Enhanced Reality Visualization in a Surgical Environment

Enhanced reality visualization is the process of enhancing an image by adding to it information which is not present in the original image. A wide variety of information can be added to an image ranging from hidden lines or surfaces to textual or iconic data about a particular part of the image. Enhanced reality visualization is particularly well suited to neurosurgery. By rendering brain structures which are not visible, at the correct location in an image of a patient's head, the surgeon is essentially provided with X-ray vision. He can visualize the spatial relationship between brain structures before he performs a craniotomy and during the surgery he can see what's under the next layer before he cuts through. Given a video image of the patient and a three dimensional model of the patient's brain the problem enhanced reality visualization faces is to render the model from the correct viewpoint and overlay it on the original image. The relationship between the coordinate frames of the patient, the patient's internal anatomy scans and the image plane of the camera observing the patient must be established. This problem is closely related to the camera calibration problem. This report presents a new approach to finding this relationship and develops a system for performing enhanced reality visualization in a surgical environment. Immediately prior to surgery a few circular fiducials are placed near the surgical site. An initial registration of video and internal data is performed using a laser scanner. Following this, our method is fully automatic, runs in nearly real-time, is accurate to within a pixel, allows both patient and camera motion, automatically corrects for changes to the internal camera parameters (focal length, focus, aperture, etc.) and requires only a single image.

Using page and section breaks, mirror margins and headers & footers in a thesis in MS Word 2011 (Mac) Manual

The University's thesis regulations give very specific guidance about margin's and page layout. This manual explains how to use set up margins to work with double sided printing; how to ensure chapters start on the right-hand page; and how to create running headers and footers in a thesis written in MS Word 2011.

Using page and section breaks, mirror margins and headers & footers in a thesis in MS Word 2010 (PC) Manual

The University's thesis regulations give very specific guidance about margin's and page layout. This manual explains how to use set up margins to work with double sided printing; how to ensure chapters start on the right-hand page; and how to create running headers and footers in a thesis written in MS Word 2010.

How do I set up my thesis so it meets the University's Page Setup regulations for paper size and margins?

This video shows how to ensure the document: • has mirror margins that alternate on left and right hand pages • is A4 in size • has margins that are in-line with the regulations • has its major sections starting on the right hand (odd numbered) page Although this video shows how to perform these tasks in Word 2010, they are virtually identical in Word 2013. In Word 2011 for Mac the steps are very similar and precise details can be found in the Word 2011 Sections manual.

Using page and section breaks, mirror margins and headers & footers in a thesis in MS Word 2013 (PC) Manual

The University's thesis regulations give very specific guidance about margin's and page layout. This manual explains how to use set up margins to work with double sided printing; how to ensure chapters start on the right-hand page; and how to create running headers and footers in a thesis written in MS Word 2013.

Experience in the Surgical Management of Abdominal Compartment Syndrome in the Hospital Occidente de Kennedy

The abdominal compartment syndrome (ACS) is the result of various physiological alterations produced by an abnormal increase of the intra-abdominal pressure. Some of these patients will undergo a surgical procedure for its management. Methods: This is a retrospective case series of 28 patients with ACS who required surgical treatment at the Hospital Occidente de Kennedy between 1999 and 2003. We assessed retrospectively the behavior of McNelis’s equation for prediction of the development of the ACS. Results: The leading cause of ACS in our study was intraabadominal infection (n=6 21,4%). Time elapsed between diagnosis and surgical decompression was less than 4 hours in 75% (n=21) of the cases. The variables that improved significantly after the surgical decompression were CVP (T: 4,0 p: 0,0001), PIM (T: 2,7; p: 0,004), PIA (T1,8; p:0,034) and Urine Output (T:-2,4; p:0,02). The values of BUN, Creatinine and the cardiovascular instability did not show improvement. The ICU and hospital length of stay were 11 days (SD: 9) and 18 days (SD13) respectively. Global mortality was 67,9% (n=19) and mortality directly attributable to the syndrome was 30% (n=8). The behavior of the McNelis’s equation was erratic. Conclusions: The demographic characteristics as well as disease processes associated with ACS are consistent with the literature. The association between physiological variables and ACS is heterogeneous between patients. Mortality rates attributable to ACS in our institution are within the range described world-wide. The behavior of the McNelis’s equation seems to depend greatly upon fluid balance.

Impacto da tomografia computorizada versus radiografia no prognóstico pós-cirúrgico do carcinoma espinocelular oral no cão

Objectivos: Neste estudo retrospectivo pretendeu-se determinar o impacto da tomografia computorizada na sobrevivência pós-cirúrgica do cão com carcinoma espinocelular na cavidade oral, comparativamente à radiografia. Enfatizando desta forma, a sua importância no diagnóstico, no planeamento cirúrgico e prognóstico. O segundo objectivo consistiu em determinar as características tomográficas dos carcinomas espinocelulares da cavidade oral em cães. Material e Métodos: Foram analisados 7 canídeos com diagnóstico de carcinoma espinocelular. Os critérios de inclusão foram: cães com carcinoma espinocelular diagnosticado por biópsia, exame imagiológico complementar (radiografia simples ou tomografia computorizada), elegibilidade para cirurgia, execução de tratamento cirúrgico e acompanhamento pós-cirúrgico durante 2 anos. Foi registada a idade, o sexo, a raça, a localização anatómica, o estadiamento T e N, as características radiográficas e tomográficas dos tumores, o tempo de recorrência e por fim o tempo de sobrevivência global descrito nos registos consultados. Procedeu-se também ao registo das variáveis das imagens radiográficas e tomográficas obtidas: definição das margens neoplásicas, presença ou ausência de reacção perióstea e de destruição de osso cortical adjacente, presença de deslocação dentária e de reabsorção dentária e densidade óssea local. Resultados: Nenhum dos meios imagiológicos permitiu uma visualização bem definida das margens neoplásicas. A nível da destruição de osso cortical adjacente, foi visível em 66,67% dos casos avaliados com radiografia e em todos os casos que foram avaliados com tomografia computorizada (100%). Foi visível reacção perióstea em 33,33% dos canídeos avaliados por radiografia e em nenhum dos avaliados por tomografia (0%). A densidade óssea local estava diminuída em todos os casos avaliados por radiografia simples ou por tomografia. A nível de reabsorção dentária estava presente em 33,33% dos avaliados por radiografia e em 25% dos avaliados por tomografia. Foi possível visualizar deslocação dentária em 66,67% dos avaliados por radiografia e em todos os avaliados por tomografia (100%). A nível de percentagem de casos com recorrência local, nenhum caso avaliado com radiografia recorreu e apenas 1 caso avaliado por tomografia recorreu em 289 dias. O tempo médio de sobrevivência foi superior no grupo dos avaliados com radiografia (1091,7 dias) relativamente ao grupo avaliado por tomografia (404 dias). Ao fim de 2 anos, 66,67% dos casos avaliados por radiografia estavam vivos e somente 25% dos casos avaliados com tomografia sobreviveram. Discussão/conclusão: Não foi possível determinar o impacto real dos dois meios de diagnóstico no prognóstico pós-cirúrgico do carcinoma espinocelular oral no cão, devido à reduzida amostra e aos tumores com pior prognóstico (por localização e estadiamento) terem sido remetidos para tomografia.

Common Problems in Surgical Patients

Presentation covering common acute conditions in surgical patients such as shortness of breath, chest pain and fever. Presentation offers diagnostic suggestions and procedures.