovacích nákladů tiskáren a používaných materiálů, včetně dostupnosti software. Další výhodou je zvyšující se počet absolventů oboru biomedicínský inženýr, kteří pomáhají lékařům s vlastní přípravou modelů a následně s jejich tiskem. Dne 17. 6. 2023 přijala Česká lékařská společnost J. E. Purkyně nově vzniklou „Českou společnost pro 3D tisk v medicíně“ jako svou organizační složku. Jejím cílem je napomáhat rozvoji 3D tisku v medicíně, nastavit standardy využití a garantovat jejich dodržování. Přehledový článek uvádí praktické příklady využití 3D tisku v otorinolaryngologii, maxilofaciální a plastické chirurgii.
Modern technologies are increasingly finding their place in medicine, rapidly establishing as invaluable assets. This is evident in 3D printing, which in a relatively short time, has become an integral part of numerous medical fields including ENT, Maxillofacial and Plastic surgery. Its expansion is substantially facilitated by the decrease in the acquisition costs of printers and used materials, including software availability. Another advantage is the increasing number of graduated biomedical engineers who assist doctors in preparing and printing their models. On June 17, 2023, the Czech Medical Society of J. E. Purkyně accepted the newly established „Czech Society for 3D Printing in Medicine“ as its organizational component. Its objective is to help the development of 3D printing in medicine, and to set standards of use and adherence. This article presents practical examples of the use of 3D printing in Otorhinolaryngology, Maxillofacial and Plastic surgery.
- MeSH
- Printing, Three-Dimensional * classification MeSH
- Head * surgery diagnostic imaging MeSH
- Neck * surgery diagnostic imaging MeSH
- Humans MeSH
- Orthognathic Surgical Procedures classification methods MeSH
- Plastic Surgery Procedures classification methods MeSH
- Imaging, Three-Dimensional classification methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
Cílem tohoto sdělení je shrnout dosavadní poznání anatomie tepen hlavy a krku prasete domácího pro potřeby experimentální chirurgie nebo zobrazovacích metod v biomedicínském výzkumu a translační medicíně. Potenciál prasete domácího jako velkého animálního modelu se zdá být značný i pro xenotransplantace některých orgánů. Nároky na znalost morfologických rozdílů analogických struktur člověka a vybraného experimentálního plemena rostou i v souvislosti s potřebou zpřesnění plánování experimentu nebo interpretace jeho výsledků. K prohloubení morfologických znalostí napomáhá také rozvoj zobrazovacích metod. Rešerše byla prováděna s použitím klíčových slov „prase domácí“, „tepny hlavy a krku“ v databázi MEDLINE, rozhraní PubMed.
The aim of this paper is to summarize the current knowledge of the anatomy of domestic pig head and neck arteries for the needs of experimental surgery and imaging methods in biomedical research and translational medicine. The potential of this large animal model seems to be valuable also for the xenotransplantation of certain organs. Demands for the knowledge of morphological differences between analogous human structures and particular breeds are growing also in connection with the need for more precise planning of experiments or interpretation of the results. Deepening anatomical knowledge is allowed also by the development of imaging methods. The search was performed using the keywords “domestic pig” and “arteries of the head and neck“ in the MEDLINE database, PubMed interface.
- Keywords
- tepny hlavy a krku,
- MeSH
- Aorta, Thoracic anatomy & histology diagnostic imaging MeSH
- Arteries * anatomy & histology diagnostic imaging MeSH
- Head diagnostic imaging blood supply MeSH
- Humans MeSH
- Models, Animal MeSH
- Swine MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
Obstetric forceps were invented in the 1600s to assist vaginal delivery of term babies following prolonged labour. This probably explains their design, with a narrow interblade distance and long blade length, to fit a severely moulded fetal head. However, in modern obstetric practice protracted labour is avoided, yet our research has shown that over 400 years forceps dimensions have remained largely unchanged. We believe it is time to optimise these dimensions based on biometry of the term, newborn baby's head, with the head width (biparietal diameter) and head length (mentovertical diameter) correlating with interblade distance and blade length respectively. We hypothesise that doing so should reduce the incidence of neonatal complications associated with forceps assisted delivery and it is also possible that the amended shape might be associated with better outcomes for women. In this article we present our rationale for the optimisation of the forceps dimensions based on the findings of our previous systematic review and an original series of mentovertical and biparietal diameter measurements using laser scanning technology.
- MeSH
- Biometry MeSH
- Head diagnostic imaging MeSH
- Humans MeSH
- Infant, Newborn MeSH
- Labor, Obstetric * MeSH
- Obstetrical Forceps * adverse effects MeSH
- Pregnancy MeSH
- Delivery, Obstetric MeSH
- Check Tag
- Humans MeSH
- Infant, Newborn MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
PURPOSE: To develop a head and neck hyperthermia phased array system compatible with a 1.5 T magnetic resonance (MR) scanner for noninvasive thermometry. METHODS: We designed a dielectric-parabolic-reflector antenna (DiPRA) based on a printed reflector backed dipole antenna and studied its predicted and measured performance in a flat configuration (30 mm thick water bolus and muscle equivalent layer). Thereafter, we designed a phased array applicator model ('MRcollar') consisting of 12 DiPRA modules placed on a radius of 180 mm. Theoretical heating performance of the MRcollar model was benchmarked against the current clinical applicator (HYPERcollar3D) using specific (3D) head and neck models of 28 treated patients. Lastly, we assessed the influence of the DiPRA modules on MR scanning quality. RESULTS: The predicted and measured reflection coefficients (S11) of the DiPRA module are below -20 dB. The maximum specific absorption rate (SAR) in the area under the antenna was 47% higher than for the antenna without encasing. Compared to the HYPERcollar3D, the MRcollar design incorporates 31% less demineralized water (-2.5 L), improves the predicted TC25 (target volume enclosed by 25% iso-SAR contour) by 4.1% and TC50 by 8.5%, while the target-to-hotspot quotient (THQ) is minimally affected (-1.6%). MR experiments showed that the DiPRA modules do not affect MR transmit/receive performance. CONCLUSION: Our results suggest that head and neck hyperthermia delivery quality with the MRcollar can be maintained, while facilitating simultaneous noninvasive MR thermometry for treatment monitoring and control.
OBJECTIVES: The head constitutes 6% of the total body weight, which is linked to the cervical spine and all other joints through the kinematic chain by various muscles. The forward head posture is one of the most common postural disorders and seems to be especially dangerous. The goal of the work was to assess the impact of 4 weeks of training neck and nape muscles on the head posture. MATERIAL AND METHODS: The subjects were 20 participants, who performed neck exercises for 20 days. The head posture in a sagittal and frontal plane was assessed photogrammetrically twice: before and after the exercises. The following have been used for the assessment: craniovertebral (CV) angle, head tilt angle (HT), and frontal head tilt angle (FHT). RESULTS: After a 20-day program of neck and nape exercises the values of specific angles were compared. The results indicated significant changes in the head posture. In the sagittal plane: the average value of the CV angle before the training was 47.17°, and 50.82° after the training; the average value of the HT angle before the exercises was at 20.99°, and 24.31° after. In the frontal plane the average value of the FHT angle before the exercises was at 2.71°, and after 20 days of training the average value of this angle decreased to 2°. CONCLUSIONS: The results demonstrate that a short, home-based targeted exercise program can improve head posture. Int J Occup Med Environ Health. 2019;32(1):43-51.
- MeSH
- Adult MeSH
- Photogrammetry methods MeSH
- Head diagnostic imaging physiopathology MeSH
- Neck diagnostic imaging physiopathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Occupational Diseases rehabilitation MeSH
- Posture * MeSH
- Exercise Therapy methods MeSH
- Public Sector MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Poland MeSH
Cíl: U pacientů s úrazem hlavy se středním nebo vysokým rizikem poranění mozku je zlatým standardem CT vyšetření. Česká indikační kritéria na rozdíl od evropských povolují v případě středně vážného rizika i provedení prostého snímku (nicméně CT je preferováno). Zaměřili jsme se na pacienty, kteří měli provedený snímek lbi, abychom posoudili, kdy je tato zobrazovací metoda vhodnější, jaký je její význam a jestli již není čas na změnu indikačních kritérií v České republice. Metodika: Retrospektivně jsme prošli data 2349 pacientů s provedeným snímkem lbi po poranění hlavy. Spočítali jsme celkový počet zjištěných traumatických změn a zaznamenali dostupné informace o pacientech. Výsledky: Nejčastější skupinou indikovanou k provedení snímku lbi byly děti do 5 let. Celkem jsme na snímcích našli 68 abnormalit. Z 16 pacientů, u kterých bylo popsáno poranění neurocrania, bylo pět dětí posláno na sledování na dětskou kliniku a zbývající měli provedeno CT, které potvrdilo pět fisur, v jednom případě se subdurálním hematomem. Závěr: Pacienti s podezřením na poranění mozku jsou indikováni k provedení CT. V naší práci bylo na snímcích zjištěno jen malé množství poranění, z toho většina na obličejovém skeletu. Česká indikační kritéria, která povolují provedení prostého snímku u pacientů po traumatu hlavy se středně vážným rizikem poranění mozku, by měla být aktualizována, aby odpovídala evropským doporučeným postupům, ve kterých není prostý snímek hlavy po poranění indikován.
Aim: CT examination is the gold standard for imaging patients after head injury with high and medium risk of brain trauma. Czech guidelines, unlike the European ones, acknowledge skull X-ray in the case of moderate trauma as well (although CT is preferred). We focused on patients who underwent skull X-ray examinations in order to determine whether this method of imaging should still be used, what its significance is, or whether it is time to change the indication criteria in our country. Methods: We retrospectively reviewed the data of 2,349 patients with skull X-ray performed after mild or moderate head injury. We calculated the total sum of traumatic findings and recorded accessible information about patients. Results: Skull X-rays were most frequently performed in children younger than five years of age. Altogether 68 abnormalities were described on X-ray. Out of 16 patients with traumatic changes in the neurocranium, five young children were sent for observation to the pediatrie department; the remaining patients had a CT scan that confirmed five fissures, including one with subdural hematoma. Conclusion: Patients with suspected brain injury are indicated for CT examination. Skull X-rays in our study group revealed only a low number of traumatic changes, with most of them found in the splanchnocranium. Czech radiology indication criteria allowing skull X-rays in patients after head trauma with moderate risk of brain injury should be updated to correspond to the European guidelines, i.e. skull X-rays after head injury should not be indicated.
- MeSH
- Child MeSH
- Adult MeSH
- Head diagnostic imaging MeSH
- Infant MeSH
- Craniocerebral Trauma * diagnostic imaging MeSH
- Humans MeSH
- Tomography, X-Ray Computed methods MeSH
- Brain Injuries diagnostic imaging MeSH
- Child, Preschool MeSH
- Retrospective Studies MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Infant MeSH
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
MR images are affected by system delays and gradient field imperfections which induce discrepancies between prescribed and actual k-space trajectories. This could be even more critical for non-Cartesian data acquisitions where even a small deviation from the assumed k-space trajectory results in severe image degradation and artifacts. Knowledge of the actual k-space trajectories is therefore crucial and can be incorporated in the reconstruction of high quality non-Cartesian images. A novel MR method for the calibration of actual gradient waveforms was developed using a combination of phase encoding increments and subsequent detection of the exact time point at which the corresponding trajectory is crossing the k-space origin. The measured sets of points were fitted to a parametrical model to calculate the complete actual acquisition trajectory. Measurements performed on phantoms and volunteers, positioned both in- and off-isocenter of the magnet, clearly demonstrate the improvement in reconstructed ultrashort echo time (UTE) images, when information from calibration of k-space sampling trajectories is employed in the MR image reconstruction procedure. The unique feature of the proposed method is its robustness and simple experimental setup, making it suitable for quick acquisition trajectory calibration procedures e.g. for non-Cartesian radial fast imaging.
- MeSH
- Algorithms MeSH
- Artifacts MeSH
- Phantoms, Imaging MeSH
- Head anatomy & histology diagnostic imaging MeSH
- Calibration MeSH
- Knee anatomy & histology diagnostic imaging MeSH
- Humans MeSH
- Magnetic Resonance Imaging methods MeSH
- Image Processing, Computer-Assisted methods MeSH
- Models, Theoretical MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
A cleft palate results from incomplete fusion of the lateral palatine processes, the median nasal septum and the median palatine process. This case report describes a rare case of congenital teratoma originating from the nasal septum that may have interfered with the fusion of the palatal shelves during embryonic development, resulting in a cleft palate. An infant girl was born at 40 weeks of gestation weighing 3020 g with a complete cleft palate associated with a large central nasopharyngeal tumour. Computed tomography (CT) of the head showed a well defined mass of mixed density. The tumour was attached to the nasal septum in direct contact with the cleft palate. A biopsy confirmed the teratoma. Tumour resection was performed at 5 months, soft palate reconstruction at 7 months and hard palate closure at 14 months. There was no sign of local recurrence 1 year later. Most teratomas are benign and the prognosis is usually good. However, recurrence is not rare if germ cell carcinomatous foci are present within the teratoma. For these reasons, we advocate the use of a two-stage procedure in which closure of the cleft palate is postponed until histological examination confirms complete excision of the teratoma.
- MeSH
- Biopsy MeSH
- Head diagnostic imaging MeSH
- Infant MeSH
- Humans MeSH
- Nose Neoplasms complications congenital pathology surgery MeSH
- Tomography, X-Ray Computed MeSH
- Cleft Palate etiology pathology surgery MeSH
- Teratoma complications congenital pathology surgery MeSH
- Check Tag
- Infant MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
Cone Beam CT (CBCT) se původně používalo téměř výhradně ve stomatologických indikacích. Posléze se systémy CBCT první generace stále více využívaly k zobrazení paranazálních dutin, zlomenin obličeje a nosu, zobrazení temporomandibulárního kloubu a k dalším. Jakmile se umožnilo zobrazení celé hlavy pomocí CBCT, bylo rovněž možno přejít k 3D studiím v oblasti hlavy a krku. Za tímto účelem bylo nutné použít techniku dvojité rotace s následnou fúzí obou výsledných datových souborů. Pro provádění studií dynamiky polykání nebo zobrazení pharyngu bylo potřeba vytvořit CBCT systémy, které umožňují zastavení rotace. Vývoj pokročilejších CBCT přístrojů umožnil zobrazování spánkové kosti a lební báze. A nakonec pokročilejší „supinační“ CBCT systémy, používající gantry, rozšířily aplikaci CBCT na muskuloskeletální radiologii v oblasti malých kloubů. Tyto nestomatologické aplikace postupně nahradily konvenční rentgenové snímky i CT/MDCT studie, protože umožnily snímání s vyšším rozlišením, nižší dávkou záření a menším počtem kovových artefaktů. Tento článek pojednává o nejdůležitějších nestomatologických indikacích CBCT.
Initially Cone Beam CT was almost exclusively used to perform dental radiology. However, the first generation CBCT systems were later increasingly used to study sinuses, facial and nose fractures, temporomandibular joints etc. 3D-cephalometric head and neck studies became possible once CBCT systems were available that allowed scanning of the complete head. For this purpose a double rotation technique with stitching of the resulting two data sets was needed. CBCT systems on which the rotation could be stopped were needed to perform dynamic swallow or pharyngography studies. The advent of more powerful high-end CBCT systems led the way to temporal bone and skull base imaging. Finally, high-end “supine” CBCT systems using a “gantry” made small joint musculoskeletal paging possible. These non-dental CBCT studies gradually replaced conventional X-rays and CT/MDCT studies because Theky allowed imaging with higher resolution, lower radiation dose and less metal artifacts. In this paper the most important non-dental CBCT indications will be discussed.
OBJECTIVES: Respiratory morbidity in congenital diaphragmatic hernia (CDH) is associated with high mortality and adverse outcome. Accurate prenatal diagnosis is essential for prognosis and potential treatment in utero. The aim was to evaluate the prenatal ultrasound findings in assessing the respiratory prognosis in fetuses with isolated left-sided CDH. METHODS: We retrospectively analyzed the medical records of 59 prenatally diagnosed left-sided CDH cases managed at a tertiary perinatal center. RESULTS: Survival rate in the study group was 73% (43/59). We found no statistically significant relationship between survival and the presence of polyhydramnios, gestational age at diagnosis, lung-to-head ratio (LHR) and observed/expected LHR (O/E LHR) values, gestational age at birth and birth weight. Intrathoracic liver herniation was a statistically significant parameter adversely affecting survival (37.2% in survivors, 68.8% in non-survivors, p = 0.031) and logistic regression confirmed this relationship. The presence of pneumothorax and severe pulmonary hypertension were significantly associated with mortality (82% non-survivors versus 15% in survivors, p = 0.0001). CONCLUSION: Intrathoracic liver herniation seems to be a reliable parameter in the prediction of survival and neonatal respiratory morbidity in fetuses with isolated left-sided CDH. In contrast, we found no significant correlation between perinatal outcome and LHR, O/E LHR values, birth weight and gestational age.
- MeSH
- Gestational Age MeSH
- Head diagnostic imaging embryology MeSH
- Liver diagnostic imaging embryology MeSH
- Humans MeSH
- Logistic Models MeSH
- Lung diagnostic imaging embryology MeSH
- Prognosis MeSH
- Retrospective Studies MeSH
- Pregnancy MeSH
- Ultrasonography, Prenatal * MeSH
- Hernias, Diaphragmatic, Congenital diagnosis embryology mortality MeSH
- Check Tag
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
