Tomography Volumetric Analysis Research Articles

Choroidal Vessel and Stromal Volumetric Analysis After Photodynamic Therapy or Focal Laser for Central Serous Chorioretinopathy.

To utilize volumetric analysis to quantify volumetric changes in choroidal vessels and stroma after photodynamic therapy (PDT) and focal laser photocoagulation (PC) for central serous chorioretinopathy (CSCR). This retrospective, comparative study included 58 eyes (58 patients) with CSCR (PC, 33 eyes; PDT, 25 eyes) followed up with swept-source optical coherence tomography at 3 months after treatment. Three-dimensional (3D) choroidal vessel and stromal volumes in each area of the central 1.5-mm-diameter circle, the torus-shaped area with 6-mm-diameter circle excluding the area of the central 1.5-mm-diameter circle, and the treated area of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid centered at the fovea were analyzed using a deep learning-based method. Changes in volume at baseline and 1 and 3 months after treatment were compared. The mean patient age was 49.3 ± 10.5 years. In the central 1.5-mm-diameter circle, the mean vessel and stromal volume rates significantly decreased after the treatment in both the PDT and PC groups (P = 0.00029 and P = 0.0014, respectively), and significant differences between the PDT and PC groups of continuous variables within times were observed in both volumes (P = 0.024 and P = 0.037, respectively). In the torus-shaped area and treated area, the PDT and PC groups both showed similar decreases in vessel and stromal volume over time. In the 3D optical coherence tomography volumetric analysis, both PDT and focal PC reduced choroid vessel volume in eyes with CSCR. This new finding is useful in elucidating the pathogenesis and healing mechanisms of CSCR.

Influence of second premolar extractions on the volume of the oral cavity proper: a control comparative cone-beam computed tomography volumetric analysis study.

To compare the pre- and postorthodontic treatment volumetric changes of the oral cavity proper (OCP) in extraction and nonextraction patients and to identify influencing variables. Pre- and posttreatment cone-beam computed tomography (CBCT) scans of patients undergoing orthodontic treatment with fixed labial appliances and who satisfied the inclusion criteria were individually landmarked. Linear, angular, and volumetric measurements were determined. Descriptive statistics, repeated measure analyses of variance, correlations, and stepwise regression statistical analyses were applied. The CBCT scans of 54 patients who underwent the extraction of second premolars and/or extraction of second primary molars associated with agenic second premolars, and 59 nonextraction patients matched for crowding, were assessed. The mean age for both groups was 15 years. There was a statistically significant increase in the volume of the OCP for both the extraction and nonextraction groups, with the nonextraction group demonstrating a larger increase in the volume of the OCP. Gender, age, changes in mandibular and maxillary arch length, and changes in mandibular and maxillary intermolar width all influenced the change in the OCP volume. The volume of the OCP increased in growing patients with and without the extraction of the second premolars and/or extraction of second primary molars associated with agenic second premolars. Patients who did not have extractions as part of their orthodontic treatment demonstrated a greater overall increase in OCP volume.

S75 Computerized Tomography Volumetric Analysis of Pancreatic Fluid Collections is Predictive of Need for SteP-Up Therapy and Re-Intervention

S75 Computerized Tomography Volumetric Analysis of Pancreatic Fluid Collections is Predictive of Need for SteP-Up Therapy and Re-Intervention

Sex-specific emphysematous changes evaluated by a three-dimensional computed tomography volumetric analysis among patients with smoking histories who underwent resection for lung cancer.

The present study evaluated the sex-specific susceptibility to the development of emphysema in patients with smoking histories who underwent lung cancer surgeries. Lung cancer patients with smoking histories who underwent lung resection at the University of Tsukuba Hospital, Japan, were enrolled. Radiologic emphysematous changes were analyzed using three-dimensional computed tomography (3D-CT). The volume proportion of emphysematous lung per unit of smoking and the relationship between emphysematous change and clinicopathologic factors were evaluated. Radiologic emphysematous changes analyzed using 3D-CT per pack-year smoked, defined as the Smoking-Emphysema Index (SEI), were greater in females than males. The difference was more profound in adenocarcinoma patients than in non-adenocarcinoma patients (0.70 ± 2.30 vs. 0.21 ± 0.28, P = 0.037). Female lung cancer patients are more susceptible to smoking-induced emphysema than males. The SEI may be an effective indicator for evaluating smoking-induced emphysema.

Reply Re: "Correlation of Automated Computed Tomography Volumetric Analysis Metrics With Motility Disturbances in Thyroid Eye Disease".

Accepted for publication December 17, 2022. The sponsor or funding organization had no role in the design or conduct of this research. Supported in part by an unrestricted grant to the Vanderbilt Eye Institute and Physician Scientist Award from Research to Prevent Blindness, New York, NY. This project was supported by NIH 1R03EB012461, 1R21EY024036, and the National Center for Research Resources, Grant UL1 RR024975-01 (now at the National Center for Advancing Translational Sciences, Grant 2 UL1 TR000445-06). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This work was conducted in part using the resources of the Advanced Computing Center for Research and Education at Vanderbilt University, Nashville, TN. L.M. has been a consultant to Horizon Therapeutics. The other author has no financial or conflicts of interest to disclose. Correspondence: Louise Mawn, M.D., Vanderbilt Eye Institute, 2311 Pierce Avenue, Nashville, TN 37232 ([email protected])

Re: "Correlation of Automated Computed Tomography Volumetric Analysis Metrics With Motility Disturbances in Thyroid Eye Disease".

Li, Joy A.B.; Li, Shirley B.A.; Park, Kristen E. B.A.; Wen, Joyce B.A.; Lee, Jonathan B.S.; Ayala, Frank Abella M.D.; Lerner, Alexander M.D.; Gokoffski, Kimberly K. M.D., Ph.D.; Zhang-Nunes, Sandy M.D.; Patel, Vishal M.D., Ph.D.; Chang, Jessica R. M.D. Author Information

Computed tomography volumetric analysis for predicting postoperative lung function for segmentectomy.

OBJECTIVESWe compared the computed tomographic (CT) volumetric analysis and anatomical segment counting (ASC) for predicting postoperative forced expiratory volume in 1 s (FEV1) and diffusing capacity for carbon monoxide (DLCO) in patients who had segmentectomy for early-stage lung cancer.METHODSA total of 175 patients who had segmentectomy for lung cancer and had postoperative pulmonary function test were included. CT volumetric analysis was performed by software, which could measure total lung and target segment volume from CT images. ASC and CT volumetric analysis were used to determine predicted postoperative (PPO) values and the concordance and difference of these values were assessed. The relationship between PPO values and actual postoperative values was also investigated.RESULTSThe PPO-FEV1 and PPO-DLCO showed high concordance between 2 methods (concordance correlation coefficient = 0.96 for PPO-FEV1 and 0.95 for PPO-DLCO). There was no significant difference between PPO values as determined by 2 methods (P = 0.53 for PPO-FEV1, P = 0.25 for PPO-DLCO) and actual postoperative values [P = 0.77 (ASC versus actual) and P = 0.20 (CT versus actual) for FEV1; P = 0.41 (ASC versus actual) and P = 0.80 (CT versus actual) for DLCO]. We subdivided the patients according to poor pulmonary function test, the number of resected segments and the location of the resected lobe. All subgroup analyses revealed no significant difference between PPO values and actual postoperative values.CONCLUSIONSBoth CT volumetric analysis and ASC showed high predictability for actual postoperative FEV1 and DLCO in segmentectomy.

Development of an Endovascular Model of Pelvic Hemorrhage Using Volumetric Computed Tomography Validation

Purpose Uncontrolled pelvic hemorrhage from trauma is associated with mortality rates above 30%. The ability of an intervention to reduce blood loss from pelvic trauma is paramount to its success. The objective of this study was to determine if computed tomography volumetric analysis could be used to quantify blood loss in a porcine endovascular pelvic hemorrhage model. Materials and Methods Yorkshire swine under general anesthesia underwent balloon dilation and rupture of the profunda femoris artery, which was confirmed by digital subtraction angiography. Computed tomography angiography and postprocessing segmentation were performed to quantify pelvic hemorrhage volume at 5 and 30 minutes after injury. Continuous hemodynamic and iliofemoral flow data were obtained. Baseline and postinjury hemoglobin, hematocrit and lactate were collected. Results Of 6 animals enrolled, 5 survived the 30-minute post-injury period. One animal died at 15 minutes. Median volume of pelvic hemorrhage was 141±106 cm3 at 5 minutes and 302±79 cm3 at 30 minutes with a 114% median increase in hematoma volume over 25 minutes (p=0.040). There was a significant decrease in mean arterial pressure (107 to 71 mm Hg, p=0.030) and iliofemoral flow (561 to 122 mL/min, p=0.014) at 30 minutes postinjury, but no significant changes in hemoglobin, hematocrit, or heart rate. Conclusion Computed tomography volumetric analysis can be used to quantify rate and volume of blood loss in a porcine endovascular pelvic hemorrhage model. Future studies can incorporate this approach when evaluating the effect of hemorrhage control interventions associated with pelvic fractures.

Heart Transplantation in Dextrocardia-Heterotaxy Syndrome

Purpose Heart transplantation in infants with dextrocardia-heterotaxy syndrome (HS) presents significant surgical challenges. There is limited data on surgical strategies to accomplish heart transplantation in these children. We report surgical strategy and outcomes of 5 patients with HS who underwent orthotopic heart transplant (HT). Methods Heart transplantation in children with HS between 2017-2020 in a tertiary care children's hospital were reviewed. Perioperative characteristics and post-operative outcomes of these 5 patients were obtained. All patients underwent pre-transplant volumetric analysis with chest computerized tomography scan to predict maximum donor size and orthotopic HT with the donor heart placed in a levoposition. Furthermore, recipient systemic veins were routed to the donor heart using extra-cardiac conduits and baffle techniques. Outcomes were compared with 10 size-matched HT patients who had no HS. Results For HS patients the median age at HT was 439 days (IQR:89-716), median weight was 8.4 kg (IQR: 4.1-10.8). For HS pts; waitlist time was 43 vs 38 days (p=0.68), median pulmonary artery pressure was 24 vs 20 mmHg (p=0.5), transpulmonary gradient was 13 vs 8 mmHg (p=0.68). There was no significant difference between groups relative to cardiopulmonary by-pass time (230 vs 163 min, p=0.13), graft ischemic time (196 vs 218 min, p=0.08), and mechanical ventilation time after HT (3.3 days vs 1.08 days, p=0.14). The length of hospital stay was longer for HS patients compared to the control group (99 vs 50 days, p=0.04). At almost one year of post-transplantation follow-up, no patient had rejection or required hospitalization for any infectious etiology in HS group. One patient required cardiac catheterization intervention of the extra-cardiac conduit between superior vena cava and right atrium. To date; all patients in HS are still alive except for one patient who died 8 months post-transplantation. Conclusion HT in infants is feasible with comparable one-year outcomes as other infants undergoing HT. Detailed preoperative planning using computed tomography volumetric analysis to define appropriate donor size and use of extra-cardiac systemic venous conduits facilitates successful HT in small infants with HS.

Correlation of Automated Computed Tomography Volumetric Analysis Metrics With Motility Disturbances in Thyroid Eye Disease.

The authors sought to examine relationships between CT metrics derived via an automated method and clinical parameters of extraocular muscle changes in thyroid eye disease (TED). CT images of 204 orbits in the setting of TED were analyzed with an automated segmentation tool developed at the institution. Labels were applied to orbital structures of interest on the study images, which were then registered against a previously established atlas of manually indexed orbits derived from 35 healthy individuals. Point-wise correspondences between study and atlas images were then compared via a fusion algorithm to highlight metrics of interest where TED orbits differed from healthy orbits. Univariate analysis demonstrated several correlations between CT metrics and clinical data. Metrics pertaining to the extraocular muscles-including average diameter, maximum diameter, and muscle volume-were strongly correlated (p < 0.05) with the presence of ocular motility deficits with regards to the superior, inferior, and lateral recti (with exception of superior rectus motility deficits being mildly correlated with muscle volume [p = 0.09]). Motility defects of the medial rectus were strongly correlated with muscle volume, and only weakly correlated with average and maximum muscle diameter. The novel method of automated imaging metrics may provide objective, rapid clinical information which may have utility in prevention and recognition of visual impairments in TED before they reach an advanced or irreversible stage and while they are able to be improved with immunomodulatory treatments.

Effects of Stromal Vascular Fraction on Breast Cancer Growth and Fat Engraftment in NOD/SCID Mice.

To overcome unpredictable fat graft resorption, cell-assisted lipotransfer using stromal vascular fraction (SVF) has been introduced. However, its effect on cancer growth stimulation and its oncological safety are debatable. We investigated the effect of SVF on adjacent breast cancer and transplanted fat in a mouse model. A breast cancer xenograft model was constructed by injecting 2 × 106 MDA-MB-231-luc breast cancer cells into the right lower back of 40 NOD/SCID mice. Two weeks later, cancer size was sorted according to signal density using an in vivo optical imaging system, and 36 mice were included. Human fat was extracted from the abdomen, and SVFs were isolated using a component isolator. The mice were divided into four groups: A, controls; B, injected with 30μl SVF; C, injected with 0.5ml fat and 30μl saline; group D, injected with 0.5ml fat and 30μl SVF. Magnetic resonance imaging and three-dimensional micro-computed tomography volumetric analysis were performed at 4 and 8weeks. Tumor volume was 43.6, 42.3, 48.7, and 42.4mm3 at the initial time point and 6780, 5940, 6080, and 5570mm3 at 8weeks in groups A, B, C, and D, respectively. Fat graft survival volume after 8weeks was 49.32% and 62.03% in groups C and D, respectively. At 2-month follow-up after fat grafting in the xenograft model, SVF injection showed an increased fat survival rate and did not increase the adjacent tumor growth significantly. Fat grafting with SVF yields satisfactory outcome in patients who undergo breast reconstruction surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Dual-graft adult living donor liver transplantation with ABO-incompatible graft: short-term and long-term outcomes.

ABO-incompatible (ABOi) dual-graft (DG) adult living donor liver transplantation (ALDLT) is not commonly performed due to its inherently intricate surgical technique and immunological complexity. Therefore, data are lacking on the short- and long-term clinical outcomes of ABOi DG ALDLT. We performed a retrospective study by reviewing the medical records of patients who underwent ABOi DG ALDLT between 2008 and 2014. Additionally, computed tomography volumetric analysis was conducted to assess the graft regeneration rate. The mean age of a total of 28 recipients was 50.2±8.5years, and the mean model for end-stage liver disease score was 12.2±4.6. The 1-, 3-, and 5-year patient survival rate was 96.4% during the mean follow-up period of 57.0±22.4months. The 1-, 3-, and 5-year graft survival rate was 96.4%, 94.2%, and 92.0%, respectively, and no significant differences were observed between ABO-compatible (ABOc) and ABOi grafts (P=.145). The biliary complication rate showed no significant difference (P=.195) between ABOc and ABOi grafts. Regeneration rates of ABOi grafts were not significantly different from those of ABOc grafts. DG ALDLT with ABOi and ABOc graft combination seems to be a feasible option for expanding the donor pool without additional donor risks.

Retrievability of calcium hydroxide intracanal medicament with three calcium chelators, ethylenediaminetetraacetic acid, citric acid, and chitosan from root canals: An in vitro cone beam computed tomography volumetric analysis.

Aim:This study compared the amount of aqueous-based and oil-based calcium hydroxide remaining in the canal, after removal with two different chelators 17% EDTA, 20% Citric acid and 0.2% Chitosan in combination with ultrasonic agitation.Methods and Material:Cleaning and shaping of root canals of 28 mandibular premolar was done and canals were filled either with Metapex or Ca(OH)2 mixed with distilled water. Volumetric analysis was performed utilizing cone beam-computed tomography (CBCT) after seven days of incubation. Ca(OH)2 was removed using either 17% EDTA, 20% Citric acid or 0.2% Chitosan in combination with ultrasonic agitation.Statistical analysis used:Volumetric analysis was repeated and percentage difference was calculated and statistically analyzed using Kruskal-Wallis and Mann-Whitney U test.Results:All the three chelators failed to remove aqueous-based as well as oil-based Ca(OH)2 completely from the root canal. Aqueous-based Ca(OH)2 was easier to be removed than oil-based Ca(OH)2. 0.2% Chitosan in combination with ultrasonics performed better than 17% EDTA and 20% citric acid in removal of Ca(OH)2.Conclusion:Combination of 0.2% Chitosan and ultrasonic agitation results in lower amount of Ca(OH)2 remnants than 17% EDTA, 20% Citric acid irrespective of type of vehicle present in the mix.

Cone-beam Computed Tomography Volumetric Analysis and Comparison of Dentin Structure Loss after Retrieval of Separated Instrument by Using Ultrasonic EMS and ProUltra Tips

IntroductionA separated instrument within the root canal may interfere in the successful outcome of endodontic treatment. The retrieval of fractured instruments might compromise the remaining tooth structure and subsequently resistance to tooth fracture. The aim of this study was to compare the change in volume of root canal and dentin thickness after retrieval of separated instrument by 2 different endodontic ultrasonic tips. MethodsEach of the instruments (EMS Endochuck and ProUltra #6, #7, and #8 tips) was used to remove 40 separated rotary ProTaper F2 instruments from the mesiobuccal roots of mandibular molar under ×15 magnification. Cone-beam computed tomography analysis of the samples was done to evaluate the change in volume, dentin thickness, weight, time taken, and success. ResultsPaired sample t test showed statistically significant (P < .05) difference in volume before and after instrument retrieval in both the EMS group, where the increase was 112.52%, and in the ProUltra group, where the increase was by 55.35%. Intergroup comparison showed statistically significant (P < .05) decrease in dentin thickness; it was more for EMS as compared with ProUltra. Overall decrease in the mean weight of EMS group (18.42%) was more than that of ProUltra group (9.36%). The overall success rate for removal of fractured instrument in this study was 87.5%; however, the difference in success rate was not statistically significant. The mean time taken for retrieval by ProUltra system was 63.89 minutes, whereas it was significantly less (P < .05) for EMS system (50.22 minutes). ConclusionsRemoval of separated instrument with EMS resulted in more significant tooth structure loss as compared to ProUltra.

Intranasal volume increases with age: Computed tomography volumetric analysis in adults

It is theorized that intranasal cavity volumes change throughout the aging process, possibly secondary to hormonal changes and atrophy of the sinonasal mucosa. Our objective is to compare intranasal volumes from different age groups to test the hypothesis that intranasal cavity volume increases with age. Case series. An analysis of computed tomography (CT) scans performed for reasons other than sinonasal complaints. Intranasal volumes of three groups (age 20-30 years, 40-50 years, and 70 years and above) were calculated using Vitrea software. The total intranasal volume was measured from the nasal vestibule anteriorly, the nasopharynx posteriorly, the olfactory cleft superiorly, and the nasal floor inferiorly. The total volume included the sum of the right and left sides. Sixty-two CT scans were analyzed. There was a progressive, relatively linear, increase in intranasal volume with increasing age: 20 to 30 years = 15.73 mL, 40 to 50 years = 17.30 mL, and 70 years and above = 18.38 mL. Mean intranasal volume for males was 19.07 mL, and for females was 15.23 mL. Analysis of variance demonstrated significant group differences in mean intranasal volume for age (P = .003) and gender (P < .001), with moderate-to-large effect size of 0.206 and 0.289 (partial η(2) ), respectively. Post hoc testing revealed a significant difference between the 20 to 30-year and >70-year age groups (P = .006). There was no significant difference in intranasal volume dependent upon body mass index. Intranasal volume increases with age and is larger in males. Specific etiologies responsible for increased intranasal cavity volume with age are actively being evaluated. 4 Laryngoscope, 126:2212-2215, 2016.

Estimation of Pleural Fluid Volumes on Chest Radiography Using Computed Tomography Volumetric Analysis: An Update of the Visual Prediction Rule.

The purpose of the study was to determine the volumes of pleural fluid (PF) required to produce visible menisci in the lateral and posterior costophrenic angles (CPA) and obscure the hemidiaphragms (HD) on upright frontal and lateral chest radiographs (CXRs), using volumetric analysis of chest computed tomography (CT). A total of 98 patients with small pleural effusions on chest CT, in whom CXRs were obtained within a 24-hour interval, were selected for retrospective analysis. PF within each hemithorax was quantified using a semiautomatic method of image segmentation. A cardiothoracic radiologist scored each hemithorax on each CXR from 0 to 3 (0-normal CPA, 1--fluid meniscus below the HD, 2--fluid meniscus at the level of the HD, 3--fluid opacity obscures the HD). Each CXR category was correlated with CT-determined PF volumes. A mean of 20 mL of PF was present on CT without a visible correlate on CXR. A meniscus below the HD on CXR correlated with roughly 100 mL; a meniscus occurring at the HD correlated with roughly 250 mL; a meniscus obscuring the HD correlated with a mean of approximately 650 mL. There were large standard deviations for all PF volumes. We provide guidelines for estimating PF volumes on upright frontal and lateral CXRs. We also confirm that the lateral radiograph is more sensitive for detection of small pleural effusions, with blunting of the posterior CPA only correlating with a mean of 26 mL of PF.

Reply

The previously mentioned perspective represents a great summary of the status of this field, with quality, quantity, and ischemia time representing the main determinants of ultimate renal function after partial nephrectomy. In reality, we have made a great progress over the past few years. As recently as 2010 there was a near total focus on ischemia, and we now have a much greater appreciation of its relative contributions. We have learned that most preserved nephrons will recover from the ischemic insult, provided that it is maintained within reasonable limits or associated with hypothermia. The commentary also alludes to one of the ongoing controversies that will mandate further investigation, namely whether patients with pre-existing chronic kidney disease are more vulnerable to ischemic injury. Our experience with more than 600 patients with a solitary kidney managed with partial nephrectomy, most of whom have had pre-existing chronic kidney disease, suggests otherwise. However, to our knowledge, a comprehensive analysis of this specific issue has not been reported yet. Editorial CommentUrologyVol. 82Issue 2PreviewThis study evaluates the role of volume preservation and ischemia during open and minimally invasive partial nephrectomy as evaluated by functional (Mag3) and computed tomography volumetric analysis using free-hand scripting. The authors find that the ultimate renal function after partial nephrectomy was primarily driven by parenchymal preservation with ischemia playing a secondary role as long as it was within a limited period. The article elaborates and further supports the concept of renal parenchymal preservation as the primary predictor of unilateral renal function after partial nephrectomy. Full-Text PDF

Editorial Comment

This study evaluates the role of volume preservation and ischemia during open and minimally invasive partial nephrectomy as evaluated by functional (Mag3) and computed tomography volumetric analysis using free-hand scripting. The authors find that the ultimate renal function after partial nephrectomy was primarily driven by parenchymal preservation with ischemia playing a secondary role as long as it was within a limited period. The article elaborates and further supports the concept of renal parenchymal preservation as the primary predictor of unilateral renal function after partial nephrectomy. It certainly adds to our knowledge of the physiology of the remnant kidney, and the authors' use of free-hand scripting introduces a more granular analysis which supports previous studies from this and other groups, using what could be described as possibly less precise measures. Parenchymal Volume Preservation and Ischemia During Partial Nephrectomy: Functional and Volumetric AnalysisUrologyVol. 82Issue 2PreviewTo determine the relative effect of type and duration of ischemia and parenchymal volume preservation on renal function after partial nephrectomy (PN). Full-Text PDF ReplyUrologyVol. 82Issue 2PreviewThe previously mentioned perspective represents a great summary of the status of this field, with quality, quantity, and ischemia time representing the main determinants of ultimate renal function after partial nephrectomy. In reality, we have made a great progress over the past few years. As recently as 2010 there was a near total focus on ischemia, and we now have a much greater appreciation of its relative contributions. We have learned that most preserved nephrons will recover from the ischemic insult, provided that it is maintained within reasonable limits or associated with hypothermia. Full-Text PDF

Comparison of the efficacy of ethylene diamine tetraacetic acid and maleic acid in the removal of three calcium hydroxide intra-canal dressings: A spiral computerized tomography volumetric analysis

Aim:To assess the efficacy of 17% ethylene diamine tetra acetic acid and 7% maleic acid in the removal of 3 calcium hydroxide preparations placed as intracanal medicaments.Materials and Methods:The root canals of 60 single rooted premolars were prepared with a step back technique and randomly assigned into 3 experimental groups (n= 20). Group A was filled with plain calcium hydroxide mixed with distilled water in which barium sulfate was added for radio opacity, Group B was filled with Apexcal and Group C was filled with Metapex. After 7 days each group was divided into 2 sub groups (n= 10). The medicaments were retrieved with 17% EDTA (first sub group) and 7% maleic acid (second sub group). Along with the above irrigants manual and ultrasonic agitation was used. The pre and post removal volume of medicaments in root canals were measured using spiral computerized tomography. The percentage difference was calculated and statistically analyzed using Kruskal Wallis and Mann Whitney U test.Results:17% EDTA and 7% maleic acid efficiently removed calcium hydroxide, distilled water mixture (P= 0.218) and Apexcal (P= 0.684), whereas 7% maleic acid showed better retrieval capability of Metapex than 17% EDTA (P= 0.002).Conclusion:Calcium hydroxide, distilled water mixture and polyethylene glycol based calcium hydroxide were efficiently removed by 17% EDTA and 7% maleic acid. 7% maleic acid removed silicone oil based calcium hydroxide preparation better than 17% EDTA.

Variation in Hepatic Segmental Volume Distribution According to Different Causes of Liver Cirrhosis

To investigate if there is difference in hepatic segmental volume distribution according to causes of liver cirrhosis (LC) using computed tomography volumetric analysis. On computed tomographic scans, hepatic segmental volumes were measured in 90 patients with LC of 4 different causes (alcohol, hepatitis B virus (HBV), hepatitis C virus (HCV), and cryptogenic cirrhosis). The volumetric indices were compared. The volume proportion of the lateral segment in the liver in patients with HBV was significantly higher than in the patients with HCV (P = 0.038). Hepatic volume distribution in alcoholic LC showed differences: larger caudate lobe volume than HBV- and HCV-induced LC (P = 0.029 and P = 0.031), larger right lobe volume (P = 0.043) and smaller proportion of the lateral segment in the liver (P = 0.003) than in HBV-induced LC. Computed tomography volumetric analysis showed differences in hepatic segmental volume distribution in cirrhotic patients according to causes of LC.