Nonsubjective Assessment of Shape, Volume and Symmetry during Breast Augmentation with Handheld 3D Device

Three-dimensional Surface Imaging (3DSI) has become a valuable tool for planning and documenting surgical procedures. Although surface scanners have allowed for a better understanding of breast shape, size, and asymmetry during patient consultation, its use has not been included in intraoperative assessment so far. Validation of the reliability of the intraoperative use of a portable handheld 3DSI equipment as a tool to evaluate morphological changes during breast augmentation surgery. The patients who underwent bilateral subpectoral breast augmentation through an inframammary incision were included in this study. Intraoperative 3DSI was performed with the Artec Eva device, allowing for visualization of the surgical area before incision, after use of breast sizers and implant, and after wound closure. Intraoperatively manual measurements of breast distances and volume changes due to known sizer and implant volumes were in comparison with digital measurements calculated from 3DSI of the surgical area. Bilateral breasts of 40 patients were 3D photographed before incision and after suture successfully. A further 108 implant sizer uses were digitally documented. There was no significant difference between manual tape measurement and digital breast distance measurement. Pre- to postoperative 3D volume change showed no significant difference to the known sizer and implant volume

Reproducibility of Novel Soft-Tissue Landmarks on Three-Dimensional Human Facial Scan Images in Caucasian and Asian

BACKGROUND Three-dimensional surface imaging is established in many disciplines for objective facial acquisition regarding anthropometry. Former studies addressed the validation of landmark-based measurements for single race. In order to distinguish racial difference, the reproducibility of the landmark measurements must first be validated. OBJECTIVES Our purpose is to validate the reproducibility of 46 facial soft-tissue landmarks on x, y, z axes to prove their reliability as 3D reference points. METHODS The study included 80 European Caucasian and 80 Chinese volunteers. Standardized 3D surface imaging was performed using Vectra 3D system. Two raters identified and defined 46 landmarks (138 coordinates), then repeatedly 3D-imaged volunteers' facial region in separate sessions. Coordinates' reproducibility of landmarks is divided into three categories (1 mm) for intra- and inter-rater reproducibility assessments. RESULTS Coordinates' reproducibility of 160 samples was distributed as follows: Intra-rater: 1 mm (13%); inter-rater: 1 mm (26.8%). The reproducibility of landmarks in nasal tip region differs slightly between Caucasians and Asians. Compared to females, males typically have higher landmark reproducibility in lip and chin region. However, there were no differences in the reproducibility ranking of landmarks by gender. CONCLUSION The majority of the 46 landmarks in the 3D plane are reproducible to 1 mm, which is clinically acceptable. All selected landmarks showed strong consistency across race and gender, suggesting their potential use as reference points in prospective clinical practice. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

Investigating the Reliability of Novel Nasal Anthropometry Using Advanced Three-Dimensional Digital Stereophotogrammetry

Three-dimensional surface imaging systems (3DSI) provide an effective and applicable approach for the quantification of facial morphology. Several researchers have implemented 3D techniques for nasal anthropometry;however, they only included limited classic nasal facial landmarks and parameters. In our clinical routines, we have identified a considerable number of novel facial landmarks and nasal anthropometric parameters, which could be of great benefit to personalized rhinoplasty. Our aim is to verify their reliability, thus laying the foundation for the comprehensive application of 3DSI in personalized rhinoplasty. We determined 46 facial landmarks and 57 anthropometric parameters. A total of 110 volunteers were recruited, and the intra-assessor, inter-assessor, and intra-method reliability of nasal anthropometry were assessed through 3DSI. Our results displayed the high intra-assessor reliability of MAD (0.012-0.29, 0.003-0.758 mm), REM (0.008-1.958%), TEM (0-0.06), rTEM (0.001-0.155%), and ICC (0.77-0.995);inter-assessor reliability of 0.216-1.476, 0.003-2.013 mm;0.01-7.552%, 0-0.161, and 0.001-1.481%, 0.732-0.985, respectively;and intra-method reliability of 0.006-0.598 degrees, 0-0.379 mm;0 0.984%, 0-0.047, and 0-0.078%, 0.996-0.998, respectively. This study provides conclusive evidence for the high reliability of novel facial landmarks and anthropometric parameters for comprehensive nasal measurements using the 3DSI system. Considering this, the proposed landmarks and parameters could be widely used for digital planning and evaluation in personalized rhinoplasty, otorhinolaryngology, and oral and maxillofacial surgery

Towards autotrophic tissue engineering: Photosynthetic gene therapy for regeneration

Artículo científicoThe use of artificial tissues in regenerative medicine is limited due to hypoxia. As a strategy to overcome this drawback, we have shown that photosynthetic biomaterials can produce and provide oxygen independently of blood perfusion by generating chimeric animal-plant tissues during dermal regeneration. In this work, we demonstrate the safety and efficacy of photosynthetic biomaterials in vivo after engraftment in a fully immunocompetent mouse skin defect model. Further, we show that it is also possible to genetically engineer such photosynthetic scaffolds to deliver other key molecules in addition to oxygen. As a proof-of-concept, biomaterials were loaded with gene modified microalgae expressing the angiogenic recombinant protein VEGF. Survival of the algae, growth factor delivery and regenerative potential were evaluated in vitro and in vivo. This work proposes the use of photosynthetic gene therapy in regenerative medicine and provides scientific evidence for the use of engineered microalgae as an alternative to deliver recombinant molecules for gene therapy

Artificial Intelligence in Dermatology Image Analysis: Current Developments and Future Trends

Background: Thanks to the rapid development of computer-based systems and deep-learning-based algorithms, artificial intelligence (AI) has long been integrated into the healthcare field. AI is also particularly helpful in image recognition, surgical assistance and basic research. Due to the unique nature of dermatology, AI-aided dermatological diagnosis based on image recognition has become a modern focus and future trend. Key scientific concepts of review: The use of 3D imaging systems allows clinicians to screen and label skin pigmented lesions and distributed disorders, which can provide an objective assessment and image documentation of lesion sites. Dermatoscopes combined with intelligent software help the dermatologist to easily correlate each close-up image with the corresponding marked lesion in the 3D body map. In addition, AI in the field of prosthetics can assist in the rehabilitation of patients and help to restore limb function after amputation in patients with skin tumors. The aim of the study: For the benefit of patients, dermatologists have an obligation to explore the opportunities, risks and limitations of AI applications. This study focuses on the application of emerging AI in dermatology to aid clinical diagnosis and treatment, analyzes the current state of the field and summarizes its future trends and prospects so as to help dermatologists realize the impact of new technological innovations on traditional practices so that they can embrace and use AI-based medical approaches more quickly

Surgical sutures filled with adipose-derived stem cells promote wound healing

Delayed wound healing and scar formation are among the most frequent complications after surgical interventions. Although biodegradable surgical sutures present an excellent drug delivery opportunity, their primary function is tissue fixation. Mesenchymal stem cells (MSC) act as trophic mediators and are successful in activating biomaterials. Here biodegradable sutures were filled with adipose-derived mesenchymal stem cells (ASC) to provide a pro-regenerative environment at the injured site. Results showed that after filling, ASCs attach to the suture material, distribute equally throughout the filaments, and remain viable in the suture. Among a broad panel of cytokines, cell-filled sutures constantly release vascular endothelial growth factor to supernatants. Such conditioned media was evaluated in an in vitro wound healing assay and showed a significant decrease in the open wound area compared to controls. After suturing in an ex vivo wound model, cells remained in the suture and ma

Clinical perspective.

<p>To determine the effect of mechanical stress on cell survival during suturing the metabolic activity of cell-filled sutures was determined before and after suturing in an <i>ex vivo</i> model using human skin, where no significant difference were observed (A). The potential to produce storable cell-filled sutures was evaluated. Therefore, the metabolic activity of ASCs in the suture was determined after freezing relative to unfrozen sutures. After freezing, 78% of the metabolic activity was preserved (B). p<0.001.</p

Cytokine release from ASC-filled sutures.

<p>A cytokine array detected a multitude of different cytokines released from ASC-filled sutures (A). VEGF was constantly released to cell culture medium for at least 16 days (B). VEGF and SDF-1α were detected in protein extracts of ASC-filled sutures 16 days after seeding (C).</p

Cellular distribution and attachment in the suture.

<p>ASCs were filled into biodegradable sutures. Laser scanning microscopy (LSM, A) shows attached cells (DAPI, blue) along the suture surface interacting with each other (phalloidin, green) and the suture itself (DAPI, blue/phalloidin, green). The suture material is autofluorescent. As observed by scanning electron microscopy (SEM, B), cells were distributed throughout the surface (left) and the inner filaments (middle, right) of the suture. Scale bars represent 50 (A and B left), 500 (B, middle), and 100 μm (B, right).</p

Cell characterization.

<p>After isolation, cells adhered to tissue culture plastic showing a fibroblast-like morphology (A, DAPI (blue)/phalloidin (red) staining) and multipotency (B–D). Chondrogenic (B), adipogenic (C) and osteogenic (D) differentiation potential was confirmed by Alcian blue, Oil red O and von Kossa staining, respectively. Scale bars represent 100 μm in A, C, D and 1 mm in B.</p