SurReal: enhancing Surgical simulation Realism using style transfer

Surgical simulation is an increasingly important element of surgical education. Using simulation can be a means to address some of the significant challenges in developing surgical skills with limited time and resources. The photo-realistic fidelity of simulations is a key feature that can improve the experience and transfer ratio of trainees. In this paper, we demonstrate how we can enhance the visual fidelity of existing surgical simulation by performing style transfer of multi-class labels from real surgical video onto synthetic content. We demonstrate our approach on simulations of cataract surgery using real data labels from an existing public dataset. Our results highlight the feasibility of the approach and also the powerful possibility to extend this technique to incorporate additional temporal constraints and to different applications

THE EFFECT OF DZIKIR CONCERNING TO PAIN LEVEL AFTER SURGICAL OPERATION REDUCTION INTERNAL FIXATION (ORIF)

ABSTRACT Background: Surgical operation of ORIF affect painful which disturb the patient’s comfortable. Dzikir have psychological benefit psichologis which affect comfortable and spiritual feelings focused to Allah, so could give a relaxation effect to percepts pain. Objective: The objectives of this thesis is to find out the effect of dzikir concerning to pain level felt after surgical operation of ORIF in RS Ortopedi Prof. Dr. R. Soeharso Surakarta. Methods: This thesis was done by true eksperimen by applying randomized control group pre-test post-test design method. The number of sample was 44 respondents were obtained by consecutive sampling based on inclusion and exclusion criteria and classified using a simple random sampling to 22 experimental group and 22 control group. Results: The average pain level of the respondents on experimental group after surgical operation of ORIF before gave dzikir was 5.18 and the pain level after dzikir was 4.05. The average pain level pretest of the respondents on control group was 4,82 and pain level of posttest was 4,77. The result of pain level before and after gave dzikir to the experiment groups shows that the significance points 0.001 and 0.317 in the control group. Conclusion: The decrease of pain level in the experimental group were given analgesic therapy and dhikr greater than the control group who were given analgesic therapy. This thesis could be used as reference and consideration for nurse to apply dzikir as a complementary therapy to diminish the pain level to the post-surgical operation patient’s of ORIF. Keyword: Dzikr, Pain, Pasca ORI

Tumors in von Hippel–Lindau Syndrome: From Head to Toe—Comprehensive State-of-the-Art Review

Von Hippel–Lindau syndrome (VHL) is an autosomal-dominant hereditary tumor disease that arises owing to germline mutations in the VHL gene, located on the short arm of chromosome 3. Patients with VHL may develop multiple benign and malignant tumors involving various organ systems, including retinal hemangioblastomas (HBs), central nervous system (CNS) HBs, endolymphatic sac tumors, pancreatic neuroendocrine tumors, pancreatic cystadenomas, pancreatic cysts, clear cell renal cell carcinomas, renal cysts, pheochromocytomas, paragangliomas, and epididymal and broad ligament cystadenomas. The VHL/hypoxia-inducible factor pathway is believed to play a key role in the pathogenesis of VHL-related tumors. The diagnosis of VHL can be made clinically when the characteristic clinical history and findings have manifested, such as the presence of two or more CNS HBs. Genetic testing for heterozygous germline VHL mutation may also be used to confirm the diagnosis of VHL. Imaging plays an important role in the diagnosis and surveillance of patients with VHL. Familiarity with the clinical and imaging manifestations of the various VHL-related tumors is important for early detection and guiding appropriate management. The purpose of this article is to discuss the molecular cytogenetics and clinical manifestations of VHL, review the characteristic multimodality imaging features of the various VHL-related tumors affecting multiple organ systems, and discuss the latest advances in management of VHL, including current recommendations for surveillance and screening

Automatic Brain Tumor Segmentation using Convolutional Neural Networks with Test-Time Augmentation

Automatic brain tumor segmentation plays an important role for diagnosis, surgical planning and treatment assessment of brain tumors. Deep convolutional neural networks (CNNs) have been widely used for this task. Due to the relatively small data set for training, data augmentation at training time has been commonly used for better performance of CNNs. Recent works also demonstrated the usefulness of using augmentation at test time, in addition to training time, for achieving more robust predictions. We investigate how test-time augmentation can improve CNNs' performance for brain tumor segmentation. We used different underpinning network structures and augmented the image by 3D rotation, flipping, scaling and adding random noise at both training and test time. Experiments with BraTS 2018 training and validation set show that test-time augmentation helps to improve the brain tumor segmentation accuracy and obtain uncertainty estimation of the segmentation results.Comment: 12 pages, 3 figures, MICCAI BrainLes 201

A novel hybrid 3D endoscope zooming and repositioning system : design and feasibility study

Background: Manipulation of the endoscope during minimally invasive surgery is a major source of inconvenience and discomfort. This report elucidates the architecture of a novel one-hand controlled endoscope positioning device and presents a practicability evaluation. Methods and materials: Setup time and total surgery time, number and duration of the manipulations, side effects of three-dimensional (3D) imaging, and ergonomic complaints were assessed by three surgeons during cadaveric and in vivo porcine trials. Results: Setup was accomplished in an average (SD) of 230 (120) seconds. The manipulation time was 3.87 (1.77) seconds for angular movements and 0.83 (0.24) seconds for zooming, with an average (SD) of 30.5 (16.3) manipulations per procedure. No side effects of 3D imaging or ergonomic complaints were reported. Conclusions: The integration of an active zoom into a passive endoscope holder delivers a convenient synergy between a human and a machine-controlled holding device. It is shown to be safe, simple, and intuitive to use and allows unrestrained autonomic control of the endoscope by the surgeon

Committed to Safety: Ten Case Studies on Reducing Harm to Patients

Presents case studies of healthcare organizations, clinical teams, and learning collaborations to illustrate successful innovations for improving patient safety nationwide. Includes actions taken, results achieved, lessons learned, and recommendations

MRI and clinical resolution of a suspected intracranial toxoplasma granuloma with medical treatment in a domestic short hair cat

A two-year-old cat was presented with a left paradoxical vestibular syndrome. MRI of the brain revealed an extra-axial homogenously contrast enhancing mass in the region of the left caudal cerebellar peduncle. Toxoplasma serology was consistent with active infection and the lesion was suspected to be a toxoplasma granuloma. Following eight weeks of tapering oral prednisolone and 11 weeks of oral clindamycin treatment, repeat MRI revealed resolution of the lesion. Eighteen months after initial diagnosis, the cat remained neurologically normal. Differential diagnoses for a solitary, extra-axial, contrast enhancing mass lesion in the feline brain should include toxoplasma granuloma, which can undergo MRI and clinical resolution with medical treatment

Incidence of wrong-site surgery list errors for a 2-year period in a single national health service board

Introduction: Wrong-site/side surgical "never events" continue to cause considerable harm to patients, healthcare professionals, and organizations within the United Kingdom. Incidence has remained static despite the mandatory introduction of surgical checklists. Operating theater list errors have been identified as a regular contributor to these never events. The aims of the study were to identify and to learn from the incidence of wrong-site/side list errors in a single National Health Service board. Methods: The study was conducted in a single National Health Service board serving a population of approximately 300,000. All theater teams systematically recorded errors identified at the morning theater brief or checklist pause as part of a board-wide quality improvement project. Data were reviewed for a 2-year period from May 2013 to April 2015, and all episodes of wrong-site/side list errors were identified for analysis. Results: No episodes of wrong-site/side surgery were recorded for the study period. A total of 86 wrong-site/side list errors were identified in 29,480 cases (0.29%). There was considerable variation in incidence between surgical specialties with ophthalmology recording the largest proportion of errors per number of surgical cases performed (1 in 87 cases) and gynecology recording the smallest proportion (1 in 2671 cases). The commonest errors to occur were "wrong-side" list errors (62/86, 72.1%). Discussion: This is the first study to identify incidence of wrong-site/site list errors in the United Kingdom. Reducing list errors should form part of a wider risk reduction strategy to reduce wrong-site/side never events. Human factors barrier management analysis may help identify the most effective checks and controls to reduce list errors incidence, whereas resilience engineering approaches should help develop understanding of how to best capture and neutralize errors