Reverzni inženjering dugih kostiju čoveka zasnovan na morfometrijskim parametrima

Development of new and improvement of existent methods of creating geometrical models of human bones is a continual process in modern medicine. Basically, most methods use medical images obtained from various devices (medical scanners) as input data. These devices can be classified into those which enable forming of 2D images of scanned object, such as X-ray or 2D ultrasound, and those which enable creation of 3D images (volumetric models), such as Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). Different types of processing can be performed on obtained data, resulting in adequate geometrical human bone models which can be used for various purposes, including: preparation and simulation of orthopedic interventions, students’ and doctor's training to perform orthopedic interventions, production of osteo-fixational material, analysis of stress and strain of assembly of bones and implants. Problem description: While creating bone models based on data acquired from medical scanners, two distinct cases which prevent their proper forming can be isolated. Both cases are related to incomplete data of morphology and geometry of human bone, but with different reasons for data deficiency. In the first case, volumetric scanners are not available, or cannot be used for specific reasons, e.g.: patient must not be treated with high level radiation, faulty device, institution doesn’t possess adequate scanner, patients with metal implants, and such. In these cases, devices such as X-ray or, less often, ultrasound are used. The outcome of this process is one or eventually two 2D images (if the device is digital), or film (if analog X-ray apparatus is used). Complete 3D bone visualization can be difficultly accomplished on the basis of 2D data, so methods which enable creation of 3D geometrical bone models based on one or more 2D images are developed today. The second case refers to inability to create an image of complete bone. This case isn’t connected to acquisition of bone data from medical images (although it can be), but it is mostly conditioned by health state of the patient. Example of these cases include: multiple bone fractures, osteoporosis, other diverse acute and chronic diseases and such. Surgeons aren’t able to properly plan surgical procedures based on a partial image; consequently, certain surgical decisions have to be made during the very surgery. Goal of research: The main goal of the dissertation has been to form a method which would enable creation of complete geometrical bone model based on both complete and incomplete entrance data of patients’ bones (regardless the cause of data deficiency), and which would also 10 greatly contribute to the process of preparation, planning and performance of orthopedic surgeries. Research Subject: Research subject of the dissertation are methods of reverse engineering which can be applied to obtain 3D geometrical models of the human long bones directly from radiology images, whether the data is complete or incomplete. Research result: Method of Anatomical Feature – MAF is formed as the result of applied research whose application enables realization of the goal of research. MAF introduce a new approach to describe geometrical entities of human bones, based on anatomical landmarks/ guide lines. MAF enables creation of 3D geometrical models and parametric point bone models. The main goal of application of MAF is to create 3D geometrical models (of whole bones, as well as of the missing bone parts) of high geometrical accuracy and anatomical correctness, even in cases when the bone data is incomplete. Based on afore mentioned, we can conclude that MAF is a universal method to create different geometrical models of bones or bones’ parts, which means that an adequate model can be created depending on the current situation (need, case). Verification and application of research results: Various types of geometrical models (polygonal, surface, volumetric, parametric) of certain bones of human body have been created to verify MAF. All created geometrical models have satisfied necessary accuracy in geometrical and anatomical terms, which is defined in scientific literature. This paper provides examples of created geometrical models of femur and tibia bones; however, more geometrical models of other bones (fibula, humerus, mandible, etc.) have been created during this research. Nevertheless, MAF has been, both directly and indirectly (geometrical models of bones created with MAF have been used) applied for other purposes. These are characteristic cases which can appear in clinical practice, some of which are: case of creation of customized sternum implant, use of MAF to create parametric model of internal fixator by Mitkovic, application of Finite Element Method (FEM) to analyze stress and strain of femur bone and internal fixator by Mitkovic, use in application prototype for the simulation of orthopedic surgeries, etc. Conclusion: Based on everything stated above, conclusion follows that research results presented in this paper display a significant scientific contribution which greatly contributes to improvement of methods used in reverse engineering and geometrical modeling of long bones of skeletal-joint system in humans

REVERSE ENGINEERING OF THE MITKOVIC TYPE INTERNAL FIXATOR FOR LATERAL TIBIAL PLATEAU

In orthopaedic surgery it is very important to use proper fixation techniques in the treatment of various medical conditions, i.e. bone fractures or other traumas. If an internal fixation method, such as plating, is required, it is possible to use Dynamic Compression Plates (DCP) or Locking Compression Plates (LCP) and their variants. For DCP implants it is important to match the patient's bone shape with the most possible accuracy, so that the most frequent implant bending is applied in the surgery. For LCP implants it is not so important to match the patient’s bone shape, but additional locking screw holes are required. To improve the geometrical accuracy and anatomical correctness of the shape of DCP and to improve the LCP geometric definition, new geometrical modelling methods for the Mitkovic type internal fixator for Lateral Tibia Plateau are developed and presented in this research. The presented results are quite promising; it can be concluded that these methods can be applied to the creation of geometrical models of internal fixator customized for the given patient or optimized for a group of patients with required geometrical accuracy and morphological correctness

Distribution of high-risk types of human papillomavirus compared to histopathological findings in cervical biopsies in women

Introduction: In over of 99% cases of cervical cancer its appearing is preceded by persistent cervical epithelium infection caused by high-risk oncogenic types of human papillomavirus (HPV). The aim of the study was to examine the distribution of high-risk oncogenic HPV types compared to patohistological diagnoses of cervical diseases in women. Materials and methods: The study included 56 women with suspected premalignant and malignant cervical lesions, due to suspected colposcopic and cytological findings (Papanicolaou test). The HPV typing by 'in situ' hybridization method on high-risk HPV types 16, 18, 31 and 33 was performed in all patients from cervical smear as well as cervical biopsy. Histological findings of cervical biopsy was a 'gold standard' in the analysis of materials. Results: Histologically detected premalignant or malignant changes of the cervix were found at 34 (60.7%) of all 56 examined women: 17 of them had LSIL, 13 of them had HSIL, while 4 had squamous cell carcinoma. A positive HPV test had a 47 (84%) of them with a prove of the presence of one or more types of HPV. The most common type of virus was HPV 16 and it was detected in 27 (48.2%) women, followed by HPV 31 that was detected in 26 (46.4%) women, HPV 18 in 18 (32.1%) of women and HPV 33 in 4 (7.1%) women. The infection caused by oncogenic type HPV16 was significantly more frequent in patients with HSIL and cervical cancer (p<0,001), while the infection caused by oncogenic type HPV 31 was significantly more frequent in patients with LSIL and cervicitis (p=0,003). The distribution of HPV 18 and HPV 33 types was not statistically significantly different in patients with different histological findings (HPV 18, p = 0.41; HPV 33, p = 1.0). Conclusion: Based on our results we can conclude that there is a good correlation of HPV infection with pre-malignant cervical lesions and cervical cancer. The incidence of HPV type 16 infection increased with severity of cervical lesions and it is usually detected high-risk oncogenic type virus in women with severe cervical lesions type like HSIL and cancer are. HPV 31 is the most common high-risk type of HPV of mild type lesions, like LSIL and cervicitis are. We believe that women infected by high-risk oncogenic HPV types, although without histologically diagnose of cervical lesion, should be more frequent control by colposcopy and cytology (Papanicolaou) test, because of possible disease progression to a more advanced level

Reverzni inženjering dugih kostiju čoveka zasnovan na morfometrijskim parametrima

Development of new and improvement of existent methods of creating geometrical models of human bones is a continual process in modern medicine. Basically, most methods use medical images obtained from various devices (medical scanners) as input data. These devices can be classified into those which enable forming of 2D images of scanned object, such as X-ray or 2D ultrasound, and those which enable creation of 3D images (volumetric models), such as Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). Different types of processing can be performed on obtained data, resulting in adequate geometrical human bone models which can be used for various purposes, including: preparation and simulation of orthopedic interventions, students’ and doctor's training to perform orthopedic interventions, production of osteo-fixational material, analysis of stress and strain of assembly of bones and implants. Problem description: While creating bone models based on data acquired from medical scanners, two distinct cases which prevent their proper forming can be isolated. Both cases are related to incomplete data of morphology and geometry of human bone, but with different reasons for data deficiency. In the first case, volumetric scanners are not available, or cannot be used for specific reasons, e.g.: patient must not be treated with high level radiation, faulty device, institution doesn’t possess adequate scanner, patients with metal implants, and such. In these cases, devices such as X-ray or, less often, ultrasound are used. The outcome of this process is one or eventually two 2D images (if the device is digital), or film (if analog X-ray apparatus is used). Complete 3D bone visualization can be difficultly accomplished on the basis of 2D data, so methods which enable creation of 3D geometrical bone models based on one or more 2D images are developed today. The second case refers to inability to create an image of complete bone. This case isn’t connected to acquisition of bone data from medical images (although it can be), but it is mostly conditioned by health state of the patient. Example of these cases include: multiple bone fractures, osteoporosis, other diverse acute and chronic diseases and such. Surgeons aren’t able to properly plan surgical procedures based on a partial image; consequently, certain surgical decisions have to be made during the very surgery. Goal of research: The main goal of the dissertation has been to form a method which would enable creation of complete geometrical bone model based on both complete and incomplete entrance data of patients’ bones (regardless the cause of data deficiency), and which would also 10 greatly contribute to the process of preparation, planning and performance of orthopedic surgeries. Research Subject: Research subject of the dissertation are methods of reverse engineering which can be applied to obtain 3D geometrical models of the human long bones directly from radiology images, whether the data is complete or incomplete. Research result: Method of Anatomical Feature – MAF is formed as the result of applied research whose application enables realization of the goal of research. MAF introduce a new approach to describe geometrical entities of human bones, based on anatomical landmarks/ guide lines. MAF enables creation of 3D geometrical models and parametric point bone models. The main goal of application of MAF is to create 3D geometrical models (of whole bones, as well as of the missing bone parts) of high geometrical accuracy and anatomical correctness, even in cases when the bone data is incomplete. Based on afore mentioned, we can conclude that MAF is a universal method to create different geometrical models of bones or bones’ parts, which means that an adequate model can be created depending on the current situation (need, case). Verification and application of research results: Various types of geometrical models (polygonal, surface, volumetric, parametric) of certain bones of human body have been created to verify MAF. All created geometrical models have satisfied necessary accuracy in geometrical and anatomical terms, which is defined in scientific literature. This paper provides examples of created geometrical models of femur and tibia bones; however, more geometrical models of other bones (fibula, humerus, mandible, etc.) have been created during this research. Nevertheless, MAF has been, both directly and indirectly (geometrical models of bones created with MAF have been used) applied for other purposes. These are characteristic cases which can appear in clinical practice, some of which are: case of creation of customized sternum implant, use of MAF to create parametric model of internal fixator by Mitkovic, application of Finite Element Method (FEM) to analyze stress and strain of femur bone and internal fixator by Mitkovic, use in application prototype for the simulation of orthopedic surgeries, etc. Conclusion: Based on everything stated above, conclusion follows that research results presented in this paper display a significant scientific contribution which greatly contributes to improvement of methods used in reverse engineering and geometrical modeling of long bones of skeletal-joint system in humans

The interlaminar strength of the glass fiber polyester composite

The paper outlines the method and the results of the experimental investigation of interlaminar strength of glass fibre reinforced polyester composites, with the aim of determining the influence that the structure, a reinforcement type and a sort of resin exert upon the interlaminar strength. The tested specimens were fabricated under different formation conditions, namely in eight composition patterns and with three sorts of resin used for polymerization

Prognostic significance of Gleason score 7 (3+4) and Gleason score 7 (4+3) in prostatic adenocarcinoma in relation to clinical stage, androgen tissue status and degree of neuroendocrine differentiation

Prognosis and choice of treatment of adenocarcinoma of the prostate (ADCP) directly depend on the numerous of predictive factors, among which the most important are summary histological tumor grade (Gleason score, which is the sum of the first and second dominant histological grade) and clinical stage. According to recent research these factors include androgen tissue status and degree of neuroendocrine differentiation. The importance of the first and second dominant histological grade becomes particularly important in ADCP Gleason score 7. Tumors with worse prognosis considered to be ADCP of higher Gleason score, the advanced clinical stage, androgen independent tumors and tumors that show a higher degree of neuroendocrine differentiation. The aim of the study was to determine the predictive significance of ADCP Gleason score 7 (3+4) and ADCP Gleason score 7 (4+3) in relation to clinical stage, androgen tissue status and degree of focal neuroendocrine differentiation. The study included 33 ADCP of Gleason score 7,26 (78.79%) ADCP 7 (3+4) and 7 (21.21%) ADCP 7 (4+3). All tumors are most often diagnosed with stage D2, when there are already distant metastases. ADCP of Gleason score 7 (4+3) were diagnosed more often at this stage, among them there are more androgen independent tumors and they show a greater degree of focal neuroendocrine differentiation. All the results are in accordance with data from the literature suggesting that ADCP of Gleason score 7 (4+3) have a worse prognosis than ADCP of Gleason score 7 (3 +4)

Geometrical Model Creation Methods for Human Humerus Bone and Modified Cloverleaf Plate

631-639In the field of orthopaedic surgery, for the treatment of bone fractures orthopaedic surgeons use external and internal fixation methods, or combination of these two techniques. Geometrical 3D models of internal fixation implants and human bones are being created by various computer based methods and technical features. These methods include application of computer visualisation techniques like Medical Imaging, Computer-Aided Design, Finite Element Analysis, etc. This paper introduces newly developed methods for the creation of surface model of human humerus and parametric model of the modified cloverleaf plate. The geometrical properties and shape of the parametric model can be customized to match the morphology of humerus bone of the specific patient, by the application of parameter values acquired from medical images (X-Ray or Computerized Tomography). Such implant models can improve pre, intra, and post operative procedures in ortophedic surgery

The descriptive and epidemiological characteristics of cervical cancer

Cervical cancer has long been a serious public health issue, both locally and worldwide. Efforts to control this disease should encompass prevention, as well as early detection and treatment, but also meticulous record-keeping and follow-up monitoring of affected women. In order to efficiently combat the disease, all of the above conditions must be met simultaneously. The goal of this article is to provide a layout of the fundamental descriptive and epidemiological characteristics of both cervical cancer patients and deaths resulting from the disease in Serbia, Europe and worldwide. We will pay special attention to a detailed epidemiological report on Central Serbia from 1999 to 2011. The article utilizes the approach of descriptive epidemiology to compound the knowledge about the disease, its incidence, and outcomes. The presented data was gathered from Globocan, a cancer surveillance database developed by the WHO, as well as the Cancer Registry of Central Serbia (for the aforementioned time period). There were 527624 new cases reported globally in 2012, corresponding to a standardized incidence ratio of 14,0 per 100000 women. Mortality-wise, there were 265653 deaths recorded in 2012, yielding a standardized mortality ratio of 6.8 per 100000 women. In other words, on average, every two minutes a woman dies of cervical cancer, totalling 720 cervical cancer mortalities per day. In Europe, there have been 58348 new cases in 2012 (11.44 per 100000 women), with 24378 deaths (3,75 per 100000 women). In Serbia, 1501 new cases were recorded in 2012 (23,8 per 100000 women), with 609 deaths (7,7 per 100000 women). These data make Serbia rank 62nd (out of 182 countries) in terms of incidence, and 84th in terms of mortality of cervical cancer, putting Serbia in the top half of the world on both criteria. According to the data supplied by the Cancer Registry of Central Serbia, the average standardized incidence ratio of 23.9/100000 women and the SMR of 7,2/100000 women in the evaluated time period point to an unfavorable epidemiological situation of this particular malignoma in Central Serbia. And while a deeper analysis of this interval reveals a slight drop in incidence of the disease in Central Serbia (y = 27,13-0,47x; p > 0,05, or roughly one new case fewer per 100000 women over the next two years), an increase in mortality is evident in the same period (y = 7.16+0,01x; p>0,05)