Common left carotid bifurcation at C7–Th1 level: a rare anatomical variant

Abstract

The left common carotid artery usually bifurcates to the internal and external carotids at or near the superior border of thyroid cartilage. In head and neck surgery, the common carotid arteries are important landmarks, defining the plane of dissection during radical neck surgeries. According to the literature, many variations exist regarding the carotid bifurcation. Anatomical knowledge of these variants is important for surgical approaches in the head and neck regions, to avoid devastating complications that may occur, mainly during anterior neck dissections. We report an interesting case of a 75-year-old male patient with low bifurcation of the left common carotid artery, accidentally found during a routine carotid Doppler ultrasonography. Bifurcation was located at the C7–Th1 intervertebral disc height, approximately 4 cm from the aortic arch.

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Common left carotid bifurcation at C7–Th1 level: a rare anatomical variant

Abstract

The left common carotid artery usually bifurcates to the internal and external carotids at or near the superior border of thyroid cartilage. In head and neck surgery, the common carotid arteries are important landmarks, defining the plane of dissection during radical neck surgeries. According to the literature, many variations exist regarding the carotid bifurcation. Anatomical knowledge of these variants is important for surgical approaches in the head and neck regions, to avoid devastating complications that may occur, mainly during anterior neck dissections. We report an interesting case of a 75-year-old male patient with low bifurcation of the left common carotid artery, accidentally found during a routine carotid Doppler ultrasonography. Bifurcation was located at the C7–Th1 intervertebral disc height, approximately 4 cm from the aortic arch.

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Early aggressive intervention for infantile atopic dermatitis to prevent development of food allergy: a multicenter, investigator-blinded, randomized, parallel group controlled trial (PACI Study)—protocol for a randomized controlled trial

Atopic dermatitis is the first clinical manifestation of the atopic march, with the highest incidence in the first year of life. Those affected often go on to develop other allergic diseases including food all...

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Early aggressive intervention for infantile atopic dermatitis to prevent development of food allergy: a multicenter, investigator-blinded, randomized, parallel group controlled trial (PACI Study)—protocol for a randomized controlled trial

Atopic dermatitis is the first clinical manifestation of the atopic march, with the highest incidence in the first year of life. Those affected often go on to develop other allergic diseases including food all...

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Bone Regeneration of Canine Peri-implant Defects Using Cell Sheets of Adipose-Derived Mesenchymal Stem Cells and Platelet-Rich Fibrin Membranes

Insufficient bone volume compromises the success rate and osseointegration of immediate implantation. The objective of the present study was to engineer bone tissue by using adipose-derived stem cell (ASC) sheets and autologous platelet-rich fibrin (PRF) to enhance new bone formation and osseointegration around dental implants.

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Bone Regeneration of Canine Peri-implant Defects Using Cell Sheets of Adipose-Derived Mesenchymal Stem Cells and Platelet-Rich Fibrin Membranes

Insufficient bone volume compromises the success rate and osseointegration of immediate implantation. The objective of the present study was to engineer bone tissue by using adipose-derived stem cell (ASC) sheets and autologous platelet-rich fibrin (PRF) to enhance new bone formation and osseointegration around dental implants.

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Bone Regeneration of Canine Peri-implant Defects Using Cell Sheets of Adipose-Derived Mesenchymal Stem Cells and Platelet-Rich Fibrin Membranes

Insufficient bone volume compromises the success rate and osseointegration of immediate implantation. The objective of the present study was to engineer bone tissue by using adipose-derived stem cell (ASC) sheets and autologous platelet-rich fibrin (PRF) to enhance new bone formation and osseointegration around dental implants.

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Bone Regeneration of Canine Peri-implant Defects Using Cell Sheets of Adipose-Derived Mesenchymal Stem Cells and Platelet-Rich Fibrin Membranes

Insufficient bone volume compromises the success rate and osseointegration of immediate implantation. The objective of the present study was to engineer bone tissue by using adipose-derived stem cell (ASC) sheets and autologous platelet-rich fibrin (PRF) to enhance new bone formation and osseointegration around dental implants.

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Thanksgiving: The Difficult Choices Caregivers Must Make During the Holidays

Photo credit Natalia - y To my loyal readers, thank you. I am deeply grateful to you for your loyalty. Whether you've been drawn to my writing by recent events or you've been following me for years, you are valuable to me. This little piece is something that I often run on Thanksgiving because it seems to illustrate to many what holidays are often like for caregivers. Blessings on this day of thanks. Carol I've been thinking of our family's past Thanksgivings. For a number of years, the grandparents on both sides were relatively healthy, and we'd have them over for Thanksgiving. They could climb the steps – sometimes with help – but they managed. At the time, my boys were in grade school. We had "adopted" our neighbor, Joe. He was a widower in his eighties and was totally dea...

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Thanksgiving: The Difficult Choices Caregivers Must Make During the Holidays

Photo credit Natalia - y To my loyal readers, thank you. I am deeply grateful to you for your loyalty. Whether you've been drawn to my writing by recent events or you've been following me for years, you are valuable to me. This little piece is something that I often run on Thanksgiving because it seems to illustrate to many what holidays are often like for caregivers. Blessings on this day of thanks. Carol I've been thinking of our family's past Thanksgivings. For a number of years, the grandparents on both sides were relatively healthy, and we'd have them over for Thanksgiving. They could climb the steps – sometimes with help – but they managed. At the time, my boys were in grade school. We had "adopted" our neighbor, Joe. He was a widower in his eighties and was totally dea...

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Evaluation of language in children with pre-lingual hearing loss and cochlear implant

ConclusionThe longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language skills, but not in all the studied semantic categories.ResumoIntroduçãoO implante coclear é um tratamento eficaz para crianças com deficiência auditiva pré-lingual de grau severo e/ou profundo, uma vez que proporciona melhoria considerável na aquisição da linguagem oral por meio da via auditiva. O uso do implante coclear contribui para o desenvolvimento da percepção auditiva favorecendo a aquisição dos processos linguísticos voltados à aquisição de habilidades comunicativas que poderá repercutir positivamente em outras áreas do desenvolvimento.ObjetivoO ob...

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Thinking styles and self-determination among university students who are deaf or hard of hearing and hearing university students

This study explores how students' thinking styles are related to their self-determination. The Thinking Styles Inventory-Revised II and the American Institutes for Research (AIR) Self-Determination Scale were administered to 913 university students (480 who were deaf or hard-of-hearing and 433 hearing) in mainland China. Results showed that, among all participants, those with Type I styles (i.e., more creativity-generating, less structured, and cognitively more complex) had higher levels of self-determination, while those with Type II styles (i.e., more norm-favoring, more structured, and cognitively more simplistic) had lower levels of self-determination. The contributions, limitations, and implications of this study are discussed. (Source: Research in Developmental Disabilities)

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Commentary to accompany the paper: The Quality of Systematic Reviews Addressing Peripheral Nerve Repair and Reconstruction

The authors are to be commended for highlighting the need for further high quality evidence to assist surgical decision making in the management of nerve injuries and for encouraging critical appraisal of available studies. Whilst it cannot be the responsibility of the individual surgeon to undertake randomised control trials (RCTs) and systematically review (SR) all available literature it is our duty of care to ensure our knowledge is best updated and our privilege to safely action innovations in our field.

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Evaluation of language in children with pre-lingual hearing loss and cochlear implant

ConclusionThe longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language skills, but not in all the studied semantic categories.ResumoIntroduçãoO implante coclear é um tratamento eficaz para crianças com deficiência auditiva pré-lingual de grau severo e/ou profundo, uma vez que proporciona melhoria considerável na aquisição da linguagem oral por meio da via auditiva. O uso do implante coclear contribui para o desenvolvimento da percepção auditiva favorecendo a aquisição dos processos linguísticos voltados à aquisição de habilidades comunicativas que poderá repercutir positivamente em outras áreas do desenvolvimento.ObjetivoO ob...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2KvuPJC

Thinking styles and self-determination among university students who are deaf or hard of hearing and hearing university students

This study explores how students' thinking styles are related to their self-determination. The Thinking Styles Inventory-Revised II and the American Institutes for Research (AIR) Self-Determination Scale were administered to 913 university students (480 who were deaf or hard-of-hearing and 433 hearing) in mainland China. Results showed that, among all participants, those with Type I styles (i.e., more creativity-generating, less structured, and cognitively more complex) had higher levels of self-determination, while those with Type II styles (i.e., more norm-favoring, more structured, and cognitively more simplistic) had lower levels of self-determination. The contributions, limitations, and implications of this study are discussed. (Source: Research in Developmental Disabilities)

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Commentary to accompany the paper: The Quality of Systematic Reviews Addressing Peripheral Nerve Repair and Reconstruction

The authors are to be commended for highlighting the need for further high quality evidence to assist surgical decision making in the management of nerve injuries and for encouraging critical appraisal of available studies. Whilst it cannot be the responsibility of the individual surgeon to undertake randomised control trials (RCTs) and systematically review (SR) all available literature it is our duty of care to ensure our knowledge is best updated and our privilege to safely action innovations in our field.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Ra9f02

The Microbiome in Atopic Dermatitis

As an interface with the environment, the skin is a complex ecosystem, colonized by many microorganisms that coexist in an established balance. The cutaneous microbiome inhibits colonization with pathogens such as S. aureus and is a crucial component for function of the epidermal barrier. Moreover, crosstalk between commensals and the immune system is now recognized, as microorganisms can modulate innate, as well as adaptive, immune responses. Host-commensal interactions also have an impact on the developing immune system in infants and subsequently the occurrence of diseases such as asthma and atopic dermatitis.

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The Microbiome in Atopic Dermatitis

As an interface with the environment, the skin is a complex ecosystem, colonized by many microorganisms that coexist in an established balance. The cutaneous microbiome inhibits colonization with pathogens such as S. aureus and is a crucial component for function of the epidermal barrier. Moreover, crosstalk between commensals and the immune system is now recognized, as microorganisms can modulate innate, as well as adaptive, immune responses. Host-commensal interactions also have an impact on the developing immune system in infants and subsequently the occurrence of diseases such as asthma and atopic dermatitis.

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Temporal window of integration estimated by omission in bone-conducted ultrasound

Publication date: Available online 23 November 2018Source: Neuroscience LettersAuthor(s): Tadao Okayasu, Tadashi Nishimura, Yuka Uratani, Akinori Yamashita, Seiji Nakagawa, Toshiaki Yamanaka, Hiroshi Hosoi, Tadashi KitaharaAbstractBone-conducted ultrasound (BCU) can be heard for both normal-hearing and some profoundly deaf individuals. Moreover, amplitude-modulated BCU can transmit the speech signal. These characteristics of BCU provide the possibility of the developing a bone-conducted ultrasonic hearing aid. Previous studies on the perception mechanism of speech-modulated BCU have pointed to the importance of temporal rather than frequency information. In order to elucidate the perception of speech-modulated BCU, further investigation is need concerning the processing of temporal informa...

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Temporal window of integration estimated by omission in bone-conducted ultrasound

Publication date: Available online 23 November 2018Source: Neuroscience LettersAuthor(s): Tadao Okayasu, Tadashi Nishimura, Yuka Uratani, Akinori Yamashita, Seiji Nakagawa, Toshiaki Yamanaka, Hiroshi Hosoi, Tadashi KitaharaAbstractBone-conducted ultrasound (BCU) can be heard for both normal-hearing and some profoundly deaf individuals. Moreover, amplitude-modulated BCU can transmit the speech signal. These characteristics of BCU provide the possibility of the developing a bone-conducted ultrasonic hearing aid. Previous studies on the perception mechanism of speech-modulated BCU have pointed to the importance of temporal rather than frequency information. In order to elucidate the perception of speech-modulated BCU, further investigation is need concerning the processing of temporal informa...

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Three-dimensional growth of tibial shaft ossification in the human fetus: a digital-image and statistical analysis

Abstract

Purposes

Tibial shaft ossification in terms of its size and growth may be criticalin describing both the fetal stage and maturity, and in identifying innate disorders. The present study was executed to quantitatively assess ossification of the tibial shaft, taking its morphometric linear, planar and volumetric parameters into account.

Materials and methods

With the use of methods of CT, digital-image analysis and statistics, the evolutionof tibial shaft ossification in 47 spontaneously aborted human fetuses at the age of 17–30 weeks was studied.

Results

Without any male–female and right-left morphometric differences, the best fit growth dynamics fortibial shaft ossification was modelled by the following functions: y = 5.312 + 0.034 × (age)² ± 0.001 (R² = 0.89) for its length, y = − 2.855 + 0.307 × age ± 0.009 (R² = 0.96) for its proximal transverse diameter, y = − 0.758 + 0.153 × age ± 0.005 (R² = 0.88) for its middle transverse diameter, y = − 1.844 + 0.272 × age ± 0.09 (R² = 0.90) for its distal transverse diameter, y = − 40.263 + 0.258 × (age)² ± 0.007 (R² = 0.94) for its projection surface area, and y = − 287.996 + 1.186 × (age)² ± 0.037 (R² = 0.92) for its volume. The femoral–to–tibial ossification length ratio was 1.15 ± 0.1.

Conclusions

The size of tibial shaft ossification displays neither sex nor laterality differences. Tibial shaft ossification follows quadratic functions with respect to its length, projection surface area and volume, and linear functions with respect to its proximal, middle and distal transverse diameters. The obtained morphometric data of tibial shaft ossification are considered normative age-specific references of relevance in both the estimation of fetal ages and the ultrasound diagnostics of congenital defects.

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Three-dimensional growth of tibial shaft ossification in the human fetus: a digital-image and statistical analysis

Abstract

Purposes

Tibial shaft ossification in terms of its size and growth may be criticalin describing both the fetal stage and maturity, and in identifying innate disorders. The present study was executed to quantitatively assess ossification of the tibial shaft, taking its morphometric linear, planar and volumetric parameters into account.

Materials and methods

With the use of methods of CT, digital-image analysis and statistics, the evolutionof tibial shaft ossification in 47 spontaneously aborted human fetuses at the age of 17–30 weeks was studied.

Results

Without any male–female and right-left morphometric differences, the best fit growth dynamics fortibial shaft ossification was modelled by the following functions: y = 5.312 + 0.034 × (age)² ± 0.001 (R² = 0.89) for its length, y = − 2.855 + 0.307 × age ± 0.009 (R² = 0.96) for its proximal transverse diameter, y = − 0.758 + 0.153 × age ± 0.005 (R² = 0.88) for its middle transverse diameter, y = − 1.844 + 0.272 × age ± 0.09 (R² = 0.90) for its distal transverse diameter, y = − 40.263 + 0.258 × (age)² ± 0.007 (R² = 0.94) for its projection surface area, and y = − 287.996 + 1.186 × (age)² ± 0.037 (R² = 0.92) for its volume. The femoral–to–tibial ossification length ratio was 1.15 ± 0.1.

Conclusions

The size of tibial shaft ossification displays neither sex nor laterality differences. Tibial shaft ossification follows quadratic functions with respect to its length, projection surface area and volume, and linear functions with respect to its proximal, middle and distal transverse diameters. The obtained morphometric data of tibial shaft ossification are considered normative age-specific references of relevance in both the estimation of fetal ages and the ultrasound diagnostics of congenital defects.

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Calcium interactions with Cx26 hemmichannel: Spatial association between MD simulations biding sites and variant pathogenicity.

This study presents a first step on finding associations between molecular features and pathological variants of the Cx26 hemichannel. PMID: 30466042 [PubMed - as supplied by publisher] (Source: Computational Biology and Chemistry)

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Calcium interactions with Cx26 hemmichannel: Spatial association between MD simulations biding sites and variant pathogenicity.

This study presents a first step on finding associations between molecular features and pathological variants of the Cx26 hemichannel. PMID: 30466042 [PubMed - as supplied by publisher] (Source: Computational Biology and Chemistry)

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Magnetomotive Displacement of the Tympanic Membrane Using Magnetic Nanoparticles: Toward Enhancement of Sound Perception

Conclusion: This study demonstrates the effectiveness of magnetically inducing vibrations on TMs containing iron oxide nanoparticles, manipulating the amplitude and the frequency of the induced TM motions, and the capability of assessing the magnetomotive dynamics via OCT. Significance: The results demonstrated here suggest the potential use of this noninvasive magnetomotive approach in future hearing aid applications. OCT can be utilized to investigate the magnetomotive dynamics of the TM, which may either enhance sound perception or magnetically induce the perception of sound without the need for acoustic speech signals. (Source: IEEE Transactions on Biomedical Engineering)

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Magnetomotive Displacement of the Tympanic Membrane Using Magnetic Nanoparticles: Toward Enhancement of Sound Perception

Conclusion: This study demonstrates the effectiveness of magnetically inducing vibrations on TMs containing iron oxide nanoparticles, manipulating the amplitude and the frequency of the induced TM motions, and the capability of assessing the magnetomotive dynamics via OCT. Significance: The results demonstrated here suggest the potential use of this noninvasive magnetomotive approach in future hearing aid applications. OCT can be utilized to investigate the magnetomotive dynamics of the TM, which may either enhance sound perception or magnetically induce the perception of sound without the need for acoustic speech signals. (Source: IEEE Transactions on Biomedical Engineering)

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A pilot study of a novel biodegradable magnesium alloy airway stent in a rabbit model

Publication date: Available online 22 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Bangde Xue, Beibei Liang, Guangyin Yuan, Limin Zhu, Hao Wang, Zhaohui Lu, Zhiwei Xu

Abstract

Objective

To preliminarily investigate the feasibility of bioabsorption tracheal stenting for the therapeutic application of congenital tracheal stenosis (CTS).

Study Design

Experimental research.

Setting

Shanghai Children Medical Center, National Children's Medical Center.

Subjects

and Methods: Five kinds of magnesium alloys with different compositions were studied in this paper, a patented Mg–Nd–Zn–Zr alloy series namely JDBM (JiaoDa BioMg) and four Mg-Ca-Zn alloys. The cytotoxicity of alloys was evaluated by the MTS ([3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) assay in rabbit tracheal epithelial cells. Specific magnesium alloys had been immersed in the cell culture medium for 24 h. The tracheal stents that were made of magnesium alloy were implanted into the trachea of New Zealand rabbits and the ablation of the stent was monitored by fiber bronchoscopy. The routine blood examination was conducted prior to and following the stent placement. The rabbits were euthanized following 2–3 months of stenting. H&E staining of the main organs was conducted and the induction of apoptosis of the tracheal tissues was monitored.

Results

The cytotoxicity of the JDBM magnesium alloy was mild and lower than the remaining 4 alloys. The stents were placed successfully in five animals. The tracheal stents were successfully placed and gradually biodegradated as monitored by fiber bronchoscopy; no significant systemic inflammatory response was noted. No significant differences in the liver and/or kidney function prior to and following stent placement were noted. H&E staining indicated the absence of pathological changes in the trachea, liver, heart and/or kidney tissues. The apoptotic assay indicated that the apoptosis ratio of the tracheal tissues was comparable between rabbits with and without tracheal stenting.

Conclusion

The results suggested the feasibility of bioabsorption stents made of biodegradable magnesium alloys using in patients with tracheal stenosis, especially in infants.

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Increased salivary fluid flow in children with newly diagnosed allergic rhinitis

Publication date: Available online 22 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Caixia Qiu, Si Ai, Xiangli Zhuang, Suping Huang, Jian Zheng

Abstract

Objectives

The pathogenesis of allergic rhinitis (AR) may involve dysregulation of the autonomic nervous system (ANS). Salivary fluid flow and salivary alpha-amylase (sAA) secretion are able to reflect the activity of parasympathetic (PNS) and sympathetic nervous system (SNS), respectively. The study aims to address the ANS profile in children with newly diagnosed AR by measuring the salivary secretion pattern.

Methods

We recruited thirty-three children with newly diagnosed AR and thirty-one age- and sex-matched healthy children as control. Saliva samples were collected in the morning and the salivary parameters, including salivary flow rate (SFR, ml/min) and sAA secretion rate (μg/min), were determined accordingly. We also measured the gene copy number of the sAA gene, AMY1, for each individual.

Results

We detected a significantly higher SFR in AR children compared with healthy control (2.20 ± 0.55 vs. 1.63 ± 0.61; p = 0.0002). Similar sAA secretion rate was observed between the two groups (312.8 ± 124.8 (Healthy) vs. 347.9 ± 114.0 (AR) μg/min; p = 0.2444). Besides, the two groups did not differ in AMY1 gene copy number (7.2 ± 2.3 (Healthy) vs. 7.7 ± 2.2 (AR); p = 0.3493).

Conclusions

Our results implicate an overactivity of the PNS while normal SNS activity in children with newly diagnosed AR. The findings support a contributing role of the ANS dysfunction in the pathogenesis of AR.

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Genetic screening involving 101 hot spots for neonates not passing newborn hearing screening and those random recruited in Dongguan

Publication date: Available online 22 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Yanhui Liu, Lixin Ye, Pengyuan Zhu, Jingfan Wu, Shujuan Tan, Jingguo Chen, Chunqiu Wu, Yukang Zhong, Yu Wang, Xiaoxia Li, Hailiang Liu

Abstract

In order to investigate essential molecular causes for hearing loss and mutation frequency of deafness-related genes, 1315 newborns who did not pass the Newborn Hearing Screening (NHS) (audio-no-pass) and 1000 random-selected infants were subjected to detection for 101 hotspot mutations in 18 common deafness-related genes. Totally, 23 alleles of 7 deafness genes were detected out. Significant difference (χ²=25.320, p=0.000) existed in causative mutation frequency between audio-no-pass group (81/1315, 6.160%) and random-selected cohort (18/1000, 1.80%). Of the genes detected out, GJB2 gene mutation was with significant difference (χ²=75.132, p=0.000) between audio-no-pass group (417/1315, 31.711%) and random-selected cohort (159/1000, 15.900%); c.109G>A was the most common allele, as well as the only one with significantly different allele frequency (χ²=79.327, p=0.000) between audio-no-pass group (392/1315, 16.84%) and random-selected cohort (140/1000, 7.55%), which suggested c.109G>A mutation was critical for newborns' hearing loss. This study performed detection for such a large scale of deafness-associated genes and for the first time compared mutations between audio-no-pass and random-recruited neonates, which not only provided more reliable DNA diagnosis result for medical practioners and enhanced clinical care for the newborns, but gave more accurate estimation for mutation frequency.

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A pilot study of a novel biodegradable magnesium alloy airway stent in a rabbit model

Publication date: Available online 22 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Bangde Xue, Beibei Liang, Guangyin Yuan, Limin Zhu, Hao Wang, Zhaohui Lu, Zhiwei Xu

Abstract

Objective

To preliminarily investigate the feasibility of bioabsorption tracheal stenting for the therapeutic application of congenital tracheal stenosis (CTS).

Study Design

Experimental research.

Setting

Shanghai Children Medical Center, National Children's Medical Center.

Subjects

and Methods: Five kinds of magnesium alloys with different compositions were studied in this paper, a patented Mg–Nd–Zn–Zr alloy series namely JDBM (JiaoDa BioMg) and four Mg-Ca-Zn alloys. The cytotoxicity of alloys was evaluated by the MTS ([3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) assay in rabbit tracheal epithelial cells. Specific magnesium alloys had been immersed in the cell culture medium for 24 h. The tracheal stents that were made of magnesium alloy were implanted into the trachea of New Zealand rabbits and the ablation of the stent was monitored by fiber bronchoscopy. The routine blood examination was conducted prior to and following the stent placement. The rabbits were euthanized following 2–3 months of stenting. H&E staining of the main organs was conducted and the induction of apoptosis of the tracheal tissues was monitored.

Results

The cytotoxicity of the JDBM magnesium alloy was mild and lower than the remaining 4 alloys. The stents were placed successfully in five animals. The tracheal stents were successfully placed and gradually biodegradated as monitored by fiber bronchoscopy; no significant systemic inflammatory response was noted. No significant differences in the liver and/or kidney function prior to and following stent placement were noted. H&E staining indicated the absence of pathological changes in the trachea, liver, heart and/or kidney tissues. The apoptotic assay indicated that the apoptosis ratio of the tracheal tissues was comparable between rabbits with and without tracheal stenting.

Conclusion

The results suggested the feasibility of bioabsorption stents made of biodegradable magnesium alloys using in patients with tracheal stenosis, especially in infants.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DVlc6R

Increased salivary fluid flow in children with newly diagnosed allergic rhinitis

Publication date: Available online 22 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Caixia Qiu, Si Ai, Xiangli Zhuang, Suping Huang, Jian Zheng

Abstract

Objectives

The pathogenesis of allergic rhinitis (AR) may involve dysregulation of the autonomic nervous system (ANS). Salivary fluid flow and salivary alpha-amylase (sAA) secretion are able to reflect the activity of parasympathetic (PNS) and sympathetic nervous system (SNS), respectively. The study aims to address the ANS profile in children with newly diagnosed AR by measuring the salivary secretion pattern.

Methods

We recruited thirty-three children with newly diagnosed AR and thirty-one age- and sex-matched healthy children as control. Saliva samples were collected in the morning and the salivary parameters, including salivary flow rate (SFR, ml/min) and sAA secretion rate (μg/min), were determined accordingly. We also measured the gene copy number of the sAA gene, AMY1, for each individual.

Results

We detected a significantly higher SFR in AR children compared with healthy control (2.20 ± 0.55 vs. 1.63 ± 0.61; p = 0.0002). Similar sAA secretion rate was observed between the two groups (312.8 ± 124.8 (Healthy) vs. 347.9 ± 114.0 (AR) μg/min; p = 0.2444). Besides, the two groups did not differ in AMY1 gene copy number (7.2 ± 2.3 (Healthy) vs. 7.7 ± 2.2 (AR); p = 0.3493).

Conclusions

Our results implicate an overactivity of the PNS while normal SNS activity in children with newly diagnosed AR. The findings support a contributing role of the ANS dysfunction in the pathogenesis of AR.

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Genetic screening involving 101 hot spots for neonates not passing newborn hearing screening and those random recruited in Dongguan

Publication date: Available online 22 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Yanhui Liu, Lixin Ye, Pengyuan Zhu, Jingfan Wu, Shujuan Tan, Jingguo Chen, Chunqiu Wu, Yukang Zhong, Yu Wang, Xiaoxia Li, Hailiang Liu

Abstract

In order to investigate essential molecular causes for hearing loss and mutation frequency of deafness-related genes, 1315 newborns who did not pass the Newborn Hearing Screening (NHS) (audio-no-pass) and 1000 random-selected infants were subjected to detection for 101 hotspot mutations in 18 common deafness-related genes. Totally, 23 alleles of 7 deafness genes were detected out. Significant difference (χ²=25.320, p=0.000) existed in causative mutation frequency between audio-no-pass group (81/1315, 6.160%) and random-selected cohort (18/1000, 1.80%). Of the genes detected out, GJB2 gene mutation was with significant difference (χ²=75.132, p=0.000) between audio-no-pass group (417/1315, 31.711%) and random-selected cohort (159/1000, 15.900%); c.109G>A was the most common allele, as well as the only one with significantly different allele frequency (χ²=79.327, p=0.000) between audio-no-pass group (392/1315, 16.84%) and random-selected cohort (140/1000, 7.55%), which suggested c.109G>A mutation was critical for newborns' hearing loss. This study performed detection for such a large scale of deafness-associated genes and for the first time compared mutations between audio-no-pass and random-recruited neonates, which not only provided more reliable DNA diagnosis result for medical practioners and enhanced clinical care for the newborns, but gave more accurate estimation for mutation frequency.

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CT-guided nephrostomy - an expedient tool for complex clinical scenarios

Publication date: Available online 23 November 2018

Source: European Journal of Radiology

Author(s): Maximilian Peter Brandt, Thomas Lehnert, Theresa Czilwik, Hendrik Borgmann, Tatjana Gruber-Rouh, Axel Thalhammer, Elisabeth Hannah Adam, Christian Thomas, Georg Bartsch, Axel Haferkamp, Thomas Joseph Vogl, Igor Tsaur

Abstract

Introduction & Objectives

Percutaneous nephrostomy [1] has emerged as a pivotal approach in the therapeutic management of the obstructed urinary tract. A consecutive incorporation of ultrasonic and radiographic guidance, the approach experienced an almost ubiquitious distribution while most centers currently applying either one or both of these tools jointly. However, success of ultrasound-guidance is limited in obese patients and non-dilated uropathy. In turn, fluoroscopy usually requires an opacification of the urinary collecting system by intravenous or antegrade contrast media injection, which might be harmful for already impaired renal function, raise intrapelvic pressure and augment the risk of sepsis and hemorrhage. CT-guided PCN aids in overcoming these limitations. In the current study, we present the experience of a tertiary referral center with this technique.

Materials & Methods

Epidemiological and clinical data of all patients treated with a CT-guided PCN of native kidneys at the University Hospital Frankfurt between October 2003 and October 2013 were retrospectively collected from the patient charts. Procedural parameters including radiological aspects, technical and therapeutic success, complication and mortality rate have been analyzed statistically.

Results

In total, 140 PCN procedures have been performed in 77 patients with a median age of 69 (± 13). The median body mass index was 27 with 66.6% of patients being overweight or obese. Charlson comorbidity index was 7 ranging 0-16. Indications for PCNs were obstructive uropathy (62.9), urine extravasation (22.9%), urinary tract fistulas (11.4%) and technical reasons (2.8%). In 68.8% of patients, initial diagnosis was malignancy. 56.4% of kidneys were non-dilated before puncture. In 78.4% prone position, otherwise supine oblique position (17.3%) or supine position (4.3%) was used. 71.4% of PCNs were carried out solely under local anesthesia. Technical success has been achieved in 90% with a complication rate of 3.6% (all grade minor B) and was not significantly different between dilated and non-dilated kidneys. 42.9% of fistulas and 64.3% of urinary tract leakages, healed after PCN placement. 30 days mortality rate was 5.2% without being directly associated with the PCN procedure itself.

Conclusion

CT-guided PCN is a feasible approach associated with low morbidity. It is particularly useful in complex clinical scenarios e.g. critically ill, newly operated or obese patients as well as non-dilated kidneys. Moreover, it represents a minimally-invasive option for treating leakages and fistulas of the urinary tract.

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Meningioma grading using conventional MRI histogram analysis based on 3D tumor measurement

Publication date: Available online 22 November 2018

Source: European Journal of Radiology

Author(s): Xiaoxin Li, Yanwei Miao, Liang Han, Junyi Dong, Yan Guo, Yuqing Shang, Lizhi Xie, Qingwei Song, Ailian Liu

Abstract

Purpose

To evaluate the application of conventional MRI histogram analysis based on the whole tumor measurement on assessing meningioma grading.

Materials and Methods

This retrospective study was approved by the institutional review board. A total amount of 90 patients with meningioma were enrolled and the preoperative MRI of them were analyzed. To be specific, the patient group were consisted of 45 patients with grade I, 38 with grade II, and 7 with grade III meningioma. Grade I meningioma is classified as low grade meningioma (LGM), whereas Grade II and III meningioma were combined and classified as high grade meningioma (HGM). ROIs were drawn along the edge of the tumor on each section of T1WI, T2WI, and contrasted T1WI. 3D ROI signal intensity histogram and all its parameters were obtained. Independent t-test and Kruskal-Wallis test were used for comparison between two groups. Univariate logistic regression analysis and Spearman's correlation analysis were used to screen for the parameters with high predictive efficiency, while multivariate logistic regression analysis was used to determine the optimal model for the classification of meningioma.

Results

There were significant differences observed between HGM and LGM groups regarding to histogram volume count, uniformity of three sequences, range of T1WI and T2WI, kurtosis, standard deviation, variance, max intensity of T2WI, skewness, mean deviation, minimum intensity, mean value, the 5^th percentile, the 10^th percentile, the 25^th percentile, the 50^th percentile, the 75^th percentile, and the 90^th percentile of contrasted T1WI. Volume count and uniformity were high predictive parameters in distinguishing HGM from LGM. Logistic regression model included contrasted T1WI histogram parameters (i.e. minimum intensity, volume count, skewness, uniformity, and the 75^th percentile) showed the best diagnostic efficiency for meningioma grade, with a sensitivity and specificity of 83.9% and 77.4% (AUC = 0.834, cutoff value = 0.413), respectively. The optimal model was achieved with a sensitivity of 71.4% and a specificity of 78.6% in the test set (AUC = 0.791, cutoff value = 0.413).

Conclusions

Histogram analysis of conventional MRI based on 3D tumor measurement can be applied in the assessment of meningioma grading in clinical.

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Characterization of prostate cancer using diffusion tensor imaging: a new perspective

Publication date: Available online 22 November 2018

Source: European Journal of Radiology

Author(s): Neda Gholizadeh, Peter B. Greer, John Simpson, Jim Denham, Peter Lau, Jason Dowling, Hubert Hondermarck, Saadallah Ramadan

Abstract

Purpose

This study is aimed at evaluating the potential role of quantitative magnetic resonance diffusion tensor imaging (DTI) and tractography parameters in the detection and characterization of peripheral zone prostate cancer with a particular attention for fiber tract density.

Materials and Methods

DTI was acquired from eleven high risk, transrectal ultrasound (TRUS)-guided biopsy proven prostate cancers with perineural invasion (histological Gleason score ≥ 7) on a 3 T magnet. Twenty parameters derived from DTI were quantified in cancer and healthy regions of the prostate. In addition, fiber tract density in normal versus cancer tissues was also calculated using DTI tractography. Support vector machine with a radial basis function kernel and area under receiver operator characteristic (ROC) were used to describe and compare the diagnostic performance of combined fractional anisotropy (FA) and mean diffusivity (MD) and other statistically significant DTI parameters. Spearman correlation analysis between DTI parameters and Gleason scores was conducted.

Results

Eighteen DTI parameters yielded statistically significant differences between cancer and healthy regions (p-value < 0.05). The ROC curve of all statistically significant DTI parameters between cancer and healthy regions was higher than the area under ROC curve using FA + MD alone (95% confidence interval = 0.988, range = 0.975-1.00) vs (95% confidence interval = 0.935, range = 0.898-0.999), respectively (p-value < 0.05). Fiber tract density was also found to be higher in cancer than in healthy tissues (+38.22%, p-value = 0.010) and may be related to the increase in nerve and vascular density reported in prostate cancer. The linear and relative anisotropy were highly correlated with Gleason score (Spearman correlation factor r = 0.655, p-value = 0.001 and r = 0.667, p-value < 0.001, respectively).

Conclusions

DTI has the potential to provide imaging biomarkers in the detection and characterization of prostate cancer. Novel quantitative parameters derived from DTI and DTI tractography, including fiber tract density, support the use of DTI in the assessment of high grade prostate cancer.

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The utility of 68Gallium-DOTATATE PET/CT in the detection of von Hippel-Lindau disease associated tumors

Publication date: Available online 22 November 2018

Source: European Journal of Radiology

Author(s): Jasmine Shell, Amit Tirosh, Corina Millo, Samira M. Sadowski, Yasmine Assadipour, Patience Green, Dhaval Patel, Naris Nilubol, Electron Kebebew

Abstract

Purpose

Patients with von Hippel-Lindau (VHL) disease may develop various tumors, including neuroendocrine tumors of the pancreas (PNETs) and adrenal, central nervous system hemangioblastomas, kidney tumors and more. ⁶⁸Ga-DOTATATE positron emission tomography (PET)/computerized tomography (CT) has been shown to be highly accurate for tumors with somatostatin receptors. We aimed to assess the performance of ⁶⁸Ga-DOTATATE PET/CT in patients with VHL disease.

Methods

Patients with a diagnosis of VHL were enrolled in a prospective study and underwent surveillance imaging for pancreatic lesions (n = 301). The current analysis includes 73 evaluations with multiple imaging modalities of 36 patients (2.1 ± 0.8 evaluations/patient, range 1-4) for a head-to-head comparison of ⁶⁸Ga-DOTATATE PET/CT, CT and/or MRI. In this post-hoc analysis we compared the detection rates of various imaging modalities for pancreatic NET (PNETs) and for any extrapancreatic tumors located within the scan field of CT/MRI abdomen.

Results

⁶⁸Ga-DOTATATE PET/CT detected a total of 206 lesions, CT detected 208 lesions and MRI detected 94 lesions in 66, 31 and 66 scans, respectively. ⁶⁸Ga-DOTATATE PET/CT (3.4 ± 0.1 per scan) was superior than CT (3.2 ± 0.1 per scan, p = 0.02) with a similar trend when comparing with MRI (2.8 ± 0.1 per scan, p = 0.03) in detecting lesions in any anatomic locations.

Conclusions

⁶⁸Ga-DOTATATE PET/CT had a significantly higher detection rate when compared with anatomic imaging for all lesions, and comparable detection rate for pancreatic lesions in VHL patients. Hence, given the higher accuracy and lower radiation exposure associated with ⁶⁸Ga-DOTATATE PET/CT, its potential role in the surveillance of VHL-associated lesions should be further studied.

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CT-guided nephrostomy - an expedient tool for complex clinical scenarios

Publication date: Available online 23 November 2018

Source: European Journal of Radiology

Author(s): Maximilian Peter Brandt, Thomas Lehnert, Theresa Czilwik, Hendrik Borgmann, Tatjana Gruber-Rouh, Axel Thalhammer, Elisabeth Hannah Adam, Christian Thomas, Georg Bartsch, Axel Haferkamp, Thomas Joseph Vogl, Igor Tsaur

Abstract

Introduction & Objectives

Percutaneous nephrostomy [1] has emerged as a pivotal approach in the therapeutic management of the obstructed urinary tract. A consecutive incorporation of ultrasonic and radiographic guidance, the approach experienced an almost ubiquitious distribution while most centers currently applying either one or both of these tools jointly. However, success of ultrasound-guidance is limited in obese patients and non-dilated uropathy. In turn, fluoroscopy usually requires an opacification of the urinary collecting system by intravenous or antegrade contrast media injection, which might be harmful for already impaired renal function, raise intrapelvic pressure and augment the risk of sepsis and hemorrhage. CT-guided PCN aids in overcoming these limitations. In the current study, we present the experience of a tertiary referral center with this technique.

Materials & Methods

Epidemiological and clinical data of all patients treated with a CT-guided PCN of native kidneys at the University Hospital Frankfurt between October 2003 and October 2013 were retrospectively collected from the patient charts. Procedural parameters including radiological aspects, technical and therapeutic success, complication and mortality rate have been analyzed statistically.

Results

In total, 140 PCN procedures have been performed in 77 patients with a median age of 69 (± 13). The median body mass index was 27 with 66.6% of patients being overweight or obese. Charlson comorbidity index was 7 ranging 0-16. Indications for PCNs were obstructive uropathy (62.9), urine extravasation (22.9%), urinary tract fistulas (11.4%) and technical reasons (2.8%). In 68.8% of patients, initial diagnosis was malignancy. 56.4% of kidneys were non-dilated before puncture. In 78.4% prone position, otherwise supine oblique position (17.3%) or supine position (4.3%) was used. 71.4% of PCNs were carried out solely under local anesthesia. Technical success has been achieved in 90% with a complication rate of 3.6% (all grade minor B) and was not significantly different between dilated and non-dilated kidneys. 42.9% of fistulas and 64.3% of urinary tract leakages, healed after PCN placement. 30 days mortality rate was 5.2% without being directly associated with the PCN procedure itself.

Conclusion

CT-guided PCN is a feasible approach associated with low morbidity. It is particularly useful in complex clinical scenarios e.g. critically ill, newly operated or obese patients as well as non-dilated kidneys. Moreover, it represents a minimally-invasive option for treating leakages and fistulas of the urinary tract.

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Meningioma grading using conventional MRI histogram analysis based on 3D tumor measurement

Publication date: Available online 22 November 2018

Source: European Journal of Radiology

Author(s): Xiaoxin Li, Yanwei Miao, Liang Han, Junyi Dong, Yan Guo, Yuqing Shang, Lizhi Xie, Qingwei Song, Ailian Liu

Abstract

Purpose

To evaluate the application of conventional MRI histogram analysis based on the whole tumor measurement on assessing meningioma grading.

Materials and Methods

This retrospective study was approved by the institutional review board. A total amount of 90 patients with meningioma were enrolled and the preoperative MRI of them were analyzed. To be specific, the patient group were consisted of 45 patients with grade I, 38 with grade II, and 7 with grade III meningioma. Grade I meningioma is classified as low grade meningioma (LGM), whereas Grade II and III meningioma were combined and classified as high grade meningioma (HGM). ROIs were drawn along the edge of the tumor on each section of T1WI, T2WI, and contrasted T1WI. 3D ROI signal intensity histogram and all its parameters were obtained. Independent t-test and Kruskal-Wallis test were used for comparison between two groups. Univariate logistic regression analysis and Spearman's correlation analysis were used to screen for the parameters with high predictive efficiency, while multivariate logistic regression analysis was used to determine the optimal model for the classification of meningioma.

Results

There were significant differences observed between HGM and LGM groups regarding to histogram volume count, uniformity of three sequences, range of T1WI and T2WI, kurtosis, standard deviation, variance, max intensity of T2WI, skewness, mean deviation, minimum intensity, mean value, the 5^th percentile, the 10^th percentile, the 25^th percentile, the 50^th percentile, the 75^th percentile, and the 90^th percentile of contrasted T1WI. Volume count and uniformity were high predictive parameters in distinguishing HGM from LGM. Logistic regression model included contrasted T1WI histogram parameters (i.e. minimum intensity, volume count, skewness, uniformity, and the 75^th percentile) showed the best diagnostic efficiency for meningioma grade, with a sensitivity and specificity of 83.9% and 77.4% (AUC = 0.834, cutoff value = 0.413), respectively. The optimal model was achieved with a sensitivity of 71.4% and a specificity of 78.6% in the test set (AUC = 0.791, cutoff value = 0.413).

Conclusions

Histogram analysis of conventional MRI based on 3D tumor measurement can be applied in the assessment of meningioma grading in clinical.

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Characterization of prostate cancer using diffusion tensor imaging: a new perspective

Publication date: Available online 22 November 2018

Source: European Journal of Radiology

Author(s): Neda Gholizadeh, Peter B. Greer, John Simpson, Jim Denham, Peter Lau, Jason Dowling, Hubert Hondermarck, Saadallah Ramadan

Abstract

Purpose

This study is aimed at evaluating the potential role of quantitative magnetic resonance diffusion tensor imaging (DTI) and tractography parameters in the detection and characterization of peripheral zone prostate cancer with a particular attention for fiber tract density.

Materials and Methods

DTI was acquired from eleven high risk, transrectal ultrasound (TRUS)-guided biopsy proven prostate cancers with perineural invasion (histological Gleason score ≥ 7) on a 3 T magnet. Twenty parameters derived from DTI were quantified in cancer and healthy regions of the prostate. In addition, fiber tract density in normal versus cancer tissues was also calculated using DTI tractography. Support vector machine with a radial basis function kernel and area under receiver operator characteristic (ROC) were used to describe and compare the diagnostic performance of combined fractional anisotropy (FA) and mean diffusivity (MD) and other statistically significant DTI parameters. Spearman correlation analysis between DTI parameters and Gleason scores was conducted.

Results

Eighteen DTI parameters yielded statistically significant differences between cancer and healthy regions (p-value < 0.05). The ROC curve of all statistically significant DTI parameters between cancer and healthy regions was higher than the area under ROC curve using FA + MD alone (95% confidence interval = 0.988, range = 0.975-1.00) vs (95% confidence interval = 0.935, range = 0.898-0.999), respectively (p-value < 0.05). Fiber tract density was also found to be higher in cancer than in healthy tissues (+38.22%, p-value = 0.010) and may be related to the increase in nerve and vascular density reported in prostate cancer. The linear and relative anisotropy were highly correlated with Gleason score (Spearman correlation factor r = 0.655, p-value = 0.001 and r = 0.667, p-value < 0.001, respectively).

Conclusions

DTI has the potential to provide imaging biomarkers in the detection and characterization of prostate cancer. Novel quantitative parameters derived from DTI and DTI tractography, including fiber tract density, support the use of DTI in the assessment of high grade prostate cancer.

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The utility of 68Gallium-DOTATATE PET/CT in the detection of von Hippel-Lindau disease associated tumors

Publication date: Available online 22 November 2018

Source: European Journal of Radiology

Author(s): Jasmine Shell, Amit Tirosh, Corina Millo, Samira M. Sadowski, Yasmine Assadipour, Patience Green, Dhaval Patel, Naris Nilubol, Electron Kebebew

Abstract

Purpose

Patients with von Hippel-Lindau (VHL) disease may develop various tumors, including neuroendocrine tumors of the pancreas (PNETs) and adrenal, central nervous system hemangioblastomas, kidney tumors and more. ⁶⁸Ga-DOTATATE positron emission tomography (PET)/computerized tomography (CT) has been shown to be highly accurate for tumors with somatostatin receptors. We aimed to assess the performance of ⁶⁸Ga-DOTATATE PET/CT in patients with VHL disease.

Methods

Patients with a diagnosis of VHL were enrolled in a prospective study and underwent surveillance imaging for pancreatic lesions (n = 301). The current analysis includes 73 evaluations with multiple imaging modalities of 36 patients (2.1 ± 0.8 evaluations/patient, range 1-4) for a head-to-head comparison of ⁶⁸Ga-DOTATATE PET/CT, CT and/or MRI. In this post-hoc analysis we compared the detection rates of various imaging modalities for pancreatic NET (PNETs) and for any extrapancreatic tumors located within the scan field of CT/MRI abdomen.

Results

⁶⁸Ga-DOTATATE PET/CT detected a total of 206 lesions, CT detected 208 lesions and MRI detected 94 lesions in 66, 31 and 66 scans, respectively. ⁶⁸Ga-DOTATATE PET/CT (3.4 ± 0.1 per scan) was superior than CT (3.2 ± 0.1 per scan, p = 0.02) with a similar trend when comparing with MRI (2.8 ± 0.1 per scan, p = 0.03) in detecting lesions in any anatomic locations.

Conclusions

⁶⁸Ga-DOTATATE PET/CT had a significantly higher detection rate when compared with anatomic imaging for all lesions, and comparable detection rate for pancreatic lesions in VHL patients. Hence, given the higher accuracy and lower radiation exposure associated with ⁶⁸Ga-DOTATATE PET/CT, its potential role in the surveillance of VHL-associated lesions should be further studied.

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A case of descending necrotizing mediastinitis secondary to odontogenic infection

Publication date: Available online 23 November 2018

Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology

Author(s): Hideki Watanabe, Hitoshi Osano, Hiromi Iida, Hirosaka Hayashi, Akihiro Dohi, Yoshiyuki Mori

Abstract

We report a case in which an odontogenic infection developed into a deep neck abscess and descending necrotizing mediastinitis (DNM). The patient was a 43-year-old man with a chief complaint of swelling extending from the right submandibular region to the neck. He had experienced repeated episodes of swelling and pain in the right mandibular molar region starting 1 year prior to the initial visit. He was emergently transported to our department from the Dental and Oral Surgery Department of a general hospital. He was febrile with a temperature of 38.3 °C and exhibited obvious swelling and redness from the right submandibular region to the anterior part of the chest. The maximum opening of the mouth was 1 fingerbreadth, and swelling, redness and pus drainage were observed in the right mandibular molar region. Laboratory tests showed a leukocyte count of 15,590/μL and a C-reactive protein level of 21.6 mg/dL. Computed tomography scans showed periapical lesions at the right mandibular second and third molars, as well as a gas pattern extending from the area around the right submandibular gland to the common carotid artery and anterior mediastinum. The clinical diagnosis was a right-sided deep neck abscess and DNM. At the initial visit, tracheotomy was performed under general anesthesia, with incision and drainage of the deep neck abscess and extraction of the right mandibular second and third molars. In consultation with the Department of Respiratory Surgery, thoracoscopic cleaning and drainage were performed. The patient was discharged in comfortable condition on Day 38.

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Modified “Dredging Method” for complicated solid/multicystic ameloblastoma in the mandible: Report of a case treated by fractionated enucleation

Publication date: Available online 22 November 2018

Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology

Author(s): Yoichi Ohiro, Tamaki Yamada, Wataru Kakuguchi, Ichizo Kobayashi, Tetsuya Kitamura, Kanchu Tei

Abstract

The purpose of this paper is to describe the treatment procedures for a solid/multicystic ameloblastoma which was treated with the "Dredging Method" modified by fractionated enucleation adopted to avoid the pathologic fracture because of the complicated expansive nature in the mandible. Ameloblastoma is defined as a benign epithelial odontogenic tumor with progressive growth potential. Currently employed surgical treatment as curative treatment is resection with adequate margins because of the characteristics of high recurrence rates with conservative treatment. In this article, a 38-year-old male with swelling on the right mandible was referred to our hospital. Image analysis showed an expansile partially honeycombed multilocular radiolucent lesion from the body to the ascending ramus of the mandible. A follicular ameloblastoma was diagnosed by the biopsy. The paper also details the management of the ameloblastoma with the "Dredging Method" to remove the tumor completely and maintain the form and function of the mandible and the 13-year follow-up post treatment.

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A case of a large thrombosed lingual varix

Publication date: Available online 22 November 2018

Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology

Author(s): Midori Eguchi, Hisao Shigematsu, Yuka Oku, Kentaro Kikuchi, Munehisa Okada, Hideaki Sakashita

Abstract

Lingual varix is a condition characterized by purplish venous ectasia. It is usually found on the ventral surface of the tongue in elderly patients. On the other hand, thrombosed oral varices are small, localized, and probably not uncommon lesions. However, large thrombosed oral varices are very rare, and there have not been any reports about thrombosis in lingual varices. This report describes a rare case of a large thrombosed lingual varix involving the sublingual vein. A 75-year-old female presented with a mass on the ventral surface of her tongue. A lingual tumor was initially suspected based on echography and magnetic resonance imaging, and an excisional biopsy was performed under general anesthesia. A definitive histopathological diagnosis of venous thrombosis was made. We would like to emphasize that venous thrombosis should always be considered as a differential diagnosis in cases in which a dark blue or purple, painless tumor arises on the ventral surface of the tongue.

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A case of descending necrotizing mediastinitis secondary to odontogenic infection

Publication date: Available online 23 November 2018

Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology

Author(s): Hideki Watanabe, Hitoshi Osano, Hiromi Iida, Hirosaka Hayashi, Akihiro Dohi, Yoshiyuki Mori

Abstract

We report a case in which an odontogenic infection developed into a deep neck abscess and descending necrotizing mediastinitis (DNM). The patient was a 43-year-old man with a chief complaint of swelling extending from the right submandibular region to the neck. He had experienced repeated episodes of swelling and pain in the right mandibular molar region starting 1 year prior to the initial visit. He was emergently transported to our department from the Dental and Oral Surgery Department of a general hospital. He was febrile with a temperature of 38.3 °C and exhibited obvious swelling and redness from the right submandibular region to the anterior part of the chest. The maximum opening of the mouth was 1 fingerbreadth, and swelling, redness and pus drainage were observed in the right mandibular molar region. Laboratory tests showed a leukocyte count of 15,590/μL and a C-reactive protein level of 21.6 mg/dL. Computed tomography scans showed periapical lesions at the right mandibular second and third molars, as well as a gas pattern extending from the area around the right submandibular gland to the common carotid artery and anterior mediastinum. The clinical diagnosis was a right-sided deep neck abscess and DNM. At the initial visit, tracheotomy was performed under general anesthesia, with incision and drainage of the deep neck abscess and extraction of the right mandibular second and third molars. In consultation with the Department of Respiratory Surgery, thoracoscopic cleaning and drainage were performed. The patient was discharged in comfortable condition on Day 38.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2SbmzRW

Modified “Dredging Method” for complicated solid/multicystic ameloblastoma in the mandible: Report of a case treated by fractionated enucleation

Publication date: Available online 22 November 2018

Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology

Author(s): Yoichi Ohiro, Tamaki Yamada, Wataru Kakuguchi, Ichizo Kobayashi, Tetsuya Kitamura, Kanchu Tei

Abstract

The purpose of this paper is to describe the treatment procedures for a solid/multicystic ameloblastoma which was treated with the "Dredging Method" modified by fractionated enucleation adopted to avoid the pathologic fracture because of the complicated expansive nature in the mandible. Ameloblastoma is defined as a benign epithelial odontogenic tumor with progressive growth potential. Currently employed surgical treatment as curative treatment is resection with adequate margins because of the characteristics of high recurrence rates with conservative treatment. In this article, a 38-year-old male with swelling on the right mandible was referred to our hospital. Image analysis showed an expansile partially honeycombed multilocular radiolucent lesion from the body to the ascending ramus of the mandible. A follicular ameloblastoma was diagnosed by the biopsy. The paper also details the management of the ameloblastoma with the "Dredging Method" to remove the tumor completely and maintain the form and function of the mandible and the 13-year follow-up post treatment.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DTA19Q

A case of a large thrombosed lingual varix

Publication date: Available online 22 November 2018

Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology

Author(s): Midori Eguchi, Hisao Shigematsu, Yuka Oku, Kentaro Kikuchi, Munehisa Okada, Hideaki Sakashita

Abstract

Lingual varix is a condition characterized by purplish venous ectasia. It is usually found on the ventral surface of the tongue in elderly patients. On the other hand, thrombosed oral varices are small, localized, and probably not uncommon lesions. However, large thrombosed oral varices are very rare, and there have not been any reports about thrombosis in lingual varices. This report describes a rare case of a large thrombosed lingual varix involving the sublingual vein. A 75-year-old female presented with a mass on the ventral surface of her tongue. A lingual tumor was initially suspected based on echography and magnetic resonance imaging, and an excisional biopsy was performed under general anesthesia. A definitive histopathological diagnosis of venous thrombosis was made. We would like to emphasize that venous thrombosis should always be considered as a differential diagnosis in cases in which a dark blue or purple, painless tumor arises on the ventral surface of the tongue.

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“A Novel Approach for Total Nasal Reconstruction”

Publication date: Available online 22 November 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Shahrouz Zarrabi, Mark Welch, John Neary, Beomjune Kim

Summary

A 61-year-old woman who lost her nose, upper lip, and most of her midface bony structures due to cancer 20 years ago underwent advanced surgical reconstruction. This patient had previously undergone multiple reconstructive surgeries that failed to satisfactorily restore her nose. Therefore, a multi-stage reconstruction was performed to recreate a complete nose and increase her upper lip length. Due to a lack of sufficient facial bone and nasal supporting structures, the reconstruction was extremely challenging. Virtual surgical planning technology was used to create a customized titanium nasal plate. The patient's nose was successfully reconstructed using the nasal plate, costal cartilage, and a paramedian forehead flap. The patient is highly satisfied with the cosmetic and functional results and has had significant psychosocial improvement since the reconstruction.

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CSIOMS to Present Research

Publication date: Available online 22 November 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s):

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R8YuLl

MNP triggers nasal allergy by modulating dendritic cell properties

Publication date: Available online 23 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Xiao-Yu Liu, Yong-Jin Wu, Li-Juan Song, Xian-Hai Zeng, Shuai Wang, Jiang-Qi Liu, Li-Hua Mo, Xiao-Rui Geng, Li-Teng Yang, Rui-Di Xie, Xiao-Wen Zhang, Zhi-Gang Liu, Ping-Chang Yang

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IgE-class-specific immunosuppression in offspring by administration of anti-IgE to pregnant mice

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Hideaki Morita, Masato Tamari, Masako Fujiwara, Kenichiro Motomura, Yasuhiko Koezuka, Go Ichien, Kenji Matsumoto, Kimishige Ishizaka, Hirohisa Saito

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2KqWKug

Transcriptome profiling of refractory atopic keratoconjunctivitis by RNA sequencing

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Akira Matsuda, Yosuke Asada, Naomasa Suita, Satoshi Iwamoto, Toshiaki Hirakata, Norihiko Yokoi, Yasuyuki Ohkawa, Yukinori Okada, Takehiko Yokomizo, Nobuyuki Ebihara

Summary

We found upregulation of 47 immunoglobulin genes and 22 S. aureus infection-related genes in refractory atopic keratoconjunctivitis tissue by RNA-seq analysis, suggesting that lymphoid neogenesis and stimuli from infection are essential components of the disorder.

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Vaccination of non-allergic individuals with recombinant hypoallergenic fragments of birch pollen allergen Bet v 1: Safety, effects and mechanisms

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Raffaela Campana, Katharina Marth, Petra Zieglmayer, Milena Weber, Christian Lupinek, Yury Zhernov, Olga Elisyutina, Musa Khaitov, Eva Rigler, Kerstin Westritschnig, Uwe Berger, Martin Wolkersdorfer, Fritz Horak, Friedrich Horak, Rudolf Valenta

Summary

This is the first double-blind, placebo-controlled study showing that vaccination with recombinant hypoallergenic allergen-derivatives is safe and induces sustained allergen-specific IgG responses which block allergic patients IgE binding to the allergen.

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“A Novel Approach for Total Nasal Reconstruction”

Publication date: Available online 22 November 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Shahrouz Zarrabi, Mark Welch, John Neary, Beomjune Kim

Summary

A 61-year-old woman who lost her nose, upper lip, and most of her midface bony structures due to cancer 20 years ago underwent advanced surgical reconstruction. This patient had previously undergone multiple reconstructive surgeries that failed to satisfactorily restore her nose. Therefore, a multi-stage reconstruction was performed to recreate a complete nose and increase her upper lip length. Due to a lack of sufficient facial bone and nasal supporting structures, the reconstruction was extremely challenging. Virtual surgical planning technology was used to create a customized titanium nasal plate. The patient's nose was successfully reconstructed using the nasal plate, costal cartilage, and a paramedian forehead flap. The patient is highly satisfied with the cosmetic and functional results and has had significant psychosocial improvement since the reconstruction.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PRmCWk

CSIOMS to Present Research

Publication date: Available online 22 November 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s):

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R8YuLl

MNP triggers nasal allergy by modulating dendritic cell properties

Publication date: Available online 23 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Xiao-Yu Liu, Yong-Jin Wu, Li-Juan Song, Xian-Hai Zeng, Shuai Wang, Jiang-Qi Liu, Li-Hua Mo, Xiao-Rui Geng, Li-Teng Yang, Rui-Di Xie, Xiao-Wen Zhang, Zhi-Gang Liu, Ping-Chang Yang

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BseySS

IgE-class-specific immunosuppression in offspring by administration of anti-IgE to pregnant mice

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Hideaki Morita, Masato Tamari, Masako Fujiwara, Kenichiro Motomura, Yasuhiko Koezuka, Go Ichien, Kenji Matsumoto, Kimishige Ishizaka, Hirohisa Saito

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2KqWKug

Transcriptome profiling of refractory atopic keratoconjunctivitis by RNA sequencing

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Akira Matsuda, Yosuke Asada, Naomasa Suita, Satoshi Iwamoto, Toshiaki Hirakata, Norihiko Yokoi, Yasuyuki Ohkawa, Yukinori Okada, Takehiko Yokomizo, Nobuyuki Ebihara

Summary

We found upregulation of 47 immunoglobulin genes and 22 S. aureus infection-related genes in refractory atopic keratoconjunctivitis tissue by RNA-seq analysis, suggesting that lymphoid neogenesis and stimuli from infection are essential components of the disorder.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BseBy2

Vaccination of non-allergic individuals with recombinant hypoallergenic fragments of birch pollen allergen Bet v 1: Safety, effects and mechanisms

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Raffaela Campana, Katharina Marth, Petra Zieglmayer, Milena Weber, Christian Lupinek, Yury Zhernov, Olga Elisyutina, Musa Khaitov, Eva Rigler, Kerstin Westritschnig, Uwe Berger, Martin Wolkersdorfer, Fritz Horak, Friedrich Horak, Rudolf Valenta

Summary

This is the first double-blind, placebo-controlled study showing that vaccination with recombinant hypoallergenic allergen-derivatives is safe and induces sustained allergen-specific IgG responses which block allergic patients IgE binding to the allergen.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Ks2PXn

Isotropically weighted intravoxel incoherent motion brain imaging at 7T

Publication date: Available online 23 November 2018

Source: Magnetic Resonance Imaging

Author(s): Ivan I. Maximov, Sebastian Vellmer

Abstract

Perfusion magnetic resonance imaging (MRI) is a promising non-invasive technique providing insights regarding the brain's microvascular architecture in vivo. The scalar perfusion metrics can be used for quantitative diagnostics of various brain abnormalities, in particular, in the stroke cases and tumours. However, conventional MRI-based perfusion approaches such as dynamic contrast-enhanced perfusion imaging or arterial spin labelling have a few weaknesses, for instance, contrast agent deposition, low signal-to-noise ratio, limited temporal and spatial resolution, and specific absorption rate constraints. As an alternative, the intravoxel incoherent motion (IVIM) approach exploits an extension of diffusion MRI in order to estimate perfusion parameters in the human brain. Application of IVIM imaging at ultra-high field MRI might employ the advantage of a higher signal-to-noise ratio, and thereby the use of higher spatial and temporal resolutions.

In the present work, we demonstrate an application of recently developed isotropic diffusion weighted sequences to the evaluation of IVIM parameters at an ultra-high 7T field. The used sequence exhibits high immunity to image degrading factors and allows one to acquire the data in a fast and efficient way. Utilising the bi-exponential fitting model of the signal attenuation, we performed an extensive analysis of the IVIM scalar metrics obtained by a isotropic diffusion weighted sequence in vivo and compared results with a conventional pulsed gradient sequence at 7T. In order to evaluate a possible metric bias originating from blood flows, we additionally used a truncated b-value protocol (b-values from 100 to 200 s/mm² with the step 20 s/mm²) accompanied to the full range (b-values from 0 to 200 s/mm²). The IVIM scalar metrics have been assessed and analysed together with a large and middle vessel density atlas of the human brain. We found that the diffusion coefficients and perfusion fractions of the voxels consisting of large and middle vessels have higher values in contrast to other tissues. Additionally, we did not find a strong dependence of the IVIM metrics on the density values of the vessel atlas. Perspectives and limitations of the developed isotropic diffusion weighted perfusion are presented and discussed.

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Sampling arterial input function (AIF) from peripheral arteries: Comparison of a temporospatial-feature based method against conventional manual method

Publication date: Available online 22 November 2018

Source: Magnetic Resonance Imaging

Author(s): Xiaowan Li, Christopher C. Conlin, Stephen T. Decker, Nan Hu, Michelle Mueller, Lillian Khor, Christopher Hanrahan, Gwenael Layec, Vivian S. Lee, Jeff L. Zhang

Abstract

It is often difficult to accurately localize small arteries in images of peripheral organs, and even more so with vascular abnormality vasculatures, including collateral arteries, in peripheral artery disease (PAD). This poses a challenge for manually sampling arterial input function (AIF) in quantifying dynamic contrast-enhanced (DCE) MRI data of peripheral organs. In this study, we designed a multi-step screening approach that utilizes both the temporal and spatial information of the dynamic images, and is presumably suitable for localizing small and unpredictable peripheral arteries. In 41 DCE MRI datasets acquired from human calf muscles, the proposed method took <5 s on average for sampling AIF for each case, much more efficient than the manual sampling method; AIFs by the two methods were comparable, with Pearson's correlation coefficient of 0.983 ± 0.004 (p-value < 0.01) and relative difference of 2.4% ± 2.6%. In conclusion, the proposed temporospatial-feature based method enables efficient and accurate sampling of AIF from peripheral arteries, and would improve measurement precision and inter-observer consistency for quantitative DCE MRI of peripheral tissues.

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Magnetic resonance imaging in the presence of projectiles and projectile fragments: Artefacts, image quality, rotation and movement

Publication date: Available online 22 November 2018

Source: Magnetic Resonance Imaging

Author(s): C. Hackenbroch, M. Wafa, S. Klinger, U.M. Mauer

Abstract

Background and purpose

Gunshot injuries have been considered a contraindication for MRI because of the risk of secondary dislodgement of retained metallic foreign bodies.

The objective of our study was to provide a systematic overview of the behaviour of projectiles and fragments in order to aid decision-making regarding the use of MRI in clinical practice.

Materials and methods

Ferromagnetic (n = 2) and non-ferromagnetic (n = 5) projectiles and fragments that were lodged in soft tissue (porcine masseter muscles) were examined using standard protocols at 1, 1.5 and 3 T, to simulate clinical situations as realistically as possible. CT was performed before and after every MRI to assess rotation and movement. Artefacts and image quality were analysed using Likert-type scales.

Results

Ferromagnetic projectiles were of poorer quality and showed larger artefacts and did not provide benefit for clinical practice compared to images of non-ferromagnetic material. Image quality of non-ferromagnetic projectiles varied widely (from very good to moderate) depending on the composition of the projectiles.

Field strength (1 T to 3 T) had no relevant influence on image quality.

Conclusions

Non-ferromagnetic projectiles are not a contraindication for MR imaging since there is no potential risk of secondary dislodgement. Image quality and the extent of artefacts, however, strongly depend on the type of ammunition used. The presence of ferromagnetic projectiles in or near vital anatomic structures is a contraindication for MRI because these objects may exhibit movement in response to magnetic fields. Knowledge of the type of projectile used appears to be important in order to guide patient management before an examination is performed.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2KseWnu

Isotropically weighted intravoxel incoherent motion brain imaging at 7T

Publication date: Available online 23 November 2018

Source: Magnetic Resonance Imaging

Author(s): Ivan I. Maximov, Sebastian Vellmer

Abstract

Perfusion magnetic resonance imaging (MRI) is a promising non-invasive technique providing insights regarding the brain's microvascular architecture in vivo. The scalar perfusion metrics can be used for quantitative diagnostics of various brain abnormalities, in particular, in the stroke cases and tumours. However, conventional MRI-based perfusion approaches such as dynamic contrast-enhanced perfusion imaging or arterial spin labelling have a few weaknesses, for instance, contrast agent deposition, low signal-to-noise ratio, limited temporal and spatial resolution, and specific absorption rate constraints. As an alternative, the intravoxel incoherent motion (IVIM) approach exploits an extension of diffusion MRI in order to estimate perfusion parameters in the human brain. Application of IVIM imaging at ultra-high field MRI might employ the advantage of a higher signal-to-noise ratio, and thereby the use of higher spatial and temporal resolutions.

In the present work, we demonstrate an application of recently developed isotropic diffusion weighted sequences to the evaluation of IVIM parameters at an ultra-high 7T field. The used sequence exhibits high immunity to image degrading factors and allows one to acquire the data in a fast and efficient way. Utilising the bi-exponential fitting model of the signal attenuation, we performed an extensive analysis of the IVIM scalar metrics obtained by a isotropic diffusion weighted sequence in vivo and compared results with a conventional pulsed gradient sequence at 7T. In order to evaluate a possible metric bias originating from blood flows, we additionally used a truncated b-value protocol (b-values from 100 to 200 s/mm² with the step 20 s/mm²) accompanied to the full range (b-values from 0 to 200 s/mm²). The IVIM scalar metrics have been assessed and analysed together with a large and middle vessel density atlas of the human brain. We found that the diffusion coefficients and perfusion fractions of the voxels consisting of large and middle vessels have higher values in contrast to other tissues. Additionally, we did not find a strong dependence of the IVIM metrics on the density values of the vessel atlas. Perspectives and limitations of the developed isotropic diffusion weighted perfusion are presented and discussed.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Ksf2eQ

Sampling arterial input function (AIF) from peripheral arteries: Comparison of a temporospatial-feature based method against conventional manual method

Publication date: Available online 22 November 2018

Source: Magnetic Resonance Imaging

Author(s): Xiaowan Li, Christopher C. Conlin, Stephen T. Decker, Nan Hu, Michelle Mueller, Lillian Khor, Christopher Hanrahan, Gwenael Layec, Vivian S. Lee, Jeff L. Zhang

Abstract

It is often difficult to accurately localize small arteries in images of peripheral organs, and even more so with vascular abnormality vasculatures, including collateral arteries, in peripheral artery disease (PAD). This poses a challenge for manually sampling arterial input function (AIF) in quantifying dynamic contrast-enhanced (DCE) MRI data of peripheral organs. In this study, we designed a multi-step screening approach that utilizes both the temporal and spatial information of the dynamic images, and is presumably suitable for localizing small and unpredictable peripheral arteries. In 41 DCE MRI datasets acquired from human calf muscles, the proposed method took <5 s on average for sampling AIF for each case, much more efficient than the manual sampling method; AIFs by the two methods were comparable, with Pearson's correlation coefficient of 0.983 ± 0.004 (p-value < 0.01) and relative difference of 2.4% ± 2.6%. In conclusion, the proposed temporospatial-feature based method enables efficient and accurate sampling of AIF from peripheral arteries, and would improve measurement precision and inter-observer consistency for quantitative DCE MRI of peripheral tissues.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BspQqv

Magnetic resonance imaging in the presence of projectiles and projectile fragments: Artefacts, image quality, rotation and movement

Publication date: Available online 22 November 2018

Source: Magnetic Resonance Imaging

Author(s): C. Hackenbroch, M. Wafa, S. Klinger, U.M. Mauer

Abstract

Background and purpose

Gunshot injuries have been considered a contraindication for MRI because of the risk of secondary dislodgement of retained metallic foreign bodies.

The objective of our study was to provide a systematic overview of the behaviour of projectiles and fragments in order to aid decision-making regarding the use of MRI in clinical practice.

Materials and methods

Ferromagnetic (n = 2) and non-ferromagnetic (n = 5) projectiles and fragments that were lodged in soft tissue (porcine masseter muscles) were examined using standard protocols at 1, 1.5 and 3 T, to simulate clinical situations as realistically as possible. CT was performed before and after every MRI to assess rotation and movement. Artefacts and image quality were analysed using Likert-type scales.

Results

Ferromagnetic projectiles were of poorer quality and showed larger artefacts and did not provide benefit for clinical practice compared to images of non-ferromagnetic material. Image quality of non-ferromagnetic projectiles varied widely (from very good to moderate) depending on the composition of the projectiles.

Field strength (1 T to 3 T) had no relevant influence on image quality.

Conclusions

Non-ferromagnetic projectiles are not a contraindication for MR imaging since there is no potential risk of secondary dislodgement. Image quality and the extent of artefacts, however, strongly depend on the type of ammunition used. The presence of ferromagnetic projectiles in or near vital anatomic structures is a contraindication for MRI because these objects may exhibit movement in response to magnetic fields. Knowledge of the type of projectile used appears to be important in order to guide patient management before an examination is performed.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2KseWnu

Evaluation of the diagnostic performance of the simple method of computed tomography in the assessment of patients with shoulder instability: a prospective cohort study

Abstract

Background

Physical examinations may reveal the instability of a glenohumeral joint but cannot diagnose the bony Bankart lesions. Soft tissue Bankart lesion cannot be visualized on traditional radiogram. Magnetic resonance images have high cost and availability issues. The purpose of the study was to access the diagnostic performance of the Computed Tomography (CT) in the assessment of patients with shoulder instability and to diagnose the Bankart and bony Bankart lesions.

Methods

A total of 145 patients with shoulder instability were included in the study. Patients were subjected to clinical examination tests, traditional radiography, and CT. Two orthopedic surgeons, two engineers (trained in musculoskeletal imaging), and two physiotherapists have analyzed the radiological images, CT scans, and the clinical examination tests respectively. The Chi-square test or one-way ANOVA/ Dunnett Multiple comparisons test was performed at 99% of confidence level.

Results

Sensitivity (0.972 ± 0.18 vs. 1, p = 0.11) and accuracy (0.942 ± 0.17 vs. 1, p < 0.0001, q = 3.88) for the clinical examination tests combining the traditional radiological images were same to CT. However, the clinical examination tests combining the traditional radiological images had more inconclusive results (5 vs. 1), false-positive results (6 vs. 5), and false negative results (4 vs. 1) than CT. The area that detects the Bankart and bony Bankart lesions at least one time for CT was higher than that of the clinical examination tests combining the traditional radiological images.

Conclusion

CT should be considered for evaluation in patients with shoulder instability and suspected Bankart and bony Bankart lesions.

Trial registration

Researchregistry3990 dated 15 December 2014 (www.researchregistry.com).

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OZINnK

Evaluation of the diagnostic performance of the simple method of computed tomography in the assessment of patients with shoulder instability: a prospective cohort study

Abstract

Background

Physical examinations may reveal the instability of a glenohumeral joint but cannot diagnose the bony Bankart lesions. Soft tissue Bankart lesion cannot be visualized on traditional radiogram. Magnetic resonance images have high cost and availability issues. The purpose of the study was to access the diagnostic performance of the Computed Tomography (CT) in the assessment of patients with shoulder instability and to diagnose the Bankart and bony Bankart lesions.

Methods

A total of 145 patients with shoulder instability were included in the study. Patients were subjected to clinical examination tests, traditional radiography, and CT. Two orthopedic surgeons, two engineers (trained in musculoskeletal imaging), and two physiotherapists have analyzed the radiological images, CT scans, and the clinical examination tests respectively. The Chi-square test or one-way ANOVA/ Dunnett Multiple comparisons test was performed at 99% of confidence level.

Results

Sensitivity (0.972 ± 0.18 vs. 1, p = 0.11) and accuracy (0.942 ± 0.17 vs. 1, p < 0.0001, q = 3.88) for the clinical examination tests combining the traditional radiological images were same to CT. However, the clinical examination tests combining the traditional radiological images had more inconclusive results (5 vs. 1), false-positive results (6 vs. 5), and false negative results (4 vs. 1) than CT. The area that detects the Bankart and bony Bankart lesions at least one time for CT was higher than that of the clinical examination tests combining the traditional radiological images.

Conclusion

CT should be considered for evaluation in patients with shoulder instability and suspected Bankart and bony Bankart lesions.

Trial registration

Researchregistry3990 dated 15 December 2014 (www.researchregistry.com).

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Cerebral blood flow changes after a day of wake, sleep, and sleep deprivation

Publication date: Available online 22 November 2018

Source: NeuroImage

Author(s): Torbjørn Elvsåshagen, Henri JMM. Mutsaerts, Nathalia Zak, Linn B. Norbom, Sophia H. Quraishi, Per Ø. Pedersen, Ulrik F. Malt, Lars T. Westlye, Eus JW. van Someren, Atle Bjørnerud, Inge R. Groote

Abstract

Elucidating the neurobiological effects of sleep and wake is an important goal of the neurosciences. Whether and how human cerebral blood flow (CBF) changes during the sleep-wake cycle remain to be clarified. Based on the synaptic homeostasis hypothesis of sleep and wake, we hypothesized that a day of wake and a night of sleep deprivation would be associated with gray matter resting CBF (rCBF) increases and that sleep would be associated with rCBF decreases. Thirty-eight healthy adult males (age 22.1 ± 2.5 years) underwent arterial spin labeling perfusion magnetic resonance imaging at three time points: in the morning after a regular night's sleep, the evening of the same day, and the next morning, either after total sleep deprivation (n = 19) or a night of sleep (n = 19). All analyses were adjusted for hematocrit and head motion. rCBF increased from morning to evening and decreased after a night of sleep. These effects were most prominent in bilateral hippocampus, amygdala, thalamus, and in the occipital and sensorimotor cortices. Group × time interaction analyses for evening versus next morning revealed significant interaction in bilateral lateral and medial occipital cortices and in bilateral insula, driven by rCBF increases in the sleep deprived individuals and decreases in the sleepers, respectively. Furthermore, group × time interaction analyses for first morning versus next morning showed significant effects in medial and lateral occipital cortices, in anterior cingulate gyrus, and in the insula, in both hemispheres. These effects were mainly driven by CBF increases from TP1 to TP3 in the sleep deprived individuals. There were no associations between the rCBF changes and sleep characteristics, vigilant attention, or subjective sleepiness that remained significant after adjustments for multiple analyses. Altogether, these results encourage future studies to clarify mechanisms underlying sleep-related rCBF changes.

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Recruitment of the occipital cortex by arithmetic processing follows computational bias in the congenitally blind

Publication date: Available online 22 November 2018

Source: NeuroImage

Author(s): Virginie Crollen, Latifa Lazzouni, Mohamed Rezk, Antoine Bellemare, Franco Lepore, Marie-Pascale Noël, Xavier Seron, Olivier Collignon

Abstract

Arithmetic reasoning activates the occipital cortex of congenitally blind people (CB). This activation of visual areas may highlight the functional flexibility of occipital regions deprived of their dominant inputs or relate to the intrinsic computational role of specific occipital regions. We contrasted these competing hypotheses by characterizing the brain activity of CB and sighted participants while performing subtraction, multiplication and a control letter task. In both groups, subtraction selectively activated a bilateral dorsal network commonly activated during spatial processing. Multiplication triggered activity in temporal regions thought to participate in memory retrieval. No between-group difference was observed for the multiplication task whereas subtraction induced enhanced activity in the right dorsal occipital cortex of the blind individuals only. As this area overlaps with regions showing selective tuning to auditory spatial processing and exhibits increased functional connectivity with a dorsal "spatial" network, our results suggest that the recruitment of occipital regions during high-level cognition in the blind actually relates to the intrinsic computational role of the activated regions.

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Disease progression timeline estimation for Alzheimer's disease using discriminative event based modeling

Publication date: Available online 22 November 2018

Source: NeuroImage

Author(s): Vikram Venkatraghavan, Esther E. Bron, Wiro J. Niessen, Stefan Klein, for the Alzheimer's Disease Neuroimaging Initiative

Abstract

Alzheimer's Disease (AD) is characterized by a cascade of biomarkers becoming abnormal, the pathophysiology of which is very complex and largely unknown. Event-based modeling (EBM) is a data-driven technique to estimate the sequence in which biomarkers for a disease become abnormal based on cross-sectional data. It can help in understanding the dynamics of disease progression and facilitate early diagnosis and prognosis by staging patients. In this work we propose a novel discriminative approach to EBM, which is shown to be more accurate than existing state-of-the-art EBM methods. The method first estimates for each subject an approximate ordering of events. Subsequently, the central ordering over all subjects is estimated by fitting a generalized Mallows model to these approximate subject-specific orderings based on a novel probabilistic Kendall's Tau distance. We also introduce the concept of relative distance between events which helps in creating a disease progression timeline. Subsequently, we propose a method to stage subjects by placing them on the estimated disease progression timeline. We evaluated the proposed method on Alzheimer's Disease Neuroimaging Initiative (ADNI) data and compared the results with existing state-of-the-art EBM methods. We also performed extensive experiments on synthetic data simulating the progression of Alzheimer's disease. The event orderings obtained on ADNI data seem plausible and are in agreement with the current understanding of progression of AD. The proposed patient staging algorithm performed consistently better than that of state-of-the-art EBM methods. Event orderings obtained in simulation experiments were more accurate than those of other EBM methods and the estimated disease progression timeline was observed to correlate with the timeline of actual disease progression. The results of these experiments are encouraging and suggest that discriminative EBM is a promising approach to disease progression modeling.

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Focus of attention modulates the heartbeat evoked potential

Publication date: Available online 22 November 2018

Source: NeuroImage

Author(s): Frederike H. Petzschner, Lilian A. Weber, Katharina V. Wellstein, Gina Paolini, Cao Tri Do, Klaas E. Stephan

Abstract

Theoretical frameworks such as predictive coding suggest that the perception of the body and world – interoception and exteroception – involve intertwined processes of inference, learning, and prediction. In this framework, attention is thought to gate the influence of sensory information on perception. In contrast to exteroception, there is limited evidence for purely attentional effects on interoception. Here, we empirically tested if attentional focus modulates cortical processing of single heartbeats, using a newly-developed experimental paradigm to probe purely attentional differences between exteroceptive and interoceptive conditions in the heartbeat evoked potential (HEP) using EEG recordings. We found that the HEP is significantly higher during interoceptive compared to exteroceptive attention, in a time window of 524–620 ms after the R-peak. Furthermore, this effect predicted self-report measures of autonomic system reactivity. Our study thus provides direct evidence that the HEP is modulated by pure attention and suggests that this effect may provide a clinically relevant readout for assessing interoception.

Graphical abstract

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