Prevalence of the Onodi cell in the Polish adult population: an anatomical computed tomography study.

BACKGROUND: Onodi cell is a posterior ethmoid air cell with the optic canal bulging into it; the common position of the bulge is into the sphenoid sinus, usually immediately posterior to the posterior ethmoid air cells. Variable pneumatisation patterns lead to various structures of lamellae and sinuses occasionally exposing important nerves and vessels, such as the optic and vidian nerves, internal carotid artery and cavernous sinus. In clinical practice, special imaging techniques are used to navigate through the paranasal sinuses and hence avoid injury to these structures. This study is aimed to determine the prevalence of the Onodi cell in the Polish population and compare it with other reported occurrences. MATERIALS AND METHODS: A retrospective analysis of 296 computed tomography (CT) scans of patients treated in Krakow, Poland, using a Siemens Somatom Sensation 16 spiral CT scanner. No contrast medium was administered. RESULTS: The Onodi cell was found in 31 out of the 296 patients, or approximately 10.5%, consistent with the majority of research reporting on Onodi variants. Additionally, there was one presentation of a bilateral Onodi cell in a male patient. No statistically significant difference was found between the male and female populations with a positive identification of the variant (p = 0.095, Chi2 test). CONCLUSIONS: This study helped approximate the Onodi variant prevalence of 10.47%, falling within a commonly reported range 8-14%. This gives clinicians and surgeons a better understanding of this variant's structure and significance, and therefore an opportunity to improve treatment outcomes and research.

A computed tomography comprehensive evaluation of the ostium of the sphenoid sinus and its clinical significance.

BACKGROUND: The purpose of this research was to evaluate the size of the sphenoid sinuses' ostia, the distance between them and the distance between the medial margin of the ostia and the median line in the Polish adult population. MATERIALS AND METHODS: The analysis was undertaken as a retrospective study of 296 computed tomography (CT) scans of patients (147 females, 149 males) with no comorbidities in their sphenoid sinuses. The paranasal sinuses were investigated by using Spiral CT Scanner (Siemens Somatom Sensation 16), in the option Siemens CARE Dose 4D, without administering any contrast medium. Having obtained transverse planes, multiplans reconstruction tool was used in order to glean sagittal and frontal planes. RESULTS: The average size of both sphenoid sinus ostia was 0.31 cm for both genders (for females ranging from 0.1 to 0.5 cm and from 0.1 to 0.6 cm for males). The mean distance between both sphenoid sinus ostia was 0.6 cm for both genders (the range for females was 0.1-1.4 cm, whereas 0.1-1.8 cm for males). The average distance between the medial margin of the ostium and the median line was 0.32 cm for both genders (0.31 cm for females in the range of 0-0.9 cm and 0.32 cm for males in the range of 0-1 cm). CONCLUSIONS: Intraoperative identification of the sphenoid sinus ostia might prove difficult and their inadequate excision could lead to potential iatrogenic complications, hence detailed anatomical descriptions are still warranted in specific populations in order to perform safe and effective procedures.

Agenesis of the sphenoid sinus and a single sphenoid sinus: a computed tomography anatomical evaluation.

BACKGROUND: Sphenoid sinuses are pneumatic spaces within the body of the sphenoid bone. Their development begins in the prenatal life and continues until the adulthood. Agenesis of the sphenoid sinuses is a situation in which they are undeveloped. On the other hand, a single sphenoid sinus lacks the presence of the main septum, leading to the formation of a single antrum. Contemporary use of transnasal transsphenoidal approaches for the pituitary surgery, as well as functional endoscopic sinus surgery urges medical professionals to be well acquainted with the aforementioned variant. MATERIALS AND METHODS: Paranasal sinuses of 300 patients (150 females, 150 males) were evaluated using computed tomography, without the use of contrast medium. Inclusion criteria involved absence of any identifiable pathology within the sphenoid sinuses and age over 18 years. Subgroup analysis involved probing for potential sources of heterogeneity, namely gender. RESULTS: In the whole research material of 300 patients, agenesis of the sphenoid sinuses was noted in 1% of the patients. No statistically significant differences were noted between the absence of the sphenoid sinuses and gender (p = 0.999). A single sphenoid sinus was found in 0.33% of the patients. There were no statistically significant differences found between the presence of fully developed sphenoid sinuses and gender (p = 0.498). CONCLUSIONS: Both agenesis of the sphenoid sinuses and a single sphenoid sinus are rare anatomical variants. Adequate planning for transsphenoidal surgeries with preoperative medical imaging is of essence in order to perform a safe and quality procedure.

Protrusion of the carotid canal into the sphenoid sinuses: evaluation before endonasal endoscopic sinus surgery.

BACKGROUND: Many reports have previously indicated the vast number of anatomical variations of the sphenoid sinuses, e.g. presence of the recesses. Notwithstanding, there are a few crucial neurovascular structures directly neighbouring with the sinuses. The following research aimed to evaluate frequency prevalence of the carotid canal's protrusion into the sphenoid sinuses in adult population. MATERIALS AND METHODS: Computed tomography (CT) scans of the paranasal sinuses of 296 patients (147 females, 149 males) were analysed in this retrospective study. The patients did not present any pathology in the sinuses. Spiral CT scanner Siemens Somatom Sensation 16 was used in the standard procedure in the option Siemens CARE Dose 4D. RESULTS: Protrusion of the carotid canal was found in the majority of the patients - 55.74%, more frequently in males (65.1% of the patients) than in females (46.26% of the patients). The said variant - regardless of gender - was noted more often bilaterally (41.55% of the cases: 29.93% females, 53.02% males) than unilaterally (14.19% of the cases: 16.33% females, 12.08% males). In the unilateral type (regardless of gender), the protrusion was more common for the left sphenoid sinus - 10.81% of the patients (12.24% females, 9.4% males) than for the right - 3.38% of the patients (4.08% females, 2.68% males). CONCLUSIONS: Complicated structure of the paranasal sinuses, derived from the high prevalence of their anatomical variations, may perplex routine surgical interventions. Henceforth, referral for a CT scan is imperative in order to abate the risks associated with an invasive procedure in the said region.

A study of the symmetry of roots and root canal morphology in mandibular anterior teeth using cone-beam computed tomographic imaging in a Polish population.

BACKGROUND: The purpose of the study was to analyse mandibular anterior teeth in a Polish population and determine the symmetry of root and root canal morphology between the right and left side using cone-beam computed tomography (CBCT) scanning. MATERIALS AND METHODS: From 111 CBCT examinations, 303 pairs of equivalent mandibular anterior teeth were analysed on the right and left sides to evaluate symmetry. Axial, sagittal, and cross-sectional slices with a thickness of 0.2-0.25 mm were used. The number of root canals and their internal patterns were classified following Vertucci's criteria. RESULTS: All incisors in this study had 1 root. Canines usually had a single root and much less often had 2 roots. Type I and III root canal configurations were found most often, while type V and II configurations were less frequent. Significant compatibility between the left and right side was observed in all evaluated variables. Incisors had the highest symmetry with regard to the number of roots (100%). Second canals were observed more often in males than females, but only the results in lateral incisors were significant. CONCLUSIONS: This study provides supplemental information for dentists and should help them to better predict the morphology of mandibular anterior teeth in complicated cases in the Polish population. Symmetry was observed in roots and root canal morphology in all examined parameters.

Muscle oxygenation and blood volume reliability during continuous and intermittent running.

The reliability of near infrared spectroscopy derived tissue oxygenation index (TOI) and total haemoglobin concentration (tHb) were examined during continuous (CR) and interval (INT) running. In a repeated measures design, 10 subjects twice performed 30 min of CR at 70% of their peak treadmill velocity, followed by 10 bouts of INT at 100%. Between trial reliability of mean and amplitude changes in TOI and tHb during CR were determined. Muscle de-oxygenation and re-oxygenation rates during INT were calculated using 3 analytical methods; i) linear modelling, ii) minimum and maximum values during work/rest intervals, and iii) mean values during work/rest intervals. Reliability was assessed using coefficient of variation (CV; %). During CR, mean TOI was more reliable (3.5%) compared with TOI amplitude change (34.7%), while mean tHb (12%) was similar to both absolute (9.2%) and relative (10.2%) amplitude changes. During INT, de-oxygenation rates analysed via linear modelling produced the lowest CV (7.2%), while analysis using min-max values produced the lowest CV (9.3%) for re-oxygenation rates. In conclusion, while the variables demonstrated CVs lower than reported changes in training-induced adaptations and/or differences between athletes and controls (23- 450%), practitioners are encouraged to consider the advantages/disadvantages of each method when performing their analysis.

The mandible and its foramen: anatomy, anthropology, embryology and resulting clinical implications.

The aim of this paper is to summarise the knowledge about the anatomy, embryology and anthropology of the mandible and the mandibular foramen and also to highlight the most important clinical implications of the current studies regarding anaesthesia performed in the region of the mandible. An electronic journal search was undertaken to identify all the relevant studies published in English. The search included MEDLINE and EMBASE databases and years from 1950 to 2012. The subject search used a combination of controlled vocabulary and free text based on the search strategy for MEDLINE using key words: 'mandible', 'mandibular', 'foramen', 'anatomy', 'embryology', 'anthropology', and 'mental'. The reference lists of all the relevant studies and existing reviews were screened for additional relevant publications. Basing on relevant manuscripts, this short review about the anatomy, embryology and anthropology of the mandible and the mandibular foramen was written.

[Carotid-cavernous sinus fistula: an unusual cause of exophthalmia. Report of three cases]. / Une cause inhabituelle d'exophtalmie uni- ou bilatérale : les fistules artérioveineuses carotidocaverneuses. Trois observations.

INTRODUCTION: Exophthalmia can be associated with several disorders. Although unusual, a carotid-cavernous fistula should be ruled out systematically as it may be associated with severe complications. CASE REPORTS: We report three cases associated with both types of carotid-cavernous fistula that highlight the clinical presentation and diagnostic process. CONCLUSION: A carotid-cavernous fistula should be systematically ruled out in patients with a uni- or bilateral exophthalmia. Careful examination with auscultation of the ocular globe contributes greatly to the diagnosis that may be confirmed by MRI or arteriography.

TGF-ß1 gene polymorphism in renal transplant patients with and without gingival overgrowth.

BACKGROUND: The incidence of gingival overgrowth among renal transplant patients treated with cyclosporine A ranges from 13% to 84.6%, and the overgrowth is not only esthetic but also a medical problem. We studied the determination of association between TGF-ß1 (TGFB1) gene polymorphism and gingival overgrowth in kidney transplant patients medicated with cyclosporin A. METHODS: Eighty-four kidney transplant patients with gingival overgrowth and 140 control transplant patients without overgrowth were enrolled into the case control study. TGFB1 polymorphism was determined using the PCR-RFLP assay for +869T > C in codon 10 and +915G > C in codon 25 as well as TaqMan real-time PCR assays for promoter -800G>A and -509C > T SNPs. RESULTS: In kidney transplant patients suffering from gingival overgrowth, mean score of gingival overgrowth was 1.38 ± 0.60, whereas in control subjects it was 0.0. The patients with gingival overgrowth were characterized by similar distribution of TGFB1 genotypes and allele in comparison to subjects without gingival overgrowth. Among 16 potentially possible haplotypes of TGFB1 gene, only four were observed in the studied sample of kidney transplant patients: G_C_T_G, G_T_C_G, G_C_C_C, and A_C_T_G, with similar frequency in patients with and without gingival overgrowth. CONCLUSION: No association between the TGFB1 gene polymorphism and gingival overgrowth was revealed in kidney transplant patients administered cyclosporine A.

Root surface temperature rise of mandibular first molar during root canal filling with high-temperature thermoplasticized Gutta-Percha in the dog.

This in vitro study evaluated the temperature rise on the outer root surface of the mandibular first molar following root canal filling using the high-temperature, thermoplasticized, Gutta-Percha technique (HTTG) (BeeFill) in the dog. Twelve extracted dog mandibular first molars were used. After root canal preparation, the teeth were filled with thermoplasticized Gutta-Percha and root canal sealer. Temperature changes on the vestibular surfaces of the mesial and distal roots of mandibular first molars were measured using a thermal imaging camera. The results of this in vitro study showed that using HTTG to fill mandibular first molars in dogs produces a safe temperature rise on the root surface and, therefore, should not damage the periodontal ligament and/or surrounding tissues.

[Studies comparing the efficacy of root canal filling with gutta-percha lateral condensation and Thermafil obturators]. / Badania porównawcze skutecznosci wypelniania kanalów korzeniowych gutaperka metoda kondensacji bocznej i cwiekami Thermafil.

A comparative analysis of the efficacy of root canal filling with laterally condensed gutta-percha and Thermafil obturators with titanium carrier was performed on the basis of experimental and clinical findings. Experimental part. Twenty-four extracted human teeth with root canals filled with laterally condensed gutta-percha (12 teeth) or Thermafil obturators (12 teeth) were studied in order to evaluate the quality of root filling. The Apexit sealer was used in both groups. Radiographs were obtained and the linear dye penetration test was done. Placement, homogeneity and adaptation of root canal filling were evaluated on the radiographs. Twenty teeth with root canals filled with laterally condensed gutta-percha (10 teeth) or Thermafil obturators (10 teeth) were studied using SEM. Clinical part. Eighty-seven patients were enrolled. One hundred and sixty-two single canal teeth with irreversible pulp disease with vitale (70 cases) or necrotic (54 cases) pulp and chronic apical parodontitis (38 cases) comprised the study material. Group I consisted of 84 teeth with root canals filled with laterally condensed gutta-percha, while group II had 78 teeth with Thermafil obturators. The Apexit sealer was applied in both groups. In vitro radiological examination revealed a better quality of placement of root canal fillings in group I (11 correctly filled root canals, 1 underfilling) when compared to group II (1 correctly filled root canal, 11 overfillings). No differences were observed between groups as to homogeneity or adaptation of root canal filling. The seal evaluated using the linear dye penetration test revealed no differences between both types of root canal filling. SEM confirmed the presence of interfaces between the filling material and root canal wall in both groups. The width of interface in group I was 1-5 microns, seldom exceeding 10 microns, and uniform throughout the whole root canal. In group II the width varied from 1-5 microns in the apical part to 10-25 microns in the middle and coronal parts. SEM revealed no major differences regarding homogeneity between both groups. Radiographs performed in the clinical part showed a higher frequency of overfillings of root canal filling into the apical parodontium in group I (30.8%) than II (9.5%). Thermafil turned out to be less satisfactory with regard to adaptation of root canal filling to the canal walls. Evaluation of immediate results of treatment demonstrated no differences between both techniques. A positive result after one year was found in 94.2% of laterally condensed gutta-percha fillings and in 90.2% of Thermafil fillings. After two years, the respective figures were 93.7% and 90.0%. The use of Thermafil obturators seems to be less tedious and time-consuming when compared to laterally condensed gutta-percha.

[Analysis of the frequency of prevalence of endometrial hyperplasia and endometrial adenocarcinoma based on own material in the year 1975, 1985 and 1995]. / Analiza czestosci wystepowania rozrostów blony sluzowej trzonu macicy i raka gruczolowego w materiale Kliniki w latach 1975, 1985 i 1995.

We analysed the frequency of prevalence of endometrial hyperplasia and endometrial adenocarcinoma in the years 1975, 1985 and 1995. Significant differences between endometrial simple hyperplasia and complex hyperplasia with atypia was found. There were no statistic differences in the frequency of the prevalence of endometrial adenocarcinoma between analysed years.

[Amniotic fluid disease: a case report]. / Zespól pasm owodniowych--opis przypadku.

A rare case of amniotic disease with extensive malformations of fetus was described. A data obtained from literature was done with special consideration of etiopathology.

[The evaluation of the use of transvaginal ultrasonography in the diagnosis of endometrial carcinoma]. / Ocena przydatnosci ultrasonografii przezpochwowej w diagnostyce raka endometrium.

In our study we estimated the uses of transvaginal ultrasonography in the diagnostic of endometrial carcinoma. There was noted that the most characteristic symptoms of this neoplasma in USG is the thickening of the endometrium and the absence or distortion of "central echo" (imaging of the endometrial cavity). We confirmed the co-existence of common epidemiologic factors of carcinoma endometrium too.

Repeatability of spectral components of short-term blood pressure and heart rate variability during acute sympathetic activation in healthy young male subjects.

1. Changes in the low-frequency (LF) components of blood pressure and heart rate variability and in the ratio of LF to high-frequency (HF) components of heart rate variability (LF/HF ratio) are used to assess acute changes in sympathetic control of blood pressure or heart rate and in sympathovagal balance that occur in response to physiological or pharmacological stimuli. Before these spectral indexes can be used to assess the effects of drug therapy or other clinical interventions on reflex sympathetic activity, their repeatability must be evaluated. 2. Intra-observer repeatability was studied by analysing changes in the LF components (expressed as absolute or normalized units) of cardiovascular variability and in the LF/HF ratio during sympathetic activation induced by nitroglycerin infusion (n = 10 subjects) or 60 degrees head-up tilt (n = 13 subjects) repeated on two occasions, 2 days and 1 week apart respectively, in healthy young male volunteers. Repeatability was estimated as recommended by Bland and Altman. 3. Bland and Altman's plots of the repeatability of changes in the LF components and LF/HF ratio showed that measurements were sufficiently repeatable to be used over periods of time of up to 1 week in clinical studies. 4. The sample-size tables derived from our results show that expression of spectral components as normalized units, and use of a cross-over design, minimize the number of subjects to be included in clinical studies conducted using similar designs and LF component changes as endpoints.

Expanded polytetrafluoroethylene grafts in restoring bile drainage in dogs.

Expanded polytetrafluoroethylene grafts were evaluated for use in restoring bile drainage in 21 dogs with experimental stenosis of the common bile duct. Rigid PTFE grafts reinforced with rings and armed with a polyethylene ring fastened to tissues adjacent to the hepatoduodenal ligament could not be compressed or displaced and provided a satisfactory bile drainage for periods of 12 months. Focal regeneration of common duct epithelium external to the graft was observed.