X-ray Examination Research Articles

Primary Hydatid Cysts in Rare Sites: A Series of Four Cases

Hydatid disease is caused by the larval stage of the tapeworm Echinococcus granulosus. The definitive hosts include dogs and canines. Humans are accidental hosts and do not play a role in the biological cycle of the worm. The mode of infection is through ingesting food contaminated with dog feces containing gravid proglottids and free eggs, which hatch in the intestine and form larvae. The larvae then penetrate the intestinal wall, enter the bloodstream, and typically settle in the liver followed by the lungs. However, in rare instances, hydatid cysts can occur in various unusual sites throughout the body and even in a disseminated manner, leading to atypical clinical presentations and diagnostic challenges. Hereby, authors report a series of four cases (three males and one female) of hydatid cysts occurring at unusual sites, mainly the brain, kidney, spleen, and lung. The common age group among the observed cases was the second to fourth decade, showing a male predominance. In cases of splenic and renal hydatid cysts, patients presented with intermittent dull aching pain over the left and right flanks, respectively. In both cases, ultrasonography revealed the presence of multiple cysts in the spleen and kidney. In the case of cerebral hydatid cysts, the patient provided a history of short-term memory loss along with a few non specific symptoms, and Magnetic Resonance Imaging (MRI) revealed a hyperintense cystic lesion. In pulmonary hydatid cysts, the patient presented with symptoms of cough, dyspnoea, chest pain, and expectoration. X-ray examination supported the presence of the cyst. Surgery, preferably radical cystectomy, is considered for treatment, and the diagnosis is always confirmed by histopathology.

Skin dose estimation in adults undergoing diagnostic chest X-ray examinations at Al-Zahra Teaching Hospital in Wasit Governorate, Iraq

This research intended to calculate skin dose (mgy) was determined in 30 adult patients. The average value of the Tube’s potential kVp range from 72 kVp To 100 (kVp) is 9.646±1.76 kVp. The average value of the SSD (cm) range from 100 cm to 180 cm is 22.558±4.118 cm, and the average value of the Tube load (mAs) range from 3 MAs to 16 MAs is 3.727±0.680. Additionally, the SKIN DOSE was from 0.06 mGY to 0.57 mGY, with an average of 0.120 mGY. It was found that the dose results were within the prescribed range of 0.4 mGy; this is recommended by international organizations that protect against radiation. Except for a few instances, the frequency of quality assurance (QA) and quality control (QC) was higher. As a result, the skin dose to patients who have chest exams at Al-Zahra Teaching Hospital in Wasit Province was equivalent to the Global standard.

Methods of treatment of patients with skeletal forms of distal occlusion using dental alveolar compensation. The role of digital technologies and the approach to treatment

Improving the effectiveness of complex treatment in patients with distal occlusion of the dentition during the period of active skeletal growth. 202 patients with skeletal distal occlusion were examined and treated. Patients are divided into three subgroups depending on the position/size of the jaw bones and the main link of pathogenesis. The parameters of TRG and CBCT sections were measured before and after treatment. Various parameters were used for the analysis: skeletal (SNA, SNB, ANB, etc.), dental (II/SN, II/ii, APog-I, APog-i, etc.), skeletal profile and soft tissue parameters. Various orthodontic techniques have been applied, including FNTA, the Damon bracket system, the Biederman apparatus and others. In the retention period, non-removable retainers in the frontal section and removable night retention devices of various structures were used. Patients were monitored for up to 15 years after the completion of the active orthodontic treatment stage. The analysis of the X-ray examination data indicates the normalization of the mutual position of the jaw bones in relation to the base of the skull, optimization of the ratios of the bone elements of the TMJ. An algorithm has been developed for the treatment of patients with dental anomalies in the sagittal plane, with narrowing of the upper jaw during the bite of permanent teeth. Comprehensive treatment of patients with distal occlusion during the period of active skeletal growth makes it possible to achieve significant improvements in dentition, position and closure of teeth, as well as skeletal parameters of X-ray examinations. The results indicate the importance of early intervention using modern orthodontic techniques. Long-term follow-up in the retention period shows the stability of the results and the effectiveness of the treatment.

Genetic Polymorphism in Alcohol Metabolism and Drinking Behavior are Associated with Gastric Cancer Risk in Men.

Objective In recent years, there has been a growing focus on health risks associated with alcohol consumption. The present study investigated whether or not the genetic variant of aldehyde dehydrogenase 2 (ALDH2) influences the risk of gastric cancer among individuals identified as hazardous drinkers using the Alcohol Use Disorders Identification Test (AUDIT), which provides a comprehensive assessment of hazardous drinking behavior. Patients We enrolled men with hazardous drinking behavior (AUDIT score ≥ 8) who had undergone gastric cancer screening (either endoscopy or a barium X-ray examination of the upper gastrointestinal tract) between April 2013 and March 2020 within 1 year from entry and who had subsequently undergone at least one more gastric cancer screening up to March 2021. Functional single-nucleotide polymorphisms of ALDH2 (rs671) were measured using a direct TaqMan PCR method with unprocessed saliva. Results A total of 246 men were enrolled, comprising 193 individuals with active ALDH2 (ALDH2*1/*1) and 53 with less-active ALDH2 (ALDH2*1/*2). The cumulative incidence of gastric cancer in the less-active group was higher than in the active ALDH2 group (p=0.01, hazard ratio: 4.6, 95% confidence interval: 1.2-16.7). Alcohol consumption was lower in the less-active ALDH2 group than in the active ALDH2 group, although no marked difference was observed in the AUDIT score. Conclusion In individuals with hazardous drinking behavior, a heightened risk of gastric cancer was observed among those with less-active ALDH2 variants, even when their alcohol consumption was comparatively lower than in those with active ALDH2 variants.

Radiation measurements in dentistry

When patients undergo X-ray examinations, millions of photons pass through their bodies. In dental radiography, the part of the head that receives the greatest dose is the skin in the area where the X-rays enter, including brain, salivary gland and thyroid. The effective usage of radiation in dental practice has been studied for many years and several guidelines have been proposed. While not high doses of radiation are associated with dental radiography in the field of using radiation in dentistry practice it is the most important to provide periodical radiation measurements for radiographs used in dental clinics, to measure such main X-rays specifications, as Kilovoltage Peak (kVp), Dose/Exposure, Dose/Exposure Rate, Exposure Time – Radiographic Modes, Elapsed Time – Fluoro Modes, Average Pulse Rate – Pulsed Fluoro, Average Pulse Width – Pulsed Fluoro and Half-value Layer HVL. Besides these parameters of mAs spesifications da DoseMate specifications also must be measured. Quality control of radiological devices is very important. So, we plan periodical radiation measurements in more than 50 dental clinics in Georgia and hope that results of these measurements will be successful, encouraging. After the measurements, the results will be known to all stakeholders. We will also talk about them in our next publications.

Early history of posterior malleolus fractures in ankle fractures.

No comprehensive treatise on the early history of fractures of posterior malleolus (PM) has yet been published, and many substantial discoveries have fallen into oblivion-particularly if not having been published in English originally. Literature search was performed in original publications and historical sources. Early history of PM fractures from their first description up to the beginnings of their operative treatment may be divided into three basic periods, covering the era between 1828 and 1940. In the pre-radiological period (1828-1895), description of PM injuries was based merely on the autopsy findings in deceased patients. The first mentions of this injury were published by the British authors. In the radiologic period (1899-1916), the x-ray examination started a revolution also in diagnostics of ankle fractures, with the first radiographs performed as early as in 1899. Radiographic examination had subsequently become an integral part of the diagnostics of these injuries and initiated a number of significant studies of PM fractures. The first detailed mention of a PM injury may be found in the French and German literature. The period of early operative treatment (1918-1940), i.e., open reduction and internal fixation of PM, was started by the younger post-WWI generation, primarily the French surgeons, represented by Gaston Picot. His operative technique and the first six cases treated operatively between 1918 and 1921 were described in 1921 by Edouard Huc. Picot himself published his technique in great detail in 1923. The early history of diagnostics and treatment of PM fractures witnesses the remarkable body of knowledge gathered about that topic by numerous visionary surgeons predominantly French and German surgeons immediately before and after World War I. They substantially contributed to the radiological examination and operative treatment of this injury.

PSORIATIC ARTHRITIS: PROBLEMS AND SOLUTIONS (CASE REPORT)

The purpose of this study is to evaluate the effectiveness of therapy for psoriatic arthritis with tumor necrosis factor inhibitor α–Adalimumab. Material and methods. Retrospective and prospective analyses of psoriatic arthritis course were performed in a patient along with a comprehensive examination before and after administering therapy with a tumor necrosis factor inhibitor α-Adalimumab. The diagnosis of the patient was made on the basis of psoriatic arthritis classification criteria, the assessment of psoriatic rashes was performed according to PASI index. The laboratory study included complete blood cell count and biochemical blood tests. The patient underwent X-ray examinations of the joints and magnetic resonance imaging of the lumbosacral spine in the STIR mode. Study results. The patient's first manifestations of psoriasis were detected at the age of 12 years. At the age of 22, the patient had pain in the lower back of VAS 2-3 points, as well as enthesites in the area of the lateral epicondyle of humerus, wings of the iliac bones, trochanter major, the upper edge of the patella and tibial tuberosity, the PASI index was 17.3 points. In order to relieve pain, the patient took non-steroidal anti-inflammatory drugs. Against the background of therapy with non-steroidal anti-inflammatory drugs, the intensity of pain in the lower back decreased, but enthesites persisted. At the age of 35, the patient was diagnosed with psoriatic arthritis, activity III, stage II, dactylitis, enthesites, PASI index 38.5 points; right-sided active sacroiliitis, ASDAS ESR index activity was 3.92 points, joint functional insufficiency of the 2nd degree. Methotrexate therapy was prescribed. There was no positive dynamics against the background of treatment, in connection with this, therapy with genetically engineered biological drugs was initiated. We observed positive dynamics in the clinical course of psoriatic arthritis when Adalimumab was included in the treatment: after the 2nd week of treatment, the articular syndrome subsided, joint pain decreased when evaluated on a scale of 2-3 points, the number of psoriatic plaques on the trunk and limbs decreased as well, the index of psoriatic rashes was 5.3 points. After 8 weeks from the start of therapy with Adalimumab, regression of pathological skin rashes was noted, the index of psoriatic rashes was 0 points. Conclusions. Therapy with Adalimumab in the patient resulted in regression of psoriatic manifestations on the skin, suppression of psoriatic arthritis activity. The study showed the clinical effectiveness of a genetically engineered biological drug – Adalimumab in achieving persistent clinical remission of psoriatic arthritis.

Comparison of Orthodontic Tooth Movement of Regenerated Bone Induced by Carbonated Hydroxyapatite or Deproteinized Bovine Bone Mineral in Beagle Dogs.

Orthodontic treatments often involve tooth movement to improve dental alignment. In this study, we aimed to compare tooth movement in regenerated bone induced by two different bone fillers, carbonated hydroxyapatite (CAP) and deproteinized bovine bone mineral (DBBM). Four beagle dogs were used in this comparative study. The first, second, and fourth lower mandibular premolars (P1, P2, and P4) on both sides of the mouth were extracted, and CAP was implanted into the extraction site on the left side and DBBM into the right side. Following regenerative bone healing, orthodontic devices were attached to perform orthodontic tooth movement of the lower third mandibular premolar (P3) on both sides. X-ray examination, intraoral scan, and histological analysis were performed. The Mann-Whitney U test was used for statistical analysis, and p < 0.05 was considered significant. Bone regeneration and orthodontic tooth movement were observed in the CAP and DBBM groups. Histologically, normal periodontal tissue remodeling was observed on the compression and tension sides of CAP and DBBM. No statistical difference was observed in the number of osteoclasts around the periodontal ligament and the root resorption area. Orthodontic tooth movement of regenerated bone induced by CAP and DBBM was therefore achieved.

Image Quality Comparison between 10kVp Technique and 15 Percent Rule on AP Supine Abdominal X-ray Examination

The abdomen is one of the thickest parts of the human body and there are challenges in obtaining good images due to the thickness and pathology of the patient during an abdominal X-ray. The 15% rule and the 10 kVp technique are used as exposure manipulation methods in abdominal radiography, however, theoretically, the 15% rule is preferred. The 15% rule provides optimal exposure while the 10 kVp technique is simpler in terms of calculating the exposure factor. These two techniques have their advantages; therefore, this study aims to compare the image quality between the 15% rule and the 10 kVp technique of X-ray supine anteroposterior (AP) abdominal radiography image quality and evaluate whether 10 kVp could be an exposure replacement technique for the 15% rule. Five abdomen radiographic images were taken based on both techniques and evaluated quantitatively using ImageJ software and qualitatively based on scoring by two radiographers. Based on the result of the experimental study, the SNR (signal-to-noise) ratio, CNR (contrast-to-noise ratio) and image mean score had no significant differences (p-value&gt;0.05) between the 10 kVp and 15% rule. In conclusion, the 10 kVp technique is a possible substitution for the 15% rule in obtaining valuable diagnostic image quality during AP abdominal X-ray projection and is more suitable to be implied in clinical settings compared to the 15% rule.

Methodology of Examination of Patients with Osteoarthritis and Aseptic Necrosis of Hip and Knee Joints when Using Regenerative Interventional Technologies

Background. Diagnosis of osteoarthritis of the hip and knee joints, as of today, would seem to be a well-studied issue. Radiography, magnetic resonance imaging, ultrasonography - each of these methods makes it possible to make a diagnosis. At the same time, the use of new methods of treatment of osteoarthritis requires new approaches to its diagnosis.&#x0D; Objective: to develop a methodology for examining patients with osteoarthritis and aseptic necrosis of the hip and knee joints during treatment with regenerative technologies.&#x0D; Material and Methods. The material for the study was case histories of 233 patients with osteoarthritis and 58 patients with osteoarthritis of the hip and knee joints. Clinical, laboratory, and instrumental research methods were used.&#x0D; Results. The methodology of clinical examination of patients when using regenerative technologies is based on filling out quality of life questionnaires. A feature of the methodology of laboratory examination of patients with osteoarthritis and aseptic necrosis of the hip and knee joints when using regenerative technologies is oncological screening in the case of the use of biotechnological products containing MSCs, with the determination of epigenetic markers of the risk of oncogenesis in the form of miRNA.&#x0D; Conclusions. The methodology of the instrumental examination of patients with osteoarthritis is as follows: the key is an X-ray examination with the establishment of the stage of osteoarthritis according to the Kellgren-Lawrence classification and the subsequent ultrasound and MRI examination in order to assess the extent of damage to the soft tissues of the hip and knee joints, subchondral bone and paraarticular structures. In patients with aseptic necrosis of the hip and knee joints, when using regenerative technologies, the key is an MRI study followed by X-ray and ultrasound examination.

Critical Management of Atelectasis ec Adenomous Cell Carcinoma of the Right Lung with Pleural Effusion: A Case Report

Background: Massive pleural effusion occurs in association with malignancy. In Western countries, lung cancer is the leading cause of death, and 8-15% of cancer patients require treatment in an intensive care unit.&#x0D; Case presentation: A 56-year-old woman has complained of increased shortness of breath for the past three days. Lung examination from percussion found dullness on the right, resonance on the left, palpation decreased vocal fremitus on the right and auscultation, Diminished or absent breath sounds on the right, and bronchovesicular breath sounds on the left. Chest X-ray examination results with the conclusion of massive pleural effusion dextra. Bronchoscopy was performed under general anesthesia (GA), and a pigtail catheter was inserted. One day after bronchoscopy, a repeat thoracic X-ray was performed with the impression of atelectasis in the right lung, and a bronchoscopy and bronchial toilet were planned. &#x0D; Conclusion: Pleural effusion with lung tumor and atelectasis are common cases in critical care. The management provided can help in reducing patient morbidity.

Osteoid-osteoma of trapezium bone in a child (clinical case)

BACKGROUND: Osteoid osteoma is a benign neoplasm of bones with a diameter of up to 1.5 cm. It is most common in children in the second decade of life and at the age of 20–30 years, predominantly in men. In large neoplasms (1.5 cm) with a histological study identical to osteoid osteoma, the pathological process is regarded as osteoblastoma or giant osteoid osteoma. The tumor is most often located in long tubular bones and on the hand in 5%–15% of the patients. Differential diagnosis is carried out with rheumatoid arthritis, inflammation, and other neoplasms. Various options for the treatment of osteoid osteoma, both conservative and operative, have been proposed.&#x0D; CLINICAL CASE: A 17-year-old patient underwent surgical treatment for trapezium bone neoplasm and pronounced chronic pain syndrome.&#x0D; DISCUSSION: The identification and treatment of osteoid osteoma remain challenging, which is associated with the similarity of clinical symptoms and ineffectiveness (in the initial stages of its development) of X-ray examination. Thus, computed tomography is necessary to identify a pathological structure. If a formation on the hand is detected, surgery (tumor resection) is advised; if necessary, bone grafting of the defect is performed. After surgical treatment, relapse may occur within 7 months, which is associated with incomplete tumor removal. To confirm the diagnosis, a pathomorphological study is necessary.&#x0D; CONCLUSIONS: Chronic pain syndrome requires a thorough examination of the patient and a differential diagnosis. Surgical treatment allows the restoration of hand functions and alleviates the tumor-associated pain syndrome.

Monitoring of Curve Progression in Patients with Adolescent Idiopathic Scoliosis Using 3-D Ultrasound

ObjectiveTo investigate whether 3D ultrasound can provide comparable results to conventional X-ray examination in assessing curve progression in AIS patients. Methods136 AIS subjects (42 males and 94 females; 10-18 years of age, mean of 14.1 ± 1.9 years) with different severities of scoliosis (Cobb angle ranged from 10-85 degrees, mean of 24.3 ± 14.4 degrees) were included. Each subject underwent bi-planar low-dose X-ray EOS® and 3D ultrasound system scanning with the same posture on the same date. Subjects underwent the second assessment at routine clinical follow-up. Manual measurement of scoliotic curvature on ultrasound coronal projection images and posterior-anterior radiographs were presented as ultrasound curve angle (UCA) and radiographic Cobb angle (RCA), respectively. RCA and UCA increments of five degrees or more represented a scoliosis progression detected by X-ray assessment and 3D ultrasound assessment, respectively. ResultsThe sensitivity and specificity for UCA measurement for detecting scoliosis progression were 0.93 and 0.90, respectively. The negative likelihood ratio of the diagnostic test for scoliosis progression by the 3D ultrasound imaging system was 0.08. ConclusionThe 3D ultrasound imaging method is a valid technique to detect coronal curve progression as compared to conventional radiography in follow-up of AIS. Substituting conventional radiography by 3D ultrasound is effective in reducing the radiation dose to be suffered by AIS patients during their follow-up examinations.

Chest X-Ray ESD and ESAK Assessment in A Few Diagnostic Radiological Facilities in Delta State

Background: The utilization of X-rays in medical procedures has sparked apprehension regarding their potential adverse consequences, despite their undeniable advantages in the realms of diagnosis and therapy. The present study aimed to evaluate the levels of Entrance Skin Dose (ESD) and Entrance Skin Air Kerma (ESAK) associated with chest X-ray examinations conducted in diagnostic radiological facilities located within Delta State. The present study employed a standardized approach to describe the materials and methods used in the research. The dose assessment was performed on a sample of 700 patients who were 18 years of age or older. These patients were selected from 10 operational facilities located throughout the State. The findings of the study are as follows: The effective dose (ESD), ascertained through the utilization of patient anatomical data and exposure parameters, fell within the recommended reference dose limits of 1 mGy (National Nuclear Regulatory Agency) and 0.4 mGy (International Atomic Energy Agency) for the majority of healthcare facilities. Nevertheless, certain centers demonstrated elevated dose levels, which can be attributed to factors such as increased exposure rates, aging x-ray tubes, and inadequate technician competency. The effective dose values (ESD) exhibited a range of 0.018 to 1.671 mGy for males and 0.084 to 1.542 mGy for females. The range of Entrance Skin Air Kerma (ESAK) values for males was found to be between 0.019 and 0.085 mGy, while for females it ranged from 0.016 to 0.098 mGy. These values were observed to be within the recommended dose limits. In conclusion, this study emphasizes the significance of surveillance of radiation exposure and the implementation of quality assurance protocols in order to safeguard patient well-being and mitigate potential hazards linked to chest X-ray procedures conducted in diagnostic radiological establishments.

Radiology Department: A Potential Source of Multidrug-Resistant Microorganisms: A Cross-Sectional Study at Tertiary Hospital, Palestine.

Globally, healthcare facilities face a great challenge in the form of hospital-acquired infections (HAIs). Aside from the morbidity and mortality they cause, these illnesses are also extremely costly. Research on infection transmission in the medical field has been considerable, but not so much in the radiology department. This study aims to identify the presence of multidrug-resistant (MDR) microbes on surfaces that are frequently touched in computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), plain X-ray examination rooms, and portable radiography that are susceptible to contamination as well as to investigate the potential dangers of contracting MDR organisms to patients and healthcare providers. Materials and Method. In this study, 160 swab samples were collected from the radiology department during May and June 2022. Samples were obtained from 80 predefined surfaces twice within and outside of CT and MRI examination rooms as well as from US and plain X-ray machines and portable X-ray machines. Samples were taken at 7:00 a.m. using cotton swabs following the regular cleaning procedure. Bacterial colony-forming units (CFUs) per square centimeter were calculated after swabbing a 100 cm2 surface. Nearly all of the surfaces tested had bacterial CFUs. The highest contamination rate was found on keyboards ranging from (1.2-8) CFU/cm2, the sides of patient tables (1.2-20) CFU/cm2, knee coil (2.4-3) CFU/cm2, and patient leg supports (1.2-8) CFU/cm2. A noticeable increase in the contamination was noticed in June compared to May, and this was consistent with the increase in the number of isolated patients in the hospital, the workload in the radiology department, and the number of patients referred to the hospital. In our study, none of the examined sites showed contamination with MDR Gram-negative bacteria such as extended-spectrum beta-lactamases producing Enterobacterales (ESPL) or Carbapenemase-producing Enterobacterales (CPE). On the other hand, methicillin-resistant Staphylococcus (MRS), vancomycin-resistant Staphylococcus (VRS), and vancomycin-resistant Enterococcus (VRE) were detected. All of the radiology department equipment and sites could be a source of bacterial infection including MDR, so the obligatory and committed disinfection protocol must be revised and implemented in the morning and between patients.

Short-term effectiveness of ultrasound-guided Kirschner wire provocation technique in treatment of Salter-Harris types Ⅰ and Ⅱ periosteal entrapment of distal tibial epiphyseal fractures in children and adolescents

To investigate the short-term effectiveness of ultrasound-guided closed reduction by Kirschner wire provocation technique in the treatment of Salter-Harris types Ⅰ and Ⅱ periosteal entrapment of distal tibial epiphyseal fractures in children and adolescents. Between May 2019 and May 2022, 41 patients with Salter Harris types Ⅰ and Ⅱ distal tibial epiphyseal fractures were admitted, all of whom had periosteal entrapment on preoperative MRI, and 38 cases (92.7%) were confirmed to have periosteal entrapment by intraoperative ultrasound. There were 24 males and 14 females, the age ranged from 6.8 to 15.7 years, with an average of 10.7 years; and there were 20 cases of Salter Harris type Ⅰ and 18 cases of type Ⅱ. The time from injury to operation was 22-76 hours, with an average of 28.4 hours. The preoperative imaging examination showed excellent alignment in 4 cases, good in 20 cases, and poor in 14 cases. The ultrasound guided Kirschner wire provocation technique for closed reduction and percutaneous Kirschner wire internal fixation were performed. The operation time, intraoperative fluoroscopy frequency, fracture healing time, and complications were recorded. Anteroposterior and lateral X-ray films of the affected ankle joint were taken before operation, at 3 months after operation, and at last follow-up to observe the healing of the fracture, and anteroposterior X-ray films of the whole length of both lower limbs were taken to evaluate the alignment of the force lines of the affected limbs. The range of motion (ROM), visual analogue scale (VAS) score, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used to evaluate ankle function. The mechanical lateral distal tibia angle (mLDTA) and the anatomic anterior distal tibia angle (aADTA) were measured. The operation time ranged from 17 to 52 minutes, with an average of 22.6 minutes, and the intraoperative fluoroscopy frequency ranged from 3 to 11 times, with an average of 4.2 times. X-ray examination during operation and at 2 days after operation showed that anatomical reduction was achieved. All patients were followed up 10-24 months, with an average of 16.4 months. All fractures healed in 6.1-7.2 weeks, with an average of 6.3 weeks; no fracture displacement occurred, and the patients recovered to their pre-injury level of motion at 6 months after operation. Needle tail irritation occurred in 2 cases at 4 weeks after operation, and they recovered after symptomatic treatment. During the follow-up, there was no serious complication such as incision deep infection, bone nonunion, delayed union, and malunion. At last follow-up, the patients' alignment were all excellent, and the difference was significant when compared with preoperative one ( Z=-7.471, P<0.001). The VAS score, AOFAS ankle-hindfoot score, dorsiflexion-plantar flexion ROM, varus-valgus ROM, mLDTA, and aADTA significantly improved at 3 months after operation and last follow-up when compared with preoperative ones ( P<0.05). Ultrasound-guided closed reduction by Kirschner wire provocation technique for treating Salter-Harris types Ⅰ and Ⅱ periosteal entrapment of distal tibial epiphyseal fractures in children and adolescents is minimally invasive and safe.

ON THE TOPIC OF ADVISABILITY OF ENDODONTIC TREATMENT OF RETAINED (PERSISTENT) PRIMARY TEETH

Treatment of complicated caries in children and adolescents has a number of features, which is determined by age-related anatomy and the limited functioning time of temporary teeth, as well as the timing of their root resorption. Today, the treatment of pulpitis of preserved temporary (persistent) teeth is of particular clinical interest. Persistent (delayed) teeth are temporary (baby) teeth that are preserved in the dentition after the physiological time of their replacement and are capable of functioning for 10 years or more. In most cases, the presence of retained temporary teeth is due to congenital edentia of permanent teeth, retention or death of their rudiments. There is no data in the literature on the features of the anatomical structure of persistent teeth and recommendations for their endodontic treatment. At the same time, in the treatment of this pathology, the methods of pulpotomy (devital amputation, impregnation method) and pulpectomy (pulp extirpation, vital method) are widely used, followed by obturation of the root canals with resorbable filling materials. Taking into account the above, we conducted a retrospective analysis of 192 orthopantomograms of patients with congenital permanent adentia and the presence of 289 persistent teeth. The anatomical features of the structure of the root canals of persistent teeth have been determined. The results of treatment of 44 preserved temporary teeth with chronic fibrous pulpitis in 27 patients of childhood and adolescence using the method of vital extirpation followed by restoration of the crown parts of the teeth using therapeutic and orthopedic methods are presented. Long-term treatment results up to 60 months were assessed. Meanwhile, the results obtained indicated the absence of signs of root resorption in persistent teeth over a long period of time from the period of their physiological change, as well as the features of the anatomical structure of root canals, similar to that of permanent teeth, and allowing endodontic treatment of preserved teeth using classical for permanent teeth pulpectomy method. The results of clinical observation and X-ray examination in the long term after treatment allow us to conclude that the approach used is highly effective, which reduced the risk of periapical complications and created conditions for the longterm functioning of persistent teeth.

Optimization of Radiation Exposure when Examining Patients with Pathology of the Craniovertebral Region

The diagnostics are based on the principle of obtaining informative and high-quality images with minimal radiation exposure using radiation diagnostic methods: traditional radiography, multislice and cone-beam computed tomography.When conducting X-ray examinations, the main factors in reducing the risk of radiation exposure are the use of highly sensitive digital diagnostic image receivers, minimal exposure time, and a minimum number of images per examination. A lower current value and high anode voltage values, a minimum focal spot size, the placement of the tube as far as possible from the patient and the image receiver as close to the patient as possible, collimation of the radiation beam, and preference for a low radiation dose rate mode are also factors in reducing the risk of radiation exposure.Imaging of the craniovertebral region using cone beam computed tomography offers the opportunity to evaluate the bone structure of the region in detail, with an equal or less effective dose to the patient.

A Deep Learning Review of ResNet Architecture for Lung Disease Identification in CXR Image

The lungs are two of the most crucial organs in the human body because they are connected to the respiratory and circulatory systems. Lung cancer, COVID-19, pneumonia, and other severe diseases are just a few of the many threats. The patient is subjected to an X-ray examination to evaluate the health of their lungs. A radiologist must interpret the X-ray results. The rapid advancement of technology today can help people in many different ways. One use of deep learning in the health industry is in the detection of diseases, which can decrease the amount of money, time, and energy needed while increasing effectiveness and efficiency. There are other methods that can be used, but in this research, the convolutional neural network (CNN) method is only used with three architectures, namely ResNet-50, ResNet-101, and ResNet-152, to aid radiologists in identifying lung diseases in patients. The 21,885 images that make up the dataset for this study are split into four groups: COVID-19, pneumonia, lung opacity, and normal. The three algorithms have fairly high evaluation scores per the experiment results. F1 scores of 91%, 93%, and 94% are assigned to the ResNet-50, ResNet-101, and ResNet-152 architectures, respectively. Therefore, it is advised to use the ResNet-152 architecture, which has better performance values than the other two designs in this study, to categorize lung diseases experienced by patients.

An improved biologically transparent illumination system that increases the accuracy of detecting the correct position of a nasogastric tube in the stomach

The aim of this study was to determine whether an improved biologically transparent illumination system results in more reliable detection of the correct position of the nasogastric tube in surgical patients. In total, 102 patients undergoing general surgery were included in this prospective observational study. After general anesthesia, all patients were inserted a nasogastric tube equipped with an improved biologically transparent illumination catheter. Identification of biologically transparent light in the epigastric area indicated successful insertion of the nasogastric tube into the stomach. The position of the tube was confirmed by X-ray examination, and its findings were compared with those of the biologically transparent illumination system. We observed biologically transparent light in epigastric area in 87 of the 102 patients. X-ray examination revealed that the nasogastric tube was placed in the stomach in all of these 87 patients. Light was not observed in the remaining 15 patients; the tube position was confirmed in the stomach in 11 of these patients but not in the other 4 by X-ray examination. Illumination had a sensitivity of 88.8% and a specificity of 100%. Our results suggest that this improved biologically transparent illumination system increased the accuracy of detecting the correct position of a nasogastric tube in the stomach. X-ray examination is required to check the position of the nasogastric tube in patients when biologically transparent illumination light is negative.