Cervical Pathology Research Articles

Scapular winging secondary to serratus anterior dysfunction: analysis of clinical presentations and etiology in a consecutive series of 96 patients.

This study aimed to establish the relative incidence of etiologies causing serratus anterior (SA) dysfunction in patients with proven abnormality on needle electromyography. This was a retrospective review of patients with scapular winging secondary to SA dysfunction. Each patient underwent a detailed clinical, radiological, and neurophysiological assessment to arrive at the precise etiological diagnosis. Patients with atypical clinical features were referred for a neurologist's assessment. Hematological and genetic testing were requested at the discretion of the neurologist. A scapular winging severity score based on clinical signs was devised to aid clinical grading. Between 2014 and 2020, a consecutive series of 108 patients with suspected SA dysfunction were assessed, of whom 96 met the inclusion criteria. There were 34 females and 62 males, with a mean age of 38 years (range, 15-77 years). Winging affected the right scapulae in 69 patients, the left scapulae in 17 patients, and was bilateral in 10 patients. This was caused by a myopathic disorder in 12 (12%) patients. Eighty-four (88%) patients had a long thoracic nerve lesion, caused by cervical pathology (2), iatrogenic injury (2), trauma (33), and neuralgic amyotrophy (NA) (47). Among those with NA, winging resolved spontaneously within 3 years of onset in 22 patients (mean duration, 16 months; range, 3-36 months). No patients recovered fully if their duration of winging lasted longer than 3 years. Patients with palsy secondary to NA tended to have a worse severity of winging than those due to a traumatic cause (P = .04). NA accounted for approximately half of the patients with SA dysfunction; therefore, it is essential to also consider the differentials of myopathy, trauma, iatrogenic injury, and spinal pathology. We recommend the judicious employment of ancillary tests and a low threshold of referral to a neurologist, in order to arrive at the exact diagnosis to accurately guide patient treatment.

ANALYSIS AND EVALUATION OF FIRST TRIMESTER BLEEDING – A RETROSPECTIVE STUDY

Introduction : About one fourth of pregnant women present with bleeding in the rst trimester .The four major sources of nontraumatic bleeding in early pregnancy are ectopic pregnancy, miscarriage (threatened, inevitable, incomplete, complete), implantation of the pregnancy, cervical, vaginal, or uterine pathology (eg, polyps, inammation/infection, trophoblastic disease). Although 50% of cases presenting with vaginal bleeding continue to have a normal healthy pregnancy, but the maternal anxiety about risk of miscarriage should be assessed and counselled. The present study is an overview of etiologies and evaluation of bleeding upto 12 weeks of gestational age. Aim:To evaluate the incidence and etiology of rst trimester bleeding. Objective: To correlate the association between rst trimester bleeding and miscarriage. Methodology:A retrospective study among pregnant women with rst trimester bleeding was conducted for a period of 1 year at Chettinad hospital and Research Institute.Detailed History taking and pelvic examination was done for 139 patients.Specic blood investigation along with Transvaginal USG probe 3-5 MHz was performed and appropriate treatment was given. Results: Out of 900 pregnant women attending the out patient (OP) over a period of one year, 139 patients presented with rst trimester bleeding , incidence being 15.44%. The present study suggest that 41.007% women had miscarriage following rst trimester bleeding . It is depicted that 20.14% of women had history of previous abortions and 12.23% had history of bleeding in previous pregnancy. The major cause of bleeding in the rst trimester in our study was threatened abortion (32.37%). Conclusion :We conclude that the present study helps in giving appropriate treatment to women presenting with rst trimester bleeding . Ultrasonography plays a key role in the diagnosis of cause of bleed . Early care and close monitoring will inevitably improve pregnancy outcome .

Would Women With Solid Organ Transplant Qualify for Triennial Cervical Cancer Screening as Recommended by the American College of Obstetricians and Gynecologists in 2016 and American Society for Colposcopy and Cervical Pathology in 2019?

The aim of the study was to assess the applicability and safety of cervical cancer screening guidelines recommended by the American College of Obstetricians and Gynecologists (2016) and American Society for Colposcopy and Cervical Pathology (2019) for women with solid organ transplants (SOTs). We analyzed data previously abstracted through December 2015 for 971 women (18-60 y) who received their first SOT at Mayo Clinic (Rochester, MN) from January 17, 1995, through December 31, 2011. Inclusion criteria were initial benign findings on cervical cytology after SOT and at least 1 subsequent cytologic screening. Of 415 women whose initial cytologic findings were benign, 310 met inclusion criteria. The cumulative incidence of abnormal cervical cytology among these 310 women was 4.3% (95% CI = 1.9%-6.7%) by 30 months and 11.2% (95% CI = 7.1%-15.4%) by 60 months after their initial benign results. Considering all women with SOT, 68.4% (284/415) had no documented abnormal cytologic findings within 60 months (26 had abnormality; 284 no abnormality; and 105 not assessed). In women with negative tests for human papillomavirus, high-grade squamous intraepithelial lesions were not documented on cytology with variable duration of follow-up. No cervical squamous cell carcinoma was identified. Of women with initial benign cervical cytology after SOT, more than two thirds would have been eligible for extended-interval screening. Further study is needed, particularly regarding the role of high-risk human papillomavirus testing.

Computed tomographic analysis of cervical spine pedicles in the adult Indian population.

Background: Cervical pedicle screw insertion is a technically demanding procedure that carries the risk of catastrophic damage to surrounding neurovascular structures. Here, we analyzed computed tomography (CT)-based three-dimensional cervical spine pedicle geometry to determine the level and sex-specific morphologic differences in the adult Indian population.Methods: The CT scans of 200 patients (2400 pedicles) without significant cervical spine pathology were collected. The mean pedicle width (PW), pedicle height (PH), pedicle axial length (PAL), and pedicle transverse angle (PTA) from C2 to C7 were measured.Results: The smallest mean PW was at C3 in both males (4.85 ± 0.73 mm) and females (4.31 ± 0.43 mm); 7.08% of all pedicles were found to have mean PW of <4 mm. The smallest mean PH was at C5 in both males (6.25 ± 0.67mm) and females (5.54 ± 0.52 mm). The smallest mean PAL was at C2 in both males (27.46 ± 1.69mm) and females (25.90 ± 1.88 mm). The mean PW, PH, and PAL were significantly greater in males than females at all levels (P < 0.05). The smallest mean PTA was at C3 in males (41.79 ± 2.53°) and at C7 in females (42.40 ± 2.27°).Conclusion: In the adult Indian population, the PW, PH and PAL were smaller than in the typical western population. Females had even smaller PW, PH and PAL as compared to males. We recommend that a small inventory of 3.5mm screws between 20mm to 30mm length be used in most cases where cervical pedicle screws are being used in the Indian population. However, individual vertebrae should be screened preoperatively with CT scans to exclude gross anatomical variations, especially in females and at the C3 and C4 levels.

Loop Electrosurgical Excision Procedure in a Low-Resource Setting: Feasibility of Selective See-and-Treat Approach

To assess the correlation between cervical smear, colposcopic findings and loop electrosurgical excision procedure (LEEP) histopathology and thereby assess the feasibility of performing LEEP bypassing cervical biopsy in selected cases. This is a retrospective study of patients who underwent LEEP at our institution from 2014 to 2018. We traditionally follow a three-step approach for detection and treatment of pre-invasive lesions of cervix—(1) pap smear, (2) colposcopy of abnormal pap smear cases and directed biopsy, and (3) treatment of abnormal biopsies with LEEP. LEEP was performed for cervical intraepithelial neoplasia (CIN) 2, CIN3, persistent CIN1 cases. Swede score ≥ 6 or major lesion on International Federation for Cervical Pathology and Colposcopy (IFCPC) scoring on colposcopy was considered to be suggestive of high-grade lesion. Of the 123 patients who underwent LEEP, 80 patients had high-grade squamous intraepithelial lesion (HSIL) on cervical smear and swede score ≥ 6 on colposcopy. Seventy-seven (96.3%) of these patients had high-grade lesion on final histopathology. Avoiding cervical biopsy and proceeding with LEEP in these patients would reduce an additional procedure in 77 patients with overtreatment of only 3 patients (2.4%). Overtreatment rate was 3.2% when IFCPC scoring was used instead of Swede score. LEEP may be considered in patients with high-grade lesions on both colposcopy and cervical smear, bypassing cervical biopsy, thereby reducing the number of procedures performed. This reduces the financial burden for the individual and the healthcare facilities, also decreasing the anxiety and apprehension associated with multiple hospital visits and procedures.

Association of Chiropractic Colleges Research Agenda Conference 2021 Abstracts of Proceedings.

Association of Chiropractic Colleges Research Agenda Conference 2021 Abstracts of Proceedings.

Perioperative Corticosteroids Reduce Dysphagia Severity Following Anterior Cervical Spinal Fusion: A Meta-Analysis of Randomized Controlled Trials.

The anterior approach to the cervical spine is commonly used to treat cervical pathology. It is, however, associated with high rates of dysphagia, which may be associated with substantial patient morbidity. Perioperative corticosteroid administration has been advocated to decrease dysphagia rates; its efficacy, however, remains uncertain. We conducted a meta-analysis of randomized trials to determine the efficacy of perioperative corticosteroid administration in reducing postoperative dysphagia as well as any adverse effects, such as pseudarthrosis and infection. We conducted a systematic search of electronic databases (MEDLINE, Embase, CENTRAL [Cochrane Central Register of Controlled Trials], ClinicalTrials.gov) to identify randomized controlled trials (RCTs) that evaluated corticosteroids versus any comparator for prevention of postoperative dysphagia after anterior cervical spine procedures. Two independent reviewers used the GRADE (Grades of Recommendation Assessment, Development and Evaluation) criteria to assess eligibility and risk of bias, perform data extraction, and rate the quality of evidence. The primary outcome was severity of postoperative dysphagia. We conducted meta-analyses of dysphagia (both overall and by delivery method), pseudarthrosis, and postoperative infection. After screening of 927 articles, a total of 7 studies were eligible for final inclusion. These included 431 patients, of whom 247 received corticosteroids and 184 received placebo or a control treatment. Moderate-quality evidence demonstrated a significant improvement in postoperative dysphagia rates (odds ratio, 0.35; 95% confidence interval, 0.20 to 0.63; p < 0.001), and this finding was robust to both permutation analyses and sensitivity analyses removing the studies with a high risk of bias. There was no significant difference between intravenous and local steroid administration (p = 0.16). There were no documented infections. There was no significantly increased risk of pseudarthrosis in those receiving steroids compared with placebo or a control treatment (p = 0.13). This meta-analysis found moderate-quality evidence supporting the use of perioperative corticosteroid administration as an adjunct to anterior cervical spinal procedures. Patients treated with corticosteroids intravenously or locally had significantly decreased severity of dysphagia. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Osteochondral fragmentation of the cervical articular process joints; prevalence in horses undergoing CT for investigation of cervical dysfunction.

Computed tomography (CT) imaging of the cervical spine of mature horses under general anaesthesia is becoming increasingly accessible. Osteochondral fragmentation (OF) of the cervical articular process joints (APJs) has been identified on CT imaging; the prevalence, clinical features and significance of this finding are currently unknown. To describe the prevalence and clinical features of a population of horses with CT evidence of OF within the cervical APJs. Retrospective, descriptive case series. The study population consisted of all horses undergoing CT imaging of the entire cervical spine between April 2016 and December 2019 at Liphook Equine Hospital for investigation of clinical signs localised to this region. CT scans were examined for evidence of OF within the APJs and additional case features were recorded. A total of 55 horses underwent CT imaging during the study period. OF was identified in 13 horses, giving a CT prevalence of 24% in the study population. OF occurred in a range of ages, breeds and uses of equine, presenting with varied clinical signs. It was identified at every level of the neck. Additional cervical pathology was identified in 11/13 OF cases. Retrospective analysis of a clinical caseload with a lack of clinically normal controls or post mortem confirmation of imaging findings. Low case numbers. OF within the cervical APJs is recognised on CT imaging in horses with cervical dysfunction. Fragments are commonly identified in combination with additional cervical pathology. Further investigation is required to confirm their clinical significance and develop potential treatment options where necessary.

Effects of Orally Administered Preliminary Analgesic Therapy in Diagnostic Colposcopy Patients: A Prospective Questionnaire Study

Background: Colposcopy has a key role in the diagnostic work-up and management of abnormal cervical cytology, but it might generate negative feelings of mainly anxiety and pain to the patients undergoing such examination. These feelings are interrelated, with the anxiety fueling the painful sensations. The aim of our study was to investigate the effects of preliminary administration in terms of pain and anxiety relief that the preliminary administration of paracetamol would have on patients undergoing diagnostic colposcopy. Materials &amp; Methods: We conducted a single center prospective study which enrolled 112 patients with diagnosed or suspected cervical pathology who were examined at the Outpatient Colposcopy Clinic of Patras University Hospital, over a 7-months period. Patients were randomly assigned to one of the two groups. The interventional group received 1gr of paracetamol (acematiminofen) in pill form, 30 to 60 minutes before colposcopic assessment; the control group received no medication. At the end of consultation, all participants completed a 2-page questionnaire. Results: More patients of the interventional arm did not experience any pain at all during colposcopy compared with the control group. However, this difference was statistically not significant, probably because of the small number of patients. Moreover, there were no differences in mild and moderate pain rates between the interventional and control groups. Severe pain was only experienced by patients in the control group. Further data analysis from the first time as and for repeat colposcopy patients showed similar findings regarding pain intensity rates in the interventional and control group. When considering anxiety levels, no differences were observed between the two groups. Conclusion: The preliminary administration of low dose paracetamol in a pilot sample of colposcopy patients did not illustrate significant benefits in terms of experienced pain and anxiety levels.

Noninvasive, in vivo assessment of the cervical microcirculation using incident dark field imaging

AimThis study evaluates the feasibility of handheld vital microscopy for noninvasive, objective assessment of the microcirculation of the human uterine cervix. We qualitatively and quantitatively describe the microcirculation in healthy subjects in order to provide a basis for its application in cervical pathology. MethodsIncident dark field imaging was used to image the microcirculation in four quadrants of the uterine ectocervix in ten healthy participants. If the squamocolumnar junction was visible, measurements were repeated on the endocervical columnar epithelium as well. Image acquisition time was recorded and participants scored the experienced level of discomfort. Angioarchitecture was classified according to Weber's classification. Quantitative parameters included capillary density (CD), total and perfused vessel density (TVD, PVD), proportion of perfused vessels (PPV) and microvascular flow index (MFI). ResultsImage acquisition was easy, fast and well tolerated. Angioarchitecture was characterized by two distinctive and organized patterns; capillary loops underneath the squamous epithelium of the ectocervix and vascular networks underneath the columnar epithelium. In the image sequences containing capillary loops, mean CD was 33.2 cpll/mm2 (95% CI 28.2–38.2 cpll/mm2). In the image sequences with vascular networks, mean TVD was 12.5 mm/mm2 (95% CI 11.2–13.77 mm/mm2), mean PVD was 12.2 (95% CI 11.0–13.5 mm/mm2), MFI was 3 and PPV was 100%. ConclusionsIncident dark field imaging allows for noninvasive, real time visualization and objective evaluation and quantification of the microcirculation of the uterine cervix. The organized vascular patterns and optimal perfusion observed in healthy subjects allow for comparison with cervical pathology, for example in patients with cervical dysplasia or cervical cancer.

The outcome of colposcopy in women attending with persistent postcoital bleeding and negative HPV-DNA test

Objective: Women with postcoital bleeding (PCB) are recommended to be evaluated by colposcopy even if cytology is negative. Human papillomavirus (HPV) testing increases the detection of cervical intraepithelial neoplasia or worse compared to the Pap smear test. We aimed to determine the incidence of cervical pathology among women with persistent PCB with a negative Pap smear or HPV-DNA test. Our study, therefore, questions the place of HPV DNA test in women with PCB.&#x0D; Material and Methods: The clinical data of 212 women with persistent PCB and negative cytology or negative HPV DNA test referred to colposcopy, between January 2010 and June 2019, were retrospectively evaluated.&#x0D; Results: Among the 212 PCB patients, 161 (75.9%) were cytology negative and 51 (24.1%) were HPV DNA test (n=40) or co-test (n=11) (negative for HPV DNA test and cytology) negative. There were no cases of invasive cancer. The women referred with negative cytology were more likely than those with negative HPV DNA to have CIN (21/161 (13%), 1/51 (1.9%) p=0.042. Seven women (4.3%) were diagnosed with high-grade cervical dysplasia in the negative cytology group. None of the patients in the HPV DNA negative group was diagnosed with high-grade cervical dysplasia.&#x0D; Conclusion: Our data show that a normal Pap smear cytology in women with PCB does not rule out the possibility of HSIL. HPV DNA testing is a useful triage test to determine if colposcopy referral is required in the context of post-coital bleeding with negative smear test.

C2 quad-screws facilitate 4-rod fixation across the cervico-thoracic junction.

Background: Cervical spine deformity is a potentially devitalizing problem. Contemporary techniques for repair and reconstruction include fusion using rods of tapered diameter alone, or quadruple-rod constructs in which primary rods are joined to floating accessory rods by connectors. Here, we present how we utilized a quadruple-rod construct to perform five C2 to thoracic spine fusions.Methods: Our hospital electronic medical record revealed five patients who underwent the four rod C2-thoracic spine fixation. Patients ranged in age from 14-years-old to 78-years-old. The mean operative time was 715.8 min (range 549–987 min), and average estimated blood loss was 878 cc (range 40–1800 cc).Results: None of the five patients sustained any intraoperative complications, and none demonstrated progressive kyphotic deformity over the average follow-up interval of 8 months.Conclusion: We successfully treated five patients with degenerative or oncologic cervical pathology requiring fixation across the cervicothoracic junction utilizing a 4-rod C2-cervicothoracic fusion technique.

Long-term clinical and radiological outcomes of anterior uncoforaminotomy for unilateral single-level cervical radiculopathy: retrospective cohort study

BACKGROUND CONTEXTAnterior cervical discectomy and fusion is a common procedure for degenerative cervical radiculopathy. In 1996, Dr. H.D. Jho reported an operative technique allowing nerve root decompression via anterior uncoforaminotomy whereas avoiding fusion. PURPOSETo assess long-term clinical and radiological outcomes of anterior uncoforaminotomy in patients with degenerative cervical spine pathology. STUDY DESIGNA single clinic, retrospective cohort study. PATIENT SAMPLEAdult patients who underwent anterior uncoforaminotomy from 2013 to 2018. OUTCOME MEASURESClinical outcomes were assessed using VAS, NDI, SF-36 criteria. Radiological parameters included sagittal balance, disc height and White anPanjabi criterion. MATERIALS AND METHODSAll patients underwent unilateral single-level anterior uncoforaminotomy, and long-term clinical and radiologic follow up was carried out. Clinical outcomes were assessed using VAS, NDI, SF-36 criteria. Radiological parameters evaluated included sagittal balance, disc height and White and Panjabi criteria (3.5 mm of translation, 11 degrees of kyphosis). The mean follow-up period was 33.3 ± 10.6 months (range 12–57 months). RESULTSAll measures of clinical outcome improved. VAS (neck) and VAS (arm) decreased 3 [2; 4] and 5 [3; 5.2] points (median [interquartile range]), respectively (p<0.001); NDI improved from 0.38 [0.36; 0.4], to 0.29 [0.22; 0.34] (p<0.001). Two patients (6%) required additional surgery one year after operation. There were no complications in the perioperative period. Disc height decreased 0.8 mm [0.1; 2.1] (p<0.001). All patients retained stability of the cervical spine based on White and Panjabi criteria. Sagittal balance parameters did not change significantly. CONCLUSIONUncoforaminotomy is an effective and safe method to decompress a unilateral single-level nerve root in degenerative cervical radiculopathy whereas preserving anatomy and motion of the cervical spine.

Proprioception: the missing link in the pathogenesis of tinnitus?

The object of this study was to relate cervical spine pathology to the occurrence of tinnitus and of cervical pain. A retrospective analysis of 124 patients with tinnitus as main complaint and 300 patients with cervical pain as main complaint who visited our clinic in a two-year period. In patients with tinnitus as main complaint, 64% of the patients have also cervical pain, and in patients with cervical pain as main complaint, 44% of the patients have tinnitus. Both groups of patients have in common a high prevalence of postural instability and dizziness, degeneration of the intervertebral disc between the fifth and seventh cervical vertebrae, and a large anterior spur in front of the fifth cervical vertebrae. Patients with cervical pain as main complaint have more degeneration of the intervertebral disc between the third and fourth cervical vertebrae, a larger anterior spur in front of the third cervical vertebrae and more loss of cervical lordosis. Postural instability is an important discriminant factor in patients with cervical pain and in patients with tinnitus as main complaint. In patients with cervical pain postural instability was associated with the occurrence of tinnitus. In patients with tinnitus, there is evidence for two profiles of somatic tinnitus, discriminated by the occurrence of postural instability and low-frequency hearing loss. It seems that the combination of tinnitus and postural instability begins as a cervical pain syndrome and that the tinnitus aggravates in time, possibly by the occurrence of hearing loss, internal diseases, or surgery of the lower limb.

Upper limb neurodynamic testing with radial and ulnar nerve biases: An analysis of cervical spinal nerve mechanics

BackgroundClinical research supports a combination of upper limb neurodynamic testing (ULNT) strategies to rule out upper limb and cervical neurogenic pathology; however, knowledge of the biomechanical response of spinal nerves during ULNT is lacking for radial and ulnar nerve biases. ObjectiveTo assess whether radial and ulnar nerve biased strategies of ULNT elicit significant displacement and strain of cervical spinal nerves. Study designCross-sectional. MethodsRadiolucent markers were implanted into spinal nerves C5–C8 proximal and distal to the intervertebral foramen in nine unembalmed cadavers (six male; three female) age 80.1 ± 13.2 years. Fluoroscopic images were captured during ULNT with radial and ulnar nerve biases. Images at rest and maximum tension were digitized and displacement and strain were measured. All data were analyzed using one sample t-tests and a generalized linear mixed models approach. ResultsUpper limb neurodynamic testing with radial nerve bias resulted in displacement (2.44–3.04 mm) and strain (7.99–11.98%) and ULNT with ulnar nerve bias resulted in displacement (2.16–4.41 mm) and strain (7.12 and 12.95%). Significant extraforaminal displacement occurred during radial and ulnar nerve biases for all spinal nerves (all P < 0.05) whereas significant strain occurred during ulnar nerve biases for all spinal nerves but only in C6–C8 during radial nerve bias. ConclusionUpper limb neurodynamic testing using both radial and ulnar nerve biases resulted in cervical spinal nerve displacement and strain. Such techniques could be used to tension load or mobilize or cervical spinal nerves to evaluate for pathology.

Aerobic Vaginitis-Underestimated Risk Factor for Cervical Intraepithelial Neoplasia.

The aim of this study is to analyse the association between vaginal microbiota and the histological finding of CIN. From July 2016 until June 2017, we included 110 consecutive patients with abnormal cervical cytology results referred for colposcopy to Riga East Clinical University Hospital Outpatient department in the study group. 118 women without cervical pathology were chosen as controls. Certified colposcopists performed interviews, gynaecological examinations and colposcopies for all participants. Material from the upper vaginal fornix was taken for pH measurement and wet-mount microscopy. Cervical biopsy samples were taken from all subjects in the study group and in case of a visual suspicion for CIN in the control group. Cervical pathology was more often associated with smoking (34.6% vs. 11.0%, p < 0.0001), low education level (47.2% vs. 25.5%, p = 0.001), increased vaginal pH (48.2% vs. 25.4%, p < 0.0001), abnormal vaginal microbiota (50% vs. 31.4%, p = 0.004) and moderate to severe aerobic vaginitis (msAV) (13.6% vs. 5.9%, p = 0.049) compared to controls. The most important independent risk factors associated with CIN2+ were smoking (OR 3.04 (95% CI 1.37–6.76), p = 0.006) and msAV (OR 3.18 (95% CI 1.13–8.93), p = 0.028). Bacterial vaginosis (BV) was found more often in CIN1 patients (8/31, 25.8%, p = 0.009) compared with healthy controls (8/118, 6.8%), or CIN2+ cases (8/79, 10.1%). In the current study msAV and smoking were the most significant factors in the development of CIN in HPV-infected women, especially high grade CIN. We suggest that AV changes are probably more important than the presence of BV in the pathogenesis of CIN and progression to cervix cancer and should not be ignored during the evaluation of the vaginal microbiota.

FEATURES OF DENTINE CHEMICAL COMPOSITION OF INTACT TEETH AND TEETH WITH WEDGE-SHAPED DEFECTS

The aim: Is to define dentine chemical composition of intact teeth and those with wedge-shaped defects followed by the analysis of revealed differences. Materials and methods: Longitudinal sections of 22 clinically removed teeth (12 – clinically intact ones, 10 – with wedge-shaped defects) from both jaws were studied in patients aged between 25-54 years. JSM-6490 LV focused beam electron microscope (scanning) with system of energy-dispersive X-ray microanalysis INCA Penta FETх3 was used. The chemical composition of 148 dentine areas in the incisal region (tubercle), equator, cervical area has been determined as a percentage of the weight amounts of carbon, oxygen, calcium, phosphorus, sodium, magnesium, sulfur, chlorine, zinc, potassium, aluminum. Results: Dentine chemical composition of teeth with wedge-shaped defects differed from those of intact teeth by significantly lower content: sodium, chlorine and calcium – in the incisal region (tubercle); sodium, magnesium − at the equator; sodium, chlorine and calcium – in the cervical region (p≤0.05). In the sample groups with cervical pathology there was more sulfur and oxygen in the incisal region (tubercle), phosphorus and zinc – at the equator, carbon and potassium – in the cervical region (p≤0.05). Conclusions: Differences in the chemical composition of intact teeth and teeth with wedge-shaped defects, the presence of correlation between the studied chemical elements confirm the role of macro- and microelements in the pathogenesis of non-carious cervical lesions.

Study of the morphological structure of enamel and correlation of its chemical composition with dentin in intact teeth and with a cervical pathology

Study of the morphological structure of enamel and correlation of its chemical composition with dentin in intact teeth and with a cervical pathology

Badanie budowy morfologicznej i składu chemicznego zębiny w zębach zdrowych i objętych zmianami chorobowymi w obrębie szyjek zębowych

Badanie budowy morfologicznej i składu chemicznego zębiny w zębach zdrowych i objętych zmianami chorobowymi w obrębie szyjek zębowych

Research on Application of Classification Model Based on Stack Generalization in Staging of Cervical Tissue Pathological Images

Cervical cancer is a malignant tumor that threatens women's health and life. Cervical pathology examination, as the gold standard for cervical cancer diagnosis, provides an important basis for the surgical plan and postoperative follow-up strategy for cervical cancer. Cervical biopsy diagnosis includes normal, low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) and squamous cell carcinoma (SCC). At present, cervical pathology examination still relies on the doctor's personal clinical experience and subjective judgment, which is time-consuming and may cause misdiagnosis or missed diagnosis. In addition, the current intelligent classification of cervical pathological images still has disadvantages such as imperfect classification system and low classification accuracy. Therefore, this experiment uses the ResNet50 model of the convolutional neural network as the feature extractor, and selects the K-Nearest Neighbour (KNN), Random Forest (RF), Support Vector Machine (SVM) classifiers in Machine Learning to perform cervical tissue pathological images Discrimination, the accuracy of the classification results were 85.83%, 80.33%, and 86.67%. In order to further improve the accuracy of the model and enhance the applicability and stability of the model, this experiment proposes the Stacked Generalization (SK) classification model. The first-layer base learner of the SK classification model selects CNN-KNN, CNN-RF, CNN-SVM, and the second-layer classifier selects Multilayer Perceptron (MLP). Among them, MLP makes the final result by learning the classification performance of the base learner for label discrimination, the accuracy of the classification model after ensemble learning is 90.00%. In addition, this experiment uses the Synthetic Minority Oversampling Technique (SMOTE) algorithm to amplify the training samples, and the amplified data set has a classification accuracy of 89.17% under the training of the SK classification model. The results show that the SK classification model in this experiment has a high classification ability for cervical histopathological images, and has good generalization ability and robustness.