Anatomical Size Research Articles

Head and Neck Sarcomas-clinicopathological Findings, Treatment Modalities and Its Outcome - A Retrospective Study.

Introduction:Sarcomas are malignant neoplasms constituting an important group of tumours due to their high morbidity and mortality. They can arise either from soft tissue or bone. Soft tissue sarcomas are common, but bone sarcomas are rare. The aims and objective of this study are to carry out the study of head-and-neck sarcomas between January 2006 and May 2020.Materials and Methods:Eighty-two patients of head-and-neck sarcoma were included. Study of demographic and clinicopathological characteristics including age, sex, gender, presenting symptoms, origin, primary anatomical location, size, tumour grade, staging, treatment modality, recurrence, metastasis, and patient status during the recent visit.Results:Fifty-six (68.3%) were males and 26 (31.7%) were females. The male/female ratio was 2.28:1. The most affected age group was 0–19 years. Tumour size of >5 cm in greatest dimension was seen in 67.1% cases and tumour size of <5 cm in 32.9%. Chemotherapy + radiotherapy (CT + RT) was given in 23.8% followed by surgery in 13.9%. Recurrence was seen in 19.5% and metastasis in 18.3%.Discussion:Rhabdomyosarcoma was the most predominant histological type. Maximum patients reported in late stage. The most commonly used treatment was the combination of CT and RT. Recurrence was seen in 19.5% and distant metastasis in 18.3% patients. Head-and-neck sarcomas are rare so epidemiological studies involving more cases must be carried out for better understanding and better outcome.

РОЛЬ ЛУЧЕВЫХ МЕТОДОВ ДИАГНОСТИКИ У ПАЦИЕНТОВ С ПРИОБРЕТЕННЫМИ ДЕФЕКТАМИ ЧЕЛЮСТНО-ЛИЦЕВОЙ ОБЛАСТИ

Purpose. To compare radiological methods in clinical dental practice of the patients with acquired defects of the maxillofacial region after tumor treatment manipulations. The search of literature has been done in the date bases SCOPUS, Web of Science, Pubmed, Russian Science Citation Index. The usage of different radiology methods combined with IT-technology makes it possible to improve prosthetic dental treatment of the patients with acquired defects of the maxillofacial region, especially of large anatomical size. However, difficult clinical condition and complicated anatomical relations of the acquired defect do not always allow to choose the specific method or technology. This fact effects on quality of the future dental prosthetic denture. Conclusion. According to the obtained data, both visual analysis and semi-quantitative assessment of 18Ffluorodeoxyglucose PET/CT images showed a good diagnostic performance in the detection of PV IE. The optimal parameter for the diagnosis of IE PV is the SUVratio using aorta with threshold of 1.95 (AUC=0.961).

A study of size of nutrient foramina of humerus of Gujarat region

Delayed union or non-union of fracture shaft humerus occurs if there is damage to nutrient artery of humerus during surgical procedure of open reduction of fracture or by displaced bone fragments of fracture or any soft tissue interposition. This implies vital role of nutrient artery of humerus in fracture healing. 200 human dried humeri were studied for its anatomy of size and number of nutrient foramina. Size of nutrient foramen and thereby size of nutrient artery was decided with use of hypodermic needle No. 20 G & No. 24 G from Eastern medikit Limited. Observations made were compiled and tabulated. In present study, out of 282 nutrient foramina, 98 (35%) were large sized. Single nutrient foramina were found on 63% of humerus which is indicative of single nutrient artery to humerus and amongst them 40% humerus having large sized nutrient foramina. 65% of large sized nutrient dominant foramina were found on humerus having more than one nutrient foramina. 60 (49%) large sized nutrient foramina were found on right side humerus which is points to more use of right arm. Orthopaedic surgeons treating opened or displaced fracture shaft humerus can very well prevent damage to nutrient artery of humerus with sound knowledge of size of nutrient foramina and thereby its artery and add to better prognosis of fracture healing.

Evaluation of risk factors of anterior cruciate ligament (ACL) Injury: A prospective comparative analysis

Introduction: Anterior Cruciate Ligament (ACL) is the most frequently injured knee ligament. Combination of valgus force with internal rotation is the most common mechanism involved in ACL injury. Both modifiable and non-modifiable risk factors are responsible for the ACL injury. Purpose: To determine the risk factors causing ACL injury by comparing lower limb anatomical features, ACL size and body mass index (BMI) between ACL deficient and ACL intact knees. Materials and Methods: Mechanical axis deviation from vertical axis, tibiofemoral angle, hip neck-shaft angle, posterior tibial slope, notch width index were compared using radiography. BMI and ultrasonographic (USG) diameter of ACL were also measured for comparison. Results: Among the anatomical lower limb parameters mechanical axis deviation from vertical axis, hip neck shaft angle and tibiofemoral angle showed non-significant (p value>0.05) differences while there were significant differences of femoral notch width index (p= 0.014) and posterior tibial slope angle (p

Can an injured discoid lateral meniscus be returned to the correct anatomic position and size of the native lateral meniscus after surgery?

BackgroundNo previous studies have compared the position and size of the remaining discoid lateral meniscus (DLM) with that of a normal lateral meniscus. This study aimed to evaluate the postoperative position and size of DLM compared with that of normal controls using magnetic resonance imaging (MRI). MethodsThis retrospective study involved 52 symptomatic complete type DLMs (discoid group) who underwent arthroscopic surgery and 50 normal controls (control group). Pre- and postoperative MRI evaluations, height, width, and relative percentage of extrusion (RPE) were assessed. Sagittal position parameters, including distances from articular cartilage center to anterior meniscus (CAMD) and from anterior articular cartilage margin to anterior horn (ACMD), were also assessed. Logistic regression analysis was performed to find factors with extrusion of remaining DLM. ResultsThe height of the discoid group was significantly lower than that of the control group (P = 0.000). RPE in the discoid group was significantly larger than in the control group (P = 0.005). Only CAMD and ACMD in the discoid group were different (positioned more anteriorly) from the control group (P = 0.000). Preoperative meniscal shift (odds ratio (OR): 12.448; P = 0.003) and operative technique, especially partial meniscectomy with repair (OR: 19.125; P = 0.000), were the major factors associated with extrusion. ConclusionThe width of remaining DLM was comparable to that of normal controls, but the position was found to be more anterior and lateral than that of normal controls. Preoperative meniscal shift and combined meniscus repair were the major factors for smaller width and greater extrusion; thus, surgeons should address and counsel these factors before surgery.

Abstract 15899: A Hybrid Artificial Intelligence-Intrinsic Frequency Method for Instantaneous Determination of Myocardial Infarct Size

Introduction: Intrinsic Frequency (IF) method is a recently developed systems-based method that extracts dynamics information about left ventricle function (LV), arterial dynamics, and the LV-arterial coupling from arterial waveforms. We have recently shown (Alavi et al. Circulation, 140 (2019), A12573-A12573) that IF can detect occurrence of an acute myocardial infarction (MI) using a single carotid pressure waveform. Here, we propose that the myocardial infarct size (area of necrosis over total LV area) can be approximated using a hybrid IF-artificial neural network (ANN) method. Methods: The standard MI model was used in anesthetized Sprague Dawley rats (n=27). The proximal left coronary artery was occluded for 30 minutes to ensure necrosis followed by 3 hours of reperfusion. The left ventricle slices were incubated in triphenyl tetrazolium chloride (TTC) to distinguish the necrotic (white) and the non-necrotic (dark red) areas (Fig.1a), thereby obtaining the size of MI through histopathology. IF parameters were computed from random carotid pressure waveforms 2 hours after the reperfusion. A 3-layer ANN model (4 input, 5 hidden, and 1 output node) was applied on IFs from 22 rats to design the ANN (18 for training, 4 for validation). The model was then tested on 5 different rats with the same MI procedure described above. Results: The results showed a significant correlation (R=0.64, P&lt;0.0005) between our IF-artificial intelligence (IF-AI) model and the infarct size. The correlation was especially strong (R=0.84, P&lt;0.0001) without the two outliers shown in Fig.1b. Conclusions: Our results suggest that a hybrid IF-AI method can predict the anatomic infarct size from an arterial waveform without advanced imaging. This technique is clinically significant since infarct sizes are link to the survival and development of heart failure in MI patients, and IF parameters can be obtained noninvasively from carotid waveforms using arterial tonometry devices or an iPhone.

Mimics of vasculitis

While prompt diagnosis of vasculitis is important, recognition of vasculitis mimics is equally essential. As in the case of vasculitis, an approach to mimics based on the anatomic size of vessels can be useful. Infections can mimic vasculitis of any vessel size, including the formation of aneurysms and induction of ANCAs. Genetic disorders and vasculopathies are important considerations in large and medium vessel vasculitis. Cholesterol emboli, thrombotic conditions and calciphylaxis typically affect the medium and small vessels and, like vasculitis, can cause cutaneous, renal and CNS manifestations. Reversible cerebral vasoconstriction syndrome is important to distinguish from primary angiitis of the CNS. As an incorrect diagnosis of vasculitis can result in harmful consequences, it is imperative that the evaluation of suspected vasculitis includes consideration of mimics. We discuss the above mimics and outline a systematic and practical approach for differentiating vasculitis from its mimics.

Colchicine-induced tetraploidy in Dendrobium cariniferum and its effect on plantlet morphology, anatomy and genome size

Dendrobium cariniferum Rchb. f. is an important crossing parent that is primarily used to produce aromatic Dendrobium orchid cultivars due to its beautiful flowers and pleasant orange fragrance. However, there are no offspring within the limited progenies that fully inherit this odor trait. Thus, converting diploid D. cariniferum into tetraploids for interploid hybridization is another promising approach to creating a new orange aroma germplasm. This study reports a novel in vitro colchicine-induced chromosome doubling protocol that would effectively convert diploid D. cariniferum protocorms into tetraploids. A total of 120 tetraploid genotypes were identified by flow cytometry. The tetraploid induction rate was significantly affected by interaction between the colchicine concentration and exposure time. Treatment with 0.05% colchicine for 24 h produced the optimal results, yielding 54% surviving regenerated plantlets with a 33% tetraploid induction rate. The tetraploid plantlets displayed obvious morphological variations (broader, thicker leaves and greater stem and root diameters) than the diploid plantlets. Tetraploidization also caused a significant change in the leaf anatomical structure, including larger stomata with lower densities, more chloroplasts per stomata, thicker spongy tissues, larger leaf veins and decreased adaxial epidermal cell and trichome densities. We were the first to observe that there are one to five branched trichomes in the leaf sheath in both diploids and tetraploids, and we propose that the leaf adaxial epidermal cell density can be used to identify tetraploids. Moreover, tetraploids exhibited a 1.75-fold greater genome size than diploids. Our study lays the foundation for breeding triploid aromatic Dendrobium orchids. Autotetraploidy causes morphological, anatomical and genome size variations. This is the first report of trichome types in the leaf sheath. Leaf adaxial epidermal cell density is useful for identifying tetraploids.

Spontaneous closure of ventricular septal defects in newborns the first year of life

Abstract Background Ventricular septal defect (VSD) is one of the most common congenital heart defects. Some VSDs close spontaneously while persistence of the VSD may result in heart failure and, at long term, irreversible pulmonary hypertension. Consequently, identification of factors associated with spontaneous closure are important to ensure relevant clinical follow up of those at risk of a persistent VSD. Purpose We aimed to assess the rate of spontaneous closure in a population-based cohort of newborns with VSD and to identify significant predictors for spontaneous closure. Methods The study is part of a large-scale population-based study, focusing on cardiac structure and function, including newborns born from 1st April 2016 to 31st October 2018. Newborns with a VSDs at baseline were followed with echocardiography at 3, 6 and 12 months (+30 days) of age. Cox proportional hazard model was used to determine significant predictors of spontaneous closure Results Based on echocardiographies of 25.750 newborn, 850 newborns (3.3%) with a VSD were identified. The majority of newborns with VSDs were born at term (88.7%) and the mean age at inclusion was 11.7±8.1 days. VSDs were more frequent in females (57.1%, p&amp;lt;0.001). Of all VSDs, 787l (92.6%) were of a muscular type, 60 (7.0%) of perimembranous type and 3 (0.4%) were of subarterial type. Multiple VSDs were found in 98 (11.5%) cases and all were of a muscular type. Muscular VSDs were significantly smaller than perimembranous VSDs (1.9±0.7 mm vs. 3.7±1.8 mm, p&amp;lt;0.0001). During the follow up period, seven (0.8%) children underwent surgical repair: five (5 of 56) children with perimembranous VSDs and two (two of three) children with subarterial VSDs. Follow-up was complete in 89.4% of all children. After one year 82.6% (601 of 727) VSDs had closed spontaneously. The prevalence of VSD in one-year old children was thus 0.5%. The majority of VSD closed spontaneously during the first 6 months of life (57.6% (419/727)). Muscular VSDs showed significantly higher rate of spontaneous closure compared with perimembranous VSDs (86.9% (582 /670) vs. 46.2% (25/54), p=0.0001) during the first year of life. No subarterial VSDs closed spontaneously during follow-up. Muscular type (p=0.002), size (p&amp;lt;0.001) and presence of one VSD as opposed to multiple (p&amp;lt;0.0025) were associated to spontaneous closure. Sex did not significantly influence spontaneous closure rate (p=0.65). Conclusion In a population study including more than 25,000 newborns we found that the vast majority, i.e. almost 9/10 of all VSDs, closed spontaneously during the first year of life, ultimately resulting in a prevalence of VSD in one-year old children of 0.5%. The identified factors associated with spontaneous closure – anatomical location, size and presence of multiple VSDs are of use for future management of VSDs in newborns. Funding Acknowledgement Type of funding source: Other. Main funding source(s): The Danish Heart Foundation

Radiographic Methods Are as Accurate as Magnetic Resonance Imaging for Graft Sizing Before Lateral Meniscal Transplantation

Background: Accurate allograft matching is deemed critical for meniscal transplantation; thus, precise measurements are essential to correctly calculate meniscal size. Several methods for meniscal sizing have been described, but there remains a discussion on which is the most accurate for the lateral meniscus. Purpose: To compare the accuracy of radiographic, anthropometric, and magnetic resonance imaging (MRI) methods of determining width and length of the lateral meniscus with actual dimensions after anatomic dissection. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen human cadaveric knees without any evidence of meniscal or ligamentous injury were primarily imaged using radiography and MRI and subsequently underwent dissection to assess the anatomic size of each meniscus. Four methods were used to predict the size of the lateral menisci: anthropometric, radiographic (Pollard and Yoon), and MRI. Absolute differences in length and width between actual and predicted sizes were determined. Results: The anatomic lateral meniscal width and length were 33.01 ± 4.25 mm (mean ± SD; range, 24.84-40.18 mm) and 31.41 ± 5.06 mm (range, 25.2-40.05 mm), respectively. Regarding width, the anthropometric method demonstrated an absolute difference from anatomic measurement significantly greater when compared with the Pollard technique and MRI (P = .002). Regarding length, the Pollard method presented an absolute difference significantly greater than all other techniques (P = .003). In terms of the ability to measure width and length, MRI accurately predicted meniscal size within 10% of the anatomic size in 65% of measurements, the Yoon method in 54%, and the Pollard method in 20% (P = .01). Radiographs tended to overestimate the true size of the lateral meniscus, while the anthropometric technique overestimated width in all specimens. Conclusion: This study demonstrated that MRI and the Yoon radiographic method are comparable in terms of accuracy for graft sizing before lateral meniscal transplantation. While MRI is useful, a contralateral MRI is required, which makes the Yoon radiographic method recommended given the ease and cost advantage. The original Pollard technique and the anthropometric method are not recommended. Clinical Relevance: Over- and undersizing of meniscal transplants has been implicated in graft failure. Therefore, increasing the reliability of preoperative meniscal measurements is deemed important for the success of meniscal allograft transplantation.

Features of peripheral blood B cell phenotype in patients with pressure ulcers

Pressure ulcers represent most common surgical pathology in the pattern of nosocomial complications. However, no unified mechanism leading to development of pressure ulcers has been proposed yet despite the lead role played by compression and immobilization. In this regard, examining immune system as the main component maintaining integrity of anatomical barriers in the skin and mucous membranes seems highly promising for creating new methods to prevent and treat pressure ulcers. Our study was aimed at investigating phenotypic profile of peripheral blood B cells in patients with pressure ulcers. There were enrolled 67 patients complicated with pressure ulcers at the Department of Surgery. Examination of pressure ulcers included determining anatomical localization, investigating depth (degree) and size of the lesion (by measuring wound area), skin color and assessing nature of pressure ulcer edges and edema, wound bottom, presence of cavity with tendons and/or bone formations may be recognized therein, characteristics of exudate (smell, color), pain sensation. In control group there were included 81 apparently healthy subjects. All groups contained age- and sex-matched subjects. Phenotyping of peripheral blood B cells was performed by using flow cytometry with panel of monoclonal antibodies. It was found that count of B cells in patients did not change in parallel with increased total lymphocyte count, but was associated with their functional activity (increased percentage of CD23- and CD38-positive B cells). Moreover, percentage of B1 and naive B2 cells declined in patients with pressure ulcers that seemed to be associated with the premorbid background of the main disease, lack of adequate wound healing process coupled to tissue necrosis and damage to skin capillaries. The more severe the clinical course of pressure ulcers (regarding area and stage of development), the smaller percentage of B2 cells (both naive and memory B cell subsets) was detected in the patient peripheral blood. At the same time, changes in the B cell phenotypic profile from patients are associated with the area of lesion, but not with the stage of developing pressure ulcers evidencing that B cells affect healing of pressure ulcers. The features of B cell phenotype promote unfavorable disease outcome evidenced by the lack of quantitative differences in B cell lineage composition or level of surface expression for activation markers.

How are midfoot (i.e. Chopart and Lisfranc joint) kinematics altered in adolescents with CP with plano-valgus feet, compared to healthy subjects?

Detecting pseudarthrosis following spinal fusion is important for accurate diagnosis and treatment. Current diagnostic measures hold certain drawbacks. Radiostereometric analysis (RSA) is a radiographic technique with the capability to measure intervertebral segment changes and may be a novel way of assessing fusion.The purpose of this work was to measure the accuracy and precision of RSA in instrumented posterior cervical and lumbar spinal fusion for measuring intervertebral movement. Further, to gain surgical practice with RSA in spine and determine optimal bead placements.Artificial bone and cadaveric spine models were used to simulate a 3-level cervical (C3–C6) and a 2-level (L4–S1) lumbosacral posterior spinal fusion to analyze bead placements and to measure RSA accuracy and precision.Preliminary RSA bead placements were planned and measured in the artificial model. Secondary bead placements were adjusted slightly in the cadaveric model to consider additional fusion scenarios. Bead spread, detectability, and stability were measured to determine optimal placements. Translational and rotational precision of both models were measured. Accuracy was measured in the artificial spine model. Model-based RSA software was used for analysis.Optimal bead placements were found to be throughout the lateral mass of C3–C6 and in the spinous process, transverse process, and within the screw canal of L4–S1. Detectability was high among all segments. Spread was greater in L4–S1 than C3–C6 due to bead collinearity along the transverse axis of the cervical vertebrae. Translational and rotational RSA accuracy in cervical and lumbosacral regions ranged between 0.005 to 0.014 mm and 0.058 to 0.208°. Translational and rotational precision measured in the phantom models ranged 0.017 to 0.131 mm and 0.058 to 0.394° in C3–C6, and 0.086 to 0.191 mm and 0.200 to 0.369° in L4–S1. Translational and rotational precision measured in the cadaveric models ranged 0.054 to 0.548 mm and 0.148 to 1.386° in C3–C6, and 0.068 to 0.164 mm and 0.100 to 0.270° in L4–S1.RSA was found to be a feasible radiographic technique in C3–C6 and L4–S1 spinal fusion when measured in artificial and cadaveric models. Optimal bead placements were determined. Bead spread was shown to be better throughout the lumbar region than the cervical region due to anatomical size variations. RSA accuracy and precision were within acceptable RSA criteria.The results from this work contribute to the accuracy, precision, and bead placements for studying RSA in cervical and lumbar spinal fusions. This work may further support the development of clinical studies to assess spinal fusion by evaluating postoperative intervertebral movement using RSA.

Losing Regulation of the Extracellular Matrix is Strongly Predictive of Unfavorable Prognostic Outcome after Acute Myocardial Infarction.

This study tested the hypothesis that MMP-9−/−tPA−/− double knock out (i.e., MTDKO) plays a crucial role in the prognostic outcome after acute myocardial infarction (AMI by ligation of left-coronary-artery) in MTDKO mouse. Animals were categorized into sham-operated controls in MTDKO animals (group 1) and in wild type (B6: group 2), AMI-MTDKO (group 3) and AMI-B6 (group 4) animals. They were euthanized, and the ischemic myocardium was harvested, by day 60 post AMI. The mortality rate was significantly higher in group 3 than in other groups and significantly higher in group 4 than in groups 1/2, but it showed no difference in the latter two groups (all p < 0.01). By day 28, the left-ventricular (LV) ejection fraction displayed an opposite pattern, whereas by day 60, the gross anatomic infarct size displayed an identical pattern of mortality among the four groups (all p < 0.001). The ratio of heart weight to tibial length and the lung injury score exhibited an identical pattern of mortality (p < 0.01). The protein expressions of apoptosis (mitochondrial-Bax/cleaved-caspase3/cleaved-PARP), fibrosis (Smad3/T-GF-ß), oxidative stress (NOX-1/NOX-2/oxidized-protein), inflammation (MMPs2,9/TNF-α/p-NF-κB), heart failure/pressure overload (BNP/ß-MHC) and mitochondrial/DNA damage (cytosolic-cytochrome-C/γ-H2AX) biomarkers displayed identical patterns, whereas the angiogenesis markers (small vessel number/CD31+cells in LV myocardium) displayed opposite patterns of mortality among the groups (all p < 0.0001). The microscopic findings of fibrotic/collagen deposition/infarct areas and inflammatory cell infiltration of LV myocardium were similar to the mortality among the four groups (all p < 0.0001). MTDKO strongly predicted unfavorable prognostic outcome after AMI.

Synchronized Inflations Generate Greater Gravity-Dependent Lung Ventilation in Neonates

To describe the regional distribution patterns of tidal ventilation within the lung during mechanical ventilation that is synchronous or asynchronous with an infant's own breathing effort. Intubated infants receiving synchronized mechanical ventilation at The Royal Children's Hospital neonatal intensive care unit were studied. During four 10-minute periods of routine care, regional distribution of tidal volume (VT; electrical impedance tomography), delivered pressure, and airway flow (Florian Respiratory Monitor) were measured for every inflation. Post hoc, each inflation was then classified as synchronous or asynchronous from video data of the ventilator screen, and the distribution of absolute VT and delivered ventilation characteristics determined. In total, 2749 inflations (2462 synchronous) were analyzed in 19 infants; mean (SD) age 28 (30) days, gestational age 35 (5) weeks. Synchronous inflations were associated with a shorter respiratory cycle (P=.004) and more homogenous VT (center of ventilation) along the right (0%) to left (100%) lung plane; 45.3 (8.6)% vs 48.8 (9.4)% (uniform ventilation 46%). The gravity-dependent center of ventilation was a mean (95% CI) 2.1 (-0.5, 4.6)% toward the dependent lung during synchronous inflations. Tidal ventilation relative to anatomical lung size was more homogenous during synchronized inflations in the dependent lung. Synchronous mechanical ventilator lung inflations generate more gravity-dependent lung ventilation and more uniform right-to-left ventilation than asynchronous inflations.

Reliability of dopamine transporter PET measurements with [18F]FE-PE2I in patients with Parkinson\u2019s disease

BackgroundReliable quantification of dopamine transporter (DAT), a biomarker for Parkinson’s disease (PD), is essential for diagnostic purposes as well as for evaluation of potential disease-modifying treatment. Due to degeneration of dopaminergic neurons and thus lower expected radioligand binding to DAT, higher measurement variability in PD patients might be expected than earlier reproducibility results in healthy controls. Therefore, we aimed to examine the test-retest properties of [18F]FE-PE2I-PET in PD patients.MethodsNine patients with PD (Hoehn and Yahr stage < 3) were included (men/women 6/3; mean age 65.2 ± 6.8 years). Each patient underwent two [18F]FE-PE2I-PET measurements within 7–28 days. The outcome measure was non-displaceable binding potential generated using wavelet-aided parametric imaging with cerebellum as reference region. We assessed test-retest performance using estimates of reliability and repeatability. Regions for primary analysis were caudate, putamen, ventral striatum, and substantia nigra. Exploratory analysis was performed for functional subdivisions of the striatum. We also compared the more vs. less affected side.Results[18F]FE-PE2I showed absolute variability estimates of 5.3–7.6% in striatal regions and 11% in substantia nigra and ICCs of 0.74–0.97 (median 0.91). The absolute variability for functional striatal subdivisions was 6.0–9.6% and ICCs of 0.76–0.91 (median 0.91). The less affected substantia nigra exhibited greater consistency than the more affected side. According to power calculations based on the current sample size, DAT changes of 5–11% in the striatum and 28% in the substantia nigra can be detected with a power of 0.8 (p < 0.0125).ConclusionDAT-PET measurements with [18F]FE-PE2I in PD patients showed good repeatability and reliability. The slightly lower reliability in the substantia nigra in patients may be explained by lower DAT density and smaller anatomical size. Power calculations suggest that [18F]FE-PE2I PET is a suitable marker for longitudinal DAT decline in PD.Trial registrationEudraCT 2017-003327-29

Evaluation of sclerotherapy of benign oral vascular lesions with monoethanolamine oleate.

To investigate the efficacy of sclerotherapy with monoethanolamine oleate (MEO) in a series of cases of benign oral vascular lesions (BOVL). Clinical records and images were retrieved (2015-2019), and data regarding age, gender, location, size, symptomatology, treatment and outcomes of patients were collected. All patients were diagnosed according to the classification of International Society for the Study of Vascular Anomalies and received the same treatment protocol (MEO 0.05 g/mL). The collected data were submitted to descriptive analysis and Pearson's chi-square test (p ≤ 0.05). Thirty-seven patients were treated. Most were female (70.3%) aged 9 to 88 years (median, 57.5 ± 17.4 years). Lower lip (54.1%) was the most affected site followed by buccal mucosa (16.2%). Thirty-two lesions were asymptomatic and 35.1% showed ≤ 0.5 cm in size. In 48.6% of the patients, only one application of MEO was performed. Complete regression occurred in 62.2% of cases, whereas 27% showed partial regression. One patient showed hypersensitivity during treatment. There was no significant difference between clinical outcome and age, anatomic site, size, and number of applications of MEO. Sclerotherapy with MEO is an acceptable and affordable treatment and can provide satisfactory results in BOVL, especially where other treatment options could compromise the esthetic aspects. As it is a non-invasive therapy leading, in most cases, to adequate clinical results, safety, and tolerability, sclerotherapy with MEO can be considered an effective treatment for BOVL.

Comparison of Selected Anatomical and Treatment-related Diagnostic Parameters Estimated by Cone-Beam Computed Tomography and Digital Periapical Radiography in Teeth with Apical Periodontitis.

ABSTRACTObjectivesTo compare selected anatomical and treatment-related diagnostic parameters estimated by cone-beam computed tomography and by digital periapical radiography in teeth with apical periodontitis, and to evaluate reliability of different examiners in interpretation of images obtained by both methods.Material and MethodsTeeth with apical periodontitis were evaluated independently by 2 endodontists and 1 radiologist based on 128 cone-beam computed tomography (CBCT) and 162 digital periapical radiography (DPR) images. Anatomical (size, relation with root, location of periapical radiolucency) and treatment-related (canal obturation length, homogeneity, coronal seal) parameters were assessed. Fleiss kappa reflected inter-observer agreement while intra-examiner agreement was estimated by Cohen’s kappa. McNemar and McNemar-Bowker tests served for evaluation of differences between CBCT- and DPR-based estimates.ResultsCohen’s kappa ranged from 0.62 to 1 for all examiners. Fleiss kappa values were nearly perfect for majority of parameters. Diagnostic discrepancy between methods was found for size of radiolucency that in 15 - 17% cases was larger, and in 25 - 28% smaller in DPR than in CBCT images. DPR revealed 20% of root canals scored as non-obturated while in CBCT - obturation present. Canal obturation was rated as homogenous by CBCT, while absent or non-homogenous by DPR, in 17 - 23%, and 11 - 14% of cases, respectively. Radiologist detected more root perforations in CBCT than in DPR images.ConclusionsGood intra- and inter-examiner agreement for anatomical and treatment-related diagnostic parameters was achieved using cone-beam computed tomography and digital periapical radiography methods and demonstrated similar diagnostic capability, although variation regarding root perforations and canal obturation quality was observed.

A Novel and Reproducible Classification of the Vertebral Artery in the Subaxial Cervical Spine.

An injury of the vertebral artery (VA) is one of the most catastrophic complications in the setting of cervical spine surgery. Anatomic variations of the VA can increase the risk of iatrogenic lacerations. To propose a novel and reproducible classification system that describes the position of the VA based on a 2-dimensional map on computed tomography angiographs (CTA). This cross-sectional retrospective study reviewed 248 consecutive CTAs of the cervical spine at a single academic institution between 2007 and 2018. The classification consists of a number that characterizes the location of the VA from the medio-lateral (ML) aspect of the vertebral body. In addition, a letter describes the VA location from the anterior-posterior (AP) aspect. The reliability and reproducibility were assessed by 2 independent raters on 200 VAs. The inter- and intrarater reliability values showed the classification's reproducibility. The inter-rater reliability weighted κ-value for the ML aspect was 0.93 (95% CI: 0.93-0.93). The unweighted κ-value was 0.93 (95% CI: 0.86-1.00) for "at-risk" positions (ML grade ≥1), and 0.87 (95% CI: 0.75-1.00) for "high-risk" positions (ML grade ≥2). The weighted κ-value for the intrarater reliability was 0.94 (95% CI: 0.95-0.95). The unweighted κ-values for the intrarater reliability were 0.95 (95% CI: 0.91-0.99) for "at-risk" positions, and 0.87 (95% CI: 0.78-0.96) for "high-risk" positions. The proposed classification is reliable, reproducible, and independent of individual anatomic size variations. The use of this novel grading system could improve the understanding and interdisciplinary communication about VA anomalies.

A Comprehensive Review of Radiohumeral Synovial Plicae for a Correct Clinical Interpretation in Intractable Lateral Epicondylitis

Radiohumeral synovial plicae (RHSP) have been studied by different authors in different ways; in spite of this, the evidence is poor and the results are controversial and inconclusive even when it comes to referring to this elbow structure. The aim of this article is to review the embryologic development, anatomy and histology, pathophysiologic features, clinical manifestations, physical examination, imaging findings, and treatment of radiohumeral synovial plicae, for their correct clinical interpretation in patients with intractable lateral epicondylitis. Radiohumeral synovial plicae syndrome (RHSPS) can cause intractable lateral epicondylitis and can be easily confused with other clinical conditions affecting the elbow. Many clinicians are not familiar with radiohumeral synovial plica syndrome since there are not many studies about it and previous reports do not seem to reach a consensus. Although its role in elbow injuries and epicondylitis is accepted and its surgical treatment is effective, there is no clear consensus about clinically relevant aspects. RHSP are remnants of normal embryo development of the articular synovial membrane with different anatomical locations, size and shape. Traumatism or overuse can turn RHSP into symptomatic structures at any age and can be compressed between the radial and humeral heads during movement. This compression can cause pain and other symptoms such as snapping, catching, mobility restriction, pitching, clicking, locking, blockage, popping and swelling. Radiohumeral synovial plica syndrome (RHSPS) may be an isolated condition or it can be associated with other elbow abnormalities. The findings on physical examination and imaging diagnosis are multiple and variable. Nowadays, RHSPS are quite unknown and previous reports do not seem to agree, leading to misdiagnoses as epicondylitis and making this structure the main cause of some cases of "intractable lateral epicondylitis". The outcomes of surgical treatments are quite promising although more, higher quality research is needed. Taking this into account, this review is meant to be a starting point for new anatomical and clinical studies.

Correlation of Neurological Deficits in Patients with Myelomeningocele on the Basis of Anatomical Location and Size of Base of Defect

Correlation of Neurological Deficits in Patients with Myelomeningocele on the Basis of Anatomical Location and Size of Base of Defect