•3D face contours are compared between upright and supine postures using DI3D.•In supine, the soft tissue extruded inferior and lateral to the eyes (Δ=1.2–3.0mm).•In supine, the tissue volume around ...the nasolabial fold and mouth was less (Δ=−1.0 to −2.4mm).•Correction factors are provided to convert supine tissue thicknesses to the upright equivalents.
Soft tissues of the human face hang from the skull under the downward vector of gravity. Subsequently, the fall of the tissues is not likely the same between supine, prone or upright positions with ramifications for soft tissue measurements such as average soft tissue thicknesses used in craniofacial identification. Here we use high-resolution Dimensional Imaging® DI3D stereo-photographs (Glasgow, Scotland) to map the shape change between upright and supine position in the same 62 participants and encode the surface shell differences as greyscale pixel intensity values. Statistical tests were conducted using MANOVA at 31 capulometric landmarks, with posture as the independent factor in a repeated measures design, and sex, somatotype and age (two groups of <50 and>50 years) as independent factors in a between subjects design. Results indicate that facial morphology changed in characteristic fashion between the positions: when supine, the soft tissue extruded inferior and lateral to the eyes (Δmin=+1.2mm; Δmax=+3.0mm, p<0.05) and retracted lateral to the mouth and around the nasolabial fold (Δmin=−1.0mm; Δmax=−2.4mm, p<0.05). These patterns were more marked in older subjects (posture=p<0.01, η2=0.55; and age=p<0.01; η2=0.29). By calculating mean heat maps for the faces, this study clearly demonstrates that posture influences the cheeks/eyes as well as the nasolabial fold, thereby holding broader ramifications for face morphology than previously reported. Since many prior facial soft tissue thickness studies report data for supine subjects, correction factors are provided for converting supine facial soft tissue thickness data to upright estimates. Out-of-sample performance tests of posture-corrected supine means derived from two CT samples (using upright B-mode ultrasound data from living subjects as ground truths) confirmed the utility of the correction factors for landmarks that fall in zones affected most by the posture change (lower standard errors after correction). The standard error improvements were −0.9, −0.6, −0.5, and −1.4mm respectively for the mio-mio′, go-go′, zy-zy′ and mr-mr′ landmarks (reductions indicated by the negative sign).
We tested the hypothesis that the use of outward displacement of the soft tissue between the apex and the chest wall as seen in TTE, is a sign of apical displacement and would allow for more accurate ...diagnosis of apical dyskinesis. This is a retrospective study of 123 patients who underwent TTE and cardiac magnetic resonance imaging (MRI) within a time frame of 6 months between 2008 and 2019. 110 subjects were deemed to have good quality studies and included in the final analysis. An observer blinded to the study objectives evaluated the echocardiograms and recorded the presence or absence of apical dyskinesis. Two independent observers evaluated the echocardiograms based on the presence or absence of outward displacement of the overlying tissue at the LV apex. Cardiac MRI was used to validate the presence of apical dyskinesis. The proportion of studies which were identified as having apical dyskinesis with conventional criteria defined as outward movement of the left ventricular apex during systole were compared to those deemed to have dyskinesis based on tissue displacement. By cardiac MRI, 90 patients had apical dyskinesis. Using conventional criteria on TTE interpretation, 21 were diagnosed with apical dyskinesis (23.3%). However, when soft tissue displacement was used as the diagnostic marker of dyskinesis, 78 patients (86.7%) were diagnosed with dyskinesis, p < 0.01. Detection of displacement of soft tissue overlying the LV apex facilitates better recognition of LV apical dyskinesis.
Abstract Introduction During external fixator treatment, displacement of soft tissue at pin sites may cause infection and contracture. Due to surrounding soft tissue thickness, the femur is ...especially susceptible to severe complications. However, standard textbooks demonstrate only how major neurovascular bundles should be avoided. This study is the first cadaver study investigating which pin sites within safe zones exhibit minimal soft tissue displacement. Methods To identify the clear direction of any pin, the femoral shaft was divided into eight levels, from I to VIII. The transverse sections at each level were further divided into 12 radial positions analogous to a clock face, where the anterior direction was assigned twelve o’clock, the medial three, etc. Fifteen adult cadavers were used. Twelve wires were aligned radially on the examined ring, and were dyed at each point toward the soft tissue. Each soft tissue displacement was measured by marking the surface before and after three particular joint motions, namely hip flexion (0-90 degrees), abduction (0-45), and knee flexion (0-90). The same procedures were performed in three layers of soft tissue: skin, fascia, and muscle. Results The average displacement was determined in 89 directions excluding the groin part, upon three joint motions. The three layers of skin, fascia, and muscle showed similar data curves. Greater displacements were seen at juxta-articular areas than at the mid-diaphyseal. The data curve exhibited a bimodal characteristic, with larger displacements at the extension and flexion directions. The amount of displacement at 6 o’clock was large at the levels near the hip joint, whereas at 12 o’clock, it was large near the knee joint. Discussion “Reference positions” for transosseous elements were defined within zones absent neurovascular bundles, indicating 30 sites with minimal tissue displacement. Three or four directions at each level were chosen: I.9-11, II.9-11, III.8-11, IV.8-11, V.7-10, VI.3, 7-9, VII.3, 4, 8, 9, and VIII.3, 4, 8, 9. The anterolateral aspect near the hip joint and the posterolateral aspect near the knee tended to be chosen. They may prove useful in perioperative practice.
Objective. To evaluate significant differences in heel pad stiffness within a cohort of runners with diagnosed plantar heel pain and to explore the clinical importance of maximum heel pad stiffness ...values.
Design. A cross-sectional design was used to quantify the heel pad stiffness of 166 runners with 33 diagnosed with plantar heel pain.
Background. Palpation is still widely used to evaluate heel pad stiffness subjectively in everyday clinical practice. However, there is limited quantifiable data pertaining to heel pad stiffness measurements in runners and those with heel pain.
Methods. A portable hand-held device measured force applied by a metal probe, and its displacement into the plantar surface of the heel pad. Non-linear modelling allowed curve coefficients
b
0 and
b
1 to be evaluated and was described by an exponential function using a non-linear regression equation. Exploratory analysis was used to describe a single-point approximation for clinical use.
Results. An independent
t-test demonstrated a statistically significant difference between the curve coefficient
b
1 (
p<0.05). No significant difference was found for coefficient
b
0 between the plantar heel pain group and the non-plantar heel pain group (
p>0.05). Exploratory analysis demonstrated maximum mean stiffness of 3.22 N/mm for the non-plantar heel pain group and 2.87 N/mm for the plantar heel pain-group, an 11% mean difference.
Conclusion. The results suggested that heel pad stiffness may be associated with plantar heel pain subjects.
Relevance
Heel pad stiffness measurements may give a better insight into the mechanical properties of the heel pad in subjects with plantar heel pain.
