Anatomical Location Research Articles

Augmented Reality in Dentistry: Enhancing Precision in Clinical Procedures—A Systematic Review

Background: Augmented reality (AR) enhances sensory perception by adding extra information, improving anatomical localization and simplifying treatment views. In dentistry, digital planning on bidimensional screens lacks real-time feedback, leading to potential errors. However, it is not clear if AR can improve the clinical treatment precision. The aim of this research is to evaluate if the use of AR-based instruments could improve dental procedure precision. Methods: This review covered studies from January 2018 to June 2023, focusing on AR in dentistry. The PICO question was “Does AR increase the precision of dental interventions compared to non-AR techniques?”. The systematic review was carried out on electronic databases, including Ovid MEDLINE, PubMed, and the Web of Science, with the following inclusion criteria: studies comparing the variation in the precision of interventions carried out with AR instruments and non-AR techniques. Results: Thirteen studies were included. Conclusions: The results of this systematic review demonstrate that AR enhances the precision of various dental procedures. The authors advise clinicians to use AR-based tools in order to improve the precision of their therapies.

Temporal Bone Myeloid Sarcoma Presenting as Necrotizing Otitis Externa: A Case Report and Literature Review.

Myeloid sarcoma (MS) is a proliferation of immature myeloid cells that occurs extramedullary, often accompanying acute myeloid leukemia (AML). It typically presents in areas such as lymph nodes, skin, and the head and neck regions. The emergence of MS within the temporal bone is rare, and it can manifest through nonspecific symptoms. In this paper, we reported a case of A 47-year-old female presented with right-sided otalgia, otorrhea, tinnitus, reduced hearing, and ear fullness, and developed facial asymmetry. She was initially diagnosed with necrotizing otitis externa and was treated accordingly. Further investigations were conducted, leading to the diagnosis of MS. She began treatment with induction chemotherapy followed by consolidation therapy. And we reviewed the literature and included 14 MS cases with the same anatomical localization, discussing the primary presentation, immunohistochemistry, and treatment approaches of these patients. In conclusion, temporal bone MS should be considered in patients with a history of AML presenting with nonspecific symptoms. Diagnostic modalities for MS include computed tomography and magnetic resonance imaging scans. Systemic chemotherapy remains the preferred treatment approach. The complexity and diversity of temporal bone MS presentations necessitate further comprehensive research to enhance understanding and improve management strategies for this rare condition.

Two Decades of Insights: Comprehensive Histopathological and Epidemiological Analysis of Conjunctival Tumors

This study analyzed 2102 conjunctival lesions excised between 1981 and 2003 at a single tertiary center in Serbia, with the aim of evaluating their histopathological characteristics, anatomical localization, and demographic distribution. Of the total cases recorded, 55.1% were male, indicating a slight male predominance. The bulbar conjunctiva was the most commonly affected site (34.5%), with 39.3% of tumors extended to multiple regions of the conjunctiva, including areas such as the plica and caruncula. The most common benign lesion was compound conjunctival nevus (16.7%), while squamous cell carcinoma (SCC) (11.4%) and melanoma (11.3%) were the most prevalent malignant tumors. Tumor incidence peaked in the 61–70 and 51–60 year age groups, with malignant tumors such as SCC being more frequent in males. Comparisons with similar global studies reveal that our findings align with worldwide trends, such as the predominance of SCC, which has been linked to UV exposure, and the frequency of melanoma in fair-skinned populations. However, the lower prevalence of fibrodegenerative lesions like pterygia and pinguecula in our cohort likely reflects Serbia’s cooler climate compared to regions with higher UV exposure. These findings underscore the diverse nature of conjunctival tumors, the critical role of histopathological examination for diagnosis, and the influence of environmental factors. This study provides valuable insights into the epidemiology of conjunctival tumors, contributing to global understanding and guiding future diagnostic and therapeutic approaches.

ETIOPATHOGENIC ASPECTS OF ODONTOGENIC MAXILLARY SINUSITIS OF PERIAPICAL ORIGIN

Anatomically, the roots of the upper premolar and molar teeth are near the maxillary sinuses. Thus, periapical inflammation of the elements close to the sinuses enables the formation of odontogenic sinusitis. This study aimed to analyze the available literature on the etiopathogenic aspects of odontogenic maxillary sinusitis of periapical origin. A literature review was conducted in the following databases: SciELO, MEDLINE/Pubmed, and LILACS, using the keywords "Maxillary Sinusitis", "Dentistry", "Tooth" and "Infection". Articles written in English, Spanish, and Portuguese were included; those that fit the focus of the paper and those that were most relevant in terms of outlining the desired information. Papers reporting odontogenic sinusitis arising from an operative process were excluded. Odontogenic maxillary sinusitis (OMS) occurs due to sinus infection caused by inflammation of one or more dental elements near this cavity. Despite presenting specific features, sinusitis of odontogenic and non-odontogenic origin are quite similar, making the differential diagnosis difficult. Cone-Beam Computed Tomography (CBCT) is considered the reference standard for diagnosis, and the best treatment is to eliminate the causal factor. It was also found that apical periodontitis is the main non-iatrogenic cause and premolars and molars are the most affected teeth due to their anatomical location near the maxillary sinuses. The anatomical location of the maxillary sinus and the roots of the molars and premolars will allow, through the proximity between them, the OMS. In cases where periodontitis has proven to be the most frequent non-iatrogenic cause of this condition, also due to a great symptomatological similarity with non-odontogenic sinusitis, complementary examinations such as CBCT are necessary. Moreover, the treatment can be performed in a case-specific manner, through accurate diagnosis and etiopathogenesis.

Revolutionizing endometriosis treatment: automated surgical operation through artificial intelligence and robotic vision.

Clinical limitations due to poverty significantly impact the lives and health of many individuals globally. Nevertheless, this challenge can be addressed with modern technologies, particularly through robotics and artificial intelligence. This study aims to address these challenges using advanced technologies in robotic surgery and artificial intelligence, proposing a method to fully automate endometriosis robotic surgery with a focus on interpretability, accuracy, and reliability. A methodology for fully automatic endometriosis surgery is introduced. Given the complexity of endometriosis lesions detection, they are categorized by their anatomical location to improve system interpretability. Then, three ensemble U-Net frameworks are designed to detect and localize common types of endometriosis lesions intraoperatively. A cross-training approach is employed, exploring U-Net models with diverse neural architectures-such as ResNet50, ResNet101, VGG19, InceptionV3, MobileNet, and EfficientNetB7-to develop U-Net ensemble models for precise endometriosis lesions segmentation. A novel image augmentation technique is also introduced, enhancing the segmentation models' accuracy and reliability. Furthermore, two U-Net models are developed to localize the ovaries and uterus, mitigating unexpected noise and bolstering the method's accuracy and reliability. The image segmentation models, assessed using the Intersection over Union (IoU) metric, achieved outstanding results: 97.57% for ovarian, 96.35% for uterine, and 92.58% for peritoneal endometriosis. This study proposes a fully automatic method for some common types of endometriosis surgery, including ovarian endometriomas and superficial endometriosis. This method is centered around three ensemble U-Net frameworks and a noise reduction technique using two additional U-Nets for localizing the ovaries and uterus. This approach has the potential to significantly improve the accuracy and reliability of robotic surgeries, potentially reducing healthcare costs and improving outcomes for patients worldwide.

The two-stage detection-after-segmentation model improves the accuracy of identifying subdiaphragmatic lesions

Chest X-rays (CXRs) are primarily used to detect lung lesions. While the abdominal portion of CXRs can sometimes reveal critical conditions, research in this area is limited. To address this, we introduce a two-stage architecture that separates the abdominal region from the CXR and detects abdominal lesions using a specialized dataset. We compared the performance of our method on whole CXRs versus isolated abdominal regions. First, we created masks for the right upper quadrant (RUQ), left upper quadrant (LUQ), and upper abdomen (ABD) regions and trained corresponding segmentation models for each area. For detecting abdominal lesions, we curated a dataset of 5,996 images, categorized into 19 classes based on anatomical locations, air patterns, and levels of stomach or bowel dilation. The detection process was initially conducted on the original images, followed by the three regional areas, RUQ, LUQ, and ABD, extracted by the segmentation models. The results showed that the detection model trained on the entire ABD region achieved the highest accuracy, followed closely by the RUQ and LUQ models. In contrast, the CXR model had the lowest accuracy. This study highlights that the two-stage architecture effectively manages distinct segmentation and detection tasks in CXRs, offering a promising avenue for more accurate diagnoses. It also suggests that an optimal ratio between the sizes of the target lesions and the input images may exist.

Uveitis characteristics and multiple sclerosis phenotype of patients with multiple sclerosis-associated uveitis: A systematic review and meta-analysis.

To summarize and meta-analyze uveitis characteristics and multiple sclerosis (MS) phenotype of patients with multiple sclerosis-associated uveitis (MSAU) within a systematic review and meta-analysis. A comprehensive literature search was performed on January 25, 2023, utilizing PubMed, Embase, and Virtual Health Library (VHL) databases. We included studies involving patients with MSAU, such as case series with over 10 patients, cross-sectional, case-control, and cohort studies. Quality and risk of bias were assessed using CLARITY tools and validated metrics like the Hoy et al. and Hassan Murad et al. tools. The pooled analysis focused on 1) uveitis characteristics, 2) ocular complications, 3) MS phenotype, and 3) administered treatments for uveitis and MS. Gender-based subgroup analysis was conducted across continents; heterogeneity was measured using the I2 statistic. Statistical analysis was performed using R software version 4.3.1. The study was registered in PROSPERO with CRD42023453495 number. Thirty-six studies were analyzed (24 with a low risk of bias, 8 with some concerns, and 4 with a high risk of bias), including 1,257 patients and 2,034 eyes with MSAU. The pooled analysis showed a mean age of 38.2 ± 12.1 years with a notable female predominance (67%, 95% CI [59%-73%]). MS before uveitis was seen in 59% of the cases (95% CI [48%-69%]), while uveitis was present before MS in 38% (95% CI [30%-48%]). The mean age for the first uveitis episode was 35.7 ± 8.3 years, predominantly affecting both eyes (77%, 95% CI [69%-83%], from 23 studies involving 452 patients). Intermediate uveitis was the most frequent anatomical location (68%, 95% CI [49%-82%], from 22 studies involving 530 patients), often following a recurrent course (63%, 95% CI [38%-83%]). Key complications included vision reduction (42%, 95% CI [19%-70%], from five articles involving 90 eyes), macular compromise (45%, 95% CI [20%-73%], from 4 studies involving 95 eyes), and cataracts (46%, 95% CI [32%-61%], from eight articles involving 230 eyes). Concerning MS phenotype, relapsing-remitting MS (RRMS) was the most common subtype (74%, 95% CI [64%-82%], from eight articles involving 134 patients), followed by secondary progressive MS (24%, 95% CI [18%-33%], from eight articles involving 125 patients). The most frequently occurring central nervous lesions were supratentorial (95%, 95% CI [70%-99%], from two articles involving 17 patients) and spinal cord (39%, 95% CI [16%-68%], from two articles involving 29 patients). The mean Expanded Disability Status Scale (EDSS) score and annual recurrence rates were 2.9 ± 0.6 and 1.07 ± 0.56, respectively. Treatment trends showed the prevalent use of Fingolimod (96%, 95% CI [17%-100%], from two articles involving 196 patients), Mycophenolate (48%, 95% CI [11%-87%], from four articles involving 51 patients), and Interferon-beta (43%, 95% CI [24%-65%], from 11 articles involving 325 patients). MSAU primarily affects young adult females, typically presenting as bilateral intermediate uveitis with vision-related complications. The most common MS phenotype is RRMS, often associated with supratentorial and spinal cord lesions on imaging. These findings give ophthalmologists and neurologists a comprehensive clinical picture of MSAU, facilitating prompt diagnosis.

The risk and distribution of second primary cancers according to subsite of primary stomach cancer: a retrospective cohort population-based study

Background: The development of second primary cancers (SPCs) following a diagnosis of stomach cancer presents a significant clinical challenge, with varying risks depending on the anatomic subsite of the primary tumor, patient demographics, and treatment modalities. This study aims to assess the risk of SPCs in stomach cancer survivors, focusing on differences across anatomic subsites, gender, age, and treatment periods. Methods: We conducted a retrospective cohort study using data from stomach cancer patients, analyzing the incidence of SPCs based on the anatomic location of the primary tumor, with stratifications by gender, age, latency period, and year of diagnosis. Standardized incidence ratios (SIRs) were calculated to compare the observed SPC rates with those expected in the general population. Results: Elevated stomach SPC risk was observed across most anatomic subsites, particularly in the body (SIR 8.84) and fundus (SIR 7.34). Females exhibited higher SIRs compared to males, especially in the fundus (SIR 13.33 for females vs. 4.55 for males). Younger patients (<50 years) had significantly higher SPC risks, particularly for cancers originating in the fundus (SIR 49.56). Notably, patients diagnosed after 2010 showed the highest SIRs, indicating a potential impact of advances in diagnostic and therapeutic modalities. Non-stomach SPCs, including colorectal, lung, and thyroid cancers, were significantly elevated, with distinct patterns based on the primary tumor site. Conclusions: The study highlights the critical role of primary tumor location, gender, age, and treatment era in determining SPC risk in stomach cancer survivors. These findings underscore the need for tailored surveillance strategies to manage long-term cancer risks in this population.

Screening of Klebsiella pneumoniae isolates reveals the spread of strong biofilm formers and class 1 integrons.

Klebsiella pneumoniae is a Gram-negative bacterium that can colonize, penetrate, and cause infections at several human anatomical locations. The emergence of hypervirulent K. pneumoniae and its ability to evade the immune system and develop antibiotic resistance has made it a key concern in the healthcare industry. The hypervirulent variants are increasingly involved in community-acquired infections. Therefore, it is pertinent to understand the biofilm formation potential among the clinical isolates. We acquired 225 isolates of K. pneumoniae from the Department of Microbiology, Symbiosis University Hospital and Research Centre (SUHRC), Pune, India over 1 year from March 2022- March 2023, and evaluated antimicrobial susceptibility, hypermucoviscous phenotype, virulence, and antimicrobial-resistant gene distribution in K. pneumoniae isolates and established a correlation between antimicrobial resistance and integrons. Most isolates were strong biofilm formers (76%). The isolates harbored one or more carbapenemase/ beta-lactamase encoding gene combinations. Hypermucoviscous (HMKP) isolates had considerably greater positive rates for iutA, magA, K2 serotype, rmpA, and rmpA2 than non-HMKP isolates. Isolates carrying integrons (43%) showed significantly more antibiotic resistance. The study reveals spread of strong biofilm formers with extensive virulence and antimicrobial-resistant genes, and integrons responsible for multi-drug resistance among the clinical isolates of K. pneumoniae in Pune, India, posing a threat to the public health and necessitating close surveillance, accurate diagnosis, control, and therapeutic management of infections.

Dendritome Mapping Unveils Spatial Organization of Striatal D1/D2-Neuron Morphology.

Morphology is a cardinal feature of a neuron that mediates its functions, but profiling neuronal morphologies at scale remains a formidable challenge. Here we describe a generalizable pipeline for large-scale brainwide study of dendritic morphology of genetically-defined single neurons in the mouse brain. We generated a dataset of 3,762 3D-reconstructed and reference-atlas mapped striatal D1- and D2- medium spiny neurons (MSNs). Integrative morphometric analyses reveal distinct impacts of anatomical locations and D1/D2 genetic types on MSN morphologies. To analyze striatal regional features of MSN dendrites without prior anatomical constraints, we assigned MSNs to a lattice of cubic boxes in the reference brain atlas, and summarized morphometric representation ("eigen-morph") for each box and clustered boxes with shared morphometry. This analysis reveals 6 modules with characteristic dendritic features and spanning contiguous striatal territories, each receiving distinct corticostriatal inputs. Finally, we found aging confers robust dendritic length and branching defects in MSNs, while Huntington's disease (HD) mice exhibit selective length-related defects. Together, our study demonstrates a systems-biology approach to profile dendritic morphology of genetically-defined single-neurons; and defines novel striatal D1/D2-MSN morphological territories and aging- or HD-associated pathologies.

Deep Learning Models for Anatomical Location Classification in Esophagogastroduodenoscopy Images and Videos: A Quantitative Evaluation with Clinical Data.

During gastroscopy, accurately identifying the anatomical locations of the gastrointestinal tract is crucial for developing diagnostic aids, such as lesion localization and blind spot alerts. This study utilized a dataset of 31,403 still images from 1000 patients with normal findings to annotate the anatomical locations within the images and develop a classification model. The model was then applied to videos of 20 esophagogastroduodenoscopy procedures, where it was validated for real-time location prediction. To address instability of predictions caused by independent frame-by-frame assessment, we implemented a hard-voting-based post-processing algorithm that aggregates results from seven consecutive frames, improving the overall accuracy. Among the tested models, InceptionV3 demonstrated superior performance for still images, achieving an F1 score of 79.79%, precision of 80.57%, and recall of 80.08%. For video data, the InceptionResNetV2 model performed best, achieving an F1 score of 61.37%, precision of 73.08%, and recall of 57.21%. These results indicate that the deep learning models not only achieved high accuracy in position recognition for still images but also performed well on video data. Additionally, the post-processing algorithm effectively stabilized the predictions, highlighting its potential for real-time endoscopic applications. This study demonstrates the feasibility of predicting the gastrointestinal tract locations during gastroscopy and suggests a promising path for the development of advanced diagnostic aids to assist clinicians. Furthermore, the location information generated by this model can be leveraged in future technologies, such as automated report generation and supporting follow-up examinations for patients.

Preliminary Characterisation of Immune Cell Populations in the Oral Mucosa of a Small Cohort of Healthy Dogs (Canis lupus familiaris).

Pre-determined anatomical locations in the oral cavity were biopsied, and their histomorphology was characterised using haematoxylin and eosin staining (H&E). The most abundant cell type was of dendritic morphology. Lymphocyte foci were not evident in the palatoglossal folds or the gingiva. Immunohistochemical staining (IHC) for validated leukocyte markers followed, including CD3, CD20, CD79α, CD204, andIba1. Consistent with H&E findings, CD204 immunoreactivity predominated amongst all niches. With the exception of the alveolar mucosa and palatoglossal folds, we also demonstrate a significant difference in the population of macrophages by region for only the Iba1 antigen (p < 0.0001). B lymphocytes were found, and a significant difference was noted in the sub-epithelium where CD20-positive cells outnumbered those labelled as CD79a positive (p = 0.001), suggesting the possibility that these cells are in an active state in health. A similar significant difference was found in the subepithelial tissue for myeloid cells, as there were more cells labelled as CD204 positive over Iba1, which, along with their distribution pattern, indicates a possible functional and morphological overlap between these cells. No significant difference was found in epithelial tissues for cells of either myeloid or lymphoid origins. The results from this study suggest different regions of the oral cavity exhibit variations in the distribution of immune cells, particularly macrophages and B lymphocytes. Though more studies would be needed to confirm these findings, these differences may have implications for the immune response and overall health of the oral mucosa.

Epispadic accessory urethra in an 8 months old female with urethral duplication: a case report

Introduction and Importance: Urethral duplication is an uncommon urogenital congenital disability that presents as an accessory urethra in an atypical location. This condition is often coupled with other congenital anomalies like bladder exstrophy, pseudohermaphroditism, and renal disorders. Case Presentation: We report a case of a female infant aged eight months with urethral duplication, showing an unusual urinary opening in the prepubic area and urinary discharge. A comprehensive diagnostic assessment, consisting of a clinical exam, imaging tests, and cystoscopy, verified the existence of an accessory urethra and the normal one in epispadias. The patient had a successful surgery to remove the accessory tract with primary closure. Clinical Discussion: Urethral duplication is associated with diverse clinical signs and symptoms. Accurate diagnosis needs thorough imaging studies, and treatment should be tailored according to the type and anatomical location of the accessory tract. Conclusion: The histological confirmation of urethral duplication was obtained following the surgical excision of the additional tract. This case underscores the significance of accurate diagnosis and treatment approaches to manage this case.

A magnetic resonance imaging-based morphometric analysis of bilateral L1-L5 oblique lumbar interbody fusion corridor: feasibility of safe surgical approach and influencing factors.

Retrospective cross-sectional study. To investigate the size and local anatomy of the right and the left-sided oblique corridors between L1-L5 levels and identify the potential impact of increasing age and sex on corridor size. The oblique lumbar interbody fusion (OLIF) was introduced by Silvestre and his colleagues as a solution to the approach-related complications associated with anterior lumbar interbody fusion and lateral lumbar interbody fusion. Limited data were available describing the local anatomy and morphology of this approach. Imaging data of 300 patients (150 males and 150 females) who underwent 1.5T magnetic resonance imaging (MRI) scans of the lumbar spine at Indian Spinal Injuries Centre, New Delhi, India between January 2023 and January 2024 were retrospectively reviewed. The cohort was stratified into six age groups (21-30, 31-40, 41-50, 51-60, 61-70, and >70 years) with 25 patients in each age group for both sexes. T2 weighted axial MRI images were analyzed from the L1-L5 level at the mid-disc level to calculate the corridor size. The local anatomical differences were recorded. At L1-L2, L2-L3, L3-L4, and L4-L5 levels, the mean corridor sizes in males were 17.48, 15.50, 13.41, and 9.32 mm on the left side, and 11.48, 7.12, 4.34, and 1.64 mm on the right side, respectively. The corresponding mean corridor sizes in females were 10.34, 12.94, 12.64, and 7.22 mm on the left side and 2.66, 3.52, 3.69, and 1.64 mm on the right side, respectively. For both sides, the corridor size was significantly affected by sex, increased with age, and decreased at the lower lumbar disc levels. A left-sided OLIF approach is more feasible for both sexes. The right-sided approach is less likely to be performed effectively.

Non-invasive miRNAs for early detection and diagnosis of lacrimal adenoid cystic carcinoma.

Lacrimal adenoid cystic carcinoma (LACC) is one of the most common malignant epithelial tumors of the lacrimal gland, characterized by high rates of local recurrence, distant metastases, and tumor-related mortality. This malignancy impairs the lacrimal gland's ability to secret tears, thereby disrupting the normal function of the ocular surface. Due to ineffective diagnostic approaches and the complex anatomical location of the lacrimal gland within the orbit, many LACC patients are often diagnosed at the later stages. Therefore, it is urgent to develop a simple and convenient method for early detection of LACC through biomarker analysis by liquid biopsies, such as blood or tears. Various microRNAs (miRNAs) derived from liquid biopsies have been shown to serve as biomarkers for early diagnosis of tumors. In the present study, we screened LACC-specific miRNAs using miRNA microarray analysis in both primary and recurrent patient groups. We then validate their expression by qPCR experiments conducted in tissues, cell lines, tear fluid and serum to explore the association between these miRNAs and LACC development and prognosis. Our findings reveal that hsa-miR-200b-3p, hsa-miR-200c-3p and hsa-miR-141-3p are significantly upregulated in LACC, and the microarray data showed that these three miRNAs were significantly elevated in the recurrence group compared to the primary group. In conclusion, detecting miRNA expression in tear fluid and serum provides non-invasive biomarkers for the early diagnosis of LACC and may facilitate monitoring outcomes related to lacrimal gland diseases.

Anatomical Location of Rib Fractures and Associated Analgesic Benefits Achieved From Serratus Anterior Plane Blocks: A Spatial Point Pattern Analysis.

Anatomical Location of Rib Fractures and Associated Analgesic Benefits Achieved From Serratus Anterior Plane Blocks: A Spatial Point Pattern Analysis.

Mesenchymal tumors of the mediastinum: analysis of the clinical case

Mediastinal tumors include a wide range of benign and malignant neoplasms. The latter in the early stages are characterized by a long latent course and carry a significant threat of com pression and / or invasion of vital organs of the mediastinum. The complexity of their diagnosis is complemented by a mixed clinical picture, similar to other somatic diseases. Considering all of the above, mediastinal tumors are an urgent problem for the modem oncological community, they require improving knowledge and gaining experience in their surgical and conservative treatment. Mesenchym al tumors of the mediastinum make up a small part of tumors of the mediastinal space, and the low incidence of neoplasm s of this anatomical localization dictates the need for an interdisciplinary approach to the diagnosis and treatment of mesenchym al tumors of the mediastinal space. A clinical case of the disease is considered, an effective and radical surgical treatment method is demonstrated. The asymptomatic course of the early stages of the disease, as w ell as the relatively low effectiveness of surgical intervention in the late period of oncogenesis, dictates the need to search for new approaches in the diagnosis and treatment of mediastinal tumors.

Antibacterial effect of semiconductor laser radiation against the strains of S. aureus and P. aeruginosa, leading pathogens in osteomyelitis

Introduction The study of the antibacterial effect of photodynamic therapy against the leading pathogens of chronic osteomyelitis is one of the promising directions today.Purpose of the work was to evaluate the antibacterial effect against the strains of Staphylococcus aureus and Pseudomonas aeruginosa with the ALOD-01 laser system in the presence of photodithazine.Materials and methods The object of the study was 24-hour archival cultures of gram-positive and gram-negative microorganisms belonging to two taxa: Staphylococcus aureus (25923), Pseudomonas aeruginosa (27853). The antibacterial effect after the exposure to laser radiation in the presence of photodithazine on the microbial cells of the studied cultures was assessed by the absence of microorganism growth in the area of the light beam.Results Laser exposure in combination with photodithazine (concentration 0.5–1.0 mg/ml) on S. aureus for two minutes at 200–300 J achieved a bactericidal effect in the beam area. A bactericidal effect on the entire surface of the Petri dish was achieved with light exposure of 400 J for 5 minutes and a photodithazine concentration of 1.0 mg/ml. Laser exposure for 2 minutes in the presence of photodithazine at a concentration of 0.5 mg/ml and 1 mg/ml did not have an antibacterial effect on P. aeruginosa strains. Continuous growth of microorganisms was observed on the dish. Increasing the light dose and exposure time contributed to a decrease in the growth of microbial cells. A bactericidal effect was obtained only in the center of the dish in treating the bacterial suspension with photodithazine at a concentration of 5 mg/ml.Discussion The effectiveness of PDT depends on the type of microorganisms, the anatomical location of the infection site, as well as the properties of the photosensitizer and the laser used. Depending on the structure of the cell wall, different susceptibility of bacteria to photodynamic effects is observed.Conclusion S. aureus strains can be successfully photoinactivated using photodithazine. For P. aeruginosa strains, it was not possible to find a regime in which microbial cell growth was absent throughout the dish. The photodynamic reaction occurs only when adequate doses of light energy act on the photosentisizer in the presence of oxygen in the medium, while the photodynamic damage is local and the bactericidal effect is limited by the zone of light exposure.

Emerging Applications of Image Post-Processing 3D Visualisation for Cerebrovascular Diseases.

Intracranial vascular-related diseases are a common occurrence in neurosurgery. They have complex and diverse pathogeneses; further, their diagnosis and treatment remain unclear. Three-dimensional image post-processing technology is an emerging technology that involves converting a brain image scan into a digital model using image post-processing software, thus establishing a 3D view of the region of interest. Three-dimensional visualisation of the brains of patients with cerebrovascular diseases can allow a more intuitive examination of the local anatomy of the lesion as well as the adjacency between the lesion and peripheral nerves, brain tissue, and skull bones. Subsequently, this informs pre-operative planning, allows more accurate diagnosis of cerebrovascular diseases, and improves the safety of surgical treatment. This review summarised the current literature regarding cerebrovascular diseases and the application of 3D image post-processing technology in different cerebrovascular diseases.

Improved Localization of Insulinomas Using 68Ga-NODAGA-Exendin-4 PET/CT.

Precise anatomic localization of insulinomas is crucial for surgical treatment. Current routine noninvasive imaging techniques, including CT, MRI, and 68Ga-DOTA-somatostatin analog (DOTA-SSA) PET/CT, have limited sensitivity. Endoscopic ultrasound is highly sensitive but invasive. In this prospective multicenter study, we compared the diagnostic accuracy of 68Ga-NODAGA-exendin-4 (exendin) PET/CT with all routine imaging procedures for the localization of insulinomas. Methods: Sixty-nine adults with biochemically proven adult endogenous hyperinsulinemic hypoglycemia underwent exendin PET/CT and current routine imaging. Images were evaluated in a clinical reading and in an expert reading. Image quality was determined by quantitative analysis. Results: Based on clinical readings, the accuracy of exendin PET/CT (94.4%; 95% CI, 84.6%-98.8%) was greater than that of DOTA-SSA PET/CT (64.8%; 95% CI, 50.6%-77.3%), contrast-enhanced CT/contrast-enhanced diffusion-weighted imaging-MRI (83.3%; 95% CI, 70.7%-92.1%), and endoscopic ultrasound (82.8%; 95% CI, 64.1%-94.1%). In 13% of patients, a correct diagnosis was only reached after exendin PET/CT. Interobserver agreement between readings was higher for exendin PET/CT than for DOTA-SSA PET/CT and contrast-enhanced CT/contrast-enhanced diffusion-weighted imaging-MRI (Cohen κ, 1.0 vs. 0.5 and 0.55). Exendin PET/CT provided a higher insulinoma-to-background ratio (15.3 ± 6.7 vs. 5.2 ± 3.0) and contrast-to-noise ratio (22.6 ± 11.1 vs. 5.1 ± 3.7) than did DOTA-SSA PET/CT. Conclusion: This study demonstrates the superiority of exendin PET/CT in a unique prospective comparison to all current routine imaging modalities for preoperative localization of benign insulinomas, providing the level of evidence needed for clinical implementation.