Axial Sections Research Articles

Periradicular Surgery Guided with Erbium Er Cr Laser:YSGG. Case Report

Purpose: The aim of the study is to observe the bone healing process of a guided periradicular surgery, performed in the endodontics postgraduate course of the University of Santo Tomas, in which an osteotomy was performed for a bone window with erbium, chromium: yttrium, scandium, gallium, garnet (Erbium,Chromium:YSGG) laser, and the healing process was evaluated by cone beam computed tomography (CBCT) during the first four months after surgery. Materials and Methods: After completing the clinical history and studying the CBCT scans, a patient was selected with a diagnosis of symptomatic apical periodontitis, periapical lesion less than 5mm with intact vestibular cortex that required periradicular surgery due to the presence of an adapted fixed prosthesis and the proximity of the mental foramen to the apex of the tooth to be treated. The treatment plan was established, the surgical guide was designed and the osteotomy was performed with Erbium,Chromium:YSGG laser. The size of the periradicular lesion and the bone density of the surgical area were measured at three points in time: pre-surgical (T0) and post-surgical at 24 hours (T1), at 4 months (T2) and at one year. Results: Bone density measured in Hounsfield units (HU) on CBCT in the axial section showed preoperative values in the vestibular apex of 1478 and 1435 HU, at 24 hours after surgery -95 and -210 HU, and in the control at 4 months of 992 and 860 HU. In the coronal slice in the mid vestibular area at the apex level, a preoperative value (T0) of 1335 HU was reported, at 24 hours (T1) -18 HU and at 4 months 1269 HU. At one year of evolution, greater bone density was evidenced comparing between month 4 and month 12. Conclusions: By performing a surgical procedure with guided technique and Erbium,Chromium:YSGG laser for the osteotomy, the adverse effects of the surgical procedures are reduced, achieving results with greater accuracy and better prognosis.

Angular Insertion Depth in Inner Ear Malformations, Relationship to Cochlear Size, and Implications for Electrode Selection.

The objectives were to determine the interrater agreement of the Skull AP X-ray in measuring angular insertion depth (AID), to provide descriptive information about the insertion depths of different electrodes used in inner ear malformations (IEMs), to investigate the effect of cochlear size and electrode length on AID, and to guide clinicians in electrode selection in IEMs. Retrospective case review. Tertiary referral center. A total of 198 IEMs (n = 169 patients) and 60 cochleae with normal anatomy (n = 60 patients) were selected from patients with severe mixed or sensorineural hearing loss who presented to our clinic and underwent cochlear implantation (CI) between January 2010 and December 2022. Three neurotologists independently measured AID on Skull AP X-rays. Basal turn length of the cochlea was measured in axial and coronal oblique reformatted sections on HRCT images. Interrater reliability (ICC) of the AID measurements on Skull AP X-ray, determining the impact of cochlea size and electrode length on AID measurements. The interrater reliability (ICC) test showed a high level of consistency in measuring AID in the Skull AP X-ray (R = 0.906, p < 0.001). In the control group, a negative correlation was observed between the AID and the basal turn length of the cochlea, while a positive correlation was found between electrode length and AID (R = 0.947, p < 0.001). The Skull AP X-ray appears to be a dependable tool for measuring AID. In cases of IEMs, it is important to select an electrode of appropriate length, considering the dimensions of the cochlea.

Puffed-Cheek CT Improved Evaluation of Buccal Mucosal Neoplasm in Contest to Conventional CT Scan

Background: Oral cancer is a frequent cancer in our country, most people are affected by this cancer are older age. Accurate evaluation of this cancer difficult due to close proximity of bones and soft tissue. So for improve diagnostic accuracy Puffed cheek maneuver should be used with traditional Multidetector Computed Tomography (MDCT).Objective: To determine the improved diagnostic accuracy of Puffed cheek Computed Tomography (PCCT) in evaluation of buccal mucosa tumors in contest to non puffed cheek Computed Tomography.Materials and Methods: This descriptive cross sectional study was carried out in Radiology and Imaging department of Khwaja Yunus Ali Medical College and Hospital from 2022(January) to 2023(July). Cases were referred from different department. After meeting the inclusion criteria patients were subjected for CT scan. Imaging was performed from paranasal sinus and neck region with axial sections from pituitary fossa to arch of aorta, after injection of intravenous iodinated contrast media, multiplanar sagittal, coronal reformation images were obtained. Puffed cheek manoeuvre was performed to separate gingival and oral buccal mucosa in all the cases for improved detailed evaluation. The CT result were then compared with non puffed cheek scans results. Results: Among 30 patients 7 cases were missed by conventional CT scan, thirteen patients showed a mass in the oral cavity that were inseparable from 2 mucosal surfaces. Puffed-cheek images clearly showed the mass and surface of tumor involvement. Other 10 patients in conventional CT showed mass in the margins of tongue, oral cavity but extension and infiltration of surrounding structures by the lesion could not be well delineated, puffed-cheek images clearly showed the specific location, extension, adjacent muscles and other structures infiltration. Conclusion: Puffed cheek CT gives better performance to diagnosis the small buccal mucosal tumors, any irregularity, thickening, more detailing of mucosal surface of oral cavity than conventional CT scan, so can helps in choosing the management &amp; surgical approach also. KYAMC Journal Volume: 15, No: 01, April 2024: 29-32.

THE ASSOCIATION BETWEEN FACET JOINT TROPISM AND LUMBAR DISC HERNIATION

ABSTRACT Background/Aims: Facet joint tropism is thought to be associated with lumbar disc herniation (LDH), but this relationship has not been fully established. The aim of this study was to investigate the relationship between facet joint tropism and LDH in patients (25-30 years old and body-mass index 28-30 kg/m²) using computed tomography (CT) and lumbar magnetic resonance imaging (MRI). Methods: Facet joint angles were measured on lumbar MRI and CT images of 24 male patients with left-sided LDH; 16 patients with right-sided LDH. Facet joint angle was measured by calculating the angle of the facet joints with the vertebral sagittal line in axial sections parallel to the end plate plane. Patients with trauma, rheumatic and oncologic diseases, additional lumbar or spinal and systemic diseases, patients with far lateral, foraminal and central lumbar disc herniations were excluded. Results: The mean left facet joint angle was 44,56º+/-11,29° and the mean right facet joint angle was 41,2º+/-11,27° in 24 patients with left-sided LDH. In 16 patients with right-sided LDH, the mean right facet joint angle was 45,87º +/-16,41°and the mean left facet joint angle was 42,74º+/-12,54°. Conclusions: In the statistical evaluation, no significant correlation was found between LDH and facet joint angle, but in the numerical analysis, it was observed that the left facet joint angle was larger in patients with left-sided LDH and the right facet joint angle was larger in patients with right-sided LDH.

Predictors of nasolacrimal duct intubation failure for primary acquired nasolacrimal duct obstruction: a computed tomography-dacryocystography (CT-DCG) study.

Making a choice between nasolacrimal duct intubation and dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO) is an important issue in clinical practice. This study aimed to determine the potential lacrimal sac characteristics that could be used as predictors of unsuccessful intubation for PANDO based on computed tomography-dacryocystography (CT-DCG). In this retrospective comparative observational study, we included PANDO patients with a history of failed intubation for nasolacrimal duct obstruction as the intubation failure group and PANDO patients without a history of intubation as the control group. We analyzed the lacrimal sac height, lacrimal sac width, and obstruction site based on CT-DCG, all measured based on several reference levels on axial sections (upper, intermediate, lower level, common canaliculus level, and lowermost contrast level), which were defined according to the contrast and the bony structure. A total of 114 sides of the PANDO were studied, including 36 in the intubation failure group and 78 in the control group. The intubation failure group showed a smaller lacrimal sac height (11.69±4.59 mm) and width (2.28±1.97 mm, intermediate level) than the control group (14.13±2.92, 3.32±2.02 mm, P=0.005 and 0.012, respectively). The intubation failure group had a higher obstruction site than the control group (P=0.009). A small lacrimal sac and high obstruction site are predictors of nasolacrimal duct intubation failure in PANDO. For PANDO patients with a small lacrimal sac or a high obstruction position, DCR is recommended as opposed to intubation.

Research on the high-performance computing method for the neutron diffusion spatiotemporal kinetics equation based on the convolutional neural network

Due to the uncertainty of computational results and the lack of interpretability of models in solving physical field equations in current deep learning, this paper designs a convolutional neural network that can be used to solve the neutron diffusion spatiotemporal kinetics equation in polar and cylindrical coordinate systems. This algorithm directly utilizes the macroscopic cross-section of the material without using the lattice homogenization method, replaces the finite volume method with the extended matrices, and solves the extended matrices using the convolutional kernels instead of the iterative algorithms. Taking the simplified Tsinghua High Flux Reactor (THFR) as an example, the feasibility of the algorithm is verified on the PyTorch platform and compared with the calculation results of the source iteration method running on the GPU. The calculation results show that when the number of grids in the radial and axial sections of the simplified THFR model is 804,600 and 3,576,000, respectively, and the algorithm is iterated 3000 times, the normalized power of the convolutional neural network and the source iteration method converges to 10−10, and the maximum point by point error of the neutron flux density of the above two algorithms converges to 10−5. The computational time consumed by the convolutional neural network is approximately 880.64 s and 3729.62 s, which reduces the computational time by 4.66% and 5.05% compared to the GPU parallel accelerated source iteration method, and the former consumes 43.75% less memory compared to the latter. The convolutional neural network is mainly used as the virtual physics engine for the THFR digital twin system, in addition to solving the neutron diffusion spatiotemporal kinetics equation and further improving computational speed. The algorithm directly utilizes the neutron macroscopic cross-section of the material to calculate the neutron flux density distribution without using the lattice homogenization, providing theoretical guidance and algorithm support for developing the high-precision multi-physical field coupling model.

Simplifying the Orientation of S1 Iliosacral Screws for Placement in the Dysmorphic Sacrum.

Determining the proper iliosacral screw orientation in a dysmorphic S1 sacral segment using a C-arm is difficult, and pelvic computed tomography (CT) is often necessary for the preoperative planning. On the preoperative pelvic axial CT section, the intended screw trajectory can be delineated intraosseously along the axis of the oblique osseous corridor. An inherently accurate orientation would be determined by 2 factors: (1) the trajectory is in the pelvic transverse plane, and (2) it is oriented relative to the coronal plane at a patient-specific angle, which should be measured preoperatively. Based on the above reasoning, we aimed to simplify and verify the orientation. After establishing the starting point on the sacral lateral view, we tested a method of simplifying the guidewire orientation: placing the guidewire in the pelvic transverse plane and then manipulating it to be angled relative to the coronal plane at the preoperatively measured patient-specific angle. The guidewire orientation should then be reproducibly accurate on the pelvic outlet and inlet views. The feasibility and safety of our method were verified through computer-simulated virtual surgical procedures in 95 dysmorphic sacra and clinical surgical procedures in 12 patients. The primary outcome parameters were the guidewire orientation and screw placement accuracy. Using our method, the S1 guidewire orientation was reproducibly accurate on the pelvic outlet and inlet views in all of the virtual and clinical surgical procedures. Ninety-five virtual S1 screws (1 screw in each left hemipelvis) were placed intraosseously in the pelvic transverse plane. Fourteen unilateral S1 screws were placed intraosseously in the pelvic transverse plane in the 12 patients (2 patients had double screws) without iatrogenic injuries. The guidewire orientation can be simplified by placing the guidewire in the pelvic transverse plane and replicating the preoperatively measured patient-specific angle between the guidewire and the coronal plane. After establishing the starting point on the sacral lateral view, our simplified manipulation yields a reproducibly accurate orientation on the pelvic outlet and inlet views. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Crista Fenestra Heights Measured by HRCT Predicts the Necessity for Extended Round Window Approach for Slim Modiolar Electrode

Objective To evaluate the morphology of the crista fenestra (CF) using three-dimensional reconstruction based on high-resolution computed tomography (HRCT) and to examine the influence of CF height on the insertion approach used for CI632/532 implants. Study design Retrospective study Setting Tertiary referral center Patients Forty-five ears of 37 patients who received CI632/532 implants were included. Interventions HRCT images were reconstructed into three-dimensional images, and CF structures were identified. The patients were divided into two group based on the insertion approach: round window approach (RW; n = 27) and extended round window approach (eRW; n = 18). To evaluate CF interference, 10 cases in the eRW group in which the sheath or electrode did not pass through the RW before widening the RW niche (nRW group) were specifically included in the analysis. Main outcome measure The identified CF cross-sections were confirmed by HRCT axial sectioning, and CF heights were measured. Results The mean CF height was significantly greater in the nRW group than in the RW group (0.97 vs. 0.78 mm). Conclusion CF was identified using three-dimensional computer graphics (3DCG) and the CF height on the HRCT axial sections. Thus, measuring the CF height using 3DCG reconstruction can facilitate the preoperative selection of the electrode insertion approach.

The role of radiomics analysis in the assessment of renal nodules on CT

PurposeTo develop a radiomics model for the characterization of renal nodules on CT.MethodsPatients who underwent surgical resection of renal nodules, with preoperative CT (LightSpeed VCT, GE) with contrast agent (Iopamidol 370; 1.5 ml/kg) and availability of a histopathological report, were retrospectively included. Renal lesions were segmented by two radiologists in consensus, in the arterial phase on the axial section with greater diameter. The radiomics analysis was performed with validated software (PyRadiomics on Syngo.via Frontier, Siemens) by applying normalization, resampling (1,1,1), setting bin width (15), and applying padding (2). The extracted features were used for training and testing machine learning models (random forest and support vector machine (end point: clear cell carcinoma, ccRCC).Results45 patients were included (mean age 56 years; 34/45 ccRCC). SVM e RF models obtained an AUC of 0.84 and accuracy of 0.87 and 0.80, respectively, in the testing phase.ConclusionRadiomics analysis is feasible and effective in the characterization of renal lesions on CT.

Assessing the Reliability of Postoperative Cross-Table Radiographs Compared to CT Scans for Measuring Acetabular Anteversion Angle Following Total Hip Arthroplasty.

This study aimed to evaluate acetabular anteversion following total hip arthroplasty (THA) using cross-table lateral radiographs and CT scans and to determine the reliability of cross-table lateral radiographs compared to computed tomography (CT) scans for measuring acetabular anteversion. We conducted a cross-sectional study of patients undergoing THA at Justice K.S. Hegde Charitable Hospital, Deralakatte, Mangalore, from January 2020 to June 2021. Radiographs are typically taken in both anteroposterior (AP) and lateral views after THA. However, for this study, a cross-table lateral view was used instead of the usual lateral radiograph to measure the angle of anteversion. The anteversion was calculated using the method described by Woo and Morrey. Additionally, CT scans were performed on all patients as part of the study protocol. The anteversion measured in these scans was compared to that in the cross-table radiographs to assess the latter's reliability for routine use. The risk of radiation exposure from CT scans was minimized by adhering to the ALARA (As Low as Reasonably Achievable) principle, with only axial sections of the acetabular cup being scanned. The results show that the radiographic acetabular anteversion and CT scan measurements have a mean difference of 0.3036. There is a positive correlation between these measurements. The p-value is not statistically significant (p=0.698). Therefore, the measurements are correlated with each other with a linear relationship (r=0.919). For anteversion measurements using the X-ray method, the mean was 27.16 degrees with a standard deviation of ±9.49. The median was 27.26 degrees, ranging from 10.27 to 42.58 degrees. In comparison, the CT method yielded a mean anteversion of 27.40 degrees with a standard deviation of ±8.50 degrees. The median was 27.64 degrees, ranging from 12.35 to 43.11 degrees. Cross-table lateral radiographs are a reliable and comparable method to CT scans for measuring acetabular anteversion following total hip arthroplasty.

Issue Information

Gastroschisis (GS) and omphalocele (OC) are two prevalent congenital abdominal wall defects. This narrative review explores their global prevalence and the potential preventive role of maternal folic acid supplementation. The image includes clinical photographs (A, GS; C, OC) and schematic representations of inferior axial sections (B, GS; D, OC), illustrating key anatomical distinctions. Arrow indicates the abdominal wall membrane; I, intestine; K, kidney; UC, umbilical cord. image

Prevalence of the Huschke Foramen in Colombian Population: An Important Anatomic Alteration for the Planning of TMJ Arthroscopy

Abstract Background Ignoring this anatomic structure would have implications for iatrogenic perforation with the trocar toward the FH during the initial blind drilling or due to the diffusion of the infusion liquid toward the middle ear. Purpose To analyze the prevalence of the FH in an institutional population with a high incidence of TMD to provide further guidelines in diagnosing this anomaly and the planification of TMJ arthroscopy. Materials and Methods A retrospective tomographic study was conducted at the ENT—Oral and Maxillofacial and Radiology Department of the Hospital Universitario la Samaritana in Bogotá, Colombia. Inclusion criteria were patients over 18 years of age who had complementary exams such as ear, face, paranasal sinus, and/or TMJ tomography. Exclusion criteria were history of direct trauma to the external auditory canal in the medical history, patients with craniofacial syndromes, congenital anomalies, and/or history of cranial, mandibular, or temporal fractures. Two radiologists were part of the evaluators of the CT images who conducted the measures in the axial tomographic section and established the presence of the tympanic defect. Results A sample size of 139 medical records of patients, where females represent n: 101 (72.6%) and males represent n: 38 (27.4%). The average age was 43 years ± 18 years. Among the studied population, a total of five FH were detected, corresponding to a prevalence of 3.6% (95% CI 1.5–8.1%). The average size of the defect was 3.52 mm ± 1.1 mm. All the patients had TMJ-related symptoms, but none of them reported otalgia. Conclusion The initial evaluation of each patient must be addressed to assess the integrity of the tympanic bone. In this study, the defects size was smaller than others previously reported. However, diffusion through the tympanic defect could spread the lavage substance into the middle ear during TMJ arthroscopic surgery.

Evaluation of the forces applied by rubber dam clamps on mandibular first molar teeth with different endodontic access cavities: a 3D FEA study.

This study aimed to examine the effect of the force applied by rubber dam clamps made from different materials on mandibular first molar teeth with various designs of endodontic access cavities using finite element analysis. A intact tooth (IT) and seven different endodontic access cavities namely, a traditional endodontic cavity (TRADAC), a guided endodontic cavity (GEC), a conservative endodontic cavity (CAC), an ultra-conservative access cavity (UAC), a truss access endodontic cavity (TRSAC), a mesial caries access cavity (MCAC), and a distal caries access cavity (DCAC), along with two different clamp finite element models, were created. The clamp models were made of polyether ether ketone (PEEK) and stainless steel (SS). The forces applied by the clamps were calculated based on the axial section distance of the tooth, and these forces were applied to the contact areas on the tooth. Stress distribution models were calculated using maximum von Mises (vM) stress. The lowest vM stress under the forces applied by the SS and PEEK clamps was found in the IT model (80.914 MPa) with the PEEK clamp. The highest vM stress was found in the DCAC model (759.49 MPa) applied with the SS clamp. The forces applied by SS clamps resulted in higher vM stress values in every cavity design than those applied by PEEK clamps. PEEK clamps generated less force than SS clamps. However, clinicians should follow various isolation strategies (clamp made of different materials, split dam, etc.) according to different cavity types of the tooth.

Fetal premature excess vertebral linear calcification: a case series.

During embryogenesis, the vertebrae begin development during the 6th week of gestation via two lateral chondrification centers per segment. It was assumed that when disruptions occur in the process of somitogenesis during membranous vertebral body formation, chondrification and ossification will follow the anomalous membranous vertebral body scaffolding, resulting in an anomalous vertebral formation, such as a hemivertebra. Another hypothesis is that hemivertebra may result from anomalous distribution of intersegmental arteries of the vertebral column. There is no description in the medical literature of "excess linear calcifications" of part of the fetal vertebra, characterized by the presence of linear calcifications in the vertebrae of a developing fetus. In the first two trimesters of pregnancy, the fetal vertebrae usually show three calcified points in an axial section: the vertebral body and two transverse processes. Premature linear vertebral calcification was defined as an anterior or posterior echogenic connection between two of the points (Fig. 1). In this study, we describe seven cases of premature fetal linear vertebral calcification.

Radiographic Anatomy of the Common Carotid Artery for Direct Carotid Puncture

Direct common carotid puncture (DCP) is conventionally used as a bailout technique in stroke patients. However, little is known about the relevant anatomy. Our objective was to examine the relationship of the common carotid artery (CCA) to surrounding structures based on different DCP trajectories passing through the artery's center. Fifty randomly selected head/neck CTAs were analyzed. The trajectory of DCP and relationship to the internal jugular vein (IJV) and thyroid were analyzed at 1cm intervals above the clavicle on 7 axial sections. Using the trans-carotid sagittal plane as the 0° trajectory, we plotted 3 additional trajectories at 30° intervals and the relationship with the IJV and thyroid proximity was graded as following: 0=absent, 1=adjacent, and 2=crossing. The CCA tortuosity index was also analyzed for each vessel. Analysis of 2800 trajectories across 100 CCAs showed that the IJV and thyroid were least encountered on the axial sections 2cm above the clavicle, at 0° on the right (9 thyroids and 6 IJV), and at 90° on the left (0 Thyroids and 14 IJVs). The tortuosity index of the CCA was significantly lower above the clavicle than its entire length (P < 0.001). DCP performed 2cm above the clavicle at 0° on the right, and 90° on the left appears to minimize encounters with the IJV and thyroid gland, reducing potential complications. However, despite these findings, ultrasound guidance remains vital for DCP safety. Further focus on endovascular device safety in DCP is needed.

Musculoskeletal Dimension and Brightness Reference Values in Lumbar Magnetic Resonance Imaging-A Radio-Anatomic Investigation in 80 Healthy Adult Individuals.

Background/Objectives: Magnetic resonance imaging (MRI) is the preferred diagnostic means to visualize spinal pathologies, and offers the possibility of precise structural tissue analysis. However, knowledge about MRI-based measurements of physiological cross-sectional musculoskeletal dimensions and associated tissue-specific average structural brightness in the lumbar spine of healthy young women and men is scarce. The current study was planned to investigate characteristic intersexual differences and to provide MRI-related musculoskeletal baseline values before the onset of biological aging. Methods: At a single medical center, lumbar MRI scans of 40 women and 40 men aged 20-40 years who presented with moderate nonspecific low back pain were retrospectively evaluated for sex-specific differences in cross-sectional sizes of the fifth lumbar vertebrae, psoas and posterior paravertebral muscles, and respective sex- and age-dependent average brightness alterations on T2-weighted axial sections in the L5-level. Results: In women (mean age 33.5 years ± 5.0 (standard deviation)), the investigated musculoskeletal cross-sectional area sizes were significantly smaller (p < 0.001) compared to those in men (mean age 33.0 years ± 5.7). Respective average musculoskeletal brightness values were higher in women compared to those in men, and most pronounced in posterior paravertebral muscles (p < 0.001). By correlating brightness results to those of subcutaneous fat tissue, all intersexual differences, including those between fifth lumbar vertebrae and psoas muscles, turned out to be statistically significant. This phenomenon was least pronounced in psoas muscles. Conclusions: Lumbar musculoskeletal parameters showed significantly larger dimensions of investigated anatomical structures in men compared to those in women aged 20-40 years, and an earlier onset and faster progress of bone loss and muscle degradation in women.

A New Approach to Ultrasound Study of the Left Adrenal Lodge

Ultrasound examination of the left adrenal gland is generally associated with relatively low sensitivity and specificity. It is strongly influenced by the operator’s experience, patient characteristics, and the type of equipment available. In particular, the left adrenal gland remains a structure that is diffcult to investigate, even for experts. Therefore, we aimed to improve the ultrasound explorability of the left adrenal gland and, thus, contributing to enhancing the overall diagnostic sensitivity of the technique, allowing for a more widespread application by the addition, alongside traditional structural landmarks, of vascular landmarks. The vascular landmarks are represented by 1) the abdominal aorta at the level of the emergence of the superior mesenteric artery, 2) the splenic vein, and 3) the vascular pedicle of the left kidney. The adrenal gland is located in the space between the aorta medially, the renal pedicle caudally, and the splenic vein anteriorly. Therefore, with a left paramedian axial section, the abdominal aorta is sought at the level of D12, where the superior mesenteric artery originates. Aligning with the splenic vein, which acts as the roof of the space under examination, the area of interest is explored by tilting the probe superiorly and medially towards the aorta, inferiorly and medially towards the left renal vein, and superiorly and laterally towards the renal border, trying to maintain the view of the splenic vein as the true anterior-lateral margin of the area. In cases where the conditions allow for accurate visualization and measurement of the lesion, ultrasound may be preferred over CT for long-term surveillance, especially in young individuals, due to its lack of radiation exposure, simplicity, and lower cost.

Study on wind-sand dynamics observation of blowout in Xilingol sandy grassland

This study investigated airflow changes and sediment transport in the blowouts of the sandy grassland in Xilingol, Inner Mongolia. The results show that the wind direction inside the blowout is influenced by the direction of the incoming wind. Specifically, when the angle between the incoming wind direction and the long axis of the blowout is less than 15°, both sides of the wall tend to generate a wind flow towards the east exit. Meanwhile, the main airflow along the central axis airflow deflects towards the north side wall. However, when the angle is greater than 15°, the airflow on the north wall first disperses and then converges towards the wellbore. Conversely, the airflow on the south wall blows out in a southeast direction, and the axial airflow deflects towards the south wall. The rate of wind speed acceleration on both sides of the wall increases with height within the blowout but decreases along the central axis section. Higher wind speeds correlate with greater cumulative sand transport heights. Sand transport heights on both sides of the deflation basin are smaller than those along the central axis section, with the opposite observed in the depositional lobe. The rate of sand transport is primarily influenced by wind direction and wind speed, followed by, topography, vegetation coverage, slope, and aspect. These variations in airflow, combined with sediment transport, lead to the blowout taking on a develop deeper, longer, and wider shape.

SPINAL INTRADURAL EXTRAMEDULLARY TUMORS AND SIMILAR PATHOLOGIES: A SINGLE CENTER STUDY

Background: We wanted to analyze the neurological symptoms and prognosis of five spinal IDEM (intradural extramedullary) tumors cases diagnosed, and to emphasize that a spinal cord tumor can be found incidentally in evoluation of the proximal regions of the vertebral column in patients who were mistakenly operated for lumbar disc herniation on lumbar MRI, but whosesymptoms did not resolve. Objective: To emphasize the need for examinations such as MRI along the vertebral columna in patients with different spinal pathologies and whose symptoms and clinical signs do not improve. Methods: Patients with spinal IDEM tumors treated with surgical excision and followed for more than 2 years were retrospectively analyzed. Issessed pain with the visual analo scale (VAS), and neurological function with the Nurrick grade.Preoperative complaint time,location of tumor in sagital and axial sections in MRI and pathological diagnosis were investigated. Results: The pathological diagnosis in our study was meningioma in two cases,dural arteriovenous fistula in one case,teratoma in one case ,and myxopapilary epandimoma in one case.İn one case,disc herniation surgery was performed in another hospital due to misdiagnosis, but because the patient’s complaints were resistant. In examination, an IDEM tumor at T11 level was detected, and he was operated. In all cases the VAS score (mean) was reduced from 7.8 to 0.4 as well as the Nurrick grade (mean) was from 2.0 to 0.6. In the dAVF case, spasticity in the lower extremities, bladder and bowel disfunction continued. Conclusion: In cases with severe neurological deficits, MRI scanning of the proximal parts of the vertebral column will help in the differential diagnosis of the lesion occupying the intraspinal space.

Simulation-based echocardiography learning contribution on training of medical residents.

Echocardiography is a pivotal exam in critically ill patients, a specific training is crucial. Medical residents often lack echocardiography practice. This study aims to evaluate the impact of simulation-based training on medical residents' echocardiography mastery. This interventional study was conducted among medical residents at the Simulation Center of the Faculty of Medicine in Monastir (CeSim) in January 2022. The intervention consisted of a theoretical training and a simulator-based practical training concerning echocardiography. Residents underwent evaluation before and after training through a "Pre-Test" and a "Post-Test," respectively, using a French-language questionnaire. Participation was entirely voluntary. A total of 28 medical residents participated in our study, with the majority being female (57.1%). The median age was 29 years (interquartile range: 28-31.75). Following training, the proportion of participants who reported having the necessary skills for echocardiography interpretation significantly increased (p<0.05). Respondents demonstrated significant improvements in their scores on theoretical tests and practical skills assessments. Concerning echocardiographic views, the percentage of participants who correctly identified the title of the parasternal small axis section increased from 53.6% before training to 100% after training (p <10-3). Significant enhancements were observed in all parameters evaluating the practice of echocardiographic sections by respondents on a mannequin after training, encompassing time to obtain the view, view quality, image quality, visualization of structures, interpretability, and image stability (p<10-3). There was a significant improvement in average response rates for echocardiographic clinical syndroms among medical residents before and after training. All participants emphasized the indispensability of ultrasound education in the training of physicians specializing in managing cardiopulmonary emergencies. This study reports the beneficial role of simulation-based training in enhancing the mastery of medical residents in echocardiography. Incorporating such training methods into their learning curricula is advisable.