Cervical Area Research Articles

MRI Assessment of Cervical Spinal Cord Cross Sectional Area in Patients with Multiple Sclerosis in Iraq

MRI Assessment of Cervical Spinal Cord Cross Sectional Area in Patients with Multiple Sclerosis in Iraq

Fusion of the 2nd with the 3rd Cervical Vertebrae (C2-C3): A Case Series with Possible Clinical Significance

Purpose. The current case series describes three cases of fusion between the 2nd cervical vertebra, the axis (C2), and the 3rd cervical vertebra (C3), creating a C2-C3 osseous complex and highlighting its morphological type of fusion (partial or complete) and morphometric details. The developmental background of this complex is emphasized, pointing out the possible clinical significance. Materials and Methods. The osseous complexes were derived from disarticulated skeletons of body donors and were collected from the osseous collection of the Anatomy Department of the Medical School of the National and Kapodistrian University of Athens. Results. Three blocked vertebral complexes (2 partial and 1 complete C2-C3 osseous masses) were identified. In two cases, the vertebral bodies were partially fused and in one case were completely fused. In the 1st case, the C2-C3 complex had fused spinous processes and distinct transverse processes. Facets were completely fused on the left and partially fused on the right side. In the 2nd case, the C2-C3 complex had partially fused vertebral bodies and distinguishable spinous processes. In the 3rd case, the C2-C3 complex had completely fused vertebral bodies, facets, laminae, and transverse and spinous processes. Conclusions. Among the three (C2-C3) fused osseous complexes, the two were partially and the one was completely ossified. The fused vertebrae were characterized by osteophytic formations (at the dens and C3 area) and osteoporotic lesions. Taking into consideration the C2-C3 fusion, and possible coexisted variants, particular caution should be made in the upper cervical area, to interpret possible neurological manifestations and to reach a safe surgical plan.

Predicting Fractures Using Vertebral 18F-NaF Uptake in Prostate Cancer Patients

Background: Patients with prostate cancer tend to be at heightened risk for fracture due to bone metastases and treatment with androgen-deprivation therapy. Bone mineral density (BMD) derived from dual energy X-ray absorptiometry (DXA) is the standard for determining fracture risk in this population. However, BMD often fails to predict many osteoporotic fractures. Patients with prostate cancer also undergo 18F-sodium fluoride (<sup>18</sup>F-NaF)-positron emission tomography/computed tomography (PET/CT) to monitor metastases. The purpose of this study was to assess whether bone deposition, assessed by <sup>18</sup>F-NaF uptake in <sup>18</sup>F-NaF PET/CT, could predict incident fractures better than DXA- or CT-derived BMD in patients with prostate cancer.Methods: This study included 105 males with prostate cancer who had undergone full body <sup>18</sup>F-NaF PET/CT. Standardized uptake value (SUVmean and SUVmax) and CT-derived Hounsfield units (HU), a correlate of BMD, were recorded for each vertebral body. The average SUVmean, SUVmax, and HU were calculated for cervical, thoracic, lumbar, and sacral areas. The t-test was used to assess significant differences between fracture and no-fracture groups.Results: The SUVmean and SUVmax values for the thoracic area were lower in the fracture group than in the no-fracture group. There was no significant difference in cervical, thoracic, lumbar or sacral HU between the 2 groups.Conclusions: Our study reports that lower PET-derived non-metastatic bone deposition in the thoracic spine is correlated with incidence of fractures in patients with prostate cancer. CT-derived HU, a correlate of DXA-derived BMD, was not predictive of fracture risk. <sup>18</sup>F-NaF PET/CT may provide important insight into bone quality and fracture risk.

Understanding cytomorphologic changes in Pap tests of transgender men on testosterone therapy

Abstract Introduction/Objective Pap test findings in transgender men on testosterone therapy can often lead to misdiagnosis of dysplasia, especially in the setting of a positive HPV test. We reviewed relevant literature to analyze the cytomorphological nuances and applicable correlations to subsequent pathology in Pap tests of transgender men on testosterone therapy. Methods/Case Report We searched peer-reviewed journals on PubMed, synthesizing five articles published from 2018-2022 that specifically address cytomorphological findings on cervical Pap tests and biopsy results in transgender men on testosterone therapy. Results (if a Case Study enter NA) Various cytological changes, such as small parabasal-type cells and transitional cell metaplasia (TCM) can be mistaken for dysplasia in transgender men. In fact, these changes are representative of atrophy due to testosterone, as such findings have been observed in patients undergoing tamoxifen therapy. Small parabasal-type cells are described as clusters or sheets with intermittent nuclear enlargement and hyperchromatic nuclei, whereas TCM comprises flat sheets of cells with oval to spindle-shaped nuclei, powdery chromatin, and prominent nuclear grooves. Relevant clinical history can often help clarify cytologic diagnoses, as Pap tests that show atrophic changes can be misinterpreted as being abnormal. In several cases described in the literature, original diagnoses of atypical squamous cells of undetermined significance (ASCUS) were re-interpreted as atrophic changes after eliciting a history relevant for testosterone therapy. Small parabasal-type cells found on cytology have correlated with sections of the ectocervix that have groups of small hyperchromatic cells attached to the surface of atrophic cervical epithelium or areas of TCM. These cells may be mistaken for endometrial cells, especially in patients over 45 years old. Distinguishing atrophic changes from dysplasia on surgical pathology may modify cytologic diagnoses. Conclusion Transgender men on testosterone therapy often retain their cervix, necessitating ongoing cervical cancer screening. However, Pap test results from these individuals often exhibit atrophic changes through the presence of small parabasal-type cells and TCM. Differentiating between atrophy and dysplasia can pose a diagnostic challenge, especially in the setting of positive HPV testing or inflammation. Continued analyses into these cytomorphological nuances will assist providers in refining their diagnostic approaches and providing personalized care to transgender men.

Using Ultrasound Imaging system validity of cervical thymus cross-sectional area measurements in the evaluation of calf thymus growth

Using Ultrasound Imaging system validity of cervical thymus cross-sectional area measurements in the evaluation of calf thymus growth

The cervical ligamentum flavum area: A new sensitive morphological parameter for identifying the cervical spinal stenosis.

Thickening of the cervical ligamentum flavum (CLF) has been considered as a main cause of cervical spinal stenosis (CSS). A previous study reported that cervical ligamentum flavum thickness (CLFT) is correlated with CSS. However, the whole hypertrophy is different from focal thickness. Therefore, to analyze hypertrophy of the CLF, we created a new morphological parameter, called the cervical ligamentum flavum area (CLFA). We hypothesized that the CLFA is an important morphological parameter in the diagnosis of CSS. CLF samples were acquired from 83 patients with CSS, and from 84 controls who underwent cervical magnetic resonance imaging (C-MRI). T2-weighted axial C-MRI images were acquired. We measured the CLFA and CLFT at the C6-C7 intervertebral level on C-MRI using appropriate image analysis software. The CLFA was measured as the cross-sectional area of the entire CLF at the level of C6-C7 stenosis. The CLFT was measured by drawing a straight line along the ligament side towards the spinal canal at the C6-C7 level. Mean CLFA was 25.24 ± 6.43 mm2 in the control group and 45.34 ± 9.09 mm2 in the CSS group. The average CLFT was 1.48 ± 0.28 mm in the control group and 2.09 ± 0.35 mm in the CSS group. CSS patients had significantly higher CLFA (P < .01) and CLFT (P < .01). For the validity of both CLFA and CLFT as predictors of CSS, a receiver operating characteristic curve analysis revealed an optimal cutoff point for the CLFA was 31.66 mm2, a sensitivity of 92.8%, specificity of 88.4%, and an area under the curve of 0.97 (95% CI, 0.94-0.99). The optimal cut off-point of the CLFT was 1.79 mm, with a sensitivity of 83.5%, specificity of 84.5%, and an area under the curve of 0.92 (95% CI, 0.87-0.96). Both CLFT and CLFA were significantly related to CSS, but CLFA was the more sensitive measurement parameter. Therefore, to evaluate patients with CSS, treating physicians should test for CLFA.

The Effect of Aqueous and Alcoholic Extract of Ziziphus Spina-christi on some Bacterial Isolates Causing Gingivitis

Bacterial gingivitis is a most common and mild form of periodontal disease that causes bleeding, redness and swelling (inflammation) of gingiva, around the cervical area of teeth. Untreated gingivitis can progress to periodontal disease, periodontitis, by spreading to supporting tissue of teeth involving bone and periodontal ligament, a much more serious condition that can lead to tooth loss. The study was conducted to investigate the bacteria causing gingivitis with an attempt to investigate the bacterial inhibitory effect of seder leaves extract. Samples consist from (230) gingivitis swab were collected from the patients which are admitted to dental clinics in Tikrit city , among the period extended from March 2016 to February 2017 .Cultural, microscopical and biochemical tests were performed to identify the bacteria causing gingivitis .The results showed 165positive heavy culture of causative bacteria as follows :Gram positive ; Streptococcus mutans (% 18.78 ) , Streptococcus pyogens (% 8.48 ), Streptococcus salivarius (% 6.06 ) , Streptococcus angiosus (% 4.84 ) ,Streptococcus pneumoniae (%3.03 ), Staphylococcus aureus (% 16.96 ), Staphylococcus epidermidis (% 9.09 ) ,while gram negative included Pseudomonas aeruginosa (% 13.93),Escherichia coli (% 9.69 ) ,Klebsiella .spp (%6.66) , and finallyPseudomonas monilli (%2.42).The present study showed that the aqueousand alcoholic extract of Ziziphus spina-christi leaves had inhibitory activity agiants the bacterial species . At the concentration of (200 mg/ml) of seder leaves extract showed the highest effect on bacteria . All the types of bacteria that isolated from the patients with gingivitis had revealed disproportionately sensitivity against antibiotics : Amikacin , ampicillin , tetracycline , gentamicin , chliromphenicol , nalidixic acid , amoxicillin , trimethoprim .The mixture of aqueous extract of seder leaf and antibiotic Gentamicin , Amikacin and amoxicillin revealed high inhibitory synergetic effect against aginst resistant bacteria.

The Effect of Aqueous and Alcoholic Extract of Ziziphus Spina-christi on some Bacterial Isolates Causing Gingivitis

Bacterial gingivitis is a most common and mild form of periodontal disease that causes bleeding, redness and swelling (inflammation) of gingiva, around the cervical area of teeth. Untreated gingivitis can progress to periodontal disease, periodontitis, by spreading to supporting tissue of teeth involving bone and periodontal ligament, a much more serious condition that can lead to tooth loss. The study was conducted to investigate the bacteria causing gingivitis with an attempt to investigate the bacterial inhibitory effect of seder leaves extract. Samples consist from (230) gingivitis swab were collected from the patients which are admitted to dental clinics in Tikrit city , among the period extended from March 2016 to February 2017 .Cultural, microscopical and biochemical tests were performed to identify the bacteria causing gingivitis .The results showed 165positive heavy culture of causative bacteria as follows :Gram positive ; Streptococcus mutans (% 18.78 ) , Streptococcus pyogens (% 8.48 ), Streptococcus salivarius (% 6.06 ) , Streptococcus angiosus (% 4.84 ) ,Streptococcus pneumoniae (%3.03 ), Staphylococcus aureus (% 16.96 ), Staphylococcus epidermidis (% 9.09 ) ,while gram negative included Pseudomonas aeruginosa (% 13.93),Escherichia coli (% 9.69 ) ,Klebsiella .spp (%6.66) , and finallyPseudomonas monilli (%2.42).The present study showed that the aqueousand alcoholic extract of Ziziphus spina-christi leaves had inhibitory activity agiants the bacterial species . At the concentration of (200 mg/ml) of seder leaves extract showed the highest effect on bacteria . All the types of bacteria that isolated from the patients with gingivitis had revealed disproportionately sensitivity against antibiotics : Amikacin , ampicillin , tetracycline , gentamicin , chliromphenicol , nalidixic acid , amoxicillin , trimethoprim .The mixture of aqueous extract of seder leaf and antibiotic Gentamicin , Amikacin and amoxicillin revealed high inhibitory synergetic effect against aginst resistant bacteria.

Functional Load Capacity of Teeth with Reduced Periodontal Support: A Finite Element Analysis.

The purpose of this study was to investigate the functional load capacity of the periodontal ligament (PDL) in a full arch maxilla and mandible model using a numerical simulation. The goal was to determine the functional load pattern in multi- and single-rooted teeth with full and reduced periodontal support. CBCT data were used to create 3D models of a maxilla and mandible. The DICOM dataset was used to create a CAD model. For a precise description of the surfaces of each structure (enamel, dentin, cementum, pulp, PDL, gingiva, bone), each tooth was segmented separately, and the biomechanical characteristics were considered. Finite Element Analysis (FEA) software computed the biomechanical behavior of the stepwise increased force of 700 N in the cranial and 350 N in the ventral direction of the muscle approach of the masseter muscle. The periodontal attachment (cementum-PDL-bone contact) was subsequently reduced in 1 mm increments, and the simulation was repeated. Quantitative (pressure, tension, and deformation) and qualitative (color-coded images) data were recorded and descriptively analyzed. The teeth with the highest load capacities were the upper and lower molars (0.4-0.6 MPa), followed by the premolars (0.4-0.5 MPa) and canines (0.3-0.4 MPa) when vertically loaded. Qualitative data showed that the areas with the highest stress in the PDL were single-rooted teeth in the cervical and apical area and molars in the cervical and apical area in addition to the furcation roof. In both single- and multi-rooted teeth, the gradual reduction in bone levels caused an increase in the load on the remaining PDL. Cervical and apical areas, as well as the furcation roof, are the zones with the highest functional stress. The greater the bone loss, the higher the mechanical load on the residual periodontal supporting structures.

Thermal profile classification of the back of sportive and sedentary healthy individuals

BackgroundInfrared thermography (IRT) is a non-harmful, risk-free imaging technique and it has application for healthy and pathological population. ObjectiveThe aim of this study is to evaluate the thermographic profiles of the back of sport practitioners from different disciplines and compare it with those of sedentary healthy individuals. MethodThe back of 160 healthy subjects were evaluated, and participants were grouped considering their sport practice: team sport (TS), individual sport (IS), weight training (WT), inactive (I). Three regions of interest were identified to analyze the cervical, thoracic and lumbar temperatures of the back. ResultsThe Multivariate analysis of variance (MANOVA) resulted significant showing statistical differences for the cervical (p < 0.001), dorsal (p = 0.0011), and lumbar areas (p = 0.0366). The Tukey post-hoc test for pairwise comparison showed statistically significant differences between groups. For the cervical area significance was found between the IN and WT group (p = 0.002), the IN and IS group (p < 0.001), IN and TS group (p = 0.020). The dorsal area resulted significant between the IN and WT group (p = 0.007), the IN and IS group (p < 0.001), IN and TS group. The lumbar area showed significant differences only between the IN and WT group and the IN and IS group (p = 0.043). ConclusionThis study demonstrated that inactive individuals manifest a statistically significant higher temperature in the cervical, dorsal and lumbar area of the back compared to sportive individuals.

Elastic Taping Application on the Neck: Immediate and Short-Term Impacts on Pain and Mobility of Cervical Spine.

The aim of this study was to measure the effects on three-planar active cervical range of motion (ACROM) and self-perceived pain of elastic taping (ET) application in the cervical area. Thirty participants (n: 22-M and 8-F, age 35.4 ± 4.4 years; body height 173.1 ± 8.4 cm; body mass 73.5 ± 12.8 kg) in the study group (SG) and twenty participants (n: 11-M and 9-F, age 32.6 ± 3.9 years; body height 174.9 ± 10.9 cm; body mass 71.2 ± 12.9 kg) in the control group (CG) were recruited. All subjects had neck and cervical pain in baseline condition. Each group performed an ACROM test and measured the perceived pain in the neck based on the Numerical Rating Scale (NRS 0--10, a.u.) at the baseline (T0), after 20' from the ET application (T1), and after three days of wearing the ET application (T2). Between T0 and T1, an ET was applied to the cervical area of the SG participants. Statistical analysis did not show any significant change in CG in any measurement session for ACROM and neck pain parameters. Conversely, the SG showed significant improvements for ACROM rotation to the left (T0 64.8 ± 7.7°-T2 76.0 ± 11.1° p < 0.000) and right (T0 66.0 ± 11.9°-T2 74.2 ± 9.6° p < 0.000), lateral inclination to the left (T0 37.5 ± 6.9°-T2 40.6 ± 10.8° p < 0.000) and right (T0 36.5 ± 7.9°-T2 40.9 ± 5.2° p < 0.000), extension (T0 47.0 ± 12.9°-T2 55.1 ± 12.3° p < 0.001), and flexion (T0 55.0 ± 3.6°-T2 62.9 ± 12.0° p < 0.006). A significant decrease was also measured in SG for pain NRS between T0 and T2 (T0 7.5 ± 1.0°-T1 5.5 ± 1.4-T2 1.4 ± 1.5° p < 0.000). In conclusion, a bilateral and symmetrical ET cervical application is useful to enhance multiplanar ACROM and reduce subjective self-perceived cervical pain when it is needed. Based on the evidence, the use of ET on the neck is recommended for managing neck motion restrictions and pain in adult individuals.

Three-dimensional finite element analysis of the uprighting movement of mandibular mesially inclined second molars

The mesially inclined mandibular second molar can be supported upright by the microimplant anchorage. This study established the finite element model to analyze the displacement trend and periodontal ligament (PDL) stress distribution of the uprighting mandibular second molar with the microimplant under different conditions. A 3-dimensional model of the mandible and dentition was established. The mesial inclination of the mandibular second molar was 30°, 45°, and 60°. Microimplants were implanted between the buccal side of the second premolar and the first molar and in the distal part of the mandibular second molar, respectively. Six groups were set, each loaded with 0.5 N of force. The second molar initial displacement trend and PDL stress distribution were evaluated. The PDL stress of mandibular second molars in all groups was within the physiological limit, and the PDL stress of mandibular second molars in the distal implant groups was lower than that of mandibular second molars in the mesial implant groups. PDL stress concentration in the cervical area. Tooth displacement decreased as the mesial inclination angle of the second molars increased. The sagittal displacement of mesial implant groups was larger, and there was a tendency of mesiobuccal torsion when standing uprighting; the vertical displacement of distal implant groups was larger, and there was a tendency of distal lingual torsion when standing uprighting. Distal microimplant has a better extrusion effect on the mesially inclined second molar, whereas mesial microimplant has a better effect on the distal movement. The optimal orthodontic force for microimplant traction on mesially inclined second molars is 0.5-0.8 N.

Sonographic features of the uncomplicated postoperative abdomen in dogs treated for pyometra by ovariohysterectomy.

Pyometra is a prevalent disease in intact bitches and the standard treatment is ovariohysterectomy (OHE). Published descriptions of normal sonographic findings after OHE are currently lacking. The aims of this prospective observational study were to describe and compare postoperative abdominal sonographic features for three timepoints following OHE in a group of dogs with pyometra and an uneventful recovery. A total of 22 dogs had sequential focused abdominal ultrasound examinations on days 1, 4-6, and 10-15 postsurgery. Recorded sonographic features for each examination time point and characteristics of the cervical stump and the mesovarium, size, and echogenicity of medial iliac lymph nodes (MILNs), presence of free peritoneal fluid, and pneumoperitoneum. The cervical stump appeared as a heterogenous area with a hypoechoic center surrounded by hyperechogenic tissue in all dogs. The cervical stump transverse-sectional area was larger on day 4-6 compared with day 1 and day 10-15 (P=.0009). Mesovarium ligature reactions were identified as heterogeneous and hyperechoic areas with central and/or edge shadowing in all dogs. The size and echogenicity of MILNs and the mesovarium reactions did not significantly differ among time points. Free peritoneal fluid was detected in 45%, 41%, and 9% and pneumoperitoneum in 95%, 82%, and 14% of dogs at sequential time points. Findings from this sample of dogs with an uneventful recovery following OHE due to pyometra can be used to assist veterinarians in interpreting postoperative abdominal ultrasonographic characteristics in future dogs treated surgically for pyometra.

Quantitative brainstem and spinal MRI in amyotrophic lateral sclerosis: implications for predicting noninvasive ventilation needs.

Respiratory complications resulting from motor neurons degeneration are the primary cause of death in amyotrophic lateral sclerosis (ALS). Predicting the need for non-invasive ventilation (NIV) in ALS is important for advance care planning and clinical trial design. The aim of this study was to assess the potential of quantitative MRI at the brainstem and spinal cord levels to predict the need for NIV during the first six months after diagnosis. Forty-one ALS patients underwent MRI and spirometry shortly after diagnosis. The need for NIV was monitored according to French health guidelines for 6 months. The performance of four regression models based on: clinical variables, brainstem structures volumes, cervical spinal measurements, and combined variables were compared to predict the need for NIV within this period. Both the clinical model (R2 = 0.28, AUC = 0.85, AICc = 42.67, BIC = 49.8) and the brainstem structures' volumes model (R2 = 0.30, AUC = 0.85, AICc = 40.13, BIC = 46.99) demonstrated good predictive performance. In addition, cervical spinal cord measurements model similar performance (R2 = 0.338, AUC = 0.87, AICc = 37.99, BIC = 44.49). Notably, the combined model incorporating predictors from all three models yielded the best performance (R2 = 0.60, AUC = 0.959, AICc = 36.38, BIC = 44.8). These findings are supported by observed positive correlations between brainstem volumes, cervical (C4/C7) cross-sectional area, and spirometry-measured lung volumes. Our study shows that brainstem volumes and spinal cord area are promising measures to predict respiratory intervention needs in ALS.

Hard tissue density of permanent teeth as a radiometric biomarker of their quality

Background. The use of radiographic methods for examining patients with the ability to determine the density of examined tissues opens up wide opportunities for individually predicting damage to hard tissues of teeth, as well as determining risk groups for the development of their pathology at early stages, which requires a detailed study of the mineral density indicators of hard tissues of teeth of different groups within the norm, taking into account their age, sex, ethnic, and other characteristics. The aim of the study was to determine the density indicators of hard tissues of permanent teeth of different groups in the cervical area and compare them. Material and Methods. The density of hard tissues was determined by analyzing radiographs of 320 intact permanent teeth of 10 patients. Radiographs were made using a Siemens Sirona (XIOS XG Supreme, Germany) dental radiography unit with Trophy Radiologie software (version 7.0, Slovakia). The images were processed using Gendex VixWin Pro software (version 3.5, USA). The density was measured in Conditional Unit of Grayness (CUG). The results were presented as Me (25%; 75%), where Me represents the median, 25% denotes the 25th percentile (first quartile), and 75% denotes the 75th percentile (third quartile). Results. Incisors, canines, and premolars exhibited the highest density in the dentin area; the lowest density was observed in incisors and premolars for cementum and in canines for enamel. In molars, enamel had the highest density, while cementum had the lowest. Significant differences in enamel density were observed among incisors and premolars, incisors and molars, canines and premolars, canines and molars, and premolars and molars. Significant differences in dentin density were found among incisors and canines, incisors and premolars, incisors and molars, canines and premolars, and canines and molars. Significant differences in cementum density were observed among incisors and canines, incisors and premolars, incisors and molars, canines and premolars, and premolars and molars. Conclusion. The density indicators of enamel, dentin, and cementum established for groups of permanent incisors, canines, premolars, and molars are different for different tooth groups with characteristic density patterns. Keywords: enamel, dentin, cementum, incisors, canines, premolars, molars.

Assessment of Nanoscale Configuration of Dentin in Non-carious Cervical Lesions.

Introduction Non-carious cervical lesions (NCCLs) are structural deformities or tissue loss in the cervical region of teeth, which are closer to the gum linethat do not result from caries (tooth decay). On the tooth enamel at the gingival margin, these lesions are frequently seen as V- or U-shaped notches. The causes of NCCLs are multifaceted and involve intricate relationships between chemical, mechanical, and biological elements. The slow loss of enamel and dentin in the cervical area occurs due to mechanical causes like abrasive toothbrushing and occlusal tension, as well as chemical variables such as erosive acidic food components. As NCCLs advance, dental discomfort, aesthetic issues, and impaired tooth function may result. The aim of this study was to assess the nanoscale configuration of dentin in non-carious cervical lesions using scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS). Methodology Sterilized teeth samples were selected from the extracted tooth repository of Saveetha Dental College and Hospitals, Chennai. Tooth samples were thinly sliced using a diamond bur. The sliced teeth were examined using a scanning electron microscope. Ionic configuration was assessedusing EDS and elemental analysis. Results The findings showed the nanoscale morphology and elemental configurations present. Elemental mapping showed specific elemental localization in the affected area. Conclusion NCCLs can be attributed as a predominant factor leading to gingival recession causing dentin exposure and hypersensitivity. NCCLs can also threaten the integrity of dentin; therefore, early diagnosis of non-carious cervical lesions is crucial to ensure proper treatment plan and therapeutic regimens.

HPV E6/E7 mRNA combined with thin-prep cytology test for the diagnosis of residual/recurrence after loop electrosurgical excision procedure in patients with cervical intraepithelial neoplasia

To evaluate the diagnostic value of combining HPV E6/E7 mRNA testing with Thin-Prep cytology (TCT) for residual/recurrence detection, a total of 289 patients who underwent loop electrosurgical excision procedure (LEEP) for high-grade cervical lesions were included. Patients were followed up at different time points, and residual/recurrent lesions were confirmed through vaginoscopy. TCT, HPV-DNA, and HPV E6/E7 mRNA tests were conducted. Diagnostic performance, including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, was assessed. Among the patients, 76 cases showed residual lesions/recurrence, while 213 cases showed no residual/recurrence. Positive margins in the cervical-vaginal and cervical canal areas were associated with a higher risk of residual/recurrence. The combined HPV E6/E7 mRNA and TCT test showed higher diagnostic efficacy than individual tests at 6-, 12-, and 24-months follow-up. The combined test consistently demonstrated higher specificity and sensitivity, with significantly larger area under the curve (AUC) values compared to the individual tests.

The Effect of Preparation Design on Stress Distribution in Lithium Disilicate Laminate Veneer using 3D Finite Element Analysis.

Background: A layer of ceramic bonded to the facial surfaces of prepared teeth to create a ceramic esthetic veneer, also known as a laminate veneer. Objective: This study aimed to examine the effect of preparation design on the stress distribution in lithium disilicate veneer at different angulations of masticatory loading. Methods: The finite element approach assessed the structure stress distribution. So, Exocad dental CAD was used to obtain the models, which consist of an upper central incisor in three dimensions (3D), and prepare them with the same software for an indirect veneer. The models were imported into software (SolidWorks; Dassault Systems) to construct solid models. The external load used in this study was 100 N at 60 degrees (intercuspal) and 125 degrees (protrusive) in the palatal surface, two mm below the incisal edge. The models were restored using e-max laminate veneers with different tooth preparation designs (palatal chamfer and window preparation designs). Analysis and calculations were performed on the stress distributions and maximum stress values of the tooth structures, cement layer, and laminate veneer. Results: With a window preparation design, the maximum stress values in the tooth and laminate veneer were higher. In the palatal chamfer design, stresses were dispersed more consistently through the cement layer and laminate veneer. Higher stress was generated by protrusive movement than by intercuspal movement. Conclusion: Compared to window preparation, the palatal chamfer design for lithium disilicate laminate veneer showed a more favourable stress distribution. Regardless of the preparation design, maximum stress values were observed in the cervical and incisor areas of the tooth structure.

The Effect of Preparation Design on Stress Distribution in Lithium Disilicate Laminate Veneer using 3D Finite Element Analysis.

Background: A layer of ceramic bonded to the facial surfaces of prepared teeth to create a ceramic esthetic veneer, also known as a laminate veneer. Objective: This study aimed to examine the effect of preparation design on the stress distribution in lithium disilicate veneer at different angulations of masticatory loading. Methods: The finite element approach assessed the structure stress distribution. So, Exocad dental CAD was used to obtain the models, which consist of an upper central incisor in three dimensions (3D), and prepare them with the same software for an indirect veneer. The models were imported into software (SolidWorks; Dassault Systems) to construct solid models. The external load used in this study was 100 N at 60 degrees (intercuspal) and 125 degrees (protrusive) in the palatal surface, two mm below the incisal edge. The models were restored using e-max laminate veneers with different tooth preparation designs (palatal chamfer and window preparation designs). Analysis and calculations were performed on the stress distributions and maximum stress values of the tooth structures, cement layer, and laminate veneer. Results: With a window preparation design, the maximum stress values in the tooth and laminate veneer were higher. In the palatal chamfer design, stresses were dispersed more consistently through the cement layer and laminate veneer. Higher stress was generated by protrusive movement than by intercuspal movement. Conclusion: Compared to window preparation, the palatal chamfer design for lithium disilicate laminate veneer showed a more favourable stress distribution. Regardless of the preparation design, maximum stress values were observed in the cervical and incisor areas of the tooth structure.

A systematic review of deep learning-based cervical cytology screening: from cell identification to whole slide image analysis

Cervical cancer is one of the most common cancers in daily life. Early detection and diagnosis can effectively help facilitate subsequent clinical treatment and management. With the growing advancement of artificial intelligence (AI) and deep learning (DL) techniques, an increasing number of computer-aided diagnosis (CAD) methods based on deep learning have been applied in cervical cytology screening. In this paper, we survey more than 80 publications since 2016 to provide a systematic and comprehensive review of DL-based cervical cytology screening. First, we provide a concise summary of the medical and biological knowledge pertaining to cervical cytology, since we hold a firm belief that a comprehensive biomedical understanding can significantly contribute to the development of CAD systems. Then, we collect a wide range of public cervical cytology datasets. Besides, image analysis approaches and applications including cervical cell identification, abnormal cell or area detection, cell region segmentation and cervical whole slide image diagnosis are summarized. Finally, we discuss the present obstacles and promising directions for future research in automated cervical cytology screening.