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From axons to tracts
From axons to tracts Mohamed 21,100 Views • 3 years ago

The complex circuitry interconnecting different areas in the brain, known collectively as white matter, is composed of millions of axons organized into fascicles and bundles. Upon macroscopic examination of sections of the brain, it is difficult to discern the orientation of the fibers. The same is true for conventional imaging modalities. However, recent advancements in magnetic resonance imaging (MRI) make such task possible in a live subject. By sensitizing an otherwise typical MRI sequence to the diffusion of water molecules it is possible to measure their diffusion coefficient in a given direction1. Normally, the axonal membrane and myelin sheaths pose barriers to the movement of water molecules and, thus, they diffuse preferentially along the axon2. Therefore, the direction of white matter bundles can be elucidated by determining the principal diffusivity of water. The three-dimensional representation of the diffusion coefficient can be given by a tensor and its mathematical decomposition provides the direction of the tracts3; this MRI technique is known as diffusion tensor imaging (DTI). By connecting the information acquired with DTI, three-dimensional depictions of white matter fascicles are obtained4. The virtual dissection of white matter bundles is rapidly becoming a valuable tool in clinical research.

Our journey begins with a transverse section of tightly packed axons as seen through light microscopy. Although represented as a two-dimensional "slice", we see that these axons in fact resemble tubes. A simulation of water molecules diffusing randomly inside the axons demonstrates how the membranes and myelin hinder their movement across them and shows the preferred diffusion direction --along the axons. The tracts depicted through DTI slowly blend in and we ride along with them. As we zoom out even more, we realize that it is a portion of the corpus callosum connecting the two sides of the brain we were traveling on and the great difference in relative scale of the individual axons becomes evident. The surface of the brain is then shown, as well as the rest of the white matter bundles--a big, apparently chaotic tangle of wires. Finally, the skin covers the brain.

With the exception of the simulated water molecules, all the data presented in the animation is obtained through microscopy and MRI. Computer algorithms for the extraction of the cerebral structures and a custom-built graphics engine make our journey through the brain's anatomy possible in a living person.

Micrograph courtesy of Dr. Christian Beaulieu, University of Alberta.
Music by Mario Mattioli.

References:
1. Stejskal, E.O., et al., J. Chem. Phys., 1965. 42:
2. Beaulieu, C., NMR Biomed., 2002. 15:435-55.
3. Basser, P.J., et al., J. Magn. Reson. B, 1994. 103:247-54.
4. Mori, S., et al., NMR Biomed., 2002. 15:468-80.

Anchoring suture of esophagojejunostomy after total gastrectomy
Anchoring suture of esophagojejunostomy after total gastrectomy Mohamed 12,965 Views • 3 years ago

Next to esophagojejunostomy stapling for the reconstruction following total gastrectomy, several silk stitches anchoring the jejunum to endoabdominal fascia are made to restore the function of phrenoesophageal ligament.
anchoring suture reduces the impairment of the anastomotic blood flow that is caused by gravitational tension and so is useful to protect the esophagojejunostomy after total gastrectomy.

Nuclear Stress Test
Nuclear Stress Test M_Nabil 15,435 Views • 3 years ago

This animated video will run you through the process of nuclear stress test.

Spread of Prostate Cancer
Spread of Prostate Cancer Mohamed Ibrahim 13,756 Views • 3 years ago

Prostate Cancer spreads in 3 ways. First is spreads by local growth. Second it spreads through the lymphatic system, and lastly, it spreads through the blood stream. Dr. Patrick Swift, a radiation oncologist, discusses how prostate cancer spreads.

Two Hands Tie
Two Hands Tie DrPhil 12,243 Views • 3 years ago

Demonstration of a two-hand tie for wound closure

Homan sign for DVT
Homan sign for DVT Doctor 28,057 Views • 3 years ago

Homan's sign for deep vein thrombosis

Minimally Invasive Aortic Heart Valve Replacement
Minimally Invasive Aortic Heart Valve Replacement Emery King 27,791 Views • 3 years ago

This minimally invasive procedure for the replacement of a defective aortic valve has many advantages over traditional open heart surgery. ~ Detroit Medical Center

Wide exision of a Melanoma
Wide exision of a Melanoma Doctor 11,376 Views • 3 years ago

Wide exision of a Melanoma

Suturing a Wound
Suturing a Wound Mohamed Ibrahim 43,749 Views • 3 years ago

The proper way to suture a wound for best healing and cosmetic results

laparoscopic cornuotomy using a temporary tourniquet suture and diluted vasopressin injection in int
laparoscopic cornuotomy using a temporary tourniquet suture and diluted vasopressin injection in int Dae-Sook Eun 10,480 Views • 3 years ago

laparoscopic cornuotomy using a temporary tourniquet suture and diluted vasopressin injection in interstitial pregnancy video

Tracheostomy in the ICU
Tracheostomy in the ICU Surgeon 20,787 Views • 3 years ago

Tracheostomy in the ICU

Oral Medications Absorption
Oral Medications Absorption Surgeon 20,996 Views • 3 years ago

A video showing the process of Oral Medications Absorption

Hepatitis C Treatment
Hepatitis C Treatment Mohamed 9,510 Views • 3 years ago

Current treatment is a combination of pegylated interferon-alpha-2a or pegylated interferon-alpha-2b (brand names Pegasys or PEG-Intron) and the antiviral drug ribavirin for a period of 24 or 48 weeks, depending on hepatitis C virus genotype. In a large multicenter randomized control study among genotype 2 or 3 infected patients (NORDymanIC),[35] patients achieving HCV RNA below 1000 IU/mL by day 7 who were treated for 12 weeks demonstrated similar cure rates as those treated for 24 weeks.[36][37]

Pegylated interferon-alpha-2a plus ribavirin may increase sustained virological response among patients with chronic hepatitis C as compared to pegylated interferon-alpha-2b plus ribavirin according to a systematic review of randomized controlled trials .[38] The relative benefit increase was 14.6%. For patients at similar risk to those in this study (41.0% had sustained virological response when not treated with pegylated interferon alpha 2a plus ribavirin), this leads to an absolute benefit increase of 6%. About 16.7 patients must be treated for one to benefit (number needed to treat = 16.7; click here [39] to adjust these results for patients at higher or lower risk of sustained virological response). However, this study's results may be biased due to uncertain temporality of association, selective dose response.

Treatment is generally recommended for patients with proven hepatitis C virus infection and persistently abnormal liver function tests.

Treatment during the acute infection phase has much higher success rates (greater than 90%) with a shorter duration of treatment; however, this must be balanced against the 15-40% chance of spontaneous clearance without treatment (see Acute Hepatitis C section above).

Those with low initial viral loads respond much better to treatment than those with higher viral loads (greater than 400,000 IU/mL). Current combination therapy is usually supervised by physicians in the fields of gastroenterology, hepatology or infectious disease.

The treatment may be physically demanding, particularly for those with a prior history of drug or alcohol abuse. It can qualify for temporary disability in some cases. A substantial proportion of patients will experience a panoply of side effects ranging from a 'flu-like' syndrome (the most common, experienced for a few days after the weekly injection of interferon) to severe adverse events including anemia, cardiovascular events and psychiatric problems such as suicide or suicidal ideation. The latter are exacerbated by the general physiological stress experienced by the patient.

Have You Had Your Medical Tune Up?
Have You Had Your Medical Tune Up? News Canada 7,744 Views • 3 years ago

When it comes to our health men over the age of 45 are in need of regular doctor visits and testing, as a large percentage of medical decisions are based on the lab test results.

Examination of Neck Swelling
Examination of Neck Swelling Medical_Videos 9,606 Views • 3 years ago

Examination of Neck Swelling

Cerclage In Pregnancy Laparoscopic HD
Cerclage In Pregnancy Laparoscopic HD Scott 9,667 Views • 3 years ago

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Meningeococcal Bacterial Maningitis Introduction
Meningeococcal Bacterial Maningitis Introduction Scott 8,650 Views • 3 years ago

Meningeococcal Bacterial Maningitis Introduction

Lasic in 10 years old girl for Myopia
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Congestive Heart Failure 3D Animation
Congestive Heart Failure 3D Animation Scott 75,713 Views • 3 years ago

Congestive Heart Failure 3D Animation

Pacemaker Implantation 3D Animation
Pacemaker Implantation 3D Animation Scott 9,961 Views • 3 years ago

Pacemaker Implantation 3D Animation

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