Dental developmental anomalies and post-eruption dental disorder: a series of panoramic radiographs

Panoramic radiographs are complementary exams to evaluate oral alterations in an early manner, these changes can be dental developmental anomalies, and post-eruption dental disorder. Aim: This study evaluated the findings in panoramic radiographs and correlated the variables of gender and dental location. Methods: A retrospective study was through the observation of 1.111 panoramic radiographs from the Radiology Department in Brazil. It was included patients from 5 to 79 years of age of both gender, and it classified the anomalies in shape, size, and number and post-eruption dental changes in and correlated with gender and location. Patients with syndromes were excluded from the sample. Results: The majority of the sample was composed of fameles 752 (67.7%), as to the frequency of dental developmental anomalies related lesions 684 cases (61.6%) and post-eruption dental disorder 567 (51.8%), in the radiographs. The most prevalent change was endodontic treatment (32.6%), followed by root dilaceration (25.9%), and included tooth (19.5%). The most prevailing alteration when correlated with the gender variables was the cyst root (p<0.01) in females, and orthodontic treatment (p=0.02) in males and the variable location in the mandible was root dilaceration, giroversion, impacted tooth, taurodontia, microdontia, and endodontic treatment (p<0.01). Conclusion: Our findings provide evidence that dental developmental anomalies e post-eruption dental disorder are frequent alterations in the population with particular characteristics of distribution by sex and location

Prenatal diagnosis of fetal double aortic arch by echocardiography / 中华医学超声杂志（电子版）

Objective To investigate the echocardiographic features and clinical significance of prenatal diagnosis of fetal double aortic arch (DAA). Methods Totally 21 596 fetuses underwent fetal echocardiography in Nanjing Medical University Afifliated Suzhou Hospital and ifve cases were diagnosed as DAA by echocardiography. Echocardiographic characteristics, types and outcomes of these ifve cases were summarized retrospectively. Results Five fetal cases were diagnosed as DAA by fetal echocardiography. 1. Prenatal echocardiographic features:In three-vessel and trachea view, the normal“V”-shaped conlfuence formed by the aortic arch and ductal arch was absent. However, the ascending aorta bifurcated into the left and right aortic arch and these two arches encircled the trachea. Annular lfow signal around trachea was seen on color Doppler imaging. 2. Types:Among these ifve fetuses, three cases were called right arch predominant type, whose diameters of right arches were larger than those of left arches. The other two were balanced type, whose diameters of right arches were almost equal to those of left arches. 3. Accompanied malformations:Case 2 was accompanied with membranous ventricular septal defect and permanent left superior vena cava. Case 4 was associated by hemivertebrae. The other three cases had no other abnormalities. 4. Follow-up:These five cases were all arranged for MRI subsequently and all were confirmed by follow-up till to the induction of labor or three months after birth. Conclusions Double aortic arch is a kind of severe congenital heart disease. Echocardiography is the ifrst choice to diagnose DAA prenatally and three-vessel and trachea view are the effective cross sections in the diagnosis of double aortic arch.

A chromosome 1q44 deletion in a 4-month-old girl; The first report in Korea / 소아과

The deletion of the distal long arm of chromosome 1 is associated with a characteristic facial appearance and a pattern of associated malformations. Characteristic manifestations include a round face with prominent 'cupid's bow' and downturned corners of the mouth, thin vermilion borders of lips, a long upper lip with a smooth philtrum, a short and broad nose, epicanthal folds, apparently low-set ears, micrognathia, microcephaly, abnormal hands and feet, variable cardiac or genital anomalies, moderate to severe mental retardation, and growth retardation. Using fluorescent in situ hybridization (FISH) analysis to map precisely the deletion, we present a case of chromosome 1q44 deletion with craniofacial characteristics, multiple congenital anomalies, and growth and psychomotor retardation. In comparison with other reported cases of 1q43-44 deletion, the subject does not show hydrocephalus, seizure, syn- or polydactyly of hands, and a urogenital anomaly. However, an arachnoid cyst, pinpoint dimple on the midline of the forehead, a right-sided supernumerary nipple and auricular pit, polydactyly of the right foot, adducted thumb, and flexion restriction of the proximal interphalangeal joint with a simian line in both hands were observed additionally.

Outcome of adults with repaired tetralogy of Fallot

Outcome of adult patients with repaired tetralogy of Fallot (TOF) was studied with emphasis on postrepair problems. A retrospective review of clinical, echocardiographic, catheterization, and surgical data was performed for 48 patients who underwent corrective repair of TOF after 15 years of age. All patients survived total repair and have been followed up from 3 months to 11 years (median 4.6 years). Postoperatively, 81.3% of patients were in functional class I and 85.4% had normal right ventricular function. One patient (2.1%) died during follow-up. There were 6 reoperations (12.5%) in 5 patients. The indications for reoperation included residual ventricular septal defect (VSD) (n=1), right ventricular outflow obstruction with VSD (n=4), and pulmonary regurgitation (n=1). The 10-year actuarial survival rate was 97.1%, and the 10-year freedom from reoperation was 81.3%. Aortic regurgitation was seen preoperatively in 6 patients (12.5%) and there were 2 newly developed aortic regurgitations after operation, one of which was caused by infective endocarditis. Corrective repair of TOF can be recommended in this patient group since the survival rate, postrepair functional status and hemodynamics are acceptable. Continued close follow-up, however, is essential for early identification and correction of post-repair problems.

Brain MRI Findings of the Olivopontocerebellar Atrophy

PURPOSE: To demonstrate the MRI findings of olivopontocerebellar atrophy. MATERIALS AND METHODS: We retrospectively reviewed the MRI findings of eight patients who had been diagnosed by clinical manifestation and the peculiar pattern of atrophy and signal change on MRI. RESULTS: Seven patients had an atrophy of the olive, pons and cerebellum and increased signal change of the transverse pontine fiber, median raphe and middle cerebellar peduncle on T2WI. Of these, six patients had severe atrophy of the olive, pons and cerebellum and decreased signal change of the basal ganglia, red nucleus, substantia nigra or dentate nucleus on T2WI. Additionally, four of six patients had a cerebral atrophy. Except one patient who had an urinary incontinence, these 5 patients had not been associated with extrapyramidal or autonomic symptom. The other patient with relatively short duration of the disease had only cerebellar atrophy without signal change on T2WI . CONCLUSION: With progressing of the olivopontocerebellar atrophy, cerebral atrophy and decreased signal change of the basal ganglia, red nucleus, substantia nigra or dentate nucleus on T2WI is combined. Thus, MRI is essential in establishing the diagnosis and evaluating the severity of olivopontocerebellar atrophy.

Congenital Anomalies of the Coronary Arteries Detected in Adulthood

BACKGROUND: Although congenital anomalies of the coronary arteries are rare, which may cause serious clinical problems in diagnostic or surgical procedures, the accurate knowlegde and understanding of these are essential. We are to assess the clinical and angiographic characteristics of congenital anomalies of the coronary arteries detected in adulthhood. METHODS: We retrospectively analyzed a total of 67 cases of primary congenital anomalies of the coronary arteries with particular emphasis in angiographic findings in corelation with the clinical and surgical findings, reviewing 16,099 coronary angiography performed during last 6 years in three institutes. RESULTS: The incidence of congenital anomalies of the coronary arteries detected in coronary angiography was 0.4% and all were primary anomalies, among which major anomalies were 53 cases(79%) and minor anomalies were 14 cases(21%). Twenty-nine cases had associated cardiac defects. Among them congenital heart disease were 10 cases(34%), valvular heart disease were 10 cases(34%), coronary atherosclerotic disease were 8 cases(28%) and hypertrophic obstructive cardiomyopathy was 1 cases(4%). The coronary artery fistula were 40 cases, which was the most common anomaly among major group and the communication between coronary artery and bronchial artery were 6 cases, which was the most common one among minor group. Myocardial ischemia was observed in 49% of major and in 29% of minor anomalies. CONCLUSION: We are reporting 67 cases of the congenital anomalies of the coronary arteries detected in adulthood with the clinical and the angiographic characteristics. We suggest that new modified classification of the congenital coronary anomalies is necessary, because symptoms and signs of myocardial ischemia were observed in a significant number of patients among minoranomaly group.

Cerebellar Arteries Originating from the Internal Carotid Artery: Angiographic evaluation and Embryologic Explanations

PURPOSE: To find and describe the cerebellar arteries arising from the internal carotid artery, explain them embryologically, and evaluate their clinical implication. MATERIALS AND METHODS: To determine the point in the internal carotid artery from which the cereballar artery arose anomalously, consecutive angiographic studies performed in the last three years were reviewed. The distribution of such anomalous cerebellar arteries, the point in the internal carotid artery from which the anomalous vessels originated, and associated findings were analyzed. RESULTS: Five anomalous origins of cerebellar arteries arising arising directly from the internal carotid artery were found in five patients. Three anterior inferior cerebellar arteries (AICA) and one common trunk of an AICA and a posterior inferior cerebellar artery (PICA) were found to originate from the internal carotid artery at a point close to the origin of the primitive trigeminal artery. A PICA arose from an artery presenting a course similar to the proatlantal intersegmental artery. Intracranial aneurysms in two patients, Moyamoya disease in one, and facial arteriovenous malformation in one. CONCLUSION: In our series, AICAs supplied from the arteries considered to be persistent trigeminal artery variants were the most common type. A correlation between type of anomalous cerebellar artery and type of carotid-vertebrobasilar anastomosis may exist. Cerebellar arteries originating anomalously from the internal carotid artery seem to occur as a result of the persistence of carotid-vertebrobasilar anastomoses associated with incomplete fusion of the longitudinal neural arteries. An understanding of these anomalous cerebellar arteries may help prevent accidents during therapeutic embolization and surgical treatment, as well as misinterpretation.

The application of telescopes in the restoration of alveolar process cleft and the defects of front maxillae / 实用口腔医学杂志

Objective: To explore the possibility to restore alveolar process cleft and the defects of front maxillae with telescope techniques. Methods: 4-5 telescopes were used as retainers of a prosthesis for cleft alveloar process or the defects of front maxillae; metal framework was used as connector of abutments and obturator in soft-tissue defect. Porcelain or resinmetal crowns were applied to restore defects in dentition. Acrylic resin was applied to repairs the deftcts of alveolar process and front maxillae or defect of palate. By above ways, prostheses were fabricated, the patients were followed up. Results:The following up for 26-28 months in 6 cases showed that the prosthesis retained with telescopes had follow advantages: good retention, convenient application, high masticatary function and satisfactory esthetics effects. Conclusion:The prosthesis with telescopes is feasible for the restoration of cleft alveolar process and the defects of front maxillae.