Search results for: inferior alveolar neurovascular bundle
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 353

Search results for: inferior alveolar neurovascular bundle

233 Recurrent Anterior Gleno-Humeral Instability Management by Modified Latarjet Procedure

Authors: Tarek Aly

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The shoulder is the most mobile joint whose stability requires the interaction of both dynamic and static stabilizers. Its wide range of movement predisposes to a high susceptibility to dislocation, accounting for nearly 50% of all dislocations. This trauma typically results in ligament injury (e.g., labral tear, capsular strain) or bony fracture (e.g., loss of glenoid or humeral head bone), which frequently causes recurrent instability. Patients with significant glenoid defects may require Latarjet procedure, which involves transferring the coracoid to the antero-inferior glenoid rim. In spite of outstanding results, 15 to 30% of cases suffer complications. In this article, we discuss the diagnosis of recurrent shoulder instability, the surgical technique and various complications of Latarjet procedure.

Keywords: recurrent, anterior gleno-humeral instability, latarjet, unstable shoulder

Procedia PDF Downloads 37
232 Effects of Oxytocin on Neural Response to Facial Emotion Recognition in Schizophrenia

Authors: Avyarthana Dey, Naren P. Rao, Arpitha Jacob, Chaitra V. Hiremath, Shivarama Varambally, Ganesan Venkatasubramanian, Rose Dawn Bharath, Bangalore N. Gangadhar

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Objective: Impaired facial emotion recognition is widely reported in schizophrenia. Neuropeptide oxytocin is known to modulate brain regions involved in facial emotion recognition, namely amygdala, in healthy volunteers. However, its effect on facial emotion recognition deficits seen in schizophrenia is not well explored. In this study, we examined the effect of intranasal OXT on processing facial emotions and its neural correlates in patients with schizophrenia. Method: 12 male patients (age= 31.08±7.61 years, education= 14.50±2.20 years) participated in this single-blind, counterbalanced functional magnetic resonance imaging (fMRI) study. All participants underwent three fMRI scans; one at baseline, one each after single dose 24IU intranasal OXT and intranasal placebo. The order of administration of OXT and placebo were counterbalanced and subject was blind to the drug administered. Participants performed a facial emotion recognition task presented in a block design with six alternating blocks of faces and shapes. The faces depicted happy, angry or fearful emotions. The images were preprocessed and analyzed using SPM 12. First level contrasts comparing recognition of emotions and shapes were modelled at individual subject level. A group level analysis was performed using the contrasts generated at the first level to compare the effects of intranasal OXT and placebo. The results were thresholded at uncorrected p < 0.001 with a cluster size of 6 voxels. Neuropeptide oxytocin is known to modulate brain regions involved in facial emotion recognition, namely amygdala, in healthy volunteers. Results: Compared to placebo, intranasal OXT attenuated activity in inferior temporal, fusiform and parahippocampal gyri (BA 20), premotor cortex (BA 6), middle frontal gyrus (BA 10) and anterior cingulate gyrus (BA 24) and enhanced activity in the middle occipital gyrus (BA 18), inferior occipital gyrus (BA 19), and superior temporal gyrus (BA 22). There were no significant differences between the conditions on the accuracy scores of emotion recognition between baseline (77.3±18.38), oxytocin (82.63 ± 10.92) or Placebo (76.62 ± 22.67). Conclusion: Our results provide further evidence to the modulatory effect of oxytocin in patients with schizophrenia. Single dose oxytocin resulted in significant changes in activity of brain regions involved in emotion processing. Future studies need to examine the effectiveness of long-term treatment with OXT for emotion recognition deficits in patients with schizophrenia.

Keywords: recognition, functional connectivity, oxytocin, schizophrenia, social cognition

Procedia PDF Downloads 186
231 Connectomic Correlates of Cerebral Microhemorrhages in Mild Traumatic Brain Injury Victims with Neural and Cognitive Deficits

Authors: Kenneth A. Rostowsky, Alexander S. Maher, Nahian F. Chowdhury, Andrei Irimia

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The clinical significance of cerebral microbleeds (CMBs) due to mild traumatic brain injury (mTBI) remains unclear. Here we use magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) and connectomic analysis to investigate the statistical association between mTBI-related CMBs, post-TBI changes to the human connectome and neurological/cognitive deficits. This study was undertaken in agreement with US federal law (45 CFR 46) and was approved by the Institutional Review Board (IRB) of the University of Southern California (USC). Two groups, one consisting of 26 (13 females) mTBI victims and another comprising 26 (13 females) healthy control (HC) volunteers were recruited through IRB-approved procedures. The acute Glasgow Coma Scale (GCS) score was available for each mTBI victim (mean µ = 13.2; standard deviation σ = 0.4). Each HC volunteer was assigned a GCS of 15 to indicate the absence of head trauma at the time of enrollment in our study. Volunteers in the HC and mTBI groups were matched according to their sex and age (HC: µ = 67.2 years, σ = 5.62 years; mTBI: µ = 66.8 years, σ = 5.93 years). MRI [including T1- and T2-weighted volumes, gradient recalled echo (GRE)/susceptibility weighted imaging (SWI)] and gradient echo (GE) DWI volumes were acquired using the same MRI scanner type (Trio TIM, Siemens Corp.). Skull-stripping and eddy current correction were implemented. DWI volumes were processed in TrackVis (http://trackvis.org) and 3D Slicer (http://www.slicer.org). Tensors were fit to DWI data to perform DTI, and tractography streamlines were then reconstructed using deterministic tractography. A voxel classifier was used to identify image features as CMB candidates using Microbleed Anatomic Rating Scale (MARS) guidelines. For each peri-lesional DTI streamline bundle, the null hypothesis was formulated as the statement that there was no neurological or cognitive deficit associated with between-scan differences in the mean FA of DTI streamlines within each bundle. The statistical significance of each hypothesis test was calculated at the α = 0.05 level, subject to the family-wise error rate (FWER) correction for multiple comparisons. Results: In HC volunteers, the along-track analysis failed to identify statistically significant differences in the mean FA of DTI streamline bundles. In the mTBI group, significant differences in the mean FA of peri-lesional streamline bundles were found in 21 out of 26 volunteers. In those volunteers where significant differences had been found, these differences were associated with an average of ~47% of all identified CMBs (σ = 21%). In 12 out of the 21 volunteers exhibiting significant FA changes, cognitive functions (memory acquisition and retrieval, top-down control of attention, planning, judgment, cognitive aspects of decision-making) were found to have deteriorated over the six months following injury (r = -0.32, p < 0.001). Our preliminary results suggest that acute post-TBI CMBs may be associated with cognitive decline in some mTBI patients. Future research should attempt to identify mTBI patients at high risk for cognitive sequelae.

Keywords: traumatic brain injury, magnetic resonance imaging, diffusion tensor imaging, connectomics

Procedia PDF Downloads 147
230 Study of Ground Level Electric Field under 800 kV HVDC Unipolar Laboratory level Transmission line

Authors: K. Urukundu, K. A. Aravind, Pradeep M. Nirgude, K. Sandhya

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Transmission of bulk power over a long distance through HVDC transmission lines is gaining importance. This is because the transfer of bulk power through HVDC, from generating stations to load centers over long distances is more economical. However, these HVDC transmission lines create environmental and interference effects under the right of way of the line due to the ionization of the surrounding atmosphere in the vicinity of HVDC lines. The measurement of ground-level electric field and ionic current density is essential for the evaluation of human effects due to electromagnetic interference of the HVDC transmission line. In this paper, experimental laboratory results of the ground-level electric field under the miniature model of 800 kV monopole HVDC line of length 8 meters are presented in lateral configuration with different heights of the conductor from the ground plane. The results are compared with the simulated test results obtained through Finite Element based software.

Keywords: bundle, conductor, hexagonal, transmission line, ground-level electric field

Procedia PDF Downloads 167
229 Interaction between Mutual Fund Performance and Portfolio Turnover

Authors: Sheng-Ching Wu

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This paper examines the interaction between mutual fund performance and portfolio turnover. Active trading could affect fund performance, but underperforming funds could also be traded actively at the same time to perform well. Therefore, we used two-stage least squares to address with simultaneity. The results indicate that funds with higher portfolio turnovers exhibit inferior performance compared with funds having lower turnovers. Moreover, funds with poor performance exhibit higher portfolio turnover. The findings support the assumptions that active trading erodes performance, and that fund managers with poor performance attempt to trade actively to retain employment.

Keywords: mutual funds, portfolio turnover, simultaneity, two-stage least squares

Procedia PDF Downloads 409
228 Rigorous Photogrammetric Push-Broom Sensor Modeling for Lunar and Planetary Image Processing

Authors: Ahmed Elaksher, Islam Omar

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Accurate geometric relation algorithms are imperative in Earth and planetary satellite and aerial image processing, particularly for high-resolution images that are used for topographic mapping. Most of these satellites carry push-broom sensors. These sensors are optical scanners equipped with linear arrays of CCDs. These sensors have been deployed on most EOSs. In addition, the LROC is equipped with two push NACs that provide 0.5 meter-scale panchromatic images over a 5 km swath of the Moon. The HiRISE carried by the MRO and the HRSC carried by MEX are examples of push-broom sensor that produces images of the surface of Mars. Sensor models developed in photogrammetry relate image space coordinates in two or more images with the 3D coordinates of ground features. Rigorous sensor models use the actual interior orientation parameters and exterior orientation parameters of the camera, unlike approximate models. In this research, we generate a generic push-broom sensor model to process imageries acquired through linear array cameras and investigate its performance, advantages, and disadvantages in generating topographic models for the Earth, Mars, and the Moon. We also compare and contrast the utilization, effectiveness, and applicability of available photogrammetric techniques and softcopies with the developed model. We start by defining an image reference coordinate system to unify image coordinates from all three arrays. The transformation from an image coordinate system to a reference coordinate system involves a translation and three rotations. For any image point within the linear array, its image reference coordinates, the coordinates of the exposure center of the array in the ground coordinate system at the imaging epoch (t), and the corresponding ground point coordinates are related through the collinearity condition that states that all these three points must be on the same line. The rotation angles for each CCD array at the epoch t are defined and included in the transformation model. The exterior orientation parameters of an image line, i.e., coordinates of exposure station and rotation angles, are computed by a polynomial interpolation function in time (t). The parameter (t) is the time at a certain epoch from a certain orbit position. Depending on the types of observations, coordinates, and parameters may be treated as knowns or unknowns differently in various situations. The unknown coefficients are determined in a bundle adjustment. The orientation process starts by extracting the sensor position and, orientation and raw images from the PDS. The parameters of each image line are then estimated and imported into the push-broom sensor model. We also define tie points between image pairs to aid the bundle adjustment model, determine the refined camera parameters, and generate highly accurate topographic maps. The model was tested on different satellite images such as IKONOS, QuickBird, and WorldView-2, HiRISE. It was found that the accuracy of our model is comparable to those of commercial and open-source software, the computational efficiency of the developed model is high, the model could be used in different environments with various sensors, and the implementation process is much more cost-and effort-consuming.

Keywords: photogrammetry, push-broom sensors, IKONOS, HiRISE, collinearity condition

Procedia PDF Downloads 39
227 Analyzing the Heat Transfer Mechanism in a Tube Bundle Air-PCM Heat Exchanger: An Empirical Study

Authors: Maria De Los Angeles Ortega, Denis Bruneau, Patrick Sebastian, Jean-Pierre Nadeau, Alain Sommier, Saed Raji

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Phase change materials (PCM) present attractive features that made them a passive solution for thermal comfort assessment in buildings during summer time. They show a large storage capacity per volume unit in comparison with other structural materials like bricks or concrete. If their use is matched with the peak load periods, they can contribute to the reduction of the primary energy consumption related to cooling applications. Despite these promising characteristics, they present some drawbacks. Commercial PCMs, as paraffines, offer a low thermal conductivity affecting the overall performance of the system. In some cases, the material can be enhanced, adding other elements that improve the conductivity, but in general, a design of the unit that optimizes the thermal performance is sought. The material selection is the departing point during the designing stage, and it does not leave plenty of room for optimization. The PCM melting point depends highly on the atmospheric characteristics of the building location. The selection must relay within the maximum, and the minimum temperature reached during the day. The geometry of the PCM container and the geometrical distribution of these containers are designing parameters, as well. They significantly affect the heat transfer, and therefore its phenomena must be studied exhaustively. During its lifetime, an air-PCM unit in a building must cool down the place during daytime, while the melting of the PCM occurs. At night, the PCM must be regenerated to be ready for next uses. When the system is not in service, a minimal amount of thermal exchanges is desired. The aforementioned functions result in the presence of sensible and latent heat storage and release. Hence different types of mechanisms drive the heat transfer phenomena. An experimental test was designed to study the heat transfer phenomena occurring in a circular tube bundle air-PCM exchanger. An in-line arrangement was selected as the geometrical distribution of the containers. With the aim of visual identification, the containers material and a section of the test bench were transparent. Some instruments were placed on the bench for measuring temperature and velocity. The PCM properties were also available through differential scanning calorimeter (DSC) tests. An evolution of the temperature during both cycles, melting and solidification were obtained. The results showed some phenomena at a local level (tubes) and on an overall level (exchanger). Conduction and convection appeared as the main heat transfer mechanisms. From these results, two approaches to analyze the heat transfer were followed. The first approach described the phenomena in a single tube as a series of thermal resistances, where a pure conduction controlled heat transfer was assumed in the PCM. For the second approach, the temperature measurements were used to find some significant dimensionless numbers and parameters as Stefan, Fourier and Rayleigh numbers, and the melting fraction. These approaches allowed us to identify the heat transfer phenomena during both cycles. The presence of natural convection during melting might have been stated from the influence of the Rayleigh number on the correlations obtained.

Keywords: phase change materials, air-PCM exchangers, convection, conduction

Procedia PDF Downloads 151
226 Thermo-Mechanical Characterization of MWCNTs-Modified Epoxy Resin

Authors: M. Dehghan, R. Al-Mahaidi, I. Sbarski

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An industrial epoxy adhesive used in Carbon Fiber Reinforced Polymer (CFRP)-strengthening systems was modified by dispersing multi-walled carbon nanotubes (MWCNTs). Nanocomposites were fabricated using solvent-assisted dispersion method and ultrasonic mixing. Thermogravimetric analysis (TGA), dynamic mechanical analysis (DMA) and tensile tests were conducted to study the effect of nanotubes dispersion on the thermal and mechanical properties of the epoxy composite. Experimental results showed a substantial enhancement in the decomposition temperature and tensile properties of epoxy composite, while, the glass transition temperature (Tg) was slightly reduced due to the solvent effect. The morphology of the epoxy nanocomposites was investigated by SEM. It was proved that using solvent improves the nanotubes dispersion. However, at contents higher than 2 wt. %, nanotubes started to re-bundle in the epoxy matrix which negatively affected the final properties of epoxy composite.

Keywords: carbon fiber reinforced polymer, epoxy, multi-walled carbon nanotube, DMA, glass transition temperature

Procedia PDF Downloads 308
225 Congenital Positional Anomaly of Descending Colon and Sigmoid Colon: Its Embryological Basis and Clinical Implications

Authors: Dhivyalakshmi Gnanasekaran, Sonali Adole Prasante, Raveendranath Veeramamani, H. Y. Suma

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A rare case of intestinal malrotation with midline descending colon and right sided sigmoid colon was observed in an adult male cadaver aged around 55 years during routine dissection. The descending colon began from the splenic flexure and gradually descended downwards to occupy the midline position and turned to the right side to be continued as sigmoid colon at the level of the fifth lumbar vertebra. In the right iliac fossa some part of loop of sigmoid colon displaced into the right lumbar region before entering into the true pelvis to continue as rectum. This anomalous descending and sigmoid colon was supplied by varying branching pattern of inferior mesenteric artery. It is extremely important to consider this embryological anomaly before any interventional diagnostic procedures like colonoscopy and to enhance the safety of colonic surgery.

Keywords: sigmoid colon, descending colon, hindgut, malrotation

Procedia PDF Downloads 214
224 Analysis of Gait Characteristics Using Dynamic Foot Scanner in Type 2 Diabetes Mellitus

Authors: C. G. Shashi Kumar, G. Arun Maiya, H. Manjunath Hande, K. V. Rajagopal

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Background: Diabetes mellitus (DM) is a metabolic disorder with involvement of neurovascular and muscular system. Studies have documented that the gait parameter is altered in type 2 diabetes mellitus with peripheral neuropathy. However, there is a dearth of literature regarding the gait characteristics in type 2 diabetes mellitus (T2DM) without peripheral neuropathy. Therefore, the present study is focused on identifying gait changes in early type 2 diabetes mellitus without peripheral neuropathy. Objective: To analyze the gait characteristics in Type 2 diabetes mellitus without peripheral neuropathy. Methods: After obtaining ethical clearance from Institutional Ethical Committee (IEC), 36 T2DM without peripheral neuropathy and 32 matched healthy subjects were recruited. Gait characteristics (step duration, gait cycle length, gait cycle duration, stride duration, step length, double stance duration) of all the subjects were analyzed using Windtrack dynamic foot scanner. Data were analyzed using Independent‘t’ test to find the difference between the groups (step duration, gait cycle length, gait cycle duration) and Mann-Whitney test was used to analyze the step length and double stance duration to find difference between the groups. Level of significance was kept at P<0.05. Results: Result analysis showed significant decrease in step duration, gait cycle length, gait cycle duration, step length, double stance duration in T2DM subjects as compared to healthy subjects. We also observed a mean increase in stride duration in T2DM subjects compared to healthy subjects.

Keywords: type 2 diabetes mellitus, dynamic foot scan, gait characteristics, medical and health sciences

Procedia PDF Downloads 408
223 Verification of Low-Dose Diagnostic X-Ray as a Tool for Relating Vital Internal Organ Structures to External Body Armour Coverage

Authors: Natalie A. Sterk, Bernard van Vuuren, Petrie Marais, Bongani Mthombeni

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Injuries to the internal structures of the thorax and abdomen remain a leading cause of death among soldiers. Body armour is a standard issue piece of military equipment designed to protect the vital organs against ballistic and stab threats. When configured for maximum protection, the excessive weight and size of the armour may limit soldier mobility and increase physical fatigue and discomfort. Providing soldiers with more armour than necessary may, therefore, hinder their ability to react rapidly in life-threatening situations. The capability to determine the optimal trade-off between the amount of essential anatomical coverage and hindrance on soldier performance may significantly enhance the design of armour systems. The current study aimed to develop and pilot a methodology for relating internal anatomical structures with actual armour plate coverage in real-time using low-dose diagnostic X-ray scanning. Several pilot scanning sessions were held at Lodox Systems (Pty) Ltd head-office in South Africa. Testing involved using the Lodox eXero-dr to scan dummy trunk rigs at various degrees and heights of measurement; as well as human participants, wearing correctly fitted body armour while positioned in supine, prone shooting, seated and kneeling shooting postures. The verification of sizing and metrics obtained from the Lodox eXero-dr were then confirmed through a verification board with known dimensions. Results indicated that the low-dose diagnostic X-ray has the capability to clearly identify the vital internal structures of the aortic arch, heart, and lungs in relation to the position of the external armour plates. Further testing is still required in order to fully and accurately identify the inferior liver boundary, inferior vena cava, and spleen. The scans produced in the supine, prone, and seated postures provided superior image quality over the kneeling posture. The X-ray-source and-detector distance from the object must be standardised to control for possible magnification changes and for comparison purposes. To account for this, specific scanning heights and angles were identified to allow for parallel scanning of relevant areas. The low-dose diagnostic X-ray provides a non-invasive, safe, and rapid technique for relating vital internal structures with external structures. This capability can be used for the re-evaluation of anatomical coverage required for essential protection while optimising armour design and fit for soldier performance.

Keywords: body armour, low-dose diagnostic X-ray, scanning, vital organ coverage

Procedia PDF Downloads 96
222 Multisymplectic Geometry and Noether Symmetries for the Field Theories and the Relativistic Mechanics

Authors: H. Loumi-Fergane, A. Belaidi

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The problem of symmetries in field theory has been analyzed using geometric frameworks, such as the multisymplectic models by using in particular the multivector field formalism. In this paper, we expand the vector fields associated to infinitesimal symmetries which give rise to invariant quantities as Noether currents for classical field theories and relativistic mechanic using the multisymplectic geometry where the Poincaré-Cartan form has thus been greatly simplified using the Second Order Partial Differential Equation (SOPDE) for multi-vector fields verifying Euler equations. These symmetries have been classified naturally according to the construction of the fiber bundle used.  In this work, unlike other works using the analytical method, our geometric model has allowed us firstly to distinguish the angular moments of the gauge field obtained during different transformations while these moments are gathered in a single expression and are obtained during a rotation in the Minkowsky space. Secondly, no conditions are imposed on the Lagrangian of the mechanics with respect to its dependence in time and in qi, the currents obtained naturally from the transformations are respectively the energy and the momentum of the system.

Keywords: conservation laws, field theories, multisymplectic geometry, relativistic mechanics

Procedia PDF Downloads 180
221 Modeling the Effect of Scale Deposition on Heat Transfer in Desalination Multi-Effect Distillation Evaporators

Authors: K. Bourouni, M. Chacha, T. Jaber, A. Tchantchane

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In Multi-Effect Distillation (MED) desalination evaporators, the scale deposit outside the tubes presents a barrier to heat transfers reducing the global heat transfer coefficient and causing a decrease in water production; hence a loss of efficiency and an increase in operating and maintenance costs. Scale removal (by acid cleaning) is the main maintenance operation and constitutes the major reason for periodic plant shutdowns. A better understanding of scale deposition mechanisms will lead to an accurate determination of the variation of scale thickness around the tubes and an improved accuracy of the overall heat transfer coefficient calculation. In this paper, a coupled heat transfer-calcium carbonate scale deposition model on a horizontal tube bundle is presented. The developed tool is used to determine precisely the heat transfer area leading to a significant cost reduction for a given water production capacity. Simulations are carried to investigate the influence of different parameters such as water salinity, temperature, etc. on the heat transfer.

Keywords: multi-effect-evaporator, scale deposition, water desalination, heat transfer coefficient

Procedia PDF Downloads 119
220 Charge Transport in Biological Molecules

Authors: E. L. Albuquerque, U. L. Fulco, G. S. Ourique

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The focus of this work is on the numerical investigation of the charge transport properties of the de novo-designed alpha3 polypeptide, as well as in its variants, all of them probed by gene engineering. The theoretical framework makes use of a tight-binding model Hamiltonian, together with ab-initio calculations within quantum chemistry simulation. The alpha3 polypeptide is a 21-residue with three repeats of the seven-residue amino acid sequence Leu-Glu-Thr-Leu-Ala-Lys-Ala, forming an alpha–helical bundle structure. Its variants are obtained by Ala→Gln substitution at the e (5th) and g (7th) position, respectively, of the alpha3 polypeptide amino acid sequence. Using transmission electron microscopy and atomic force microscopy, it was observed that the alpha3 polypeptide and one of its variant do have the ability to form fibrous assemblies, while the other does not. Our main aim is to investigate whether or not the biased alpha3 polypeptide and its variants can be also identified by quantum charge transport measurements through current-voltage (IxV) curves as a pattern to characterize their fibrous assemblies. It was observed that each peptide has a characteristic current pattern, which may be distinguished by charge transport measurements, suggesting that it might be a useful tool for the development of biosensors.

Keywords: charge transport properties, electronic transmittance, current-voltage characteristics, biological sensor

Procedia PDF Downloads 647
219 Generalized Mathematical Description and Simulation of Grid-Tied Thyristor Converters

Authors: V. S. Klimash, Ye Min Thu

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Thyristor rectifiers, inverters grid-tied, and AC voltage regulators are widely used in industry, and on electrified transport, they have a lot in common both in the power circuit and in the control system. They have a common mathematical structure and switching processes. At the same time, the rectifier, but the inverter units and thyristor regulators of alternating voltage are considered separately both theoretically and practically. They are written about in different books as completely different devices. The aim of this work is to combine them into one class based on the unity of the equations describing electromagnetic processes, and then, to show this unity on the mathematical model and experimental setup. Based on research from mathematics to the product, a conclusion is made about the methodology for the rapid conduct of research and experimental design work, preparation for production and serial production of converters with a unified bundle. In recent years, there has been a transition from thyristor circuits and transistor in modular design. Showing the example of thyristor rectifiers and AC voltage regulators, we can conclude that there is a unity of mathematical structures and grid-tied thyristor converters.

Keywords: direct current, alternating current, rectifier, AC voltage regulator, generalized mathematical model

Procedia PDF Downloads 228
218 Biological Activity of Mesenchymal Stem Cells in the Surface of Implants

Authors: Saimir Heta, Ilma Robo, Dhimiter Papakozma, Eduart Kapaj, Vera Ostreni

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Introduction: The biocompatible materials applied to the implant surfaces are the target of recent literature studies. Methodologies: Modification of implant surfaces in different ways such as application of additional ions, surface microstructure change, surface or laser ultrasound alteration, or application of various substances such as recombinant proteins are among the most affected by articles published in the literature. The study is of review type with the main aim of finding the different ways that the mesenchymal cell reaction to these materials is, according to the literature, in the same percentage positive to the osteointegration process. Results: It is emphasized in the literature that implant success as a key evaluation key has more to implement implant treatment protocol ranging from dental health amenity and subsequent of the choice of implant type depending on the alveolar shape of the ridge level. Conclusions: Osteointegration is a procedure that should initially be physiologically independent of the type of implant pile material. With this physiological process, it can not "boast" for implant success or implantation depending on the brand of the selected implant, as the breadth of synthetic or natural materials that promote osteointegration is relatively large.

Keywords: mesenchymal cells, implants, review, biocompatible materials

Procedia PDF Downloads 63
217 Mathematical Modelling of Human Cardiovascular-Respiratory System Response to Exercise in Rwanda

Authors: Jean Marie Ntaganda, Froduald Minani, Wellars Banzi, Lydie Mpinganzima, Japhet Niyobuhungiro, Jean Bosco Gahutu, Vincent Dusabejambo, Immaculate Kambutse

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In this paper, we present a nonlinear dynamic model for the interactive mechanism of the cardiovascular and respiratory system. The model is designed and analyzed for human during physical exercises. In order to verify the adequacy of the designed model, data collected in Rwanda are used for validation. We have simulated the impact of heart rate and alveolar ventilation as controls of cardiovascular and respiratory system respectively to steady state response of the main cardiovascular hemodynamic quantities i.e., systemic arterial and venous blood pressures, arterial oxygen partial pressure and arterial carbon dioxide partial pressure, to the stabilised values of controls. We used data collected in Rwanda for both male and female during physical activities. We obtained a good agreement with physiological data in the literature. The model may represent an important tool to improve the understanding of exercise physiology.

Keywords: exercise, cardiovascular/respiratory, hemodynamic quantities, numerical simulation, physical activity, sportsmen in Rwanda, system

Procedia PDF Downloads 217
216 A Multiple Freezing/Thawing Cycles Influence Internal Structure and Mechanical Properties of Achilles Tendon

Authors: Martyna Ekiert, Natalia Grzechnik, Joanna Karbowniczek, Urszula Stachewicz, Andrzej Mlyniec

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Tendon grafting is a common procedure performed to treat tendon rupture. Before the surgical procedure, tissues intended for grafts (i.e., Achilles tendon) are stored in ultra-low temperatures for a long time and also may be subjected to unfavorable conditions, such as repetitive freezing (F) and thawing (T). Such storage protocols may highly influence the graft mechanical properties, decrease its functionality and thus increase the risk of complications during the transplant procedure. The literature reports on the influence of multiple F/T cycles on internal structure and mechanical properties of tendons stay inconclusive, confirming and denying the negative influence of multiple F/T at the same time. An inconsistent research methodology and lack of clear limit of F/T cycles, which disqualifies tissue for surgical graft purposes, encouraged us to investigate the issue of multiple F/T cycles by the mean of biomechanical tensile tests supported with Scanning Electron Microscope (SEM) imaging. The study was conducted on male bovine Achilles tendon-derived from the local abattoir. Fresh tendons were cleaned of excessive membranes and then sectioned to obtained fascicle bundles. Collected samples were randomly assigned to 6 groups subjected to 1, 2, 4, 6, 8 and 12 cycles of freezing-thawing (F/T), respectively. Each F/T cycle included deep freezing at -80°C temperature, followed by thawing at room temperature. After final thawing, thin slices of the side part of samples subjected to 1, 4, 8 and 12 F/T cycles were collected for SEM imaging. Then, the width and thickness of all samples were measured to calculate the cross-sectional area. Biomechanical tests were performed using the universal testing machine (model Instron 8872, INSTRON®, Norwood, Massachusetts, USA) using a load cell with a maximum capacity of 250 kN and standard atmospheric conditions. Both ends of each fascicle bundle were manually clamped in grasping clamps using abrasive paper and wet cellulose wadding swabs to prevent tissue slipping while clamping and testing. Samples were subjected to the testing procedure including pre-loading, pre-cycling, loading, holding and unloading steps to obtain stress-strain curves for representing tendon stretching and relaxation. The stiffness of AT fascicles bundle samples was evaluated in terms of modulus of elasticity (Young’s modulus), calculated from the slope of the linear region of stress-strain curves. SEM imaging was preceded by chemical sample preparation including 24hr fixation in 3% glutaraldehyde buffered with 0.1 M phosphate buffer, washing with 0.1 M phosphate buffer solution and dehydration in a graded ethanol solution. SEM images (Merlin Gemini II microscope, ZEISS®) were taken using 30 000x mag, which allowed measuring a diameter of collagen fibrils. The results confirm a decrease in fascicle bundles Young’s modulus as well as a decrease in the diameter of collagen fibrils. These results confirm the negative influence of multiple F/T cycles on the mechanical properties of tendon tissue.

Keywords: biomechanics, collagen, fascicle bundles, soft tissue

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215 Photoelastic Analysis of the Proximal Femur in Deviations of the Mechanical Axis of the Lower Limb

Authors: S. F. Fakhouri, M.M. Shimano, D. Maranho, C. A. Araújo, M. V. Guimarães, A. C. Shimano, J. B. Volpon

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Pathological deviations of the mechanical axis of the lower limbs deeply alter the stress distributions on the femur and tibia and the hip, knee, and ankle articulations. The purpose of this research was to assess the effects of pathological deviations in different levels of the lower limbs in the distribution of stress in the proximal femur region using photoelasticity of plane transmission. For most of the types of deviations studied, the results showed that the internal stress was generally higher in the calcar region than in the trochanteric region, followed by the third distal of the femur head. This study allowed for the development of better criteria for the correction of angular deviations and helped identify the deviations that are most harmful to the mechanical axis in terms of the effects on the bone and the articular effort of the lower limbs. These results will lead to future improvements in studies on prostheses.

Keywords: alignment, deviations, inferior limbs, mechanical axis, photoelasticity, stress

Procedia PDF Downloads 353
214 Energy Recovery from Swell with a Height Inferior to 1.5 m

Authors: A. Errasti, F. Doffagne, O. Foucrier, S. Kao, A. Meigne, H. Pellae, T. Rouland

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Renewable energy recovery is an important domain of research in past few years in view of protection of our ecosystem. Several industrial companies are setting up widespread recovery systems to exploit wave energy. Most of them have a large size, are implanted near the shores and exploit current flows. However, as oceans represent 70% of Earth surface, a huge space is still unexploited to produce energy. Present analysis focuses on surface small scale wave energy recovery. The principle is exactly the opposite of wheel damper for a car on a road. Instead of maintaining the car body as non-oscillatory as possible by adapted control, a system is designed so that its oscillation amplitude under wave action will be maximized with respect to a boat carrying it in view of differential potential energy recuperation. From parametric analysis of system equations, interesting domains have been selected and expected energy output has been evaluated.

Keywords: small scale wave, potential energy, optimized energy recovery, auto-adaptive system

Procedia PDF Downloads 228
213 Quantification of Global Cerebrovascular Reactivity in the Principal Feeding Arteries of the Human Brain

Authors: Ravinder Kaur

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Introduction Global cerebrovascular reactivity (CVR) mapping is a promising clinical assessment for stress-testing the brain using physiological challenges, such as CO₂, to elicit changes in perfusion. It enables real-time assessment of cerebrovascular integrity and health. Conventional imaging approaches solely use steady-state parameters, like cerebral blood flow (CBF), to evaluate the integrity of the resting parenchyma and can erroneously show a healthy brain at rest, despite the underlying pathogenesis in the presence of cerebrovascular disease. Conversely, coupling CO₂ inhalation with phase-contrast MRI neuroimaging interrogates the capacity of the vasculature to respond to changes under stress. It shows promise in providing prognostic value as a novel health marker to measure neurovascular function in disease and to detect early brain vasculature dysfunction. Objective This exploratory study was established to:(a) quantify the CBF response to CO₂ in hypocapnia and hypercapnia,(b) evaluate disparities in CVR between internal carotid (ICA) and vertebral artery (VA), and (c) assess sex-specific variation in CVR. Methodology Phase-contrast MRI was employed to measure the cerebrovascular reactivity to CO₂ (±10 mmHg). The respiratory interventions were presented using the prospectively end-tidal targeting RespirActTM Gen3 system. Post-processing and statistical analysis were conducted. Results In 9 young, healthy subjects, the CBF increased from hypocapnia to hypercapnia in all vessels (4.21±0.76 to 7.20±1.83 mL/sec in ICA, 1.36±0.55 to 2.33±1.31 mL/sec in VA, p < 0.05). The CVR was quantitatively higher in ICA than VA (slope of linear regression: 0.23 vs. 0.07 mL/sec/mmHg, p < 0.05). No statistically significant effect was observed in CVR between male and female (0.25 vs 0.20 mL/sec/mmHg in ICA, 0.09 vs 0.11 mL/sec/mmHg in VA, p > 0.05). Conclusions The principal finding in this investigation validated the modulation of CBF by CO₂. Moreover, it has indicated that regional heterogeneity in hemodynamic response exists in the brain. This study provides scope to standardize the quantification of CVR prior to its clinical translation.

Keywords: cerebrovascular disease, neuroimaging, phase contrast MRI, cerebrovascular reactivity, carbon dioxide

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212 Effect of Heat Treatment on the Corrosion Behavior of Stainless Steel

Authors: Altoumi Alndalusi

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The work examines the aqueous corrosion behavior of grades of stain less steel which are used as corrosion resistant castings for applications such as valve and pump bodies. The corrosion behavior of steels in the as-cast condition has been examined using potentiostatic studies to illustrate the need for correct thermal treatment. A metallurgical examination and chemical analysis were carried out to establish the morphology of the steel structure. Heat treatment was carried out in order to compare damage in relation to microstructure. Optical and scanning electron microscopy examinations confirmed that the austenitic steels suffers from severe localized inter-dendritic pitting attack, while non homogenized castings highly alloyed duplex steels gave inferior corrosion resistance. Through the heat treatment conditions a significant of phase transformation of the duplex steel C were occurred (from ferrite to austenite and sigma plus carbides) and were gave reduction resistance.

Keywords: cast, corrosion, duplex stainless, heat treatment, material, steel

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211 Pulmonary Hydatid Cyst in a 13-Year-Old Child: A Case Report

Authors: Ghada Esheba, Bayan Hafiz, Ashwaq Al-Qarni, Abdulelah AlMalki, Esraa Kaheel

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Hydatid disease is caused by genus Echinococcus, it is transmitted to human through sheep and cattle. People who lived in an endemic area should be suspected to have the disease. Pulmonary hydatid disease can be presented by respiratory manifestations as in our case. We report a case of child, 13 years old, who was presented by shortness of breath and non-productive cough 2 months ago. The patient had an attack of hemoptysis 3 months ago but there is no history of fever, other constitutional symptoms or any medical illness. The patient has had a close contact with a horse. On examination, the patient was oriented and vitally stable. Both side of chest were moving equally with decrease air entry on the left side of the chest. Cervical lymph node enlargement was also detected. The case was provisionally diagnosed as tuberculosis. The x-ray was normal, while CT scan showed two cysts in the left side. The patient was treated surgically with resection of both cysts without lobectomy. Broncho-alveolar lavage was done and together with plural effusion and both cysts were sent for histopathology. The patient received the following medication: albendazole 200MG/BID/Orally for 30 days and Cefuroxime 250MG/Q12H/Orally for 10 days.

Keywords: Echinococcus granulosus, hydatid disease, pediatrics, pulmonary hydatid cyst

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210 An Overall Evaluation of Food Nanotechnology

Authors: Raana Babadi Fathipour

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Nourishment nanotechnology is an range of rising intrigued and opens up a entirety universe of modern conceivable outcomes for the nourishment industry. The essential categories of nanotechnology applications and functionalities right now within the improvement of nourishment bundling incorporate: the enhancement of plastic materials obstructions, the consolidation of dynamic components that can convey utilitarian properties past those of customary dynamic bundling, and the detecting and signaling of significant data. Nano nourishment bundling materials may amplify nourishment life, move forward nourishment security, alarm buyers that nourishment is sullied or ruined, repair tears in bundling, and indeed release preservatives to expand the life of the nourishment within the bundle. Nanotechnology applications within the nourishment industry can be utilized to identify microbes in bundling, or produce stronger flavors and color quality, and security by expanding the obstruction properties. Nanotechnology holds extraordinary guarantee to supply benefits not fair inside nourishment items but too around nourishment items. In reality, nanotechnology presents modern chances for advancement within the nourishment industry at monstrous speed, but instability and wellbeing concerns are moreover developing. EU/WE/global enactment for the direction of nanotechnology in nourishment are scanty. Besides, current enactment shows up unacceptable to nanotechnology specificity.

Keywords: nano technology, nano foods, food packaging, nano participle

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209 Prevalence Of Periodontal Disease In Felines In The Outskirts Of The City Of Manaus, Brazil: An Epidemiological Study

Authors: Pármenas Costa Macedo do Nascimento

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Periodontal disease is the most common disease in the oral cavity of felines. It starts with the accumulation of bacteria on the tooth surface supporting the tissues of the periodontal tissue, namely gums, alveolar bone, cementum, and periodontal ligament. The main clinical symptom observed by the owner is bad breath, which may lead to local and systemic consequences depending on the stage of periodontal disease, such as bleeding and bone loss. Therefore, the study is important to educate tutors to take better care of the felines oral health in order to try to prevent the disease. For this epidemiological study, the target population has been felines, located on the outskirts of Manaus, in the state of Amazonas, with a geographic area of 155.68 km², with no defined breed, from October 1st to 10th, 2021, whose samples has been randomly selected, with a detailed profile. The variables of interest for this study have been: absence or presence of periodontal disease, gender, age (delimited by age group), and condition (domiciled or homeless). Using a sample of 40 felines from 4 districts of the east side of Manaus chosen at random, an oral exam has been made to identify the studied disease. The animal's apparent age, condition, sex, and presence or absence of periodontal disease has been noted. It has been observed that 70% (28/40) of them had periodontal disease, mostly females, aged between 0 and 5 years and domiciled, totaling 30% (12/40).

Keywords: felines, oral cavity, oral exam, periodontal disease

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208 Arthroscopic Fixation of Posterior Cruciate Ligament Avulsion Fracture through Posterior Trans Septal Portal Using Button Fixation Device: Mini Tight Rope

Authors: Ratnakar Rao, Subair Khan, Hari Haran

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Posterior cruciate ligament (PCL) avulsion fractures is a rare condition and commonly mismanaged.Surgical reattachment has been shown to produce better result compared with conservative management.Only few techniques are reported in arthroscopic fixation of PCL Avulsion Fracture and they are complex.We describe a new technique in fixation of the PCL Avulsion fracture through a posterior trans septal portal using button fixation device (Mini Tight Rope). Eighteen patients with an isolated posterior cruciate ligament avulsion fracture were operated under arthroscopy. Standard Antero Medial Portal and Antero Lateral portals made and additional Postero Medial and Postero Lateral portals made and trans Septal portal established. Avulsion fracture identified, elevated, prepared. Reduction achieved using PCL Tibial guide (Arthrex) and fixation was achieved using Mini Tight Rope,Arthrex (2 buttons with a suture). Reduction confirmed using probe and Image intensifier. Postoperative assessment made clinically and radiologically. 15 patients had good to excellent results with no posterior sag or instability. The range of motion was normal. No complications were recorded per operatively. 2 patients had communition of the fragment while drilling, for one patient it was managed by suturing technique and the second patient PCL Reconstruction was done. One patient had persistent instability with poor outcome. Establishing trans septal portal helps in better visualization of the posterior compartment of the knee. Assessment of the bony fragment, preparation 0f the bone bed andit protects from injury to posterior neurovascular structures. Fixation using the button with suture (Mini Tight Rope) is stable and easily reproducible for PCL Avulsion fracture with single large fragment.

Keywords: PCL avulsion, arthroscopy, transeptal, minitight rope technique

Procedia PDF Downloads 233
207 Urbanization Effects on the Food-Water-Energy Nexus within Ecosystem Services: A Case Study of the Beijing-Tianjin-Hebei Urban Agglomeration in China

Authors: Ke Yang, QiHan, Bauke de Veirs

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This study addresses the need for coordinated management of natural resources in urban agglomeration. Using ecosystem services theory, The study explore the relationship between land use in the Beijing-Tianjin-Hebei (B-T-H) region and the Food-Water-Energy (F-W-E) nexus from 2000 to 2030. We assess ecosystem services using the InVEST: Habitat Quality (HQ), Water Yield (WY), Carbon Sequestration (CS), Soil Retention (SDR), and Food Production (FP). The study find an annual expansion of construction land alongside a significant decline in cultivated land. Additionally, HQ, CS, and per capita FP decline annually until 2020 and are expected to persist through 2030. In contrast, WY and SDR grow annually but may decline by 2030. Spearman coefficient analysis reveals synergies between HQ and CS, SDR and CS, and SDR and HQ, with trade-offs between CS and WY and HQ and WY. Utilizing the K-means clustering analysis method, we introduce county-based spatial planning for the F-W-E system, offering valuable insights and recommendations for sustainable resource management.

Keywords: food-water-energy (F-W-E), ecosystem services, trade-offs and synergies, ecosystem service bundle, county-based

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206 A Randomized Active Controlled Clinical Trial to Assess Clinical Efficacy and Safety of Tapentadol Nasal Spray in Moderate to Severe Post-Surgical Pain

Authors: Kamal Tolani, Sandeep Kumar, Rohit Luthra, Ankit Dadhania, Krishnaprasad K., Ram Gupta, Deepa Joshi

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Background: Post-operative analgesia remains a clinical challenge, with central and peripheral sensitization playing a pivotal role in treatment-related complications and impaired quality of life. Centrally acting opioids offer poor risk benefit profile with increased intensity of gastrointestinal or central side effects and slow onset of clinical analgesia. The objective of this study was to assess the clinical feasibility of induction and maintenance therapy with Tapentadol Nasal Spray (NS) in moderate to severe acute post-operative pain. Methods: Phase III, randomized, active-controlled, non-inferiority clinical trial involving 294 cases who had undergone surgical procedures under general anesthesia or regional anesthesia. Post-surgery patients were randomized to receive either Tapentadol NS 45 mg or Tramadol 100mg IV as a bolus and subsequent 50 mg or 100 mg dose over 2-3 minutes. The frequency of administration of NS was at every 4-6 hours. At the end of 24 hrs, patients in the tramadol group who had a pain intensity score of ≥4 were switched to oral tramadol immediate release 100mg capsule until the pain intensity score reduced to <4. All patients who had achieved pain intensity ≤ 4 were shifted to a lower dose of either Tapentadol NS 22.5 mg or oral Tramadol immediate release 50mg capsule. The statistical analysis plan was envisaged as a non-inferiority trial involving comparison with Tramadol for Pain intensity difference at 60 minutes (PID60min), Sum of Pain intensity difference at 60 minutes (SPID60min), and Physician Global Assessment at 24 hrs (PGA24 hrs). Results: The per-protocol analyses involved 255 hospitalized cases undergoing surgical procedures. The median age of patients was 38.0 years. For the primary efficacy variables, Tapentadol NS was non-inferior to Inj/Oral Tramadol in relief of moderate to severe post-operative pain. On the basis of SPID60min, no clinically significant difference was observed between Tapentadol NS and Tramadol IV (1.73±2.24 vs. 1.64± 1.92, -0.09 [95% CI, -0.43, 0.60]). In the co-primary endpoint PGA24hrs, Tapentadol NS was non–inferior to Tramadol IV (2.12 ± 0.707 vs. 2.02 ±0.704, - 0.11[95% CI, -0.07, 0.28). However, on further assessment at 48hr, 72 hrs, and 120hrs, clinically superior pain relief was observed with the Tapentadol NS formulation that was statistically significant (p <0.05) at each of the time intervals. Secondary efficacy measures, including the onset of clinical analgesia and TOTPAR, showed non-inferiority to Tramadol. The safety profile and need for rescue medication were also similar in both the groups during the treatment period. The most common concomitant medications were anti-bacterial (98.3%). Conclusion: Tapentadol NS is a clinically feasible option for improved compliance as induction and maintenance therapy while offering a sustained and persistent patient response that is clinically meaningful in post-surgical settings.

Keywords: tapentadol nasal spray, acute pain, tramadol, post-operative pain

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205 Drug Reaction with Eosinophilia and Systemic Symptoms (Dress) Syndrome Presenting as Multi-Organ Failure

Authors: Keshari Shrestha, Philip Vatterott

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Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal drug-related syndrome. DRESS classically presents with a diffuse maculopapular rash, fevers, and eosinophilia more than three weeks after drug exposure. DRESS can present with multi-organ involvement, with liver damage being the most common and severe. Pulmonary involvement is a less common manifestation and is associated with poor clinical outcomes. Chest imaging is often nonspecific, and symptoms can range from mild cough to acute respiratory distress syndrome (ARDS) . This is a case of a 49-year-old female with a history of recent clostridium difficile colitis status post treatment with oral vancomycin who presented with rash, acute liver and kidney failure, as well as diffuse nodular alveolar lung opacities concerning for DRESS syndrome with multi-organ involvement. Clinical Course: This patient initially presented to an outside hospital with clostridium difficile colitis, acute liver injury, and acute kidney injury. She developed a desquamating maculopapular rash in the setting of recent oral vancomycin, meloxicam, and furosemide initiation. She was hospitalized on two additional occasions with worsening altered mental status, liver injury, and acute kidney injury and was initiated on intermittent hemodialysis. Notably, she was found to have systemic eosinophilia (4100 cells/microliter) several weeks prior. She was transferred to this institution for further management where she was found to have encephalopathy, jaundice, lower extremity edema, and diffuse bilateral rhonchorous breath sounds on pulmonary examination. The patient was started on methylprednisolone for suspected DRESS syndrome. She underwent an evaluation for alternative causes of her organ failure. Her workup included a negative infectious, autoimmune, metabolic, toxic, and malignant work-up. Abdominal computed tomography (CT) and ultrasound were remarkable for evidence of hepatic steatosis and possible cirrhotic morphology. Additionally, a chest CT demonstrated diffuse and symmetric nodular alveolar lung opacities with peripheral sparing not consistent with acute respiratory distress syndrome or edema. Ultimately, her condition continued to decline, and she required intubation on several occasions. On hospital day 25 she succumbed to distributive shock in the setting of probable sepsis and multi-organ failure. Discussion: DRESS syndrome occurs in 1 in 1,000 to 10,000 patients with a mortality rate of around 10%. Anti-convulsant, anti-bacterial, anti-viral, and sulfonamide drugs are the most common drugs implicated in the development of DRESS syndrome; however, the list of offending agents is extensive . The diagnosis of DRESS syndrome is made after excluding other causes of disease such as infectious and autoimmune etiologies. The RegiSCAR scoring system is used to diagnose DRESS syndrome with 2-3 points indicating possible disease, 4-5 probable disease, and >5 definite disease. This patient scored a 7 on the RegiSCAR scale for eosinophilia, rash, organ involvement, and exclusion of other causes (infectious and autoimmune). While the pharmacologic trigger in this case is unknown, it is speculated to be caused by vancomycin, meloxicam, or furosemide due to the favorable timeline of initiation. Despite aggressive treatment, DRESS syndrome can often be fatal. Because of this, early diagnosis and treatment of patients with suspected DRESS syndrome is imperative.

Keywords: drug reaction with eosinophilia and systemic symptoms, multi-organ failure, pulmonary involvement, renal failure

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204 An Anatomic Approach to the Lingual Artery in the Carotid Triangle in South Indian Population

Authors: Ashwin Rai, Rajalakshmi Rai, Rajanigandha Vadgoankar

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Lingual artery is the chief artery of the tongue and the neighboring structures pertaining to the oral cavity. At the carotid triangle, this artery arises from the external carotid artery opposite to the tip of greater cornua of hyoid bone, undergoes a tortuous course with its first part being crossed by the hypoglossal nerve and runs beneath the digastric muscle. Then it continues to supply the tongue as the deep lingual artery. The aim of this study is to draw surgeon's attention to the course of lingual artery in this area since it can be accidentally lesioned causing an extensive hemorrhage in certain surgical or dental procedures. The study was conducted on 44 formalin fixed head and neck specimens focusing on the anatomic relations of lingual artery. In this study, we found that the lingual artery is located inferior to the digastric muscle and the hypoglossal nerve contradictory to the classical description. This data would be useful during ligation of lingual artery to avoid injury to the hypoglossal nerve in surgeries related to the anterior triangle of neck.

Keywords: anterior triangle, digastric muscle, hypoglossal nerve, lingual artery

Procedia PDF Downloads 150