Radiological Observations Research Articles

Stereographic assessment of mandibular canal in relation to the roots of impacted lower third molar using multiprojection narrow beam radiography

The position of the mandibular canal in relation to the superimposed roots of 173 impacted lower 3rd molars was evaluated radiologically. A multi-projection narrow beam radiography (MNBR) technique recently developed for oral radiography was applied in this study. This method enables stereoscopic examination of the area of interest. The mandibular canal was located buccally to the roots of 105 (61%) teeth, lingually to the roots of 57 (33%) teeth, and between the roots of 6 (3%) teeth. The relationship of canal to roots of 5 (3%) teeth was not possible to determine. Disagreement between radiological assessment and clinical observation was found in 4 (5%) of 80 operated teeth. The canal was visible at operation in 23 (29%) cases, which was predicted at stereographic examination in 21(91%) cases. The MNBR stereographic technique is a useful method with high sensitivity (0.83) for evaluating the bucco-lingual relationship of the mandibular canal to the roots of a 3rd molar.

Enhanced Osteoinduction by Intramuscular Grafting of BMP-.BETA.-TCP Compound Pellets into Murine Models.

The osteoinductive effects of bone morphogenetic protein (BMP, derived from murine osteosarcoma) were studied with regard to its use combined with beta-tricalcium phosphate (beta-TCP). BMP and beta-TCP were molded into pellets by the "pressure method", originated by us and transplanted to ddY mice. Control mice received interdorsal muscular implantations of either the BMP or beta-TCP pellets. The animals were sacrificed 1, 2 and 3 weeks after grafting, for radiological, histochemical, and ultrastructural observations. The BMP-beta-TCP compound pellets induced faster cartilage and bone formation, whereas these activities were slower when pellets made solely of BMP were used. The beta-TCP pellets demonstrated no osteoinductive properties. Observations revealed two types of beta-TCP resorbing multinuclear giant cells. One was osteoclastic, expressing calcitonin receptors, having numerous mitochondria and ruffled border-like structures; the other was not osteoclastic in nature. In animals grafted with the compound pellets, a great number of osteoclastic cells gathered on the pellets, much earlier than those grafted with the pellets made of BMP alone. Then, osteoblastic bone formation over the cement lines followed an osteoclastic resorption of both beta-TCP and newly formed bone. In contrast, BMP induced few osteoclastic cells, resulting in slower bone coupling. Furthermore, the faster bone formation induced by the compound pellets seemed to be associated with the presence of beta-TCP. Porous by nature, beta-TCP would entrap BMP within its micropores, and thus, the intrinsically diffusible BMP is retained and its action consequently prolonged. In addition, the compound pellet offered increased surface contact between BMP and mesenchymal cells. Therefore, BMP-beta-TCP compound pellets induce cartilage and bone formation more rapidly than does BMP alone.

Cementless total hip arthroplasty using a porous-coated prosthesis for bone ingrowth fixation: 3 1/2-year follow-up

The clinical and radiologic results of a consecutive series of 59 patients (69 hips) who had primary total hip arthroplasty using cementless prostheses was studied. Harris-Galante acetabular and femoral protheses, which have a porous fiber-metal mesh coating intended to encourage bone ingrowth fixation, were used in all cases. Two femoral components were revised during the follow-up period, one for aseptic loosening and the other for late septic loosening. In the remaining 67 hips, the average Harris hip score rose from a preoperative 52 to 94 at the last follow-up examination (average follow-up period, 44 months). Eighty-eight percent of these hips had an excellent result (Harris hip score of 90 or more). Radiologic analysis demonstrated that all the acetabular components were stable. Eighty-three percent of the femoral components appeared to have stable bone ingrowth fixation, five components (7%) had stable fibrous ingrowth, and seven (10%) were unstable. Parallel radiodense lines were seen around the smooth portion of the stem in 93% of hips, but this finding appeared to have no clinical importance. Significant stress shielding of the proximal femur was seen in 16% of hips. Endosteal lysis of the distal femur occurred in 22 % of hips, including large lesions in two patients who will require future revision surgery because of femoral diaphysis weakening. Femoral lysis was not associated with hip or thigh pain and was most common in young, male patients who had high activity levels. Because of the high incidence of femoral erosion in this series, close radiologic observation is warranted for patients who have had cementless hip arthroplasty using the Harris-Galante implant.

Induction and Prevention of Pin Loosening in External

In external fixation of fractures, pin loosening is a major concern. Preloading the pins is generally done to ensure their stability within the bone cortex. The effect of radial preload and bending preload in reducing resorption at the pin/bone interface was tested. Schanz screws were fixed to live sheep tibiae using a pneumatically operated external fixator frame. Evaluation was based on radiological observation and fluorochrome histology using sequential labels. Though not completely absent, bone resorption was minimal in the radial preload group, compared with the two other groups. More important, the bone-to-pin contact surface in the radial preload group was found to be almost intact after 5 weeks. In this study, radial preload appears to be superior to bending preload in terms of minimizing the problems of pin loosening.

Kabuki make-up (Niikawa-Kuroki) syndrome: Clinical and radiological observations in two sicilian children

The Authors describe two patients aged 5 and 8, a female and a male, affected by a condition of polymalformations known as Kabuki make-up or Niikawa-Kuroki syndrome, having a neonatal incidence of 1:32,000 in Japan. There are two hypothesis about the apparent rarity of the syndrome in the rest of the world, including the Asian Continent: the first is that it exists, but is infrequently recognized outside Japan and the second is that it is really more frequent in those parts of the world, where ethnic exchanges are uncommon, as it happens in Japan.

Prazosin in Chronic Congestive Heart Failure Due to Ischemic Heart Disease

Oral prazosin hydrochloride (2-20 mg/day) was administered to 38 patients with chronic congestive heart failure due to ischemic heart disease for 6-18 months. Half (19) of the patients were hypertensive and half (19) nonhypertensive. All were receiving furosemide (80 mg/day, orally) and 19 were receiving digoxin (0.25-0.5 mg/day, orally) in addition to prazosin. Clinical radiological, mechanocardiographic, echocardiographic, and biochemical observations were made initially, at peak response, and at the end of 6 months. Prazosin improved left ventricular function indexes at rest, relieved symptoms and signs of congestion, and remained effective for 6-18 months with little or no increase in dose. There was no reflex tachycardia, tension-time indexes fell in all patients, angina was relieved in 8 patients who complained of it, and dyskinesia of left ventricular wall was corrected in 8 of 13 patients. The New York Heart Association functional class improved in all patients, but to a greater extent in hypertensive patients and in those not receiving concomitant digoxin. Mild, transient side effects occurred in 6 patients.

上顎に発生したエナメル皮腫の４例およびその文献的考察

Ameloblastoma is one of the most common odontogenic tumors in the oral region. It appears as bone resorption in the mandible frequently but rarely in the maxilla.The authors experienced four cases of ameloblastoma which appeared in the maxilla. Four patients ranged from 25 to 83 years old. 2 cases occurred in males and 2 cases in females. At the first visit, recurrence occurred in 2 cases. In radiological observations, 2 cases were of monocystic type, 1 case polycystic type, and 1 case honeycomb type. In pathological observations, 2 cases were of follicular type, 1 case acanthomatous type, and 1 case plexiform type. They were treated by extirpation and no recurrence occurred during follow up.Only 59 cases in the maxilla have been reported in our country in the past 60 years. In this study we examine 63 cases including our four cases. The results are summarized as follows:The patients ranged from 5 to 85 years old, and the mean age was 47.0. There was no significant differences by sex. In the pathological classification, follicular type occupied 41.9%, acanthomatous type 32.3%, plexiform type 9.7%, and basal cell type 9.7%, etc. Recurrence rate was 26.9%.

水酸化アパタイト・多孔質立方体のビーグル犬広範骨欠損部単独充填の検討

Porous cuboidal hydroxyapatite (HAp) as a substitute of cancelous bone is a bioactive ceramics, and its tissue affinity as well as osteo-conductivity have been proven experimentally by Niwa et al. However, to fill the large cancellous bone defects by HAp alone, it is not clearly understood if HAp should be implanted with autogenous bone. So, the large bone defects created by curettage of cancellous bone in distal femur and proximal tibia in seven beagle dogs were filled by 4.3mm3 HAp 5 to 10 pieces. After the implantation of HAp, radiological observation by Fuji computed radiogram and histological evaluation by H-E stain and Villanueva non-decalcified stain were carried out from the bone specimens resected serially 2 to 44 weeks. Radiologically by 4 to 8 weeks after HAp implantation, the space between HAp and the preexisting bone which was mainly cortex, was reduced by radiodense newly formed trabeculae except the open window in femur site. Histologically in 2 weeks, new trabecular bone formation with abundant vascularization was observed between HAp and the preexisting bone. By 4 to 12 weeks, fibrous tissue in HAp was gradually transformed to immature bone adherent to HAp, and fibrous tissue was replaced by normal bone marrow. In 44 weeks, the porous cavities seemed enlarged by the resorption of HAp. So, the solo implantatiom of HAp in large bone defects is probably safe and secure procedure because new bone formation in and around HAp is conducted early to enforce the fragility of HAp without foreign body reactions.

Cloacal exstrophy: radiologic findings in 13 patients.

Cloacal exstrophy is a complex, multisystem malformation that has not received much attention in the radiologic literature. The clinical histories and imaging studies of 13 cases of cloacal exstrophy proved surgically or at autopsy were reviewed. Radiologic observations were based on skeletal plain films (13), contrast-enhanced examinations of the genitourinary system (12), abdominopelvic sonograms (nine), gastrointestinal studies (seven), CT scans of the pelvis and CNS (seven), MR images of the pelvis and CNS (six), renal nuclear medicine scans (three), myelography (three), and three-dimensional scans of the pelvis (two). Genitourinary and gastrointestinal abnormalities identified in our 13 patients included bladder malformations (13), hindgut anomalies (13), undescended testes (five), malrotation (five), duplicated müllerian structures (four), and renal ectopia (four). Skeletal abnormalities included symphysis pubis diastasis (13), posterior element dysraphism (12), vertebral segmentation anomalies (12), clubfeet (six), and hip dislocations (five). CNS anomalies included meningocele (nine) and Chiari malformation (one). Immediate surgical closure of the defect with maximal bowel preservation and diverting colostomy offers optimal chances for survival. Appropriate preoperative gastrointestinal and genitourinary evaluation is essential.

Endoscopic and Radiological Observations of the Growth of an Esophageal Diverticulum

Abstract:A 60‐year‐old female was admitted to the hospital because of acute mediastinitis caused by the perforation of a diverticulum of the esophagus. The patient was successfully treated with antibiotics and on the endoscopic examination the diverticulum was completely cured.Approximately two years after the first admission, the patient was admitted twice because of acute gastritis. Barium‐meal upper gastrointestinal examination and upper G. I. endoscopy were performed on each occasion. These examinations clearly suggested that the diverticulum had chronic inflammation, with polypoid hyperplasia, and documented the growth of the diverticulum between the 2nd and 3rd admission. As far as we know, this is a very rare report, describing the course and enlargement of an esophageal diverticulum.

Die segmentale Instabilität und die lumbale Wirbelkanalstenose

Clinical, radiological, surgical and experimental observations make it possible to construct a rational theory of the segmental lumbar instability which explains the pathogenesis of spondylosis, of stenosis and of several cases of disc displacement as well. This theory helps us to choose the right surgical procedure. Spinal stenosis, degenerative spondylolisthesis and some cases of disc displacement are seen as part of a degenerative process with its starting point in regressive changes of the intervertebral disc and lateral joint. This leads to a marked instability of the affected mobile segment. Signs and symptoms of unstable lumbar spine are discussed. In such cases, if decompression of the roots by laminectomy, facetectomy or discectomy is performed without fusion, the consequences are usually treated but not the main cause of the trouble, namely the instability. Finally, we describe a procedure which we prefer as the safest and best of all, using selected decompression by means of joint screws (spondylodesis) as suggested by F. Magerl (41-44).

Acute lung rejection after heart-lung transplantation: correlation of findings on chest radiographs with lung biopsy results.

This retrospective study was performed to determine if the chest radiograph could serve as a predictor for acute lung rejection in heart-lung transplantation patients. The findings on chest radiographs were correlated with the results of transbronchial biopsies in 16 heart-lung transplantation patients. The chest radiographs immediately preceding 83 biopsies were evaluated for a variety of findings. The histopathologic results of the lung biopsies were divided into five categories: (1) acute lung rejection (n = 25); (2) suggestive, but not diagnostic, of acute lung rejection (n = 8); (3) nonspecific (n = 26); (4) infection (n = 17); and (5) normal lung (n = 9). Biopsies from two patients showed both acute lung rejection and cytomegalovirus infection and were included in both categories. These histopathologic results were then correlated with the radiologic observations. We found that the combination of septal lines and new or increasing pleural effusions, without concomitant increase in cardiac size or vascular pedicle width, or evidence of vascular redistribution, indicated acute lung rejection with a sensitivity of 68% (17/25), specificity of 90% (52/58), and overall accuracy of 83% (69/83). We conclude that the chest radiograph is a useful indicator of acute lung rejection.

Anatomical and radiological observations of the sesamoid bone of the popliteus muscle in the adult dog and cat.

In a random selection of 50 adult dogs (25 males and 25 females) and 50 adult cats (25 males and 25 females), the incidence of ossification of the sesamoid structure of the popliteus muscle was characterized through anatomical dissection and radiographic techniques. The incidence of ossification was 84% in the dogs and 100% in the cats. In both anatomical and radiologic studies, it was demonstrated that when the knee was fully extended, the sesamoid bone was adjacent to the caudodistal part of the articular surface of the lateral tibial condyle in both dogs and cats. When the knee was flexed, the sesamoid bone articulated progressively with the more craniodorsal part of the tibial articular surface and when full flexion is obtained, it articulated with the articular part of the lateral surface of the lateral meniscus. The probable functions of the sesamoid bone are discussed.

ラット抜歯窩治癒過程に及ぼす低出力レーザーの影響 (第2報)

We have already reported at the ninth meeting of this academy some opinions on radiological observations of the healing process of experimentally induced extract cavities irradiated with low energy laser. This time, we reported further opinions on radiological observations of the healing process.(1) From the radiographic and macroscopic observations, there were no significant differences between the laser-irradiated groups and non-irradiated (control) groups at any period of the observation.(2) On the three and four-minute irradiated groups, the new generation and expansion of the vascular system were slightly more energetic at three and seven days after irradiation on the microangiographic specimens.(3) In microradiographic specimens of the three-minute irradiated group, the widespread generation of trabecular bone from the cavity wall as well as the cavity bottom was observed on the seventh and 14th days after tooth extraction.(4) The vascular and bony conditions of the ten-minute irradiated groups were as energetic as the non-irradiated (controll) group for any observed specimens.

Is there an accessory sphincter of the cervical oesophagus?

The transition between the pharynx proper and cervical oesophagus, the pharyngo-oesophageal segment, has received considerable attention. It corresponds roughly to the upper oesophageal sphincter and has specific anatomic and physiological functions pertinent to swallowing, respiration and posture (Bosma, 1957). With the aid of cineradiography or video techniques, it is possible to distinguish several different morphological and functional characteristics and abnormalities within this segment resulting in a more precise knowledge of its nature. Within this region, there are several well defined functional and morphodynamic abnormalities,e.g., Zenker diverticula, Kilian-Jamieson diverticula as well as cricopharyngeal incoordination, to the understanding of which radiology has contributed greatly. The purpose of this report is to describe a new radiological finding, namely, a circumscribed transient circular narrowing within the cervical oesophagus, in patients with dysphagia. A transient narrowing in the cervical oesophagus was seen in seven dysphagic patients, five women and two men, aged 55–74 years. Four of the patients had undergone cricopharyngeal myotomy; in one of these, the myotomy was part of surgical correction of a Zenker diverticulum. One patient had had surgery and radiotherapy for thyroid carcinoma. The radiological observations of the pharyngo-oesophageal segment and cervical oesophagus were compared with studies of 150 non-dysphagic volunteers: 79 men, 71 women, aged 20–82 years (mean, 52 years). These examinations were approved by the Ethical Committee of the University of Lund and Malmö General Hospital on December 13, 1979 (ref. no. 144/79).

Blast Injuries

Blast injuries cause specific lesions with which the radiologist should be familiar. The mechanism of injury and the pathophysiology of this form of trauma are discussed. The clinical effects as well as the radiologic observations in various organs are presented. Most dramatic effects are observed in the thorax.

Radiologic observation of endobronchial tuberculosis in adults

Radiologic observation of endobronchial tuberculosis in adults

Laboratory Diagnosis in Ophthalmology

Designed for residents and practicing ophthalmologists, this multiauthored text edited by Dr Karcioglu is intended to detail in step-by-step fashion those laboratory procedures that supplement clinical and radiological observations in reaching a diagnosis. The first section of the book is devoted to anatomic pathology. Chapter 1 by R. Jean Campbell is an excellent, concise review of eyelid and conjunctival lesions. Dr Karcioglu discusses orbital lesions in chapter 2 and, with the collaboration of Barrett Haik, intraocular tumors in chapter 3. However, the book does not discuss the histopathology of the cornea or lens, although corneal buttons and cataracts are common ocular specimens in many surgical pathology laboratories. [It] give[s] the practicing ophthalmologist access to clinical laboratory information that is not readily available elsewhere. In chapter 4, the application of new immunopathologic techniques to ocular diagnosis is reviewed in a scholarly and rigorous fashion by L. David Ormerod, Delia Sang, and

Pulmonary cytology in the posttherapeutic monitoring of patients with bronchogenic carcinoma

A study of 113 patients with histologically confirmed bronchogenic carcinoma and survival for at least 18 months was performed. Posttherapeutic cytologic specimens were submitted for only 52.2% (59/113), and for only 8.5% (5/59) of the individuals was specimen procurement related to clinic visits. Yet, when utilized as a diagnostic procedure for the hospitalized patient, a positive cytodiagnosis was made on 55.6% (15/27) of the patients with recurrent carcinoma, in 61.1% (11/18) with persistent disease and in all 5 patients with a metachronous primary bronchogenic carcinoma. Cytologic diagnoses of cancer compared favorably with concurrent histologic interpretations of biopsies and radiologic observations of chest films.

Radiologic Observations in Severe Neonatal Respiratory Distress Syndrome Treated with the Isolated Phospholipid Fraction of Natural Surfactant

Ten newborn babies with severe respiratory distress syndrome, all dependent on artificial ventilation, were treated via the airways with the isolated phospholipid fraction of bovine or porcine surfactant. After treatment with surfactant at a median age of 10.5 h, there was in all patients a striking improvement of lung aeration in chest films, with a decrease in parenchymal fluid retention and in distension of bronchioli. These radiologic findings were associated with a dramatic improvement of oxygenation and a significant reduction of the right-to-left shunt. In spite of the rapid therapeutic response, four patients died from cerebral hemorrhage. One of the surviving patients developed bronchopulmonary dysplasia. Our findings document efficacy of this new surfactant preparation in the neonatal respiratory distress syndrome, but the long-term effects need to be further tested in randomized clinical trials.