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  • articleNo Access

    BIPEDICLE FLAP RECONSTRUCTION FOR COMPLEX LONGITUDINAL DORSAL TISSUE DEFECTS OF THE DIGITS

    Hand Surgery01 Jan 2007

    Achieving coverage after digital injury is crucial, because simple skin defects can expose essential structures such as tendons or bones. This is particularly true on the dorsal surfaces of the digits, where the skin provides the only protection for the tendons. However, longitudinal skin defects of the digit have not been specifically identified in the literature and there have been few reports focusing on longitudinal dorsal skin defects. Here we report on the use of a bipedicle flap for reconstruction of complex longitudinal dorsal tissue defects of the digits, including those associated with tendon or bone damage.

  • articleNo Access

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    • articleNo Access

      MEASURES AND INDICES FOR INTRINSIC CHARACTERIZATION OF CARDIAC DYSFUNCTION DURING FILLING AND SYSTOLIC EJECTION

      The paper discusses the development and application of bioengineering indices for reliable diagnosis of cardiac functional modalities in filling and contraction phases.

      During diastolic filling, the left-ventricular (LV) volume developed is a response to left-atrium (LV) suction at early rapid filling and LA contraction at late filling. However, in LV ejection, the LV flow-rate and aortic pressure constitute response to LV myocardial stress and intra-LV pressure generation. The differential equations used in the governing of these relationships have been developed. By matching the solutions of these differential equations with the clinical data of LV volume and pressure, we can determine the heart model "differential equations" parameters, as well as the derived indices. These parameters and indices include: compliance and resistance-to-filling for characterizing diastolic-filling function, together with the index of LV contractility (in terms of maximum LV contractile power and stress-velocity relationship for contractile element). By evaluating them, it is possible to diagnose more reliably and differentially heart diseases due to an increase in filling-resistance and contractility abnormalities.

    • articleOpen Access

      Three-dimensional imaging of spatio-temporal dynamics of small blood capillary network in the cortex based on optical coherence tomography: A review

      Optical coherence tomography angiography (OCTA) has emerged as an advanced in vivo imaging modality, which is widely used for the clinic ophthalmology and neuroscience research in the rodent brain cortex among others. Based on the high numerical aperture (NA) probing lens and the motion-corrected algorithms, a high-resolution imaging technique called OCT micro-angiography is applied to resolve the small blood capillary vessels ranging from 5μm to 10μm in diameter. As OCT-based techniques are recently evolving further from the structural imaging of capillaries toward spatio-temporal dynamic imaging of blood flow in capillaries, here we present a review on the latest techniques for the dynamic flow imaging. Studies on capillary blood flow using these techniques will help us better understand the roles of capillary blood flow for normal functioning of the brain as well as how it malfunctions in diseases.

    • articleNo Access

      Complete Occlusion of Radial and Ulnar Arteries Following Hand Crush Injury with Multiple Carpometacarpal Joint Fracture-Dislocations

      Multiple dorsal fracture-dislocations of the carpometacarpal joints (CMCJ) occur from very high-energy trauma and are often associated with soft tissue injury or ischaemia. We report a 54-year-old male manual worker and a smoker who presented to the emergency room with history of compression of his right hand in a press machine. Radiographs showed dorsal fracture-dislocations of the scapho-trapezio-trapezoidal and third to fifth CMCJ’s. Despite emergent Guyon canal and carpal tunnel release and closed reduction and pinning, skin pallor persisted in all digits. Brachial angiography revealed total occlusion of the radial and ulnar arteries and loss of the palmar arch at the level of the fracture. Heparin and Alprostadil were injected directly. On follow-up angiography three weeks later, the vessels were still occluded and collaterals provided digital circulation. Although digital sensations recovered, cold intolerance and stiffness resulted in a poor functional outcome.

      Level of Evidence: Level V (Therapeutic)

    • chapterNo Access

      Chapter 15: Three-Dimensional Imaging of Spatio-Temporal Dynamics of Small Blood Capillary Network in the Cortex Based on Optical Coherence Tomography: A Review

      Optical coherence tomography angiography (OCTA) has emerged as an advanced invivo imaging modality, which is widely used for the clinic ophthalmology and neuroscience research in the rodent brain cortex among others. Based on the high numerical aperture (NA) probing lens and the motion-corrected algorithms, a high-resolution imaging technique called OCT micro-angiography is applied to resolve the small blood capillary vessels ranging from 5 μm to 10 μm in diameter. As OCT-based techniques are recently evolving further from the structural imaging of capillaries toward spatio-temporal dynamic imaging of blood flow in capillaries, here we present a review on the latest techniques for the dynamic flow imaging. Studies on capillary blood flow using these techniques will help us better understand the roles of capillary blood flow for normal functioning of the brain as well as how it malfunctions in diseases.

    • chapterNo Access

      Microangiography for Studying Neovascularization During Long Bone Fracture Repair in a Rat Model

      In order to understand the mechanisms of fracture healing, especially the neovascularization of the callus, we have established a closed femoral fracture model in rats. This chapter describes a microangiography technique that has been adopted to investigate temporal changes in the three-dimensional (3D) vasculature of the healing callus. Quantitative evaluation protocols for vessel size distribution, total vessel volume, and volume fraction have also been established for comparative studies.

    • chapterNo Access

      Chapter 10: Synchrotron Radiation Applications in Medicine

      Phase-contrast imaging (PCI) on synchrotron radiation (SR) light source has become a paradigm in X-ray biomedical imaging. In vitro and in vivo biomedical research has attracted high attention thanks to its capability of providing high diagnostic significant images in a wide range of organs or viscera, including the breast, joints, cartilage, lung, eyes, vasculature, brain and central nervous system. In this chapter, the basic principle, main phase-contrast imaging methods and their bio-medical applications are introduced. Various imaging methods are described and evaluated. The prospect and limitations of synchrotron-based medical imaging are briefly discussed as well.