Objectives
The clinical success of orthodontic miniplates depends on the stability of the miniscrews used for fixation. For good stability, it is essential that the application site provides enough ...bone of good quality. This study was performed to analyze the amount of bone available for orthodontic miniplates in the zygomatic process of the maxilla.
Methods
We examined 51 dental CT scans (Somatom Plus 4; Siemens, Erlangen, Germany) obtained from 51 fully dentate adult patients (mean age 24.0 ± 8.1 years; 27 male and 24 female) prior to third molar surgery. The amount of bone in the zygomatic process region at the level of the first molar root tips and at several other cranial levels as far as 15 mm from the root tips was measured
Results
Bone thickness at the root tip level averaged 4.1 ± 1.0 mm; the lowest value measured at this level in any of the patients was 2.7 mm. Bone thickness averaged 8.3 ± 1.0 mm at 15 mm cranial to the root tips; 6.9 mm was the lowest value.
Conclusion
The zygomatic process appears to provide sufficient bone to accommodate screws for miniplate fixation. While some patients may possess a borderline amount of bone at more caudal levels, lack of volume is not a problem near the zygomatic bone.
Preoperative lymph node staging of lung cancer by CT relies on the premise that malignant lymph nodes are larger than benign ones. Lymph nodes > 1 cm in size are regarded as metastatic nodes. The ...surgical approach and potential application of neoadjuvant therapy regimens are dependent on this evaluation.
In a morphometric study, hilar and mediastinal lymph nodes from 256 patients with non-small cell lung cancer (NSCLC) were analyzed. The lymph nodes were counted, the largest diameter of each lymph node was measured, and each lymph node was analyzed for metastatic involvement by histopathologic examination. The frequency of metastatic involvement was calculated and correlated with lymph node size. Preoperative CT scans of 80 patients were retrospectively analyzed by a staff radiologist. Lymph node size was measured, and lymph nodes were evaluated due to radiologic criteria. The radiologic evaluation was compared to the histopathologic diagnosis.
A total of 2,891 lymph nodes were present in the 256 specimens examined for this study. One hundred thirty-nine patients had a pN0 status, whereas 117 patients had lymph nodes that were positive for cancer. Two thousand four hundred eighty-six lymph nodes (86%) were tumor-free, while 405 (14%) showed metastatic involvement on histopathologic examination. The mean (± SD) diameter of the nonmetastatic lymph nodes was 7.05 ± 3.75 mm, whereas infiltrated nodes had a diameter of 10.7 ± 4.7 mm (p = 0.005). One thousand nine hundred fifty-three of the tumor-free lymph nodes (79%) and 170 of the metastatic lymph nodes (44%) were < 10 mm in diameter. Of 139 patients with no metastatic lymph node involvement, 101 (77%) had at least one lymph node that was > 10 mm in diameter. Of 127 patients with metastatic lymph node involvement, 12% had no lymph node that was < 10 mm. The independent radiologic evaluation of the CT scans of 80 patients yielded a sensitivity of 57.1% and a specificity of 80.6%.
Lymph node size is not a reliable parameter for the evaluation of metastatic involvement in patients with NSCLC.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Severe fungal infections remain a significant cause of morbidity and mortality in neutropenic patients undergoing dose-intensive chemotherapy for malignant diseases. Chronic disseminated candidiasis ...(CDC) is a life-threatening complication in neutropenic patients because of the lack of responsive hematopoietic precursor cells. Resolution of Candida organ lesions after hematopoietic reconstitution may take months. Here, we report the case of a 19-year-old neutropenic woman with relapsed acute myelogenous leukemia and candidiasis of liver, spleen, and kidneys. Antifungal treatment was initiated using fluconazole and caspofungin but was changed to itraconazole and caspofungin. Despite elevated C-reactive protein (CRP) levels and detectable Candida organ lesions, antileukemic therapy was restarted with interleukin 2 at the same time as antimicrobial treatment. Eight weeks after the start of interleukin therapy, CRP levels and organ lesions were decreased significantly irrespective of continuing neutropenia. This case report describes the successful treatment of CDC during neutropenia using combination antifungal therapy and suggests controlled studies to establish optimal therapeutic strategies.
The purpose of this study is to compare triphasic helical CT and fast MRI with respect to detection, characterization and staging of suspected renal masses. To achieve this triphasic helical CT ...(plain, corticonephrographic and tubulonephrographic phase) and MRI with fast T(1) weighted and T(2) weighted sequences were performed in 29 patients with a suspected renal lesion. Image quality, lesion characterization and lesion extent were assessed for both methods in all patients. The acquisition phase for CT and the image sequence for MRI offering the best image quality and best diagnostic information regarding renal parenchyma, renal vessels, detection of enlarged lymph nodes, and other abdominal organs were determined. Histologically confirmed renal cell carcinomas (n=18) were staged based on the Robson classification. Quantitative data were obtained from operator-defined regions of interest (ROIs) in all acquisition phases (CT) and all image sequences (MRI). For most criteria the rating of image quality for helical CT was generally higher as compared with fast MRI. CT and MRI detected all 24 histologically proven masses, while no false positive solid tumour was diagnosed with both imaging modalities. All three acquisition phases in CT and all applied image sequences in MRI were regarded as necessary in order to gain important diagnostic information. Altogether, 12 of 18 renal cell carcinomas (67%) were correctly staged by CT and MRI. Helical CT and fast MRI allow the correct detection and characterization of suspicious renal lesions. Both imaging modalities can be recommended for clinical routine application. Although the correct histological staging of renal cancer remains difficult for both imaging methods, both are excellent in providing the critical staging information needed before surgery. Helical CT offers a significantly shorter acquisition time to cover the entire abdomen.
Definite size and shape of radiofrequency-induced ablations (RFAs) cannot be evaluated intraoperatively. Instead, surgeons choose a radiofrequency device that is supposed to cause a necrosis of a ...determined size greater than the malignant lesion. The aim of this study was to measure the variability of the induced necroses postoperatively and to define a reproducible ablation volume in human liver.
In 24 patients, 34 RFA procedures were performed with single applications of the device. The deployment was 3 cm (n=16), 4 cm (n=5), or 5 cm (n=13). The induced necroses were analyzed by volumetric reconstructions of computed tomography (CT) scans. Measured volumes were compared with the expected volumes. Furthermore, the shape of the necrosis was classified according to an index of the diameters.
The measured volumes of postoperative necroses were 14 +/- 8 cm3 (deployment, 3 cm), 24 +/- 12 cm3 (4 cm), and 45 +/- 42 cm3 (5 cm). The diameter of a sphere fitted into the necroses reached 2.9 +/- .5 cm (3 cm), 3.5 +/- .7 cm (4 cm), and 4.1 +/- 1.1 cm (5 cm), at P<.02, significantly smaller than the deployment. The classification of shapes yielded a spherical shape (n=14), a teardrop shape (n=13), or an irregular shape (n=7). The energy consumption was 2.1 +/- 1.5 kJ/cm3 (3 cm), 2.6 +/- .5 kJ/cm3 (4 cm), or 3.5 +/- 2.0 kJ/cm3 (5 cm).
The diameter of RFA-induced liver necrosis is significantly smaller than expected from needle deployment, especially with full-needle deployment. The shape of the lesion differs in more than half of the cases from the anticipated spherical pattern. The upper limit for reproducible necrosis induction is a tumor diameter of 3.4 cm.
Objectives
The maxillary bone below the frontal process is used for orthodontic anchorage; indications have included skeletally anchored protraction of the maxilla for treating Class III ...malocclusions or the intrusion of teeth in patients with a deep bite. This study was conducted to assess the condition of bone before cortically implanting miniplates in that area of the maxilla.
Patients and methods
A total of 51 thin-sliced computed tomography scans of 51 fully-dentate adult patients (mean age 24.0 ± 8.1 years; 27 men and 24 women) obtained prior to third-molar osteotomy were evaluated. Study parameters included total bone thickness, thickness of the facial cortical plate, and width of the nasal maxillary buttress. All these parameters were measured at different vertical levels.
Results
The bone volume adjacent to the piriform aperture was most pronounced at the basal level and decreased progressively toward more cranial levels. The basal bone structure had a mean total thickness of 7.8 mm, facial cortical plate thickness of 1.9 mm, and nasal maxillary buttress width of 9.2 mm. At 16 mm cranial to the aperture base, these values fell to 5.6 mm, 1.3 mm, and 5.8 mm, respectively.
Conclusion
These bone measurements suggest that screws 7 mm in length can be inserted at the base level of the piriform aperture and screws 5 mm long at the cranial end of the bone.
We report Neocosmospora vasinfecta infection following chemotherapy for acute nonlymphocytic leukemia. N. vasinfecta, a plant pathogen, was identified by culture and genetic sequencing. ...Susceptibility testing revealed in vitro resistance for common antifungals.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Percutaneous dilational tracheotomy (PDT) and conventionaltracheostomy are still competing methods to provide an airway forintensive care patients requiring assisted ventilation. Trachealstenosis is ...a late complication for any tracheostomy and long-termintubation. However, late complications in PDT have not beenextensively studied. This article is the first to report on totalatresia of the subglottic larynx and cervical trachea after PDT. Thedimension of the lesion is visualized by three-dimensionalreconstructed CT scan. The etiology of this condition isdiscussed.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The aim of this study was to evaluate an MR technique optimized for imaging of the parotid gland ductal system.
The pulse sequence was optimized in 10 volunteers to depict static or nearly static ...fluid in the parotid ductal system. A heavily T2-weighted fast SE sequence (TR 3,600 ms/TE 800 ms) with a slice thickness of 30-40 mm using an 8 cm surface coil allowed depiction of the fluid-filled parotid duct. Thirteen patients with benign as well as malignant parotid gland pathologies were examined: sialadenitis (n = 2), sialadenosis (n = 3), Heerfordt syndrome (n = 1), pleomorphic adenoma (n = 2), parotid carcinoma (n = 1), lymphoepithelial carcinoma (n = 1), cystadenolymphoma (n = 2), and non-Hodgkin lymphoma (n = 1).
The heavily T2-weighted projection image yielded good quality sialographic images. The main duct and primary branching ducts were clearly depicted in all normal cases. The main duct was visualized in all patients. Intra- and extraglandular duct widening and ductal strictures were well depicted. Sialolithiasis with a calculus in the main duct was correctly demonstrated in one case.
MR sialography is noninvasive and does not depend on duct cannulation or contrast agent injection. Initial experience with a thick slice projection technique indicates that MR sialography can be successfully applied to image the parotid gland ductal system.
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