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© 2018 Elsevier B.V. Background and Objective: It can be challenging to delineate the target object in anatomical imaging when the object boundaries are difficult to discern due to the low contrast or overlapping intensity distributions from adjacent tissues. Methods: We propose a topo-graph model to address this issue. The first step is to extract a topographic representation that reflects multiple levels of topographic information in an input image. We then define two types of node connections - nesting branches (NBs) and geodesic edges (GEs). NBs connect nodes corresponding to initial topographic regions and GEs link the nodes at a detailed level. The weights for NBs are defined to measure the similarity of regional appearance, and weights for GEs are defined with geodesic and local constraints. NBs contribute to the separation of topographic regions and the GEs assist the delineation of uncertain boundaries. Final segmentation is achieved by calculating the relevance of the unlabeled nodes to the labels by the optimization of a graph-based energy function. We test our model on 47 low contrast CT studies of patients with non-small cell lung cancer (NSCLC), 10 contrast-enhanced CT liver cases and 50 breast and abdominal ultrasound images. The validation criteria are the Dice's similarity coefficient and the Hausdorff distance. Results: Student's t-test show that our model outperformed the graph models with pixel-only, pixel and regional, neighboring and radial connections (p-values

Introduction. The pathogenesis of Perthes disease is not fully understood and requires a greater understanding of the physical development, external and internal markers of connective tissue dysplasia. Objective. To analyze the deviations in physical development and connective tissue dysplasia in children with Perthes disease to determine its phenotypes. Materials and methods. We examined 52 patients and 36 children (control group) aged of 4–17 years. We estimated and compared their physical and proportional growth by using centile charts and Vervec’s index and defined external and internal manifestations of connective tissue dysplasia in major organs, systems, and topographic regions. Complete genealogical histories were taken by with examining the genealogies of 52 probands, including clinical examination of 136 first and second degree relatives. Results. Deviations in physical growth were observed in 33 patients (63.5%). The body height of 27 (51.9%) patients aged 4–17 years ranged from 1–2 lines (3–10%) and was significantly lower than that of the control group within 5 lines (p < 0.5). Six (11.6%) children had body lengths higher than the average 7th line (75–90%). Vervec’s index in 34 (65.4%) children ranged from 1.25–0.85 and represented mesomorphy, moderate brachy, or dolichomorphia. The primary pathology of external organs and systems was skeletal anomalies in 36 (69.2%) children, followed by dermal in 23 (44.2%) and organs of vision in 9 (17.3%). Among visceral disorders, the primary pathology was cardiovascular diseases in 17 (32,7%) children followed by surgical and urological pathologies in 7 (13.5%) and digestive system disorders in 5 (9.6%). Disease inheritance was sporadical in 48 (92.3%) children. Conclusion. The Perthes disease phenotype was related to the undifferentiated form of collagenopathies.

Climatic changes in the recent decades have led to large variations in precipitation over the different geographical regions of the globe. Changes in precipitation pattern over the space and time can severely affect the country like India, which has a large spatio-temporal variability in the precipitation. Any shift in the mean precipitation pattern pose a challenge to economy, agricultural farming and the ecosystem of these regions. In the present study, we analyze the seasonal spatio-temporal variation in trends of long term (1901–2013) observed high resolution (0.25° × 0.25°) gridded daily precipitation data of the Indian Meteorological Department over Western Ghats and coastal region of Karnataka, vulnerable to the risks of climate change. Our analysis shows increasing trend in seasonal ratio of precipitation over the Southern coastal plains and the adjacent Western Ghats region during pre-monsoon (MAM) while the southern coastal plains show decreasing trend in monsoon period (JJAS). Daily intensity index of precipitation during monsoon shows increasing trend in northern plains with decreasing trend in the medium precipitation events. Our study finds that different topographic regions of Karnataka have different responses in the trends of precipitation, particularly the response of plains is quite different to that of the higher elevated Ghat region.

Evaluation of synchronization between myoelectric signals can give new insights into the functioning of the complex system of porcine myometrium. We propose a model of uterine contractions according to the hypothesis of action potentials similarity which is possible to detect during propagation in the uterine wall. We introduce similarity measures based on the concept of synchronization as used in matching linear signals such as electromyographic (EMG) time series data. The aim was to present linear measures to assess synchronization between contractions in different topographic regions of the uterus. We use the cross-correlation function (ƒx,y[l], ƒy,z[l]) and the cross-coherence function (Cxy[ƒ], Cyz[ƒ]) to assess synchronization between three data series of a diestral uterine EMG bundles in porcine reproductive tract. Spontaneous uterine activity was recorded using telemetry method directly by three-channel transmitter and three silver bipolar needle electrodes sutured on different topographic regions of the reproductive tract in the sow. The results show the usefulness of the cross-coherence function in that synchronization between uterine horn and corpus uteri for multiple action potentials (bundles) could be observed. The EMG bundles synchronization may be used to investigate the direction and velocity of EMG signals propagation in porcine reproductive tract.

The posttraumatic hand deformity remains a difficult challenge for reconstructive surgeons. Much has been written about the relative benefits of fasciocutaneous, fascial, and muscle flap reconstruction; however, the literature is devoid of guidelines for secondary surgery after flap reconstruction to improve the appearance of the hand. We introduce the concept of visual subunits of the hand in an effort to better guide restoration of natural hand form; thenar, hypothenar, midpalm, distal palm, dorsal hand, volar forearm, and dorsal forearm subunits are proposed. The visual subunit principle has been implemented in reconstruction of posttraumatic hand deformities. Management initially focused on reestablishment of hand function and provision of soft tissue coverage via local and free tissue transfer. Secondary procedures involved partial flap elevation, targeted debulking, and redefining topographic regions where possible. By designing asymmetric skin excision patterns, the resultant length and width discrepancies can be used to purposefully enhance topographic features while re-creating the appearance of natural crease lines bordering adjacent subterritories. No complications related to partial or complete flap loss were encountered.

Objective In physiological research, there are not too many studies on multivariate data sets, containing two or more simultaneously recorded time series. It is important to examine synchronization in these kinds of signals. The aim of this study is to present the linear measures: the cross-correlation function, the coherence function, the wavelet cross-correlation and the wavelet coherence to assess synchronization between contractions in different topographic regions of the uterus. Study design Spontaneous uterine activity was recorded directly by a dual micro-tip catheter (Millar Instruments, Inc., USA). The device consisted of two ultra-miniature pressure sensors. One sensor was placed in the fundus, the other one in the cervix. For this analysis, a healthy patient with normal contractions, a patient with dysmenorrhea, a patient with fibromyomas in the follicular phase, and the patient with endometriosis were selected. Results For each method the values of synchronization parameters for normal contractions were higher than the values of these parameters for other pairs of signals. The differences between these four groups of the uterine contraction signals were clear. The lowest values of the synchronization measures were in the case of dysmenorrheic patient. Conclusion The analysis of synchronization of the uterine contractions signals may have a diagnostic value. For intrauterine pressure signals results obtained by means of different synchronization methods are different, but consistent.

The present review summarises the detailed recommendations for an optimal endoscopic-bioptic diagnostic procedure, endoscopic surveillance of and therapy for gastrointestinal diseases. The recommendations are mainly based on the S 3-guidelines and have been developed by histopathologists and gastroenterologists in interdisciplinary work. The material has been arranged according to topographic regions of the gastrointestinal tract and clinical problems. The focus is placed on diagnostic and surveillance of Barrett’s oesophagus, therapy and postoperative treatment for early gastrointestinal carcinoma, management of colon polyps and endoscopic surveillance of inflammatory bowel disease. Treatment recommendations for both ulcerative colitis and Crohn’s disease as well as low-grade and high-grade intraepithelial neoplasia and polypoid neoplasia are currently being intensively discussed. Thus we examine this controversial discussion in detail. Furthermore, the recent guidelines for Helicobacter pylori (H. pylori) and gastric MALT-lymphoma diagnostics are included in this survey. To allow the gastroenterologist a time-sparing overview during practical work, most of the recommendations are presented in itemised form and summarised in tables and figures at the end of the discussion.

In the face of the current debate on ‘cadaverless’ teaching of anatomy (Guttmann et al. 2004; McLachlan et al. 2004), the publication of the 13th edition of this classic ‘cook book’ of human dissection is a vindication of the irreplaceably tried and true method of gaining anatomical knowledge. With a new author assuming the mantle of this eponymous ‘Dissector’ with a 60-year publication record, the realities of the reduced curriculum time allocated for anatomical dissection are taken into account. The book is highly integrated with its complementary Grant's Atlas of Anatomy, 12th edition (although incorrectly indicating the 11th edition, page 4), and with three other popular anatomical atlases. The dissection instructions are organized into seven ‘stand alone’ topographic regions that allow for interchangeable approaches to the order of dissection. Each regional description follows a set pattern of surface anatomy, then osteology, with a preview of ‘before you dissect …’, followed by explicit instructions in a numbered sequence. A review, ‘after you dissect …’ emphasizes the significant facts and includes specific references (page and plate numbers) to four anatomical atlases. This theme is in keeping with the best tradition of reiteration and reinforcement as a pedagogical protocol that makes this text an admirable tutor. Colour-coded boxes distinguish the xanthochroic ‘Dissection Instructions’ from the cerulean ‘Clinical Correlations’, interspersed with clear, appropriately coloured drawings of the anatomical structures and the best approach to their dissection. The terminology used is in accordance with the Terminologia Anatomica, reducing potential confusion of nomenclature. The glossy paper on which this book is printed will serve to some extent to repel the ravages of dissection-room exposure. The spiralbound version will more likely survive the inevitable expansive opening for which the text is designed. In summary, a highly recommended tool for dissection.