Olivier Palombi

Traumatic atlantoaxial rotatory dislocation with odontoid fracture: case report and review.

Study Design. A case of traumatic rotatory dislocation associated with odontoid fracture is reported. Objectives. To report a rare case of traumatic rotatory dislocation associated with odontoid fracture, and to discuss the mechanism underlying spinal instability and management. Summary of Background Data. This case is a cross between traumatic rotatory fixation and atlantoaxial rotatory dislocation. Classification of rotatory subluxation change after osteosynthesis of the odontoid process was undertaken. Methods. A 24-year-old man sustained head and cervical injury after jumping. A Type 2 odontoid fracture without displacement was noted. Results. Without further traumatic event, 1 month after injury, computed tomography scan showed posterior displacement of the odontoid fracture and Type 4 or B atlantoaxial rotatory luxation. After surgical fixation and reduction of the odontoid fracture, the rotatory subluxation classification changed and became Type 1 or A. Posterior C1–C2 arthrodesis was performed. The patient wore a Philadelphia cervical collar for 3 months and underwent physiotherapy. Conclusions. As the pivot of rotatory subluxation changed after odontoid process osteosynthesis, posterior C1–C2 arthrodesis was performed. The patient probably could have been treated in a single-stage procedure using posterior C1–C2 transarticular fixation with bicortical interspinous graft.

Anatomy transfer

Characters with precise internal anatomy are important in film and visual effects, as well as in medical applications. We propose the first semi-automatic method for creating anatomical structures, such as bones, muscles, viscera and fat tissues. This is done by transferring a reference anatomical model from an input template to an arbitrary target character, only defined by its boundary representation (skin). The fat distribution of the target character needs to be specified. We can either infer this information from MRI data, or allow the users to express their creative intent through a new editing tool. The rest of our method runs automatically: it first transfers the bones to the target character, while maintaining their structure as much as possible. The bone layer, along with the target skin eroded using the fat thickness information, are then used to define a volume where we map the internal anatomy of the source model using harmonic (Laplacian) deformation. This way, we are able to quickly generate anatomical models for a large range of target characters, while maintaining anatomical constraints.

Cervical venous organization in the transverse foramen

The most widely accepted description of venous anatomy in the transverse foramen involves the presence of one or two veins running along and parallel to the external side of the vertebral artery. For most surgeons, the vertebral artery is surrounded by a rete of veins which is continous with the wide sinusoids which surround the thecal sac (internal vertebral venous plexus). The goal of this study was to ascertain the exact structure of the venous system in the transverse canal by micro dissection and histology. Six spinal segments (C1 to C7) removed from cadavers embalmed using 5% diluted formalin or not and studied with or without injection of colored latex after bilateral catheterization of the internal jugular vein, vertebral vein, common carotid artery, and vertebral artery. An anatomical study was performed by optical microscopy. After fixation and decalcification, tissue specimens were stained using hematoxylin–eosin–safran (HES) and immunocytochemical markers including CD43, CD31, and desmine (specific for vascular endothelium). Findings showed that venous blood in the transverse canal flows through a space formed by the periosteum. There was no evidence of a vein inside the transverse canal. The periosteum spans the space between the transverse processes and gives off fibrous leaflets to the artery thus forming a compartmentalized space lined with vascular endothelium around the artery. The venous system in the transverse canal presents itself as a sinus similar to the intracranial sinus structure.

Intraoperative and postoperative gamma detection of somatostatin receptors in bone-invasive en plaque meningiomas.

OBJECTIVE: Scintigraphy with a radiolabeled somatostatin analog (111In-diethylenetriaminepenta-acetic acid octreotide) detects the somatostatin receptors that are found in vitro in all meningiomas. Previous studies have proved the benefit of radioimmunoguided surgery, with a hand-held gamma probe, for the assessment and removal of neuroendocrine tumors. We conducted a study to determine whether intraoperative radiodetection of somatostatin receptors is feasible and could increase the probability of complete meningioma resection, especially for bone-invasive en plaque meningiomas, which are difficult to control surgically. METHODS Eighteen patients with en plaque sphenoid wing and cranial convexity meningiomas were studied by preoperative and postoperative somatostatin receptor scintigraphy. In 10 of them, intraoperative radiodetection with a hand-held gamma probe was performed 24 hours after the intravenous administration of 111In-diethylenetriaminepenta-acetic acid octreotide. This procedure was combined with a computer-aided navigation system. RESULTS: All preoperative scintigrams were positive. Intraoperative gamma probe detection was achieved for the invaded bone, dura, and periorbit of sphenoid wing meningiomas. The average tumor/nontumor count ratio was 2:1, with a maximum of 12:1, thus allowing precise detection capable of defining the tumor margins. In three cases of sphenoid wing meningiomas, postoperative scintigrams were helpful for the determination of recurrences that magnetic resonance imaging failed to detect. CONCLUSION: These preliminary data show that intraoperative radiodetection of somatostatin receptors with a hand-held gamma probe is feasible and may be helpful to guide the surgical removal of bone-invasive en plaque meningiomas. Preoperative and postoperative scintigraphy may be useful for the management and follow-up of patients with these tumors.

Qualitative behavioral reasoning from components' interfaces to components' functions for DMU adaption to FE analyses

A digital mock-up (DMU), with its B-Rep model of product components, is a standard industrial representation that lacks geometric information about interfaces between components. Component shapes reflect common engineering practices that influence component interfaces with interferences and not only contacts. The proposed approach builds upon relationships between function, behavior, and shape to derive functional information from the geometry of component interfaces. Among these concepts, the concept of behavior is more difficult to set up and connect to the geometry of interfaces and functions. Indeed, states and design rules are introduced to express the behavior of components through a qualitative reasoning process. This reasoning process, in turn, takes advantage of domain knowledge rules and facts, checking the validity of certain hypotheses that must hold true all along a specific state of the products lifecycle, such as operational, stand-by or relaxed states. Eliminating configurations that contradict one or more of those hypotheses in their corresponding reference state reduces ambiguity, subsequently producing functional information in a bottom-up manner. This bottom-up process starts with the generation of a conventional interfaces graph (CIG) with components as nodes, and conventional interfaces (CIs) as arcs. A CI is initially defined by a geometric interaction that can be a contact or an interference between two components. CIs are then populated with functional interpretations (FIs) according to their geometric properties, producing potentially many combinations. A first step of the reasoning process, the validation against reference states, reduces the number of FIs per CI. Domain knowledge rules are then applied again to group semantics of component interfaces into one functional designation per component to connect together geometric entities of its boundary with its function.

The precerebellar linear nucleus in the mouse defined by connections, immunohistochemistry, and gene expression

The linear nucleus (Li) is a prominent cell group in the caudal hindbrain, which was first described in a study of cerebellar afferents in the rat by [Watson, C.R.R., Switzer, R.C. III, 1978. Trigeminal projections to cerebellar tactile areas in the rat origin mainly from N. interpolaris and N. principalis. Neurosci. Lett. 10, 77-82.]. It was named for its elongated appearance in transverse sections. Since this original description in the rat, reference to the nucleus seems to have been largely absent from experimental studies of mammalian precerebellar nuclei. We therefore set out to define the cytoarchitecture, cerebellar connections, and molecular characteristics of Li in the mouse. In coronal Nissl sections at the level of the rostral inferior olive, it consists of two parallel bands of cells joined at their dorsal apex by a further band of cells, making the shape of the Greek capital letter pi. Our three-dimensional reconstruction demonstrated that the nucleus is continuous with the lateral reticular nucleus (LRt) and that the ambiguus nucleus sits inside the arch of Li. Cerebellar horseradish peroxidase injections confirmed that the cells of Li project to cerebellum. We have shown that Li cells express Atoh1 and Wnt1 lineage markers that are known to label the rhombic lip derived precerebellar nuclei. We have examined the relationship of Li cells to a number of molecular markers, and have found that many of the cells express a nonphosphorylated epitope in neurofilament H (SMI 32), a feature they share with the LRt. The mouse Li therefore appears to be a rostrodorsal extension of the LRt.

My Corporis Fabrica: an ontology-based tool for reasoning and querying on complex anatomical models

BackgroundMultiple models of anatomy have been developed independently and for different purposes. In particular, 3D graphical models are specially useful for visualizing the different organs composing the human body, while ontologies such as FMA (Foundational Model of Anatomy) are symbolic models that provide a unified formal description of anatomy. Despite its comprehensive content concerning the anatomical structures, the lack of formal descriptions of anatomical functions in FMA limits its usage in many applications. In addition, the absence of connection between 3D models and anatomical ontologies makes it difficult and time-consuming to set up and access to the anatomical content of complex 3D objects.ResultsFirst, we provide a new ontology of anatomy called My Corporis Fabrica (MyCF), which conforms to FMA but extends it by making explicit how anatomical structures are composed, how they contribute to functions, and also how they can be related to 3D complex objects. Second, we have equipped MyCF with automatic reasoning capabilities that enable model checking and complex queries answering. We illustrate the added-value of such a declarative approach for interactive simulation and visualization as well as for teaching applications.ConclusionsThe novel vision of ontologies that we have developed in this paper enables a declarative assembly of different models to obtain composed models guaranteed to be anatomically valid while capturing the complexity of human anatomy. The main interest of this approach is its declarativity that makes possible for domain experts to enrich the knowledge base at any moment through simple editors without having to change the algorithmic machinery. This provides MyCF software environment a flexibility to process and add semantics on purpose for various applications that incorporate not only symbolic information but also 3D geometric models representing anatomical entities as well as other symbolic information like the anatomical functions.

Neuroanatomical affiliation visualization-interface system

A number of knowledge management systems have been developed to allow users to have access tolargequantity of neuroanatomical data. The advent of three-dimensional (3D) visualization techniques allows users to interact with complex 3D object. In order to better understand the structural and functional organization of the brain, we present Neuroanatomical Affiliations Visualization-Interface System (NAVIS) as the original software to see brain structures and neuroanatomical affiliations in 3D.This version of NAVIS has made use of the fifth edition of “The Rat Brain in Stereotaxic coordinates” (Paxinos and Watson, 2005). The NAVIS development, environment was based on the scripting language name Python, using visualization toolkit (VTK) as 3D-library and wxPython for the graphic user interface. The following manuscript is focused on the nucleus of the solitary tract (Sol) and the set of affiliated structures in the brain to illustrate the functionality of NAVIS. The nucleus of the Sol is the primary relay center of visceral and taste information, and consists of 14 distinct subnuclei that differ in cytoarchitecture, chemoarchitecture, connections, and function. In the present study, neuroanatomical projection data of the rat Sol were collected from selected literature in PubMed since 1975. Forty-nine identified projection data of Sol were inserted in NAVIS. The standard XML format used as an input for affiliation data allows NAVIS to update data online and/or allows users to manually change or update affiliation data. NAVIS can be extended to nuclei other than Sol.

My Corporis Fabrica Embryo: An ontology-based 3D spatio-temporal modeling of human embryo development

BackgroundEmbryology is a complex morphologic discipline involving a set of entangled mechanisms, sometime difficult to understand and to visualize. Recent computer based techniques ranging from geometrical to physically based modeling are used to assist the visualization and the simulation of virtual humans for numerous domains such as surgical simulation and learning. On the other side, the ontology-based approach applied to knowledge representation is more and more successfully adopted in the life-science domains to formalize biological entities and phenomena, thanks to a declarative approach for expressing and reasoning over symbolic information. 3D models and ontologies are two complementary ways to describe biological entities that remain largely separated. Indeed, while many ontologies providing a unified formalization of anatomy and embryology exist, they remain only descriptive and make the access to anatomical content of complex 3D embryology models and simulations difficult.ResultsIn this work, we present a novel ontology describing the development of the human embryology deforming 3D models. Beyond describing how organs and structures are composed, our ontology integrates a procedural description of their 3D representations, temporal deformation and relations with respect to their developments. We also created inferences rules to express complex connections between entities. It results in a unified description of both the knowledge of the organs deformation and their 3D representations enabling to visualize dynamically the embryo deformation during the Carnegie stages. Through a simplified ontology, containing representative entities which are linked to spatial position and temporal process information, we illustrate the added-value of such a declarative approach for interactive simulation and visualization of 3D embryos.ConclusionsCombining ontologies and 3D models enables a declarative description of different embryological models that capture the complexity of human developmental anatomy. Visualizing embryos with 3D geometric models and their animated deformations perhaps paves the way towards some kind of hypothesis-driven application. These can also be used to assist the learning process of this complex knowledge.Availabilityhttp://www.mycorporisfabrica.org/

Contribution of embryology in the understanding of cervical venous system anatomy within and around the transverse foramen: a review of the classical literature.

Abstract Anatomic arrangement of venous system within the transverse foramen is a controversial topic among authors. Precise knowledge of this arrangement is necessary in imaging where vertebral artery dissection is suspected, as well as in surgical approaches of cervical spine. This knowledge objective cannot be achieved without a prerequisite knowledge of primitive venous system. We present here an update on the development of the transverse foramen venous system through a literature review. Our review of the classical literature aimed at synthesis of available related embryological knowledge and relating this synthesis to cervical vertebrae anatomy. Our findings with regard to different primitive descriptions were consistent and often complementary across the studies. The description has varied from a single vertebral vein to a single vein divided at certain areas, or even to a confluence of venous plexus. In this manner, the embryonic knowledge for instance on venous system can help us to better understand the segmental development of vertebral veins and their plexus arrangement. Furthermore, the cranial–caudal embryology, in particular of the nervous system, conveys the initial plexiform arrangement of vertebral veins, which ends into a single venous trunk joining the subclavian vein.