Live volumetric (4D) visualization and guidance of in vivo human ophthalmic surgery with intraoperative optical coherence tomography.

Minimally-invasive microsurgery has resulted in improved outcomes for patients. However, operating through a microscope limits depth perception and fixes the visual perspective, which result in a steep learning curve to achieve microsurgical proficiency. We introduce a surgical imaging system employing four-dimensional (live volumetric imaging through time) microscope-integrated optical coherence tomography (4D MIOCT) capable of imaging at up to 10 volumes per second to visualize human microsurgery. A custom stereoscopic heads-up display provides real-time interactive volumetric feedback to the surgeon. We report that 4D MIOCT enhanced suturing accuracy and control of instrument positioning in mock surgical trials involving 17 ophthalmic surgeons. Additionally, 4D MIOCT imaging was performed in 48 human eye surgeries and was demonstrated to successfully visualize the pathology of interest in concordance with preoperative diagnosis in 93% of retinal surgeries and the surgical site of interest in 100% of anterior segment surgeries. In vivo 4D MIOCT imaging revealed sub-surface pathologic structures and instrument-induced lesions that were invisible through the operating microscope during standard surgical maneuvers. In select cases, 4D MIOCT guidance was necessary to resolve such lesions and prevent post-operative complications. Our novel surgical visualization platform achieves surgeon-interactive 4D visualization of live surgery which could expand the surgeon\u27s capabilities

O conceito de bacia de drenagem internacional no contexto do tratado de cooperação amazônica e a questão hídrica na região The concept fo international drainagem basin in the context of amazon cooperation treaty and the water question on that region

O trabalho visa analisar a tutela dos recursos hídricos amazônicos à luz do Tratado de Cooperação Amazônica (TCA). Há que se fazer uma releitura dos artigos IV e V do TCA, tendo-se em vista a teoria da bacia de drenagem internacional, estabelecida pela International Law Association, em 1966, mas somente incorporada ao Direito Internacional, de maneira ampla, através da Convenção sobre a Utilização dos Rios Internacionais para Fins Distintos da Navegação (ONU, 1997).<br>The purpose of this paper is to analyze the guardianship of the Amazonian water resources in the Amazon Cooperation Treaty. Its important to review the Treaty's 4th and 5th articles , considering the international drainage basin theory, created by the International Law Association, in 1966, widely adopted by international law with the Convention on the Law of the Non-navigational Uses of International Watercourses (UN, 1997)